Fractures of the Spine. 67 



stomach no motion of the viscera of the abdomen could be perceived. He had 

 no feeling even in the upper part of his chest ; he had feeling on his face and 

 neck, and indistinctly near the collar-bone. He had a motion of his 

 hands, a sort of rolling motion, which may have proceeded from the 

 shoulders. When he spoke it was in a tremulous voice, like a man 

 frightened. His voice was weak, but he did not speak in a whisper ; the 

 sound of his voice was more like sighing than common breathing. Pulse 

 was felt at his wrist. In ten minutes after he was brought in, half an 

 hour from the time of the accident, he died." 



The spinous processes of the fourth and fifth cervical vertebrae 

 are broken off at their roots, the bodies of the fifth and sixth 

 cervical vertebrae have been dislocated, and the upper part of 

 the sixth vertebra has been fractured. The fifth transverse 

 process has been broken on the right side, and the sixth and 

 seventh on the left side. 



"It is clearly proved both by the sj'mptoms and the 

 dissection of the bones, that the fracture must have affected 

 the roots of the phrenic nerves ; and we are at liberty to 

 conclude that the difiference of symptoms, in comparing it with 

 the first case (3. 71) as well as the shorter period of his 

 sufferings, was due to this cause." (Sir Charles Bell's " Exposi- 

 tion of Nervous System," p. 237.) B. C. 1. 4. M. 3. 



3, 71. Fracture of the Bodies and Arches of the fifth and 



sixth Cervical Vertebrae. — Lower six cervical and first 

 dorsal vertebrae, with the muscles cleaned off to show the 

 above injury — in spirit. 



"Charles 0., £et. 36, fell through a window into an area thirteen feet 

 below. He thought that he landed on his back, but was uncertain, as he 

 lay for some time insensible. In Hospital he lay supine — legs powerless 

 and insensible, abdominal muscles relaxed and powerless, and viscera 

 flaccid. His water had to be drawn off with a catheter, and his faeces 

 were passed involuntarily ; priapism was present. Skin of abdomen and 

 up to the nipples insensible. However, he had feeling in his stomach 

 when it was pressed upon, and complained of the griping of some of his 

 medicines. 



" His breathing was frequent. At each inspiration the chest was 

 heaved with a short, quick movement ; at each expiration the belly was 

 protruded by a sudden shock and undulation {sic). The belly during this 



