nd his
improvement went on without development of any serious symptoms. At
the time of report he appeared in the best of health and was quite able
to attend to his daily avocations. Doyle appends to his report the
statement that among 394 cases embraced in Ashhurst's statistics, in
treatment of dislocations in the cervical region, the mortality has
been nearly four times greater when constitutional or general treatment
has been relied on exclusively than when attempts had been made to
reduce the dislocation by extension, rotation, etc. Doyle strongly
advocates attempts at reduction in such cases.

Figure 205 represents a photograph of Barney Baldwin, a switchman of
the Louisville and Nashville Railroad, who, after recovery from
cervical dislocation, exhibited himself about the country, never
appearing without his suspensory apparatus.

Acheson records a case of luxation of the cervical spine with recovery
after the use of a jury-mast. The patient was a man of fifty-five, by
trade a train-conductor. On July 10, 1889, he fell backward in front of
a train, his head striking between the ties; the brake-body caught his
body, pushing it forward on his head, and turned him completely over.
Three trucks passed over him. When dragged from beneath the train, his
upper extremities were paralyzed. At noon the next day, nineteen hours
after the accident, examination revealed bruises over the body, and he
suffered intense pain at the back of the neck and base of the skull.
Posteriorly, the neck presented a natural appearance; but anteriorly,
to use the author's description, his neck resembled a combined case of
mumps and goiter. The sternomastoid muscle bulged at the angle of the
jaw, and was flaccid, and his "Adam's apple" was on a level with the
chin. Sensation in the upper extremities was partially restored, and,
although numb, he now had power of movement in the arms and hands, but
could not rotate his neck. A diagnosis of cervical dislocation was
made, and violent extension, with oscillation forward and backward, was
practiced, and the abnormal appearance subsided at once. No crepitus
was noticed. On the fourth day there was slight hemorrhage from the
mouth, which was more severe on the fifth and sixth days. The lower jaw
had been forced past the upper, until the first molar had penetrated
the tissues beneath the tongue. A plaster-of-Paris apparatus was
applied, and in two months was exchanged for one of sole-leather. In
ris