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Show 96 mementos or am: srmn. ,DISLOCATION or THE SPINE. of {16065 or the dropping of the urine, and consequent moist. bras C D cannot come into their regular approximation, but stand with oblique surfaces. From what is here expressed the symptoms which characterise the accident may be learned. The person is bent down, and unable to elevate himself; there is a projection of the spine, and there is an unusual space betwixt two of the spinous processes. The reduction of this dislocation is by no means easy to accomplish. We cannot turn and twist, nor yet stretch the body, as we would an arm or leg. Was our strength equal tire of the bed. After this the patient soon sinks. OF THE DISLOCATION OF THE VERTEBRZE. DISLOCATION cannot take place in the vertebrze of the back and loins, I imagine; from the circumstance of the ligamentous connexions being fully stronger than the bone. But a species of subluxation may certainly take place in the lumbar vertebrae. This is a dislocation of the articulating processes, but not of the bodies of the vertebrae, the intervertebral substance being only a little irregularly E E z: stretched. i‘ y. i ‘i This derangement of the bones may be a consequence of the distortion of the body in wrestling or tumbling, or by a weight falling on the shoulders, when the body is bent for- ward. By this means the ligaments already stretched are torn up, and the vertebra: stand thus 2-- E A, the articulating process of the upper vertebra. f? Mow-fir 7‘7: .‘Vyvm- f.‘..'.a.¢'_.a ".47 -:, .4.-. hp". Plan of dislocated Vcrtcbrtr. Hi the articulating process of the lower one. These, it will be observed, should lie flat on each other, instead of which their points stand opposed, so that the bodies of the verte- 93' to it, there is danger, where we have the soft spinal mar- row within, and where the strong connexions of the process: es are already lacerated. The older surgeons have recom~ mended that the patients should be put over a barrel, and that the body be then bent forward until the processes of the vertebrze are disentangled. It has happened that after all methods have been tried in vain, the patient has been relieved by an accidental jolt or exertion, and the bones have slipt into their places. When the reduction has not been accomplished by the efforts of the surgeon, yet in length of time and by degrees, the spinous processes have approached, and the patient has regained the erect posture. Dislocation, I imagine, cannot happen in the vertebrae of the back, because of the firmer articulation of the processes, and the strength of their attachment by the double articulation of the ribs. But we may have subluxation in the vertebrae of the neck. A man, having slid oil a hay-stack, fell on some loose hay that covered the ground; the skull was not injured, but he never recovered the shock, and died of the concussion. In this man I found that I could introduce my fingers betwixt the third and fourth vertebrae of the neck ; and on opening the tube of the vertebrze a great quantity of fluid blood flowed from the spine and base of the skull. These, I believe, will generally be the circumstances attending the subluxation of the vertebrae of the neck, viz. that the shock of the head and spine will destroy the voL. u. o |
