Fractures of the Spine. 77 



At first he was said to have had some movement in his legs, but by 

 the time he reached the Royal Infirmary, Edinburgh, all motion and sen- 

 sation in his lower extremities had disappeared. 



His bladder was paralysed, and in two days hfematuria began and 

 continued. In spite of every care in cleansing the catheter used to draw 

 off his water, septic cystitis appeared in a few days, and carried him off 

 about a week after the accident. 



At the post-mortem examination the mucous membrane of the 

 bladder was found greatly congested, and at places sloughing. The con- 

 gestion extended up both ureters. The left kidney was bruised. 



The end of the spinal cord and beginning of the cauda 

 equina have been crushed between the laminee of the twelfth 

 dorsal and the body of the first lumbar vertebrae. 



The anterior part of the first lumbar vertebra has been so 

 much crushed that the anterior margins of the last dorsal and 

 second lumbar vertebrae nearly meet. G. C. 2799. 



Presented by John Duncan, F.R.C.S.E. 



3. 88. Fracture of the Spinal Column at the Level of the 



second Lumbar Vertebra. — Lower part of the last dorsal 

 and first three lumbar vertebrae — muscles cleaned ofi" — in spirit, 

 showing the above injury. 



"A young man, named Auton, 25 years of age, a plasterer, fell from a 

 height of 40 feet, and in his descent his back struck against the corner of a 

 stone stair, about 18 feet from the ground. When brought to the 

 Hospital, a swelling was to be felt over the lower dorsal vertebrte. On 

 pressing the finger deep, a depression or interval betwixt the spinous 

 processes could be distinguished. He complained of great pain in the 

 part, and all over the abdomen. He breathed naturally, and was perfectly 

 sensible ; there was no defect of motion or of feeling in the lower 

 extremities. He was bled to sixteen ounces, twelve leeches were apjilied 

 to his back, and he had a dose of the house physic. He was admitted 

 September 12th, 1816. 



" ISth. — He has passed a restless night. He is in great pain ; he 

 vomits everything he takes ; the purgative mixture was rejected, and he 

 had no relief in his bowels. An enema ordered. 



" lith.—B-e is delirious. His pulse frequent, not full ; his skin hot. 

 He passes his faeces and urine involuntarily, but there is no flaccidity of 

 the abdominal muscles, and he has the perfect use of his limbs. 



" 15th. — This young man's condition is very threatening ; his pulse 

 is 136. He was delirious during the night, and threw himself out of bed. 

 He is now in a state of extraordinary excitement, and although he has 



