from injury. The patient complains of
stiff neck and pain, and the lesion may be recognised in a radiogram.
A number of cases are recorded in which death took place suddenly
weeks or months after such an injury, from softening of the transverse
ligament and displacement of the bones.

[Illustration: FIG. 209.--Fracture of Odontoid Process of Axis
Vertebra.]

#Penetrating Wounds.#--These result from stabs or gun-shot accidents,
and are practically equivalent to compound fractures of the spine;
their severity depends on the extent of the damage done to the cord,
and on whether or not the wound is infected. In many cases the
condition is complicated by injuries of the pleural or peritoneal
cavities and their contained viscera, or by injury of the trachea,
oesophagus, or large vessels and nerves of the neck. When the
membranes of the cord are opened, the profuse and continued escape of
cerebro-spinal fluid may prove a serious complication.

_Treatment._--The wound of the soft parts is treated on the usual
lines. When the spinous processes and laminae are driven in upon the
cord, they must be elevated at once by operation. In injuries
involving the lumbo-sacral region it is sometimes advisable to perform
laminectomy for the purpose of suturing divided nerve cords.

When there is evidence that the spinal cord is completely divided,
operation is contra-indicated. Attempts have been made to unite the
two ends of the divided cord by sutures, but there is as yet no
authentic record of restoration of function following the operation.

CHAPTER XVII

DISEASES OF THE VERTEBRAL COLUMN AND SPINAL CORD

POTT'S DISEASE: _Pathology_; _Clinical features_--Pott's disease as it
affects different regions of the spine--Disease of the sacro-iliac
joint; Syphilitic disease of spine; Tumours of vertebrae;
Hysterical spine; Acute osteomyelitis; Rheumatic spondylitis;
Arthritis deformans; Coccydynia; Tumours of cord and
membranes--Spinal meningitis; Spinal myelitis--Congenital
deformities: _Spina bifida_; _Congenital sacro-coccygeal tumours_.
Congenital sacro-coccygeal sinuses and fistulae.

TUBERCULOUS DISEASE OF THE SPINE--POTT'S DISEASE

Percival Pott, in 1779, first described a disease of the vertebral
column which is characterised by erosion and destruction of the bodies
of the vertebrae. It is liable to produce an angular deformity of the
spine, and to be associated with abscess formation and w