The evening times., 1900-03-29
WITH A DIsLOCATED NECK.
A Strange Case That Interests BaIti-
more Physicians.

A Strange Case That Interests BaIti-
more Physicians.
BALTIMORE, March 29.-Passengers on
Carey Street trolley car on Tuesday last
little imagined that one of their fellow
passengers had dislocated neck, yet such
was the case. William Gehner, eighteen
years of age of Lansdowne, Baltimore
county. was the queer passenger.
Nearly two weeks ago young Gehner was
walking along the top rail of fence, when
he fell off and struck on his head. When
he got on his feet again he found that he
could not turn his head. and his chin was
drawn down until his Adams apple was
resting on his chest. He was unable TO
look around without turning his whole
body There was no improvement noticed
in his condition and on Monday last he was
taken to the Maryland University Hospital.
Members OF the house staff and the visiting
physicians examined him and agreed that
he was suffering with dislocated neck,
or, in other words that the ceryical ver-
tebrae were displaced.
Gehner said he could feel lump in the
back of his throat and that was apparent
when the doctors examined through his
open IuOuin Win LHtiT HuBSIS- Inc inuo-
cles Of the young mans neck are drawn
tense and stand out like cords from the un-
usual pressure put upon them. They aid
in holding his head rigid so that he is un-
able to turn ii from sid, to side or back
and forth
The doctors decided that the trouble in
Gehner's neck is with the fourth and fifth
ceryical yertebrae, there being seven bones
in the neck portion Of the spinal column.
counting from above downward. 1t Is said
that the fourth vertebra is pushed little
to the left and the fifth one little TO the
right, causing a lateral dislocation, while
both are pushed slightly forward.
In order to get picture Of the bones as
they rest In their unnatural position the
x-ray was used. AS the hospital apparatus
was out of order Gehner was taken TO the
State Normal School, where Prof William
G. A. Hammel used his x-ray machine.
The first time Gehner was taken to the
school in the hospital ambulance. The next
day however, he was taken up in a street
car accompanied by DR. Arthur j. Ed
wards, of the hospital staff. He walked
| from the car up the steps into the building
and up another flight into Prof. Hemmel's
room without assistance. His head was
unsupported except for the tensely drawn
muscles and he walked as would a man
with a stiff neck.
On account Of the low position Of the
dislocation and the congested condition of
the surrounding tissue Prof. Hammel was
unable to get a satisfactory radiograph of
he bones of the spinal column. The skull
Bones showed plainly in one picture and
n the other the upper part of the chest is
revealed in outline, but the space between
is practically a blank. The young man
was unable of course, to get his head out
- he -
unable TO lie on his back. which is the
usual posture for x-rsy photographs. It
is probable that another attempt at get
ting a radiograph viii be made BY Prof.
Hammel with especially prepared sensi-
tive plates. These will be shaped so as to
fit down over the young mans collarbone
close to his neck, and in this way a good
radiograph OF the displaced bones may be
obtained.
The doctors will probably try TO replace
the bones after the young mans muscles
| have been relaxed by an anaesthetie. 1t
may be necessary TO put a large cork in his
mouth with which to exert pressure on the
/ bones and push them gently back into
place. Similar gentle pressure will be ex-
erted on the sides Of the neck. Should
these procedures fail il may be necessary
to try cutting operation and by remOv-
ing portions of the vertebrae get them into
their proper position.
Care will have to be exercised that the
dislocation shall not be increased so as to
cause pressure on the spinal cord and re-
sulting paralysis Of the body below the
dslocation.
This dslocation from which young Geh-
ner suffers is different from that brought
about by hanging a man so that, as il is
said his neck is broken In reality this
is only the tearing apart of the two upper
vertebrae. The first one, like ring, sup
ports the head and revolves about head
like process supported on a neck of the
second yertebra. When the hanging is well
managed the jerk of the fall tears apart
the strong 1gaments connecting the two
bones pulling the head backward. so that
! the projecting head and neck of the second
bone is thrust forward through the nerve
| fbres of the spinal cord. causing instant
death BY paralysis Of the heart and lungs.
Lower down in the spinal cord the press
ure OF the bones would cause paralysis of
movement and other functions of the body,
while the lungs and heart might go on
acting as before.