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A case is described of bilateral traumatic chylothorax after complete dislocation of the thoracic spine. An explanation is advanced for the delayed, sudden onset of symptoms due to the chylothorax in this and other cases.

Summary 1 Posterior dislocation of the cervical spine is described, and contrasted with the more common type of anterior dislocation. 2 The mechanism of injury is hyperextension, with disruption of the anterior longi- tudinal ligament. 3 In all cases quadriplegia was present. The anatomical basis of this is discussed. 4 The application of these findings to the management of cervical spine injuries is discussed.

The use of traction that can be varied in force and direction of pull and controlled by x-ray is a safe and useful method of treatment of cervical spine injuries. The technic of manipulation is difficult to acquire for the man treating an occasional cervical injury. An analysis of fifty-two consecutive cases of cervical spine injury is presented.

Many therapeutic collars have been designed over a period of years. Most of them are satisfactory. The one described here is simple, comfortable, and effective. The first definite therapeutic collars were made by Hugh Owen Thomas of Liverpool and Schanz of Dresden. Dr. J. O. Wallace of Philadelphia described a collar that he used in the treatment of dislocations of the cervical vertebrae. I found it very useful for other conditions and fashioned mine along Wallace's lines (fig. 1). I always have a supply on hand, firmly rolled, wrapped in cellophane, and sealed with colored cellophane tape. It is a necessary supply in my office. The collar is useful as a first aid measure. It is helpful in taking roentgenograms in cases of acute injuries with or without deformity. In all serious injuries to the head or neck, a collar should be applied before the injured person is moved from