146 PAKTICULAK FRACTURES. 



by a cord to the wall, previous to the division of the carotid 

 artery, she fell paralyzed, and died before she was bled. 



The post mortem revealed that the luxation had been reduced 

 by the stretching ; that the fibro-cartilaginous disc, between the 

 third and fourth cervical vertebrse, was in a pulpy condition; 

 that the spinal cord and its surroundings were but slightly 

 affected ; and that there was no fracture. This case proves that 

 there can be luxation without fracture ; that such a lesion does 

 not prove fatal if the spinal cord is not pressed upon ; and that 

 reduction — causing pressure upon the cord — may be followed by 

 immediate death. I have heard of similar cases, but never saw 

 one before. I have, however, seen another case since the publi- 

 cation of the first edition of this book. 



Twisted or wry neck may occur from a variety of causes other 

 than dislocation, such as over-stretching or bruising of the 

 muscles of one side of the neck, causing inflammation ; or from 

 rheumatism affecting them, inducing loss of function of the 

 muscles of one side of the neck. It is also a symptom of hemi- 

 plegia. These various conditions may be distinguished from 

 luxation by the absence of the diagnostic symptom of the latter, 

 namely, the sudden paralysis of the limbs when attempts are 

 made to straighten the neck. 



