Because the sequence of events and the subsequent findings were rather unusual, it was thought that this case would be of interest to other members of the profession and thus it was submitted for publication.
A 61-year-old white man, a known pipe smoker, was a passenger involved in an automobile accident on July 6, 1958, at approximately 9:30 in the morning. The incident was such that the driver lost control of the vehicle and it struck a pole and overturned. Emergency care only was carried out at a local mental hospital which happened to be close by. Subsequently, the patient was transferred to St. John's Riverside Hospital in Yonkers, N. Y., approximately 75 miles away.
I was called in to examine the patient at approximately 9:30 that same evening. The patient was sitting up in bed with his head flexed and salivating from the mouth. There was rather marked swelling