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Dislocation of the Vertebrae.The object of this security in the construction of the spinal column is to afford the greatest possible protection to the delicate nervous tissue which passes through the spinal column - the spinal cord. So perfect is this structure that dislocations of the vertebrae occur with comparative rarity ; indeed it often happens that a man executed by hanging suffers no displacement of the vertebrae of the neck, notwithstanding the sudden and violent strain upon the spinal column occasioned by his sudden fall from the trap. It does sometimes happen, however, that one or more of the rings - the vertebrae - suffer displacement; this can only occur from the application of great force. The results vary according to the location of the displacement. If some of the lower vertebrae are displaced, there results usually paralysis of the lower extremities. If the vertebrae in the middle of the back are dislocated, the paralysis affects the lower part of the trunk also. If one of these rings in the neck is dislocated, the result is often immediate death from suffocation. Signs.- In some cases it is possible to feel, by careful examination of the bony prominences in the back, that one or more of the rings are displaced. The question is, usually, whether the vertebrae are dislocated or fractured. The question is not usually of much importance from a practical point of view, since the effect upon the patient is about the same in both cases. Treatment.-A few cases are on record in which dislocations of the vertebrae have been reduced, and the patient has recovered completely. Dr. Hodgen says that he " was once successful, by pulling the head gently upward, in the case of a man whose head was drawn backward and turned to one side. The accident in this case was caused by falling from the top of a load of furniture, and the patient had been totally unconscious for four hours, breathing irregularly and noisily. The bones came into place with an audible snap and the man was restored at once, swearing at the horse he supposed he was still driving. " The attempt may be made to reduce such a dislocation by pulling the head and shoulders upward, while an assistant pulls the legs and hips downward. Sometimes the effort can be assisted by gentle manipulation of the dislocated vertebrae by a third individual. These movements should be made very carefully and gently, since instances are recorded in which fatal injury has been done by the attempt to reduce the dislocation. In most cases all efforts to relieve the displacement will be unsuccessful; and even if the bones are replaced, the injury done to the spinal cord cannot be repaired. It becomes necessary to provide means for securing regular evacuations from the bowels and bladder, since the patient loses all control over these organs. The urine should be drawn three or four times a day with a soft catheter. The bowels must be kept open, either with injections of warm water or with the daily use of cascara cordial. This remedy answers admirably in securing evacuations under such circumstances ; yet, in some instances, it becomes necessary to supplement its use with injections. One of the most troublesome complications of this condition is the formation of bed sores. These form earliest over the bony prominences of the hips and pelvis. To prevent their occurrence, extreme care must be taken to wash the skin thoroughly, and to harden it by means of frequent bathing with alcohol or brandy and water in equal parts. The skin can be protected also by the use of cushions. These are best made in the shape of rings, upon which the patient's hips rest while ths bony prominences fall within the ring. The best form is made of rubber and filled with air, and known as " air cushions." These can be imitated by making a tube of cloth or muslin, stuffing it with cotton, wool or horsehair, and then sewing the ends of the tube together, so that it takes the form of a ring. The ultimate result is usually death ; the utmost care and attention succeed only in prolonging the patient's life a few months and rendering him more comfortable during this time. In a few rare instances recovery has occurred. But first, if you want to come back to this web site again, just add it to your bookmarks or favorites now! Then you'll find it easy! Also, please consider sharing our helpful website with your online friends.
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