On a remarkable diminution of the medulla oblongata and adjacent portion of the spinal marrow : consequent upon gradual spontaneous luxation of the Processus dentatus, and ankylosis at the upper part of the spine, yet unattended by any sympton of paralysis / by P.D. Handyside.

Date:
[1840]
Catalogue details

Licence: Public Domain Mark

Credit: On a remarkable diminution of the medulla oblongata and adjacent portion of the spinal marrow : consequent upon gradual spontaneous luxation of the Processus dentatus, and ankylosis at the upper part of the spine, yet unattended by any sympton of paralysis / by P.D. Handyside. Source: Wellcome Collection.

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

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    mesian line, -where an elongated narrow band, remarkably dense firm, and resisting in texture, though retaining none of its original elasticity, is stretched obliquely between these two bones, in a si- tuation where they are apart from each other to the distance of one inch and three-eiarhths. The articulations intervening between the second, third, fourth and fifth vertebrae of the neck are not very free in their move- ments, owing to the deposition of calcareous matter in the fibro- cartilages covering their surfaces. An approximation to anky- losis is sufficiently manifested in this condition of the parts. _ The membranes and vessels of the medulla oblongata and cer- vical portion of the spinal marrow were natural. The medulla oblongata itself appeared natural, with the exception of a considerable alteration in the antero-posterior diameter of its lower portion, which, from the unusually contracted limits of the spinal canal at its upper part, was reduced to only three lines in thickness. It was also remarkably altered in its position, for it rested obliquely on the basilar portion of the occipital bone, while its lower portion was placed altogether to the right side of the odontoid process of the axis and of the arcli of the atlas in a cir- cumscribed space, the antero-posterior diameter of which, as already remarked, did not exceed three lines and two-thirds, and the transverse diameter of which measured only six lines. The nerves arising from the medulla oblongata were of their natural size, consistence, and colour, and so likewise were the cer- vical nerves. No paralysis, or even any remote indication of the existence of: that state, or of any other alFection of the nervous system, present- ed Itself in any part of the body. The foregoing case serves to illustrate well the very considerable amount of pressure and torsion which the medulla oblongata and upper part of the spinal marrow may be brought gradually to sus- tam, without the production of the slightest inconvenience ; al- though these important and essential parts of the nervous system being subjected suddenly to even a moderate amount of pressure, produces an interruption, which, if maintained, may terminate speedily in a total cessation of the vital functions of the body. -Professor Rust of Vienna, who gives the best account of this morbid condition, observes, that the pressure on the spinal cord, which the luxation of the occiput upon the atlas must produce, is not fatal, because it occurs gradually.* He refers to a specimen ot Juxation and ankylosis at the upper part of the spine, contained in the Anatomical Museum at the Jardin des Plantcs at Paris, m which thevertebral canal liad been so considerably contracted that a common quill could not be introduced into the opening. The pa- tient survived, however, long enough for ankylosis to be effectedf. + .^.'■'^'■?h'''>'<'g'ei 1817, p. 82, (quoted by Mr Lawrence.) T lliJt. Natiir. G6n. ct Panic, avcc la description du Cabinet du Roi, Tom. iii. p. 99.