This paper dealt with 20 cases of me- dulla oblongatal type of cervico-vertebral syndrome treated by manipulation.The re- sults were as follows:complete remission 4 cases

marked improved 8 cases

partial im- proved 6 cases

noneffective 2 cases. The authors discussed and analysed the pathogenesis and diagnosis of the disease.They held that if the over-flexed or extended in- juries of the cervical vertebrae were sustained

apart from the direct injury to the lower portion of medulla oblongata and upper por- tion of cervical segment of spinal cord

one or more cervical vertebrae might be displaced or semidislocated to cause circulatory distur- bances to the vertebro-basilar artery system or worsen its condition which in turn might injure the function of decussation pyramids of medulla oblongata

posterior group of cra- nial nerves and cervical portion of the spinal cord.These may be important in the patho- genesis of the disease.The chief clinical manifestations are paralysis of the limbs

dysphagia

dysphonia and vertigo.Based on the fact that the pathologic changes are cen- tered in the medulla oblongata

the authors proposed to apply the term"medulla oblong- atal type of cervico-vertebral syndrome"or "sub-vertebral artery type of cervico-verte- bral syndrome".