[The following takes place in 1837, and affected James P. White, one of the founders of the Buffalo General Hospital.]
In December of that year something happened to the stagecoach in which he was riding, near Batavia, and he was violently thrown, and in such a way as to seriously injure his head and neck. I have not been able to learn any of the details either of the event or of his subsequent symptoms.
All we know thus far is that Dr. White injured his head and neck in a stagecoach accident. So far, so unremarkable; and of the next six weeks of his life nothing is known. But after that, something truly extraordinary happened to him: He coughed up part of his own spine.
[…]
This surprising occurrence was reported in a short statement that appeared in The Medical News in 1886. It was written by Joseph Pancoast, a leading surgeon of the day and therefore (one would hope) a trustworthy source. Dr. Pancoast was happy to confirm that this unlikely incident had taken place, and had even seen the portion of Dr. White’s spine, which he described as
A front segment of the atlas vertebrae, a little more than one inch on the superior margin, a little less below, with the facette which received the odontoid process.
The atlas vertebrae, also known as C1, is the topmost bone of the spine. It is named after Atlas, the Titan who in Greek mythology supported the sky on his shoulders. It’s a feature of crucial importance since it protects part of the brainstem, which among other things regulates the heart rate and respiration. The mobility of the C1 vertebra also allows us to turn our heads and nod. The odontoid process or peg is a protuberance from C2, the second vertebra of the neck. The facette (now usually spelled facet) is the joint between the two vertebrae.
This chunk of bone was not the entire vertebra but a large portion of it. It seems that Dr. White had retained just enough of the bone to protect a critical part of his spinal cord from potentially fatal injury.
[…]
The bone was in our possession in 1838-40, or thereabouts. I then understood and believed (since confirmed by conversation with Professor White) that it came from his throat, coming out through the mouth as a consequence of ulceration; the result of an accident while riding in a stagecoach on the morning of December 17th, 1837. The bone was discharged at the expiration of forty-five days after receipt of the injury.
If there was ulceration at the back of the throat, it must have hurt like hell. There are very few comparable cases on record, but in all of them, the patient had great difficulty eating or drinking, was in severe pain and confined to bed.
[…]
Writing seventy-five years after the nightmarish event, Roswell Park observes:
Of his condition during the forty-five days previous to the extrusion of the fragment there is no account, neither is there of the time elapsing before his restoration to his usual activity; but inasmuch as he died in 1881, having passed the subsequent part of his life in a most active professional career, it is legitimate to conclude that he suffered little, if at all, from the consequences of his injury.
He didn’t escape its effects entirely: According to one obituary, the loss of his vertebra left him unable to turn his head.
In 2005, this case prompted an article by an eminent orthopedic surgeon working at White’s old hospital in Buffalo, Eugene Mindell. After considering all the available evidence, Mindell concluded that White had suffered an injury known as a Jefferson fracture, in which the atlas vertebra is shattered by a sharp impact. A few fragments of bone burst through the wall of the pharynx, causing an open wound that resulted in an infection of the exposed portion of vertebra. Eventually, the infection caused necrosis, when the dead portion of bone (known technically as a sequestrum) had come free and been coughed up (yuck). Finally, scar tissue had formed (or the two adjacent vertebrae C1 and C2 fused together) and the wound healed.
Dr. White was so little affected that he was able to return to work and live a normal life for more than thirty years afterward. In 1886, The Medical News described his injury as “an interesting and remarkable accident,” a description that barely does it justice.
Source:
Morris, Thomas. “Remarkable Recoveries.” The Mystery of the Exploding Teeth: and Other Curiosities from the History of Medicine. Dutton, An Imprint of Penguin Random House LLC, 2018. 215-18. Print.
Original Source(s) Listed:
[Editorial], Medical News 49 (1886), 600.
Roswell Park, “Fracture of the atlas: separation of a fragment and its subsequent extrusion through the mouth,” Buffalo Medical Journal 68, no. 6 (1913), 312-313.
Eugene Mindell, “James Platt White, MD (1811-1881): his interesting and remarkable accident,” Clinical Orthopedics and Related Research 430 (2005), 227-231.
Further Reading:
Dr. Roswell Park: https://en.wikipedia.org/wiki/Roswell_Park_(surgeon)
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