chap, xxiv.] THE SPINE. 511 



case of a man who, after an injury to the neck from 

 a fall, presented no spinal symptoms until three days 

 had elapsed. He ultimately became paralysed, and 

 died thirty-two days after the accident. The autopsy 

 revealed a dislocation forwards of the sixth cervical 

 vertebra, of such an extent that the body below 

 projected at least half an inch into the spinal 

 canal. 



The remarkable manner in which the cord will 

 accommodate itself to a slowly progressing pressure is 

 often well seen in the results of chronic bone disease 

 in the column. 



The symptoms due to injury to the cord and to the 

 nerves contained in the spinal canal, will obviously 

 depend from the situation and extent of the lesion. 

 The diagnosis of the situation of the lesion is compli- 

 cated by the relation the nerves bear to the various 

 vertebrae, and by the fact that the majority of the 

 great trunks arise from the cord at a spot above the 

 point at which they issue from the vertebral canal. 

 The two highest nerves, the first and second cervical, 

 pursue an almost horizontal course in their passage 

 from the cord to their points of exit from the canal. 

 The remaining nerves take a more and more oblique 

 direction, until at last the lowest nerve trunks run 

 nearly vertically downwards as they pass to their 

 respective inter vertebral foramina. 



Points of exit. The first cervical nerve leaves the 

 canal above the first cervical vertebra. The remaining 

 cervical trunks escape also above the vertebrae after 

 which they are named, the eighth cervical nerve leaving 

 the canal between the last cervical and the first dorsal 

 vertebrae. The dorsal, lumbar, and sacral nerves have 

 their points of exit below the vertebrae after which they 

 are named. Thus, the first dorsal nerve will pass 

 through the foramen between the first and second 

 dorsal vertebrae, and so on. 



