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Boning Up: The Study of a Specimen at Early JMC

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Dr. Joseph Pancoast, served on JMC faculty 1838-1874.
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“A posterior view of the ligaments connecting the atlas, the axis, and the occipital bone,” from A System of Anatomy for the Use of Students of Medicine, by Joseph Pancoast, MD, 1843.

A very curious article (even for a Victorian medical journal) appeared in the November 27, 1886 issue of The Medical News (Philadelphia County Medical Society):

THERE came, accidentally, into our possession, a short time ago, a memorandum, signed by the late Joseph Pancoast, relating to a remarkable injury received by the late James P. White, the well-known gynecologist of Buffalo. The note was as follows: “A front segment of the atlas vertebra, a little more than an inch on the superior margin, a little less below, with the facette which received the odontoid process. It was in the possession of Professor Granville S. Pattison, to whom it was loaned by Dr. White, to show Professors Joseph Pancoast and McClellan. It is probable that the transverse ligament retained its hold on the two extremities of the remaining fragment of the atlas, thus protecting the spinal marrow from injury. This bone in possession of Professor Pattison I repeatedly saw, and carefully examined; he exhibited it to his class, and it was mislaid or lost. At the request of Professor White, I make this statement of facts. This bone was in our possession in 1838-39-40, or thereabout. 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 stage-coach on the morning of December 17, 1837. The bone was discharged at the expiration of forty-five days after receipt of the injury.”

This statement, signed “Joseph Pancoast,” records an interesting and remarkable accident which, so far as we know, has not been made public, and of which there are only one or two instances mentioned in literature.

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Dr. James Platt White, graduated JMC 1834.

Joseph Pancoast, Pattison, and McClellan (JMC’s founder) were all Jefferson Medical College faculty. James Platt White was a Jefferson graduate (1834) who, along with Drs. Austin Flint, Sr. and Frank H. Hamilton, founded University of Buffalo Medical College in 1846. (Incidentally, Flint’s son, Austin Flint, Jr.-- JMC 1857--co-founded Belleville Hospital Medical College, which later became NYU School of Medicine.) Dr. White headed the Obstetrics and Gynecology department and, according to a nineteenth century source, “was the first in this country (in 1850) to teach midwifery clinically.”

White did indeed survive the traveling accident and died in 1881 at the advanced age of 70. No details of the coaching incident appear to exist, but a common accident in carriages occurred when passengers would bang their heads on the interior ceiling due to poor suspension over rutted roads. Although this is pure supposition, if Dr. White carried his tubular wooden stethoscope in his top hat (as was the practice) and wore it in the coach that day, it may have exacerbated his accident, making this mishap an occupational hazard.

Sadly, the vertebra in question is still missing.

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