1. Chronic distress rarely follows a well-performed primary amputation. The proximal nerve ends are probably best dealt with by clean division and recession into mobile, well-nourished tissues.
2. One workmanlike remodeling of a badly constructed stump is advisable, with concurrent resection of any neuromata found. Further procedures of this type are worse than useless.
3. Percussion or massage of the tender area seems to promise much, and many patients discover this of their own accord. The trauma inherent in daily use of the hand is probably helpful in abolishing hypersensitivity and phantom-limb sensation.
4. When well-conceived local treatment fails to relieve, it is vital to turn without delay to the autonomic nervous system. If sympathetic block fails to relieve, it is useless to carry out sympathectomy. High chordotomy should relieve pain if done in time, but procrastination may leave the patient without prospect of relief except through the drastic medium of leukotomy.