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From the Examiner, change. The vital and animal functions were
naturally performed. Respiration, circulation, On Railway and other Injuries of the Ner- digestion, secretion, and assimilation were all vous System. By John Eric Erichsen, normal
. There was a sensible increase in the Professor of Surgery and of Clinical Sur- frequency and volume of the circulation, and gery in University College, London ; respiration was noticed to be slightly increased Examiner in Surgery at the University weight of the body became greater after than it
in frequency above the normal standard. The of London. Walton and Maberly.
had been before the injury, and the lower limbs
retained their natural heat and physical devel. MANY a sign of progress has its draw
opment. back known to the physicians. It was The patient evinced an unusual share of menmuch to exchange the tinder-box for the tal vigour after the injury, and possessed a phosphorus match; but with the phosphorus resolution and determination that are described match came the new and terrible disease as truly surprising in his forlorn and helpless that ate into the jaws of many of its makers. condition. He threw himself into the midst of We have exchanged coach travelling at society for excitement, and was fond of traveleight or ten miles an hour for railway trav- ling, lying on his back in his carriage. elling at thirty or forty; but with the swift- sented himself in the County Medical Society
In 1851, six years after the accident, he preer travelling comes the more violent concus- (Greene, New York), and requested the ampu, sion ; and even when there is no shock of tation of his lower extremities, which he stated accident, the daily traveller endures a were a burdensome appendage to the rest of his chronic jar that has a serious effect upon body, causing him much labour in moving the nervous system. This little book con- them, and stating that he wanted the room they tains the substance of half-a-dozen hospital occupied in his carriage for books and other lectures given by one of the best English articles. He insisted on the operation with his
wonted resolution and energy. The surgeon surgeons, who has thought it worth while to study carefully those obscure injuries to the whom he consulted at first refused to consent spinal cord which are suffered frequently sive a mutilation for such reasons as he gave,
to amputation, not only objectiug to so extenby persons who have been subjected to the but fearing lest the vitality of the vegetative violent shock of a railway collision. The existence enjoyed by his limbs might be insuffifreque ncy of this result has been imperfectly cient for a healthy healing process. The parecognized. The hurt is obscure. It is tient, still determined in his resolve to have the usually not perceived at the moment. The limbs cut off as a useless burden to the rest of sufferer, in the excitement of the scene the body, sought other advice, and at last had thanks God he is unhurt, busies himself in his wishes gratified.
Both limbs were amputated near the hipcare of the wounded, and goes home to experience next day, or in two or three days, tremor of a muscle. The stumps healed readily,
joints, without the slightest pain or even the the beginning of that gradual failure of and no unfavourable symptoms occurred in the power which is a common effect of concus- progress of perfect union by the first intention. sion of the spine. A medical witness in an In this mutilated state he was perfectly unable action for damages against the railway com- to move his pelvis in the slightest degree. He pany may have reason to thank Professor resumed his wandering life, and travelled over Erichsen for having directed his attention a great part of the States. He died in May, to the significance of these obscure symp- 1852, of disease of the liver, brought on by his toms.
excesses in drink, to which he had become greatly addicted since his accident. No post-mortem
examination was made. Of the effects on the spinal cord of severe This case is a most remarkable one in several blows on the back Mr. Erichsen gives some points of view, and in none more than in this, instructive cases from his own hospital ex- that a double amputation of so serious a characperience and from the records of others. ter could be successfully practised on a person The most curious of them is the following affected by complete paraplegia, and yet that from the New York Journal of Medicine : the stumps healed by the first intention. Be
sides this remarkable fact, there are two special A man, twenty-two years of age, in felling a points of interest in this case which bear upon tree, was struck on the back part of the head the subject that we are now cousidering, viz., and between the shoulders by a large bough. that the weight of the body is stated to have This accident occurred in 1845. The force of increased after the accident, and that the the blow expended itself chiefly on the lower limbs which were so completely paralyzed as 10 cervical spine and the shoulders. A complete admit of amputation with ut the patient exparalysis of sensation and motion, of all the periencing the slightest sensation of pain, had parts below this, was the immediate result. in no way wasted during the six years that they This condition continued without the slightest had been paralyzed, but retained their normal
physical development,” as is expressly stated saw this young lady ten-and-a-half months in the report of the case. We can have no after the accident, and found that, without stronger evidence than this to prove that mere fracture, the loosening of the ligaments and disuse of a limb, for a lengthened period of
muscular supports between the vertebra years even, is not necessarily followed by the
was so great, that the head was movable wasting of it.
upon the lower part of the neck in all di
rections, as if there were a ball and socket But the public is most interested in that joint. There was no pain in the spine of slighter form of injury which some surgeons the neck, and palsy was confined to the left have even begun to call the Railway Spine,' though there is, of course, no special difference between concussion of the spine" from a railway accident and its concussion by fall
Such are the injuries to which we are exfrom a horse. The difference is in degree, accidents. And again we refer to the fact
posed by the mere shock and jar of railway with probability that the railway concussion
that will be more sharp and effectual. In a case of concussion of the spine in a
One of the most remarkable circumstances farmer and miller who obtained 5,7751 dam- connected with Injuries of the Spine is, the disages, there was at the time of the accident proportion that exists between the apparently only a cut lip and a severe shaking. The trifling accident that the patient has sustained,
and the real and serious mischief that has ocsufferer proceeded on his journey. It was curred. Not only do symptoms of Concussion observed by a friend who drove him home of the Spine of the most serious, progressive, from the station that he did not seem to and persistent character, often develop themrécollect the road. He arrived home feeling selves after what are apparently slight inbruised, shaken, and confused, went to bed, juries, but frequently when there is no sign but did not consider himself ill enough to whatever of external injury. This is well exsend for medical advice till five days after-emplified in Case 9, the patient having been wards. It was fifteen months afterwards partially paralyzed simply by slipping down that Mr. Erichsen was consulted. He found a few stairs on her heels. The shake or jar that
is inflicted on the spine when a person jamping him unable to recollect numbers, - the
from the height of a few feet comes to the ages of his children, for example, unable to transact business, troubled with frightful å sitting posture has been well known to sur
ground suddenly and heavily on his heels or in dreams, waking in terror, frowning habit- geons as not an uncommon cause of spinal weakually to exclude light from his eyes, unable ness and debility. It is the same in railway to read for more than two or three minutes accidents; the shock to which the patient is at a time. Vision and hearing were over- subjected in them being often followed by a sensitive on the right side and almost lost train of slowly-progressive symptoms indicative on the left; with like difference throughout
of Concussion and subsequent Irritation and the body; he was unable to walk without Inflammation of the Cord and its Membranes. support, or to bend his spine in any direc- applied to the body are liable to be followed by
But I may not only say that sudden shocks tion without suffering severe pain, so that the train of evil consequences that we are now he sat always rigid and upright.
discussing, I may even go further, and say that
these symptoms of Spinal Concussion seldom Concussion of the spine, ending in paral- occur when a serious injury has been inflicted ysis, resulted, in one of the cases here given, on one of the limbs, unless the Spine itself has from so slight an accident as a trip down at the same time been severely and directly two or three stairs and bumping forcibly of civil life meets with an injury by which one
struck. A person who by any of the accidents upon the heels. In a railway accident, a of the limbs is fractured or is dislocated, necesthrowing of the body from side to side may sarily sustains a very severe shock, but it is the cause a twist of head and trunk, producing rarest thing possible to find that the Spinal wrench of the spine. In the Staplehurst Cord or the Brain has been injurionsly inflo. accident, an accomplished young lady, who enced by this shock that has been impressed on had been an intrepid rider, a skilful driver, the body. It would appear as if the violence and an accomplished musician, had her neck of the shock expended itself in the production so severely twisted and sprained that it lost of the fracture or the dislocation, and that a jar the power of supporting her headl, which avoided. I may give a familiar illustration of
of the more delicate nervous structures is thus fell from side to side as if the neck were this from an injury to a watch by falling on the broken. She could only keep her head ground. A watchmaker once iold me that if erect by use of a stiff collar. The use of the glass was broken the works were rarely damthe left arm also. was lost. Mr. Erichsen agcd; if the glass escapes unbroken, the jar of the fall will usually be found to have stopped some superficial bruises or cuts on the head or the movement.
legs, perhaps even no evidence whatever of ex. How these Jars, Shakes, Shocks, or Concus- ternal injury. He congratulates himself upon sions of the Spinal Cord directly influence its his escape from the imminent peril to which he action I cannot say with certainty. We do not has been exposed. He becomes unusually calm know how it is that when a magnet is struck a and self-possessed ; assists his less fortunate fel. heavy blow with a hammer, the magnetic force low-sufferers, occupies himself perhaps actively is jarred, shaken, or concussed out of the horse in this way for several hours, and then proceeds shoe. But we know that it is so, and that the on his journey. iron has lost its magnetic power. So, if the When he reaches his home, the effects of the spine is badly jarred, shaken, or concussed by injury that he has sustained begin to manifest a blow or shock of any kind communicated to themselves. A revulsion of feeling takes place. the body, we find that the nervous force is to a He bursts into tears, becomes unusually talkcertain extent shaken out of the man, and that ative, and is excited. He cannot sleep, or, if he has in some way lost nervous power. What he does, the wakes up suddenly with a vague immediate change, if any, bas taken place in sense of alarm. The next day he complains of the nervous structure to occasion that effect we feeling shaken or bruised all over, as if he had no more know than what change happens to a been beaten, or had violently strained himself magnet when struck. But we know that a by exertion of an unusual kind. This stiff and change has take place in the action of the ner- strained feeling chiefly affects the muscles of vous system just as we do in the action of the the neck and loins, sometimes extending to iron by the change that is induced in the loss of those of the shoulders apd thighs. After a time, its magnetic force.
which varies much in different cases, from a day
or two to a week or more, he finds that he is Whatever the primary change, the sec- unfit for exertion and unable to attend to busiondary effects are inflammatory, and they ness.
He now lays up, and perhaps for the are apt to develop themselves slowly. The first time seeks surgical assistance. sufferer does not know that any serious accident has happened to him:
We have not touched on questions of pa
thology or other professional details which He feels that he has been violently jolted and are discussed in this strictly professional shaken, he is perhaps somewhat giddy and con
work. But its main topic is one that confused, but he finds no bones broken, merely cerns all travellers.
We have now only to thank Mr. Froude for ingly as a lawful occupation or rather amusethe vivid account which he has given in his last ment. As Mr. Froude says, they went beyond chapter of English misdoings in Ireland. That the cruelties of Alva; except in the sack of Ireland has been, and is, disassected to England towns, where there is no great choice between we cannot wonder, when we read of the fiendish one nation and another, alva did not massacre wickedness by which men sought to keep Ire women and children. But in the eyes of England in subjection to the English Crown, and to lish soldiers and settlers an Irishwoman and her bring her into subjection to the English Church. children were much on a level with a she-wolf Those days are past, but we are still paying the and her cubs. It would have been a much penalty of them; in all these cases of national milder fate for Ireland to have been conquered wrong, the removal of wrong does not, perhaps by Turks, who would have let the unhappy for generations, carry with it the removal of the Papist pay tribute and worship after his own memory and sentiment of wrong. It is clear fashon. Indeed the Irish were worse off than that the Englishmen of Elizabeth's time looked the nègroes, except on the doctrine that life in on Irishmen simply as wild beasts, as some bondage is worse than death. It was a case in Englishmen still look on negroes or even on which the existence of slavery would have made Hindoos. Men rode out for some “killing" matters a degree less horrible. - Saturday Rethat is, for the indiscriminate murder of the view). natives of all ages and sexes, looked on seem
They held their Bairâm feast that day
With game of war and sport of love.
Volcanic fire that heaves and burns.
BEHOLD, the Waster's peace is here:
Dead silence after battle-bray. Unlike the western spring-tide dear,
When English fields are hushed in May, With populons calmn of tender sound
Of leaf and insect, fold and herd, And wild birds revelling all around,
Here sickly Nature hath no word. The ancient World's-debate is still
In desolate rest, even since that day When up yon western horned hill *
The long day's strife did roll and roar,
And their faint few might strike no more.
Their ancient strength shall melt away.
The lovely lake fills up the caves
Which once were as the mouth of hell ;
And though we mourn that Beauty dies,
A little while she flies,
From Diomede's spear-head keen and gray,
She triumphs o'er the scene.
So dies she ever, and is born.
Whence she doth marshal cloud and light,
To flame o'er fair things and forlorn.
Even when his weariest work is done.
T'hough smoke of labour blot the sun,
of trade offend the skies,
And all the dancing streams that run
In beauty over all things mean;
O Mistress, O our Queen !
On purple dark of desert Night;
With clear cold floods of dewy light.
In nameless hues of unthought sheen.
But yester-eve we lingered latė,'
Feel bit and rein, draw girths, and mount. (Being somewhat worn with sun and speed), Yet gaze along the silent shore To watch, beneath 'Tiberias' gate,
Ere this delight shall join the account The wild Hawâra play jereed.
Of all that we shall see no more. Like swallow wheel'd each wiry steed,
The bright lake mirrors slope and cliff, Until the thief who him bestrode
Each standing on its shade, as if Deck'd with all colours of the Mede,
The “ Peace, be still ” were lately said. Looked wing'd and bird-like in his selle,
The sharp-leaved oleanders glow So lithe and light he rode,
For miles of marge : a light of snow Upon the broken battlement,
Rests on the northern waves, below All cloven the day when Safed fell
Old Hermon's triple head. In one wide carnage, earthquake-rent.
In many a dream, beloved Sea, The women gazed and sang by turns.
Our souls shall walk again by thee. * Hill of Kurûn Hattin - scene of the Sermon
R. St. J.T.