A study of the paths of secondary degeneration in a case of injury of the cervical spine / by Arthur V. Meigs.

  • Meigs, Arthur Vincent, 1850-1912.
Date:
1890
Catalogue details

Licence: Public Domain Mark

Credit: A study of the paths of secondary degeneration in a case of injury of the cervical spine / by Arthur V. Meigs. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    Henry B., thirty-five years of age, a sailor by occupation, and born in England, was admitted to the surgical ward of the Pennsylvania Hospital August 20, 1888, and died September 15th of the same year. During heavy weather at sea, ten days before his admission, he was struck by a wave and dashed against the bulwarks striking the back of the head and neck against the rail. It was found at once that he had lost all sensation and power of motion from the clavicles downward, and from the time of the accident he had retention of urine and incontinence of feces. When admitted to the hospital there was a large bedsore upon the back, entire loss of sensation below the clavicles, and abolition of the reflexes. Examination of the urine gave negative results. The temperature varied between 100° and 10?4° F. There were no marks of violence nor signs of fracture or luxation of the vertebra. The treatment consisted of the administration of iodide of potas- sium, the use of a water-bed, and a poultice upon the chest. Even upon his admission there were some coarse mucous rdles to be heard upon ex- amination of the lungs, and this condition gradually increased until the lungs were full of rales, and he became unable to expel the mucus ; abdom- inal tympany came on and he became comatose and died seemingly of heart- failure. Post-mortem examination showed that there was neither luxation nor fracture of the spine, but a small extra-dural hemorrhage into the spinal canal at the level of the seventh cervical vertebra. In regard to the condition of the cord it will be necessary to give some details of the methods employed for its examina- tion and preparation for microscopical study. When first removed the dura mater was slit up upon both the anterior and posterior aspects to expose the pia and nerve-roots and the substance of the cord cut transversely at many points, the sections being made at intervals of from an inch to an inch and a half. Though it was then examined with ordinary care nothing abnormal was noticed, and it was placed in Miiller's fluid for preservation and hardening. After the tissue had been a few weeks in the fluid, when removed for examination it was at once obvious that it presented marked evidence of disease. When the lower part of the cord was looked at, a fresh transverse section having been made, it was seen that the gray matter was stained of the yellow tint produced by Miiller's fluid and that the greater portion of the white matter had the usual greenish color, but there was in the antero- lateral region upon both sides a large spot which was roundish
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