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scle； the third extended from the right sterno…cleido…mastoid midway upward to the middle of the jaw and down to the rapine of the trachea。 The external jugular； the external thyroid； and the facial arteries were severed。 Braman did not find it necessary to ligate； but was able to check the hemorrhage with lint and persulphate of iron； in powder； with pressure。 After fourteen hours the wound was closed； the patient recovered； and was returned to duty in a short time。
Thomas has reported the case of a man sixty…five years old who in an attempt at suicide with a penknife； had made a deep wound in the left side of the neck。 The sternohyoid and omohyoid muscles were divided； the internal jugular vein was cut through； and its cut ends were collapsed and 3/4 inch apart； the common carotid artery was cut into； but not divided； the thyroid cartilage was notched； and the external and anterior jugular veins were severed。 Clamp…forceps were immediately applied to the cut vessels and one on each side the aperture in the common carotid from which a small spurt of blood； certainly not half a teaspoonful； came out。 The left median basilic vein was exposed by an incision； and 20 ounces of warm saline solution were slowly perfused； an ordinary glass syringe with a capacity of five ounces； with an India…rubber tubing attached to a canula in the vein being employed。 After seven ounces of fluid had been injected； the man made a short； distinct inspiration； at ten ounces a deeper one （the radial pulse could now be felt beating feebly）； at 15 ounces the breathing became regular and deep； at 18 ounces the man opened his eyes； but did not appear to be conscious。 The clamped vessels were now tied with catgut and the wound cleansed with phenol lotion and dressed with cyanid…gauze。 The man was surrounded by hot…water bottles and the foot of the bed elevated 18 inches。 In the course of an hour the patient had recovered sufficiently to answer in a squeaky voice to his name when called loudly。 Improvement proceeded rapidly until the twenty…second day； when violent hemorrhage occurred； preceded a few hours previously by a small trickle； easily controlled by pressure。 The wound was at once opened and blood found oozing from the distal extremities of the carotid artery and jugular vein； which were promptly clamped。 The common carotid artery was not sound； so that ligatures were applied to the internal and external carotids and to the internal jugular with a small branch entering into it。 The patient was in great collapse； but quickly rallied； only to suffer renewed hemorrhage from the internal carotid nine days later。 This was controlled by pressure with sponges； and a quart of hot water was injected into the rectum。 From this time on the patient made a slow recovery； a small sinus in the lower part of the neck disappearing on the removal of the catgut ligature。
Adams describes the case of a woman who attempted suicide with a common table…knife； severing the thyroid； cricoid； and first three rings of the trachea； and lacerating the sternohyoid and thyroid arteries； she finally recovered。
There is a curious case of suicide of a woman who； while under the effects of opium； forced the handle of a mirror into her mouth。 From all appearances； the handle had broken off near the junction and she had evidently fallen forward with the remaining part in her mouth； driving it forcibly against the spine； and causing the point of the handle to run downward in front of the cervical vertebrae。 On postmortem examination； a sharp piece of wood about two inches long； corresponding to the missing portion of the broken mirror handle； was found lying between the posterior wall of the esophagus and the spine。 Hennig mentions a case of gunshot wound of the neck in which the musket ball was lodged in the posterior portion of the neck and was subsequently discharged by the anus。
Injuries of the cervical vertebrae； while extremely grave； and declared by some authors to be inevitably fatal； are； however； not always followed by death or permanently bad results。 Barwell mentions a man of sixty…three who； in a fit of despondency； threw himself from a window； having fastened a rope to his neck and to the window…sill。 He fell 11 or 12 feet； and in doing so suffered a subluxation of the 4th cervical vertebra。 It slowly resumed the normal position by the elasticity of the intervertebral fibrocartilage； and there was complete recovery in ten days。 Lazzaretto reports the history of the case of a seaman whose atlas was dislocated by a blow from a falling sail…yard。 The dislocation was reduced and held by adhesive strips； and the man made a good recovery。 Vanderpool of Bellevue Hospital； N。Y。； describes a fracture of the odontoid process caused by a fall on the back of the head； death； however； did not ensue until six months later。 According to Ashhurst； Philips； the elder Cline； Willard Parker； Bayard； Stephen Smith； May； and several other surgeons； have recorded complete recovery after fracture of the atlas and axis。 The same author also adds that statistic investigation shows that as large a proportion as 18 per cent of injuries of the cervical vertebrae occurring in civil practice； recover。 However； the chances of a fatal issue in injuries of the vertebrae vary inversely with the distance of the point of injury from the brain。 Keen has recorded a case in which a conoidal ball lodged in the body of the third cervical vertebra； from which it was extracted six weeks later。 The paralysis； which； up to the time of extraction； had affected all four limbs； rapidly diminished。 In about five weeks after the removal of the bullet nearly the entire body of the 3d cervical vertebra； including the anterior half of the transverse process and vertebral foremen； was spontaneously discharged。 Nearly eight years afterward Keen saw the man still living； but with his right shoulder and arm diminished in size and partly paralyzed。
Doyle reports a case of dislocated neck with recovery。 During a runaway the patient was thrown from his wagon； and was soon after found on the roadside apparently dead。 Physicians who were quickly summoned from the immediate neighborhood detected faint signs of life； they also found a deformity of the neck； which led them to suspect dislocation。 An ambulance was called； and without any effort being made to relieve the deformity the man was placed in it and driven to his home about a mile distant。 The jolting over the rough roads greatly aggravated his condition。 When Doyle saw the patient； his general appearance presented a hopeless condition； but being satisfied that a dislocation existed； Doyle immediately prepared to reduce it。 Two men were told to grasp the feet and two more the head； and were directed to make careful but strong extension。 At the same time the physician placed his right hand against the neck just over the pomum Adami； and his left against the occiput； and； while extension was being made； he flexed the head forward until the chin nearly touched the breast； after which the head was returned to its normal position。 The manipulation was accompanied by a clicking sensation； caused by the replacement of the dislocated vertebra。 The patient immediately showed si