Fractured ribs in the insane / by T. Claye Shaw.

Shaw, T. Claye.

Date:: [1890]

Credit: Fractured ribs in the insane / by T. Claye Shaw. Source: Wellcome Collection.

Provider: This material has been provided by King’s College London. The original may be consulted at King’s College London.

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$imagine that attendants, who know so well tlie consequences of being detected in any act of violence, would deliberately and for no reason commit one so easily found out. It has been usual to say that the ribs of the insane are more brittle, and therefore more easily broken, than those of persons in health; and with some forms of insanity this may he true, but it is by no means a universal truth, and is more of a dictum than an ascertained fact. We shall see that only in rare instances does it appear to be true, and that even where such is apparently the case, there is great difficulty in saying why it is so. With the view of determining the comparative strength of ribs in various forms of insanity, it occurred to me that some results might be obtained by ascertaining the breaking-weight of a rib fixed at one point, and arranged so as to carry weights at the other. We shall see that under the same conditions great differences are found to exist in the resistance to strain of this kind. The conditions under which broken ribs may be supposed to occur are chiefly of two kinds; first, those where a patient is struck when standing up, and secondly, those where he is either sitting in a chair or lying on the ground. Allowance must of course be made for the amount of clothing the man is wearing at the time, and for the quantity of superincumbent fat, whilst other temporary conditions also come into play which modify greatly the effect of a blow, such as the state of tension of the muscles covering the ribs at the moment of impact, the angle at which the body meets the blow, and the particular stage of inspiration or expiration by which the greater or less degree of arching of the thorax is determined. In prize-fighting and pro- fessional boxing, fractures of the ribs are of rare occurrence, partly because the hits are delivered over the best protected parts, but chiefly because the most of the shock is distributed over the whole body, which is in a loose and mobile state. The rarity of a broken rib in prize-fighting, where heavy body-blows are given, to such an extent, indeed, that large swellings of the soft tissues are produced, is remarkable; and I am informed that it is only when a blow is delivered upon an adversary at the moment when he is turning sharply round, that such a casualty occurs. It is apparently true that even a heavy, strong man, well trained to hard hitting, is unable by the strongest blow he can give, and with all his weight thrown in, to break an opponent’s rib by a direct blow, unless the same is delivered when the opponent is placed at a disadvantage, as above stated; and it is to all appearance right to say that fractures in the ribs of lunatics are not caused by hard, direct blows, but by a slighter$

Fractured ribs in the insane / by T. Claye Shaw.

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