A fatal case of concussion of the spinal cord / by Seymour J. Starkey.

  • Sharkey, Seymour John (Sir)
Date:
1883
Catalogue details

Licence: Public Domain Mark

Credit: A fatal case of concussion of the spinal cord / by Seymour J. Starkey. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

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    A FATAL CASE OF CONCUSSION OF THE SPINAL CORD. BY SEYMOUR J. SHARKEY, M.B., Assistant Physician and Joint Lecturer on Pathology at St. Thomas's Hospital. E. A., set. 25, was admitted into St. Thomas’s Hospital, under the care of Mr. Francis Mason, on January 27th, 1883, and died on March 12th, 1883. I have to thank my colleague for permission to publish the following account: The patient was one of six persons upon whom a house fell; she was found with only her head protruding from a large heaj) of bricks and rubbish, and was brought on a stretcher to the hospital. On admission, she was said to have been struck upon the back-bone, and she complained of extreme pain across the sacrum and of numbness over the left buttock. There was no anaesthesia and no paraplegia, nor was there any external evidence of fracture or of other gross injury. There was, how- ever, retention of urine. An abnormal condition of the right leg and arm was present, but this had existed from birth. It consisted of partial paralysis and atrophy of both limbs without loss of sensation, but with some contraction of the flexor muscles of the arm. The patellar and plantar reflexes were exaggerated on this side, but there was no ankle clonus. During the first week she was in the hospital, there was complete retention of urine and the bowels only acted once, and that after an enema. After this, incontinence of urine and faeces set in, and persisted till death. At the same time that the evacuations began to pass involuntarily, a bedsore suddenly appeared on each buttock. They occurred first as blebs situated on the lower edges of the buttocks, one on each side of the perinaeum. They were perfectly symmetrical, and, as the patient lay on her back, they were quite free from contact with the bedding. They soon burst, and then became ulcers. About a week later a swelling made its appearance on the sacrum, which was angry- looking and inflamed, and rapidly became an open bedsore. The temperature up to the time of the incontinence of urine was only slightly raised, generally ranging at its highest H 2