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FRACTURE DISLOCATION OF CERVICAL VERTEBRÆ WITHOUT INJURY OF THE CORD.
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such, for instance,
"
the famous syphilis" epic. But the body in health has been left severely alone. Only one poem has come to our notice in recent in any way recalls " The Isle of Man." years which " This is The Unexplored Republic," which appeared in the Speaker shortly before the decease of that admirable literary weekly. The writer conceives of the brain as an unexplored country, governed in some mysterious way by a general consensus of individual cells. Pathos enters into such a theme when death is discussed and the decay of protoas
plasm considered. Shall I then know when breeze and stream grow dumb, And the bright frontier watchfires cease to shine, And all my tiny citizens become Doomed miners in a mine ? Shall I be given, or can they, dying, give The sum of their small lives to be my spark, So that my selfish spirit still shall live When their small sprites grow dark? How is Man’s Immortality contrived ? How, if each live cell die, can I attain Unto th’ Immortal who am myriad-lived, Of living cells a chain ? 0 darkling "Purple Island," still unknownI 0 unexplored Republic, hard to span I 0 complex Self unutterably alone, 0 lone unfathomed Man1
ran to his assistance and found his head tilted forwards and to one side and held rigidly in that position. Thinking the patient was in danger of imminent death he seized his head and steadying it between his knees gave it a sudden twist. He heard a distinct click and at once the patient could Some weeks later Mr. Bird move his head again. saw him for neuralgic pains in the back of the neck and head in the course of the great occipital A skiagram showed a partial dislocation of nerve. the atlas on the axis and some crushing of the arch of the latter. After a year he had improved, but He occasionally had not completely recovered. suffered from pain and there was slight limitation I of movement of the neck. The pain was no doubt due to pressure of callus upon the nerve.
PELLAGRA INVESTIGATION.
NOTWITHSTANDING the numerous researches which have been carried out in recent times concerning the etiology of pellagra, the real origin of that disease remains shrouded in mystery. We are not, however, without hope that before long some satisfactory solution of the problem may be forth. coming as our knowledge of the subject accumulates. Other diseases have seemed equally obscure, and for long years have puzzled investigators. Two instances which may be cited are beri-beri and FRACTURE DISLOCATION OF CERVICAL VERTEBRÆ endemic goitre, in both of which a satisfactory explanation of their causation has at last been WITHOUT INJURY OF THE CORD. found. There has been no lack of hypotheses BEFORE the advent of skiagraphy little was known advanced to explain the occurrence of pellagra in of fractures of the spine unaccompanied by lesions certain places, but so far none of those put forward of the cord, for the reason that such could not be have been supported by a sufficient weight of diagnosed. Now it is known that they frequently evidence to render them acceptable to scientific occur. Fracture dislocation of the cervical spine minds. Neither maize (spoilt or unspoilt), parasitic is usually accompanied by severe injury of the cord. infection, nor a deficiency of some essential element In the Azcstradian Medical Journal of Dec. 6th, 1913, in the dietary has yet been proved to be the Mr. Alan Newton has reported the following case true cause of pellagra, and until the causaexceptional to this rule. A man, aged 26 years, tion of this mysterious malady is definitely while cycling collided with a horse and cart. The known it is impossible to formulate the most horse’s nose struck him on the back of the head, appropriate measures for preventing it. For throwing him to the ground. He did not lose this reason any contribution to the general stock consciousness and at once regained his feet. He of knowledge respecting this disease must be then felt severe pain in the upper part of the neck, heartily welcome at the present time. Among most marked posteriorly and increased by even those who have taken a conspicuous part in this slight movement. On examination he was found country in the investigation of pellagra Dr. L. W. to be muscular and well-nourished. The head Sambon comes in the first rank. It may be rememwas held immobile with the cervical spine in a bered that in 1912 he visited Italy and other parts position of slight extension. There was moderate of Southern Europe, on behalf of the British tenderness over the spines of the second and Pellagra Commission, to study the disease in some third cervical vertebrae, but no deformity was of its definitely recognised endemic areas, and to noticed. Careful examination of the nervous consider the conditions there in the light of his own revealed system nothing abnormal. A skiagram hypothesis that pellagra was due to a parasitic showed an injury much more considerable than infection transmitted to man through the agency of There was fracture dislocation some insect, probably a species of simulium or sandwas expected. between the second and third cervical vertebras. fly. In continuation of these studies Dr. Sambon The pedicles of the second were fractured, and the left England in August, 1913, on an expedition to body (in accordance with rule) projected forwards. the United States to inquire into the circumstances However, the spinal canal was not encroached on, under which pellagra occurred in certain areas and to this fact the patient owed his life. The situated in the Southern States. By invitation he projecting body could be palpated through the attended the American Pellagra Conference held in pharyngeal wall. The treatment was immediate October at Columbia, South Carolina, taking part immobilisation of the neck by means of a plaster in the discussions and comparing notes with other jacket extending from the vertex of the skull to the experts. It appears that he found a number of waist and rest in bed for two months. The jacket American medical men disposed to believe in the was then removed. Three months after the injury parasitic theory of the origin of the disease, and there was no pain or apparent limitation of the able from their own experiences to find evidence movements of the spine. A second case occurred which seemed to support it. He also examined the in the practice of Mr. Fred Bird. A man, aged work that was being done by the Thompson25 years, while building a haystack, fell from the top MacFadden Pellagra Commission in South Carolina to the ground, a distance of 12 feet. His and was much impressed with it. After leaving
brotherI
such, for instance,
"
the famous syphilis" epic. But the body in health has been left severely alone. Only one poem has come to our notice in recent in any way recalls " The Isle of Man." years which " This is The Unexplored Republic," which appeared in the Speaker shortly before the decease of that admirable literary weekly. The writer conceives of the brain as an unexplored country, governed in some mysterious way by a general consensus of individual cells. Pathos enters into such a theme when death is discussed and the decay of protoas
plasm considered. Shall I then know when breeze and stream grow dumb, And the bright frontier watchfires cease to shine, And all my tiny citizens become Doomed miners in a mine ? Shall I be given, or can they, dying, give The sum of their small lives to be my spark, So that my selfish spirit still shall live When their small sprites grow dark? How is Man’s Immortality contrived ? How, if each live cell die, can I attain Unto th’ Immortal who am myriad-lived, Of living cells a chain ? 0 darkling "Purple Island," still unknownI 0 unexplored Republic, hard to span I 0 complex Self unutterably alone, 0 lone unfathomed Man1
ran to his assistance and found his head tilted forwards and to one side and held rigidly in that position. Thinking the patient was in danger of imminent death he seized his head and steadying it between his knees gave it a sudden twist. He heard a distinct click and at once the patient could Some weeks later Mr. Bird move his head again. saw him for neuralgic pains in the back of the neck and head in the course of the great occipital A skiagram showed a partial dislocation of nerve. the atlas on the axis and some crushing of the arch of the latter. After a year he had improved, but He occasionally had not completely recovered. suffered from pain and there was slight limitation I of movement of the neck. The pain was no doubt due to pressure of callus upon the nerve.
PELLAGRA INVESTIGATION.
NOTWITHSTANDING the numerous researches which have been carried out in recent times concerning the etiology of pellagra, the real origin of that disease remains shrouded in mystery. We are not, however, without hope that before long some satisfactory solution of the problem may be forth. coming as our knowledge of the subject accumulates. Other diseases have seemed equally obscure, and for long years have puzzled investigators. Two instances which may be cited are beri-beri and FRACTURE DISLOCATION OF CERVICAL VERTEBRÆ endemic goitre, in both of which a satisfactory explanation of their causation has at last been WITHOUT INJURY OF THE CORD. found. There has been no lack of hypotheses BEFORE the advent of skiagraphy little was known advanced to explain the occurrence of pellagra in of fractures of the spine unaccompanied by lesions certain places, but so far none of those put forward of the cord, for the reason that such could not be have been supported by a sufficient weight of diagnosed. Now it is known that they frequently evidence to render them acceptable to scientific occur. Fracture dislocation of the cervical spine minds. Neither maize (spoilt or unspoilt), parasitic is usually accompanied by severe injury of the cord. infection, nor a deficiency of some essential element In the Azcstradian Medical Journal of Dec. 6th, 1913, in the dietary has yet been proved to be the Mr. Alan Newton has reported the following case true cause of pellagra, and until the causaexceptional to this rule. A man, aged 26 years, tion of this mysterious malady is definitely while cycling collided with a horse and cart. The known it is impossible to formulate the most horse’s nose struck him on the back of the head, appropriate measures for preventing it. For throwing him to the ground. He did not lose this reason any contribution to the general stock consciousness and at once regained his feet. He of knowledge respecting this disease must be then felt severe pain in the upper part of the neck, heartily welcome at the present time. Among most marked posteriorly and increased by even those who have taken a conspicuous part in this slight movement. On examination he was found country in the investigation of pellagra Dr. L. W. to be muscular and well-nourished. The head Sambon comes in the first rank. It may be rememwas held immobile with the cervical spine in a bered that in 1912 he visited Italy and other parts position of slight extension. There was moderate of Southern Europe, on behalf of the British tenderness over the spines of the second and Pellagra Commission, to study the disease in some third cervical vertebrae, but no deformity was of its definitely recognised endemic areas, and to noticed. Careful examination of the nervous consider the conditions there in the light of his own revealed system nothing abnormal. A skiagram hypothesis that pellagra was due to a parasitic showed an injury much more considerable than infection transmitted to man through the agency of There was fracture dislocation some insect, probably a species of simulium or sandwas expected. between the second and third cervical vertebras. fly. In continuation of these studies Dr. Sambon The pedicles of the second were fractured, and the left England in August, 1913, on an expedition to body (in accordance with rule) projected forwards. the United States to inquire into the circumstances However, the spinal canal was not encroached on, under which pellagra occurred in certain areas and to this fact the patient owed his life. The situated in the Southern States. By invitation he projecting body could be palpated through the attended the American Pellagra Conference held in pharyngeal wall. The treatment was immediate October at Columbia, South Carolina, taking part immobilisation of the neck by means of a plaster in the discussions and comparing notes with other jacket extending from the vertex of the skull to the experts. It appears that he found a number of waist and rest in bed for two months. The jacket American medical men disposed to believe in the was then removed. Three months after the injury parasitic theory of the origin of the disease, and there was no pain or apparent limitation of the able from their own experiences to find evidence movements of the spine. A second case occurred which seemed to support it. He also examined the in the practice of Mr. Fred Bird. A man, aged work that was being done by the Thompson25 years, while building a haystack, fell from the top MacFadden Pellagra Commission in South Carolina to the ground, a distance of 12 feet. His and was much impressed with it. After leaving
brotherI