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Foreword
The International Congress on Ski Trauma and Safety is a biennial meeting of the International Society for Skiing Safety (ISSS), a community of physicians, engineers, and researchers from universities and technical institutions, skiing professionals (including instructors, patrollers, and competitors), ski resort managers, lawyers, equipment manufacturers, and the general public that share the common mission of improving snow sport safety. The congress is their opportunity to update and report the state of the art of worldwide activities and researches that are oriented to the reduction of likelihood of injures. The 21st International Congress on Ski Trauma and Safety was held in San Vito di Cadore—Cortina d’Ampezzo, Italy, from 8 to 13 March 2015. This meeting was held in conjunction with the Winter School in Sports Engineering of the International Sports Engineering Association, as an opportunity to merge the activities of the members of both associations.
This collection of the papers is the 21st Volume of Snow Sport Trauma and Safety (formerly the Skiing Trauma and Safety published by ASTM International). The 16 papers in this volume were presented at the symposium and were subsequently accepted for publication following rigorous peer review. This publication is supported by ASTM International Committee F27 on Snow Skiing.
The editors for this publication were Irving S. Scher, Ph.D., P.E., Principal at Guidance Engineering and Affiliate Scientist in the Applied Biomechanics Laboratory at the University of Washington, Seattle, Washington, USA; Richard M. Greenwald, Ph.D., President of Simbex, Lebanon, New Hampshire, USA, and Adjunct Professor, Thayer School of Engineering, Dartmouth College, Hanover, New Hampshire, USA; and Nicola Petrone, Ph.D., Department of Industrial Engineering, University of Padova, Italy.
Peer Review Policy
Each paper published in this volume was evaluated by two peer reviewers. The authors addressed all the reviewers’ comments to the satisfaction of the technical editors. The quality of the papers in this publication reflects not only the obvious efforts of the authors and the technical editors but also the work of these peer reviewers. The editors acknowledge with appreciation their dedication and contribution of time and effort on behalf of ISSS.
Preface
The International Society for Skiing Safety (ISSS) was founded by Ejnar Eriksson, MD, of Stockholm, Sweden. After the first World Congress on Skiing Trauma and Safety that occurred in Riksgränsen, Sweden, in 1974, the ISSS was organized. The first official ISSS congress was held 3 years later in 1977 in the Sierra Nevada of Spain. After the 1977 meeting, the ISSS has held its congress every other year at or near a ski resort in many parts of the world. The congress has been held at the following sites: Queenstown, New Zealand, in 1979; Bormio, Italy, in 1981; Keystone, Colorado, USA, in 1983; Naeba, Japan, in 1985; Chamonix, France, in 1987; Riksgränsen, Sweden, in 1989; Thredbo, Australia, in 1991; Zellam Zee, Austria, in 1993; Voss, Norway, in 1995; Whistler/Blackcomb, British Columbia, Canada, in 1997; Breuil Cervinia, Italy, in 1999; Queenstown, New Zealand, in 2001; St. Moritz/Pontresina, Switzerland, in 2003; Arai, Niigata, Japan, in 2005; Aviemore, Scotland, in 2007; Garmisch-Partenkirchen, Germany, in 2009; Keystone, Colorado, USA, in 2011; San Carlos de Bariloche, Argentina, in 2013; and Cortina-San Vito di Cadore, Italy, in 2015. The next congress will be held in Innsbruck, Austria, from 17 to 22 April 2017. The Chair, Secretary General, and Medical Head for this meeting will be Werner Nachbauer, Gerhard Ruedl, and Martin Burtscher.
The objective of the ISSS has been to bring together individuals from many professions to identify, evaluate, and discuss all aspects of safety concerning outdoor winter sports activities. This and previous volumes of Snow Sport Trauma and Safety (formerly the Skiing Trauma and Safety published by ASTM International) are excellent places to start if one wants to discover what is known about skiing injury and safety. These collections of peer-reviewed papers represent the most significant body of literature in the field. The articles presented in this book represent the effort and opinions of the authors based on their studies, investigations, and sometimes conjectures. It is important to note that many of these papers document research on topics under development. Each paper has been reviewed by peers of the author, meaning that the standard of the presentation and the technical work supporting the discussion are sufficiently high to merit presentation of the author’s work, conclusions, and opinions. Publication does not mean that the substance and conclusions represent the opinion of the reviewers, editors, or the ISSS. Most
opinions and conclusions expressed in these papers should be expected to evolve and be clarified in future work.
Over 30 years ago, ski injury research was focused on reducing the incidence of tibia and fibula fractures and researchers believed that the design of releasable ski bindings was the key element to solving the injury problems in skiing. Snow sports and its equipment have changed significantly since that time. Other equipment (such as snowboards and alpine touring ski equipment), injuries (such as knee ligament tears and head injuries), and injury modes (such as landing from snow park jumps) have become the focus of attention. It is now recognized that the likelihood of injury is dependent on the combination of many factors, some of which not yet identified. While a reduction in the snow sport injury rates may be realized with equipment design, other factors may be just as likely to hold the key to this; factors described in the papers in this volume, such as skier behavior and race course equipment design, may be part of the solution. Though empirical evidence provided by injury statistics demonstrates progress in reducing the likelihood of some injuries, these same data show the need for continued attention to other injuries.
The state of the art presented in this collection of papers covers a short list of current topics in skiing research. Areas not covered include the following: national and international snow sport standards; release binding designs and adjustments; ski poles; energy management devices for collisions with fixed objects; snowboards, telemark skis, and other types of skis; helmet, goggle, and clothing design; injuries to the spine, femur, and head; competition safety practices and injuries; fatalities; and other winter sports injuries such as sunburns and hypothermia. There is no topic that has been solved completely and many are not represented in this volume. We urge all who are interested in snow sports safety to contribute to increasing our knowledge in these areas.
Part I Epidemiology and Injury Assessment
Injury Trends in Recreational Skiers and Boarders in the 16-Year Period 1996–2012 ................................................................... 3
Arne Ekeland, Andreas Rødven, and Stig Heir
New Zealand Snow Sports Injury Trends Over Five Winter Seasons 2010–2014 .......................................................................................... 17
Brenda A. Costa-Scorse, Will G. Hopkins, John Cronin, and Eadric Bressel
Skiing and Snowboarding in Switzerland: Trends in Injury and Fatality Rates Over Time ........................................................................ 29
Giannina Bianchi, Othmar Brügger, and Steffen Niemann
The Utility of Two National Injury Databases to Evaluate Snow-Sports Injuries in New Zealand .......................................................... 41
Brenda Costa-Scorse, Will G. Hopkins, John Cronin, and Eadric Bressel
A Sport Concussion Assessment Tool (SCAT2) for Use in Snowsports: Can the Balance Component of the Tool Be Improved? ............................. 51 G. Waddington, S. Trathen, T.J. Dickson, R. Adams, and A. Rumore
Part II Ski Bindings
Interactions of Tech Bindings with AT Boot Toe Inserts: Part I, Binding Toe-Piece Mechanics............................................................. 65
Jeffrey R. Campbell, Irving S. Scher, David Carpenter, Bruce J. Jahnke, and Randal P. Ching
Interactions of Tech Bindings with AT Boot Toe Inserts: Part II Binding in Skiing Mode ..................................................................... 83
Jeffrey R. Campbell, Irving S. Scher, David Carpenter, Bruce J. Jahnke, and Randal P. Ching
Matej Supej and Veit Senner
Self-Release of Ski Bindings: A Sex Comparison ......................................... 109
Markus Posch, Gerhard Ruedl, Robert Eberle, and Martin Burtscher
Part III Impact Injury Mitigation
Computer Simulation of the Skier-Flex Pole Impact in Slalom .................
Kurt Schindelwig, Peter Kaps, and Werner Nachbauer
Sagittal Plane Helmet Acceleration at Pole Contact of Alpine Ski Racers is Dependent on Slalom Pole Type and Skill Level ...................
Ronald W. Kipp and John G. Seifert
121
133
Auxetic Foam for Snow-Sport Safety Devices 145
Tom Allen, Olly Duncan, Leon Foster, Terry Senior, Davide Zampieri, Victor Edeh, and Andrew Alderson
Part IV Skier Behavior
Recorded Speed on Alpine Slopes: How to Interpret Skier’s Perception of Their Speed?
Nicolas Bailly, Sofiane Abouchiche, Catherine Masson, Thierry Donnadieu, and Pierre-Jean Arnoux
Snowsport Instructors: Their Actual Maximum Speeds, Their Estimation of Maximum Speed and Speed in Slow Zones, and Their Knowledge of Helmet Effectiveness
Tracey J. Dickson and F. Anne Terwiel
Factors Associated with Alcohol Intake in Mountain Top Huts Among Slope Tourers
Anika Frühauf, Gerhard Ruedl, Christian Kickenweiz, Sepp Thöni, and Martin Kopp
To What Extent Do Attitudes Regarding Ski Helmets Change After a Period of Utilization?
Gerhard Ruedl, Elena Pocecco, Martin Niedermeier, Larissa Ledochowski, and Martin Kopp
163
175
189
197
Part I
Epidemiology and Injury
Assessment
Injury Trends in Recreational Skiers and Boarders in the 16-Year Period 1996–2012
Arne Ekeland, Andreas Rødven, and Stig Heir
Abstract Introduction: The Norwegian Ski Lift Association has since 1996 conducted a central registration of the injuries occurring in the major Norwegian ski resorts to survey the injury types. The aim of this study was to report injury trends in the period 1996–2012.
Material and methods: The injuries occurring in 7–16 Norwegian ski resorts were recorded by ski patrols during the 16 winter seasons 1996/1997–2011/2012 and related to a series of demographic factors. The number of skiing/boarder days was calculated from sold lift tickets (day cards), but these were only centrally recorded from the 2000/2001 season.
Results: A total of 55127 injured skiers and boarders were recorded. The injury rate dropped from 1.47 to 1.27 injuries per 1000 skier/boarder days (P < 0.001), and the skiing/boarding ability increased (P < 0.001) in the period 2000–2012. Most of the injuries occurred on groomed slopes, but an increasing number of injuries occurred in terrain parks, from only 4% in the 2000/2002 seasons to 24% in the last two seasons. More serious injuries (fractures and back injuries) were recorded in terrain parks than those occurring at other locations. Many of the injuries were similarly distributed among skiers and boarders, but alpine skiers suffered more lower extremity injuries, especially knee injuries (24%) compared to snowboarders (7%), whereas the reverse was observed for wrist injuries with 22% for snowboarders and 5% for alpine skiers in the last 2-year period (P < 0.001). The prevalence of knee injuries among alpine skiers has been about 25% in the period 1996–2012, but wrist injuries among snowboarders dropped from 29 to 22% (P < 0.001). The prevalence of knee injuries was twice as high for females (31%) as for males (15%), whereas the reverse was observed for shoulder injuries with 19% for males and 7% for females in the last 2-year period (P < 0.001). These differences have been observed during the whole period. Lower leg fracture for alpine skiers <13 years dropped from 20 to 13% in the period (P < 0.001), but has remained unchanged with about
I.S. Scher et al. (eds.), Snow Sports Trauma and Safety, DOI 10.1007/978-3-319-52755-0_1
3
A. Ekeland et
4% for teenagers and adult skiers. Helmet use by injured skiers/boarders has increased from 11 to 81% in the period, and the prevalence of head injuries has dropped from 19 to 16% (P < 0.001).
Conclusion: The injury rate on Norwegian slopes dropped with 14% in the period 2000–2012. The prevalence of back injuries for injured snowboarders increased by 100% from 1996 to 2012, and this may be related to one-third of the injuries occurred in terrain parks at the end of the period. The prevalence of lower leg fracture in alpine children is declined by 35% in the period. Use of helmet by injured skiers/boarders increased from 11 to 81% and the prevalence of head injuries dropped with 16% during the same period.
Skiing has been a popular sport in the Nordic countries for more than a century [1], and snowboarding has gained increasing popularity during the last three decades. But skiing and boarding are not without risk, and it is important to perform epidemiological studies to identify risk factors. Most of the studies have been short-term covering 1–2 seasons [2–5], but several good long-term studies have been published from the USA and France [6–9].
The Norwegian Ski Lift Association has a central registry of the injuries occurring at the major Norwegian ski resorts since the season 1996/1997 [10–12]. The purpose of this study is to report the injury trends of skiing and boarding on Norwegian slopes in the 16-year period 1996/97–2011/12.
2 Material and Methods
The injuries occurring on the slopes of 7–16 major Norwegian ski resorts were recorded by ski patrols during the 16 winter seasons 1996/1997–2011/2012. These slopes accounted for about 50% of the ski lift transport in Norway during the registration period. A skiing/boarding injury was defined as an injury sustained by a skier/boarder who was treated by or consulted the ski patrol after a skiing/boarding accident.
The injuries were related to the type of skiing/boarding, the type and site of accident, age, and gender, skiing/boarding ability, use of protective helmet, physician or hospital treatment, and ambulance transport. Regarding skiing ability, the alpine skiers were classified by their performance of turns: expert (short turns), advanced skiers (parallel turns), intermediate skiers (stem turns), and beginners (plow turns) [13, 14]. The skill of snowboarders, telemarkers, and skiboarders was self-estimated.
The number of skier/boarder days was calculated from sold lift tickets (day cards and season cards). The number of day cards was only recorded from the 2000/2001 season and onwards.
The results are presented as injury rates (number of injured skiers/boarders) per 1000 skier/boarder days, mean days between injuries (MDBI), and prevalences (percentage of injured skiers and boarders in various groups). Differences were evaluated by Chi square and 2 × 2-table tests and considered significant when P < 0.05.
3 Results
3.1 Injury-Related Factors
Injury rates—A total of 55127 injured skiers and boarders were recorded. The injury rate declined from 1.47 injuries per 1000 skier/boarder days (680 MDBI) in the 2000/2002 seasons to 1.27 injuries per 1000 skier/boarder days (787 MDBI) (P < 0.001) in the 2010/2012 seasons (Fig. 1). Fifty-six percent of the injuries required physician or hospital treatment and 15% ambulance transport.
More than half of the injuries occurred during alpine skiing. Snowboarding peaked with 45% of the injuries in the two seasons 2000/2002, declining to 28% of the injuries during the last two seasons. Telemarking injuries dropped from 9 to 2% and skiboarding injuries from 4 to 2% of all injuries in the period (Fig. 2).
Fig. 1 Injury rates (incidences) for skiers/boarders the seasons 2000/2002–2010/2012. n = number of injured skiers/boarders. The population at risk is based on the number of sold day cards for skiers and boarders
Alpine skiers
Snowboarders
Skiboarders
Telemarkers
Fig. 2 Prevalences of injured skiers/boarders as percentage of all injured on the slopes the seasons 1996/1997–2010/2012. n = number of injured skiers/boarders
Location and type of injury—Many of the injuries were similarly distributed among skiers and boarders, but alpine skiers suffered more lower extremity injuries, especially knee injuries (24%) compared to snowboarders (7%) (P < 0.001), whereas the reverse was observed for wrist injuries with 22% for snowboarders and 5% for alpine skiers (P < 0.001) in the last 2-year period (Fig. 3). The prevalence of knee injuries among alpine skiers has been about 25% throughout the period, but wrist injuries for snowboarders dropped from 29 to 22% (P < 0.001) (Fig. 4). Lower leg fracture was 5.6% for alpine skiers compared to 0.7% for snowboarders (P < 0.001) in the 2010/2012 seasons, and this difference has been almost unchanged in the 16-year period. Hand injuries among alpine skiers dropped from 11 to 6% (P < 0.001) in the same period (data not shown).
Injury site—Most of the injuries occurred on groomed slopes, but an increasing number of injuries occurred in terrain parks, from only 4% in the 2000/2002 seasons to 24% in the last two seasons when 35% of the snowboarders and 20% of the alpine skiers (P < 0.001) suffered their injury in terrain parks (Fig. 5). Injuries in terrain parks were more serious (more fractures, back injuries, and ambulance transports) than those occurring at other locations (Table 1), and the prevalence of back injuries increased from 6 to 12% for snowboarders (P < 0.001) and from 5 to 8% for alpine skiers (P < 0.001) in the period (Table 2). Injuries suffered off pist and in ski lifts have been stable during the registration period and accounted for about 10%, respectively 5% of all injuries (Fig. 5).
Winter Seasons
A. Ekeland
of Injuries
Fig. 3 Type of injuries in alpine skiing and snowboarding the season 2010/2012. n = number of injured alpine skiers and snowboarders
Per cent of Injuries
Fig. 4 Prevalence of wrist injuries in snowboarders the seasons 1996/1998–2010/2012. n = number of injured snowboarders
Per cent of Injuries
Groomed Slopes
Terrain Parks Off Piste Ski lift
Winter Seasons
Fig. 5 Site of injury for injured skiers/boarders the seasons 1996/1997–2010/2012. n = number of injured skiers/boarders
Table 1 Serious injuries in terrain parks and other slopes the seasons 2010/2012 Injury type
parks
(%)
n = number of injuries
Table 2 Back injuries among alpine skiers and snowboarders in the seasons 1996/1998 and 2010/2012
Skiing/ snowboarding seasons
= 2221/1319 (%)
n = number of injuries among alpine skiers/snowboarders
(%)
3.2 Skier-Related Factors
Age—Twenty percent of the injured skiers/boarders were children <13 years, 38% adolescents 13–19 years and 42% adults >19 years. The prevalence of lower leg fracture was related to age and dropped from 20 to 13% for alpine skiers <13 years during the observation period (P < 0.001), but remained almost unchanged and about 4% for teenagers and adult skiers (Fig. 6).
Gender—Forty percent of the injured skiers/boarders were females and 60% males. Knee injuries were related to gender, and the prevalence was twice as high for females as for males throughout the period (Fig. 7), whereas the reverse was observed for shoulder injuries (Fig. 8).
Skiing/boarding ability—The skiing/boarding ability increased significantly (P < 0.001) during the 12-year period 2000–2012 (Table 3), and the ability for snowboarders increased in the period 1996–2012 (P < 0.001). (Table 4). In the 2010/2012 seasons, alpine skiers <13 years suffering lower leg fracture had a significant lower skiing ability than alpine skiers in the same age group suffering other injuries (P < 0.001) (Table 5). The ability of the latter increased significantly (P < 0.001) from the 1996/1998 to the 2010/2012 seasons (Table 5).
Children 12 years
Adolescents 13-19 years
Adults 20 years
Fig. 6 Prevalence of lower leg fractures in injured alpine skiers during the seasons 1996/1998–2010/ 2012 recorded for children, adolescents, and adults. n = number of skiers with lower leg fracture
Fig. 7 Prevalence of knee injuries in injured female and male skiers/boarders during the season 1996/1998–2010/2012. n = number of skiers/boarders with knee injury
Fig. 8 Prevalence of shoulder injuries in injured female and male skiers/boarders during the seasons 1996/1998–2010/2012. n = number of skiers/boarders with shoulder injury
Table 3 Skiing/boarding ability in the seasons 2000/2002 and 2010/2012
Skiing ability 2000/2002 season* n = 6138 (%)
n = number of injured skiers/boarders
season* n = 7695 (%)
*Significant higher ability for injured skiers/boarders in the 2010/2012 season compared to the 2000/2012 season (P < 0.001)
Table 4 Snowboarding ability for injured snowboarders in the seasons 1996/1998 and 2010/2012
Skiing ability 1996/1998 seasons* n = 1224 (%)
seasons* n = 2063 (%)
n = number of injured alpine skiers and snowboarders
*Significant higher ability for injured snowboarders in the 2010/2012 season compared to the 1996/1998 season (P < 0.001)
Table 5 Skiing ability for alpine skiers <13 years with lower leg fracture the seasons 2010/2012 and injured alpine skiers <13 years with other injuries the seasons 2010/2012 and 1996/1998
Skiers <13 years with lower leg fracture* n = 154 (%)
n = number of injured alpine skiers
Skiers <13 years with other injuries*# n = 999 (%)
Skiers <13 years with other injuries# n = 336 (%)
*Significant lower skiing ability in children with lower leg fracture compared to children with other skiing injuries (P < 0.001). #Significant higher skiing ability of alpine skiers with other injuries in the 2010/2012 compared to the 1996/1998 seasons
3.3 Equipment-Related Factors
Helmet—The use of helmet by injured skiers/boarders increased from 11 to 81% in the period, and the prevalence of head injuries dropped from 19 to 16% (P < 0.001) (Fig. 9). In the 2010/2012 seasons, 15.8% of the skiers/boarders wearing helmet suffered a head injury compared to 16.9% of those without helmet. More skiers/boarders
Fig. 9 Use of helmet and prevalence of head injuries in injured skiers/boarders during the seasons 1996/1998–2010/2012. n = number of injured skiers/boarders
Table 6 Head injury severity with and without helmet the 2010/2012 seasons
Head injury With helmet n = 943 (%) With helmet n = 234 (%)
Direct to hospital 5 13
Pianificant difference
P < 0.001
To physician 54 63 P = 0.026 n = number of skiers/boarders with head injury
without helmet needed transport direct to hospital or physician than those with helmet (Table 6). The prevalence of neck injury has been about 3% and similar for skiers/boarders with and without helmet throughout the study.
Wrist guard—Only 4% of injured snowboarders used wrist guards.
4 Discussion
The injury rate decreased by 14% during the period 2000–2012. The number of sold day cards was not recorded before 2000, only the number of lift transports. The injury rate is significantly related to skiing ability [8, 9, 15, 16], and the ability on the slopes increased significantly for skiers/boarders during the period (Table 3).
This may partly explain the reduced injury rate at the end of the period. Also Shealy et al. [9] report a reduction of the injury rate in a ski patrol study from 14 American ski resorts in the period 2000–2010, where the injury rate was 2.6 per skier visit in 2000 and 2.5 in 2010. Kim et al. [7] found a decrease in injury rate for alpine skiers, but not for snowboarders in the period 1988–2006 in a study from Vermont, USA. Laporte et al. [8] found an overall decrease in injury rate from 2.7 to 2.43 injuries per 1000 skier/boarder days during the period 2005–2010 in a study from 32 French ski resorts. The injury rate for alpine skiers remained stable in the period, whereas that of snowboarders declined after 2006.
Most of the injuries occurred during alpine skiing, whereas snowboarding peaked with 45% of the injuries on the slopes in the 2000/2002 seasons (Fig. 2). This is not related to differences in risk for alpine skiing and snowboarding, but to the size of the population of skiers and boarders on the slope. The popularity of alpine skiing increased after the carving skis were introduced in the late 1990, with a corresponding sales reduction of snowboards. The popularity of telemark skiing has also gradually decreased during the registration period. Skiboards were introduced in 2002 but did not gain popularity with low sales of the equipment. Also Kim et al. [7] report that snowboarders peaked with 34% of the population on the slopes in 2000/2001 and then dropped to 20% the last years of their study that ended in 2006.
Alpine skiers suffer mainly knee injuries whereas snowboarders suffer mainly wrist injuries. This is in agreement with several other reports [7, 9, 17]. The prevalence of knee injuries in alpine skiers remained almost the same during the period as also reported by Kim et al. [7] and Shealy et al. [9], but the prevalence of wrist injuries in snowboarders decreased (Fig. 4). Beginners were significantly overrepresented among snowboarders with wrist injuries [7, 8, 12]. Snowboarding ability increased significantly during the period with less beginners on the slopes (Table 4), and this may be a possible explanation for the reduced prevalence of wrist injuries at the end of the period. This finding is in accordance with that of Laporte et al. [8] from France whereas both Kim et al. [ 7 ] and Shealy et al. [ 9 ] found an increase of wrist injuries over time in the USA. The two latter studies do not report if the snowboarding ability changed in the recorded period.
The prevalence of knee injuries was twice as high in females as in males, whereas the reverse was observed for shoulder injuries. These findings were observed throughout the 16-year registration period (Figs. 7 and 8), and have also been reported by others [17–20]. This significant gender difference is observed both in alpine skiing, snowboarding, telemark skiing, and skiboarding, and in each of the four skiing/boarding ability groups: expert, advanced, intermediate, and beginner [12]. It may be due to anatomical sex differences and related to differences in strength and elasticity of ligament and muscles, but so far we have no convincing explanation for these observations.
The prevalence of lower leg fracture in alpine skiers was significantly higher for children than for older skiers (Fig. 6), as reported previously [21, 22]. The risk for lower leg fracture in alpine skiers decreased significantly in the 1970 and 1980, probably due to better boots and release bindings, and better binding setting and adjustment in the ski shops, levelling out to a lower plateau from the 1990 [6]. This has not
A. Ekeland et al.
been observed to the same degree in children where the prevalence of lower leg fracture decreased from 20% in the 1996/1998 seasons reaching a plateau of 12–13% from the 2006/2008 seasons. Alpine skiers <13 years with lower leg fracture have a significant lower skiing ability than skiers <13 years with other injuries, and the skiing ability of the latter increased significantly during the registration period (Table 5). This may partly explain the reduction of lower leg fracture for children in the period, together with better boots and bindings with correct adjustment and setting, and less use of second-hand equipment [23]. Also Greenwald and Laporte [22] have reported beginners to be overrepresented among skiers with lower leg fracture.
Use of a protective helmet increased from 11 to 81% in the period, but the prevalence of head injury only dropped from 19 to 16% (Fig. 9). Helmet offers protection against head injuries [24–26], but the reduction of the head injury prevalence of three percentage points or 16% after an increase of helmet use of 60 percentage points or more than seven times is less than expected and in agreement with the findings of Sulheim et al. [27]. But the injuries suffered by skiers/boarders without helmet were probably more serious as more of them required transport direct to hospital or physician than those suffered by skiers/boarders with helmet (Table 6). Skiers/boarders with helmet suffering head injuries had a higher ability than all injured skiers/boarders with helmet [12]. This may indicate that they ski faster on the slope and may have a sensation seeking behavior [25, 28]. The prevalence of neck injuries has been similar for skiers/boarders with and without helmet throughout the study. Thus, the use of helmet does not increase the risk for neck injuries, as also reported by Cusimano and Kwok [26].
Most of the injuries occurred on groomed slopes, where most of the skiing/ boarding population was located. Terrain parks started to appear in the ski resorts around 2000, and since then an increasing share of the injuries occur in terrain parks (Fig. 5). More fractures and back injuries occurred in terrain parks than in other slopes and more injuries from the parks required ambulance transport (Table 1), suggesting the injuries in terrain parks to be more serious. It is difficult to record the injury rate in terrain parks. Laporte et al. [8] reported an increased rate compared to the overall injury rate, whereas Shealy et al. [9] found no evidence for an increased injury rate in terrain parks.
The strength of this study is the high number of injuries recorded in the largest Norwegian ski resorts by the same method during 16 successive ski seasons. The limitation is the lack of a control material of uninjured skiers/boarders from the same period. In the 2001/2002 season, we were able to collect a representative control material enabling us to perform a case-control study with calculation of injury rates and injury risk for different groups of skiers/boarders [5, 16]. Another limitation is that the diagnoses have been made by ski patrols, and some conditions like fractures may have been over diagnosed. The prevalence of the different injuries has, however been quite consistent during the 16-year period. We therefore think that any weakness of diagnostic accuracy by the ski patrols may partly be compensated by the high number of injured skiers/boarders in the material. The ski patrol may also pick up some minor injuries not needing medical attention.
5 Conclusion
The injury rate on Norwegian slopes dropped 14% during the period 2000–2012, possibly due to an increase of the skiing/boarding ability. The prevalence of wrist injuries in snowboarders was also reduced, whereas the boarding ability increased. The prevalence of back injuries in snowboarders increased by 100% from 1996 to 2012, and this may be related to one-third of the injuries occurred in terrain parks at the end of the period. The prevalence of knee injuries was twice as high in females compared to males, whereas the reverse was observed for shoulder injuries throughout the period. The prevalence of lower leg fracture in children dropped by 35% at the end of the period, whereas the skiing ability of children with other injuries increased. The use of helmet increased more than seven times among injured skiers/ boarders to 81%, and the prevalence of head injuries dropped with 16% at the end of the 16-year period.
References
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A. Ekeland et al.
New Zealand Snow Sports Injury Trends Over Five Winter Seasons 2010–2014
Brenda A. Costa-Scorse, Will G. Hopkins, John Cronin, and Eadric Bressel
Abstract Ski patrol national incident data were analysed in New Zealand for alpine skiing and snowboarding injuries from 4 June 2010 to 9 November 2014. Over five winter seasons, there were 5,861,643 visitations and 18,382 incidents. The injury rate per 1000 skier/boarder days was relatively constant (3.2, 3.3, 3.4, 2.7, and 3.1, respectively). Falls accounted for the injury mechanism in 74.3% of all injuries. Four died after catastrophic falls (two skiing, two snowboarding). Overall, more knee injuries occurred skiing in soft snow conditions than hard (55 vs. 45%). Advanced skiers were 2.2 times more likely to sustain a knee injury with nonrelease of the ski-binding in hard snow surface conditions than when the ski-binding released. Despite increased helmet usage (42–83%), there was a very likely increase in concussion (1.29, 99% CI 1.06–1.57). Hard snow conditions increased wrist injuries for both intermediate and novice snowboarders (30 and 12%, respectively). Wrist protection was most likely to be beneficial in preventing wrist injuries (hazard ratio 0.65, 99% CI O.54–0.79). Good visibility compared to poor visibility led to a twofold increase in injuries. Increased slope congestion, changes in direction to avoid collision with others and speed were possible contributing factors. Collisions accounted for 9.6% of all injuries. Going forward New Zealand injury prevention initiatives need to be multifaceted. Recreational skiers need to ski on torque-tested equipment with release settings that are a match for current physical parameters, style, and the ability to ski in different snow surface conditions. Further research is
B.A. Costa-Scorse (*)
Sports Performance Research Institute New Zealand (SPRINZ), AUT University, Auckland, New Zealand e-mail: brenda.costa-scorse@aut.ac.nz
W.G. Hopkins
Institute of Sport, Exercise and Active Living, Victoria University, Melbourne, VIC, Australia
J. Cronin
Sports Performance Research Institute New Zealand (SPRINZ), AUT University, Auckland, New Zealand
School of Exercise, Biomedical and Health Science, Edith Cowan University, Perth, WA, Australia
I.S. Scher et al. (eds.), Snow Sports Trauma and Safety, DOI 10.1007/978-3-319-52755-0_2
17
B.A. Costa-Scorse et al.
needed to determine whether wearing a helmet increases reckless behaviour in some age groups. An international standard for snow sports wrist protectors with proven dimensions is also needed before ski areas can make any further investment in wrist protectors.
Injury surveillance is a requisite for understanding the injury problem in alpine skiing and snowboarding [1]. Historically, ski areas have monitored incidents in-house and Ski Areas Association New Zealand (SAANZ) has determined collaborative injury prevention endeavour with the support of technical reports. In 2005, all ski areas moved from recording injury incidents on a SAANZ paper-based incident reporting form to a computerised incident reporting system managed on behalf of SAANZ by the New Zealand Mountain Safety Council. Electronic incident data collection made it possible to undertake this first longitudinal skiing and snowboarding injury study. The findings from this study will provide SAANZ with more comprehensive evidence to determine, where injury prevention energy and resources should be focussed.
2 Objectives
Describe the injury rates and trends in snow sports in New Zealand over five winters to inform the development of a national injury prevention strategy.
3 Methods
The Auckland University of Technology ethics committee approved the study—reference 14/146. Ski patrollers, nurses, doctors, and radiographers completed incident reporting forms for all injuries at all commercial ski areas throughout New Zealand. Anonymised data were entered into the electronic database each week of each winter season over 5 years. The NZ Mountain Safety Council maintained the National Incident Database (NID). SAANZ provided ticket sale records and season pass use for each ski area. Demographic data from SAANZ national consumer satisfaction surveys (2007–2009) were supplied in excel. Bare-head and helmet wear counts were undertaken at chairlifts at two major ski areas in 2010 and 2015. Retrospective analyses were performed with the Statistical Analysis System (SAS). Uncertainties
in the true values of the outcomes were assessed using magnitude-based inferences. For precision, 99% confidence intervals were computed in SAS. Six approaches were taken in the analyses. Trends in annual incidence rates per 1000 skier/boarder days were determined by summing the injuries at each ski area for each year, then modelling the count in each year with Poisson regression using ticket sales and estimated season pass use. The proportions of skiers, snowboarders, females, and males were determined in excel using SAANZ customer surveys (25,910).
The effect of snow conditions and visibility on predicting injury types was analysed by limiting the data to the six major ski areas that had 82% of the skier/boarder days. As there were always injuries on any day that the ski area was open this strategy avoided the bias that would arise from a given snow or sky condition reducing the injury rate such that no injuries occurred on some days. Hard snow or icy conditions existed when a ski patroller in ski boots could not make an impression in the snowpack. The soft or spring conditions description was used on days when the surface easily permitted leaving a ski-boot impression in the snow. Cloud cover provided effect of visibility data on injury incidence. Clear skies or scattered cloud cover determined good visibility. Poor visibility was determined by overcast conditions with full cloud cover leading to flat light or white out conditions with snow falling, mist, or rain.
Logistical regression was used to analyse the effect of snow condition, visibility, skiing or snowboarding activity, and the ability on the proportions of a given type of injury (e.g. head) and type of incident (e.g. falls, jumps, collisions). Deaths were counted. Injured skiers’ self-reported when the ski-binding released during the incident or did not release. Skier accounts of the ski-binding pre-releasing in normal skiing manoeuvres were also included in the three level analysis of the effect of binding release. Probabilistic terms were used to describe the true value of changes in the mechanism (type of incident) over the 5-year period. Where the true value could be substantial in both a positive and negative sense, the result was unclear; otherwise, results were clear and the inference was described as likely trivial, possibly trivial, trivial, likely or a very likely increase or decrease [2].
The effect of helmet use on head injuries (cases) was determined by using other injuries as controls; a method previously applied in an investigation on the relation of head, face, and neck injury in skiers wearing helmets [3, 4]. A hazard ratio was obtained using a Poisson regression model of those that were head injured (using helmets)/(those not using helmets) divided by those that were non-head injured (using helmets)/(those not using helmets). The effect of wrist protection was examined in the same manner.
4 Results
Over five winters 5,861,643 people were active in snow sports at New Zealand ski areas and 18,382 incidents were registered. New Zealand injury trends per 1000 skier/boarder days were 3.2, 3.3, 3.4, 2.7, and 3.1, respectively (2010–2014). There
was most likely a trivial decline in injuries over this period ( 3%, 99% confidence interval 9 to 3%). The proportions of people active in each sport were determined from 25,911 SAANZ surveys: 61% skiers, 32.4% snowboarders, and 6.6% both ski and snowboard. No data was collected on the number of people tubing at ski areas. Knee injuries were the most common injury overall (see Fig. 1). Over two-thirds of knee injuries occurred in skiers when compared with snowboarders and others (tubing/hiking) (76, 21, and 3%, respectively). There was no significant difference in the frequency of back injury between skier and snowboarders; 36% occurred in the cervical/thoracic region; and 64% in the lumbar/sacral region. Wrist injuries were more common in snowboarders (80%). Snowboarders accounted for 52% of the head injuries, skiing 43%, and 5% were attributed to other activities. Shoulder injuries occurred more often in snowboarders (61%). Clavicle injuries were also more prevalent in snowboarders (64%). Conversely, 74% of injuries to the lower leg occurred during skiing.
SAANZ customer survey data indicated that the percentage of male skiers was 53%, female skiers 47% compared to 61% male and 39% female snowboarders. Female skiers injured the knee more frequently than male skiers (65% vs. 35%). Nonrelease of the ski-binding resulted in knee injury in skiers more often than release (see Table 1). More knee injuries occurred in soft snow conditions than hard (55% vs. 45%). The rates of knee injuries either in non-release or release were highest in intermediate skiers (45%), followed by novices (30%) then advanced skiers (25%).
In 2010, 42% of skiers and snowboarders wore helmets; this increased to 83% in 2015 (skiers 84% and snowboarders 79%). Concussion very likely increased over the 5 years (1.29, 99% CI 1.06–1.57). By age, 24–32 years olds were less likely to be wearing a helmet when head injured (see Fig. 2). The mean ages for each quartile were 12 years. (SD 3), 20 years. (SD 2), 27 years. (SD 2), and 47 years. (SD 10).
Fig. 1 Body part injured in all snow sports
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time to make their charge. They accordingly rushed into the street, and were face to face with the students.
‘Trapped!’ ejaculated Theria, as he felt his progress stopped, and saw the tumult below. ‘Oh, Master Blacquart, you shall pay for this.’
A terrible riot ensued. What the students wanted in numbers, they made up in strength and daring. They wrested the partisans from their opponents to turn against them, and in all probability would have come off the conquerors, had not Maître Picard opened one of his upper windows and discharged a blunderbus therefrom—not to injure his enemies, but to give the alarm by the report of this novel weapon, not long imported from Holland.9 It had the desired effect, and in a few minutes brought back the Guet Royal.
Some of the students fled at once as they saw the night-patrol advance, for they were men with whom there was no trifling. Those who remained, being a small number, were now captured by the bourgeois; and then Maître Picard emerged from his house, and Theria was let down and seized.
‘Huzza!’ cried the little chapelier, giving way to fresh antics. ‘We have caught you—eh? Take him away; to the guard-house with such a brawler. Stop—no—the glory shall be with me. Gentlemen of the Guet Royal, march on with your other prisoners; the Garde Bourgeois will take charge of the ringleader. Mauvais sujet—ugh!’
Camille took no notice of Maître Picard’s address. He was, however, chafing with anger inwardly at being thus caught.
‘To the guard-house!’ continued Maître Picard, ‘without loss of time. I have rid Paris of a brigand—a cut-purse. En avant!’
Drawing his sword as well as his short arms and fat little body permitted, Maître Picard placed himself before the prisoner, and two of the others followed. In this state they started off, the hatter leaving Blacquart in charge of his shop, and proceeded towards the nearest corps du garde. But, as they were passing down the Rue de la Harpe, Camille, who had been watching his opportunity, suddenly tripped up the chapelier, and sent him rolling into the kennel that rushed down the middle of the street, before he had time to save himself. He then as rapidly dealt a couple of heavy blows to his followers, and whilst they were aghast at the unexpected attack, rushed down the Rue du Foin, in the obscurity of which he was
immediately lost. But we must follow him along it, leaving the two guards, first to recover themselves and then to pick up Maître Picard, in as sorry a plight as might well be.
Flying along the narrow thoroughfare, a few minutes brought Camille to his abode in the Place Maubert. He went directly to the apartment of Philippe Glazer, who was at home, and briefly told him what had happened.
‘It will not stop here,’ said Theria. ‘That wretched bourgeois can make a nasty business of it if he likes, and I must leave Paris at once.’
‘Immediately?’ asked Glazer.
‘Directly. My studies, such as they have been, are nearly finished, and Liège will do for me to settle at as well as anywhere else. Besides, it is my home.’
‘Can I assist you in anything?’ asked Philippe.
‘In one thing only—a little money, for I am quite cleaned out by mes camarades. In return, Philippe, I leave you everything—my books, my rapier, and my Estelle—poor Estelle! Don’t ever part with my rapier whatever you do.’
Glazer smiled at his friend’s speech, as he collected what little money he had by him, and gave to the other.
‘Ten thousand thanks, Philippe,’ said Camille, ‘it shall be repaid some day; we do not cheat one another.’
‘I will trust you,’ said Glazer; ‘is there anything else I can do for you?’
‘One thing,’ said Camille, more seriously. ‘I am not one to boast of favours bestowed, or even hint at them, but you will find a packet of love-letters in my old escriban. Burn them all—they are from Madame de Brinvilliers.’
Glazer uttered an exclamation of mingled incredulity and surprise.
‘It is true,’ said Camille; ‘she wrote them to me, telling me that I was the only one she ever loved—that all the other attachments had been madness—folly Pshaw! each avowal was stereotyped, and did for others as well as it will again do for the next. Burn them all. Adieu! and tell Estelle to console herself.’
And, warmly shaking his friend by the hand, Theria flew down stairs, leaving Glazer almost bewildered at the rapidity of the
interview and the avowal he had just heard.
CHAPTER XII.
EXILI SPREADS THE SNARE FOR SAINTE-CROIX, WHO FALLS INTO IT
T tower of the Bastille, which the Under-Governor had designated as the Tour du Nord upon Sainte-Croix’s arrival, was generally known as the Tour de la Liberté, which title, from the mockery of the appellation, was not in frequent use. The Bastille, it may be known, consisted at that time of eight towers. Two of these—the Tour du Trésor, so called because it was chosen as the depot of the wealth amassed by the sagacious Sully for Henry IV., and the Tour de la Chapelle, were the most ancient, and had formerly been merely the towers which flanked the entrance to Paris by the Faubourg St. Antoine. Subsequently the Tour de la Liberté and the Tour de la Bertandière were added opposite to those just spoken of—the latter being the one chosen, some centuries afterwards, as the prison of the unfortunate ‘Man in the Iron Mask.’ The Tour de la Liberté was at this early period the most northern elevation—hence its second name; and the entrance to the city lay between those four towers, on the spot where the huge cast of the elephant, intended for the fountain, may be recollected by the visitor on the way to Père la Chaise. To those four towers Charles VI. added four others; about 1383 chambers were hewn in the thickness of the wall between them, drawbridges were erected, a fosse dug around, and the Bastille was completed.
All these towers contained the cells for the prisoners; and as a portion of our story must now necessarily pass in the Bastille, we will call the attention of the reader to them; but briefly as possible. In each tower were five ranges of cells. The lowest of these, or cachots, 10 were the most horrible, receiving what little light they had from the lower part of the fosse. The floor was covered with a nauseous slime, perpetually oozing from the low grounds around, and laden with rank and poisonous exhalations. Here noisome reptiles—the toad, the lizard, and the rat, had their homes— sweltering and crawling on the damp floor; from which the only
refuge allowed to the wretched prisoner was a species of bed, formed by iron bars projecting from the wall, a few inches above the ground. In many of these sinks, still greater misery was contrived for the occupant. The lower part was a mere well, cut out in the form of an inverted sugar-loaf, in which the prisoner was compelled to exist, so that the feet found no level resting-place, nor could the body repose.
Next in order of the chambres rigoureuses, were the iron cages. They were above the cachots, and were formed of small beams of wood plated with iron, being about six feet square. The next were termed the calottes. These chambers were the highest, being built in the summit of the towers, and so contrived that the prisoner could only stand upright exactly in the middle, and there was scarcely space in them for the length of a bed, although the depth of the loopholes was ten feet, being the thickness of the wall. These were small, admitting very little light, which was farther excluded by two ranges of thick iron bars, within and without. Being close to the roof, the heat of the sun in summer was insupportable, converting them almost into ovens; in winter the cold was equally terrible, since there was little space for a fire. In these rooms the victims were usually confined who were destined for the oubliettes—the wheels armed with cutting points, which, turning round, drew the sufferer between them and cut or tore him to pieces.
The intermediate chambers were somewhat more comfortable. They were fourteen or fifteen feet high; and, although the windows were heavily barred and counter-barred, were tolerably well lighted; whilst, from some of them, views could be obtained of the boulevards and various parts of the city. The rooms were generally numbered, and named after the towers in which they were situated. The one that Gaudin de Sainte-Croix now entered was the Onzième Liberté—and by the same title was the occupant known during his sojourn in the prison.
The recognition, both on the part of Gaudin and Exili, was instantaneous, and an expression of surprise burst from the lips of the former as he discovered the falcon countenance of the physician. But he directly recovered his composure, recollecting that the gaoler was still in the room, and remained silent until Galouchet departed,
closing after him, one upon another, the three massy doors which, covered with heavy locks, bolts, and iron studs, guarded each of the chambers.
The first impression of Exili had been that some new punishment was in store for him, upon seeing his late enemy enter, accompanied by the functionary. But as the man left, and Gaudin, dashing his hat upon the ground, threw himself in an old fauteuil at the foot of the pallet destined for him, he perceived that he also was a prisoner. A savage gleam of triumph passed across his livid countenance as he bade Sainte-Croix welcome in a tone of mockery
‘My prophecy has been speedily fulfilled,’ said Exili; ‘I gave you six months—little more than thrice six hours have passed, and we meet again. You may find good reason now to burn me as a sorcerer, when you wish entirely to get rid of me.’
Gaudin smarted under the taunt; but his face betokened no trace of the annoyance. He took the empty sheath of his sword, which still hung at his side, and, smiling carelessly, played with the lace that was fixed round his boot.
‘It is an odd rencontre,’ he said; ‘but you are no sorcerer, or you would not have been here. On that score you are safe. We stand a chance of being together for some time—perhaps we may become better friends.’
‘Friends!’ replied Exili, with a short, dreary laugh. ‘Never: we are not made of the stuff that can harbour such a dull sentiment. Crime —purpose—common interest—might set up some tie between us; but not friendship.’
‘I care not what you call it,’ said Gaudin; ‘our battle has become a drawn game, and we must make the best of it. Yesterday I had my revenge—to-night your turn has arrived. On the score of vengeance, then, we are quits. At least towards each other,’ he added, after a moment’s pause.
Exili had never taken his eyes from Sainte-Croix since he entered; his piercing glance appeared to be scanning the thoughts that prompted every word the other uttered. Gaudin’s last speech appeared to have awakened fresh attention.
‘And to no one else?’ asked Exili emphatically, still looking fixedly at him. ‘May I ask through whom you were sent here?’
‘Through the cause of all that can most wring and crush us, either in this world or that which is to follow, for aught I know.’
‘A woman?’
‘Your divination is again right.’
‘And that woman is the Marchioness of Brinvilliers.’
‘I mentioned no name,’ said Sainte-Croix quickly.
‘You did not,’ replied Exili; ‘and yet I knew it. You cannot suppose that I should remain ignorant of what has been the gossip of the shops and carrefours of Paris throughout many a fine spring afternoon this year.’
‘Her husband never knew it,’ said Sainte-Croix, for the minute thrown off his guard, and admitting the truth of what had been a random venture on the part of Exili.
‘In such case the husband is always the last,’ returned the physician, ‘to credit his own dishonour. And yet it was not Antoine Gobelin who sent you here.’
‘You are right once more,’ said Gaudin. ‘It was M. d’Aubray, the lieutenant-civil, her father. Curses wither him!’
The features of Exili assumed an expression that was perfectly fiendish, as he gazed upon Sainte-Croix, who was divesting himself of his garments, and flinging them carelessly about the room here and there, before lying down upon the truckle-bed. Not wishing to extinguish the lamp, yet disliking the glare in his eyes, he had removed it to the chimney-corner, near which was placed a rude table.
‘It is cold!’ he said, as he endeavoured to warm his hands before the dying embers.
‘So I thought last night,’ said Exili; ‘but I am already inured to it. It is, however, a different change for you, from the Hôtel d’Aubray. I am used to strange apartments; and I have no lady-love who may play me false during my imprisonment.’
A spasmodic tremor passed through Sainte-Croix’s frame; his hands were clenched and his lip quivered. The convulsion was slight and rapid, but it was observed by Exili. He went on.
‘It is annoying, too, to dream that others may share her affections whilst you are imprisoned here. Her years are but few—her blood is
young and vivid. The Marquis, too, neglects her—so goes report in Paris—and she must have some one to attach herself to.’
‘No more!—no more!’ cried Gaudin, with a sudden and violent outburst of passion. ‘Fiend! demon! what drives you thus to madden me?’
‘These are harsh terms to christen me by,’ returned Exili, with a ghastly smile; ‘especially when it is in my power to place in your possession what you now desire above anything else the world could bestow.’
‘And what is that?’ asked Gaudin, assuming an indifference through his anger.
‘Vengeance!’ returned Exili, as he raised himself on the pallet, and glared upon Sainte-Croix like a basilisk.
A scornful expression of contempt was Gaudin’s only reply.
But Exili saw that his prey was coquetting with the bait. He continued—
‘There are dull moralists and fools who will tell you that revenge is an ignoble passion, fitted only to those grovelling spirits who dare not resent an injury, and yet are too sharply stung to pass it over. Believe them not; it is a glorious triumph of retribution, although the success of the cast will alone decide whether it will be called justice or cowardice by the world. You are indebted for your present position to Dreux d’Aubray; you burn for vengeance. If you fail the world will call you pitiful, mean, lâche: succeed, and you become a hero. Suppose I make that success certain!’
‘Pshaw! you are leading me on to some new toil,’ said Gaudin. ‘We are powerless here; were we otherwise, I should mistrust you. This is no place for bandying smooth phrases; nor are our relations towards each other such as require them. You know my sentiments towards you.’ Then, after a moment’s pause, he added, ‘What plan do you propose?’
‘As I expected,’ thought Exili; ‘his curiosity is aroused.’ ‘It is full late,’ he continued aloud, as the sound of the bell vibrated through the building from the Tour de la Chapelle. ‘To-morrow your excitement will have somewhat abated, and all will be explained. Doubtless your couch will prove a trifle harder than the one you have
been accustomed to. Good-night; and may she visit you in your dreams, for you will have little chance here of seeing her otherwise.’
And with this last observation, which had the full effect he intended, the physician turned on his pallet and was soon asleep, or affected to be so.
But it was long before Gaudin slumbered. The events of the evening were in themselves enough to drive anything from his mind, and the last conversation with Exili had added fresh wrath to the mingled blaze of anger, jealousy, and impotent desire of revenge that consumed him. At last the objects in the room imperceptibly faded from his sight, or merged into the strange forms which his halfslumbering senses conjured up; and in this state he lay for upwards of an hour, with a consciousness of existence, but motionless and silent.
Suddenly he awoke—if it could be called awaking from a state that was scarcely a sleep—and cast his eyes across the room towards the bed of his companion. Exili was awake as well. He had raised himself in bed, and, by the light of the lamp which still burned in the chimney-corner, was staring fixedly at Sainte-Croix, with the same riveting gaze he had before directed towards him. It was not the look of human intent—a serpent would have fascinated a bird with the same expression, until the victim fell into its yawning mouth. Gaudin quailed before it—he knew not why; but there was something terrible in the unclosed and glaring eyes of the physician, which almost precluded him from inquiring what he desired.
‘You need not be alarmed,’ replied Exili, in an unconcerned tone. ‘Whatever my wishes might have been towards you yesternight, at all events, you are safe here. I was attracted by that curious bauble hanging round your neck. Where did you get it?’
He directed Sainte-Croix’s attention to a small gold heart, about the size of a walnut, which hung round his neck, and which he had not laid aside in divesting himself of his clothes for the night.
‘It is an amulet,’ said Gaudin, ‘and contains a charm against an evil eye. I have heard it will also yield visions of the future. I never put it on one side.’
As he spoke, he opened the heart in its centre, and took out a crystal of a reddish colour, set in a circle of silver. Exili gazed at it still
more earnestly than before.
‘It is a beryl!’ he exclaimed.
‘Eyes less piercing than yours might tell that,’ replied Sainte-Croix. ‘Your fool affected to expose one for sale on the Carrefour du Châtelet but a short time since.’
‘I will tell you more,’ continued Exili, still fixing his scrutinising gaze upon the amulet. ‘The names of the four angels are graven round it: they come in order thus—Uriel, Raphael, Michael, Gabriel. I have seen that stone before. Where did you get it?’
‘It matters little to you,’ replied Gaudin; ‘suffice it to say it is my own.’
‘And you did not read your arrest on its surface?’
‘I have kept it merely as a charm,’ answered Gaudin.
‘Then you have abused its power,’ continued Exili. ‘Listen! do you hear the night wind howling round the towers of the Bastille and rushing down the chimney of our apartment? To common ears it is but the wind—a viewless thing that comes and goes, hurrying on around the world until its force is spent and it dies in nothingness. To me it is far otherwise,’ he continued, as his eyes blazed with unwonted fire, and he raised his arm on high. ‘Each gust is laden with the wrath of some damned spirit waiting to be called upon to make that beryl a mirror of the future, and you neglect the appeal. Give me the stone, and let me read the fate you care not to know.’
Gaudin gazed at Exili with fixed astonishment. The physician extended his hand, and the other took the amulet from his neck and gave it to him.
‘It is the same!’ exclaimed Exili with a smothered exclamation of surprise, as he again looked intently at Gaudin. Then, fixing his eye on the stone, he continued—
‘Its surface is dull. I can see forms moving on it, but they are indistinct, and dance from before my sight like motes, all except your own, and that remains. You may yet triumph.’
Gaudin was awed by the manner of Exili; at another time he would have laughed his predictions to scorn, but the circumstances, the hour, and the place, combined to make him think very seriously of his companion’s remarks.
‘What do you mean?’ he asked.
‘I will reply by putting another question,’ said Exili; ‘where did you get this mineral?’
‘I have had it many years; let that suffice. Now, I claim to know the import of your speech.’
‘You may yet triumph,’ repeated the Italian; ‘and by my means alone. I am not, you see, the enemy you thought me. Again, I say, wait until to-morrow.’
‘Nay, to-night,’ exclaimed Sainte-Croix. ‘I beseech you tell me what you mean.’
‘The charm may be broken,’ continued the other; ‘it is not yet time.’
The manner of the physician had worked upon Sainte-Croix’s curiosity strangely. He again implored to know what the other alluded to.
‘To-night—now—this instant!’ he exclaimed.
‘I will gratify you,’ replied Exili. ‘To-morrow they will bring me my chemical glasses from the boat-mill, together with such dull elements as the ground yields—simple and harmless—in order, as they suppose, that I may practise alchemy. Fools! they little know the change that paltry lamp can work in innocuous earths.’
‘What do you propose to do?’ asked Sainte-Croix.
‘To put you in possession of all I know myself,’ continued Exili, ‘and bring Marie de Brinvilliers once more near you, unquestioned, undisturbed. Seek no further. The life and death of those you love or hate shall be alike within your grasp. The destroying angel shall become your slave, and go abroad, obedient to your will alone. Your bosom should now harbour but one thought—and that must be revenge.’
Exili threw back the amulet to Sainte-Croix, and sank back on his pillow; whilst Gaudin, finding he returned no reply to his questions, once more sought to fly from himself, and the black thoughts that haunted him, in sleep.
CHAPTER XIII.
GAUDIN LEARNS STRANGE SECRETS IN THE BASTILLE
I was not until Galouchet, the gaoler, entered the chamber of the Tour de la Liberté the next morning that Sainte-Croix awoke from his slumbers—from one of those bright dreams of freedom, triumph, and happiness, albeit always tempered with some vague mistrust, which haunt our sleeping existence; the fairer in their visioned prospects, the more gloomy and hopeless the reality.
Exili had already risen. He was looking over the contents of a small chest of carved wood, placed on the table before him. The gaoler was apparently making preparations for breakfast, clattering some metal plates upon the undraped and rude table; and in the fireplace the dense smoke was creeping through some hissing pieces of damp wood, as the sap sputtered and bubbled from their ends. Gaudin stared about him confusedly The last impression of his dreams was mingled with his waking sensations, and he remained silent for a few moments, after some incoherent words, to collect his senses. Exili muttered some conventional salute, and then went on with his scrutiny, whilst Galouchet, having put the table in order, according to his own notions, offered his assistance towards completing Sainte-Croix’s toilet.
‘What charge will monsieur choose to defray for his nourishment?’ asked the gaoler, as Gaudin rose from his pallet.
‘What do you expect?’ inquired Sainte-Croix.
‘Parbleu! we have all prices. You may live like a prince for fifty livres a-day, or starve like a valet for two. This will include your washing, if you are not over-fond of clean linen, and a candle anight. The firewood you must pay for separately.’
Gaudin looked towards the fireplace, and the struggling flame.
‘Ah!’ said Galouchet, divining his thoughts; ‘the wood is rather damp, to be sure, but that makes it last the longer; and as you and Monsieur Exili occupy the same room, it will come cheaper.’
‘Is there news in the city this morning, Galouchet?’ asked Exili.
‘But little,’ returned the functionary ‘Pierre, the scullion, sleeps out of the fortress, and tells me that an eboulement took place last night, and the Bièvre burst into some of the carrières of St. Marcel; and fell so rapidly, in consequence, that all the mills this side of St. Medard were stopped for three hours.’
‘Was anybody lost?’ inquired the physician.
‘It is believed so. A party of Bras d’Acier’s gang were hunted out of the vaults between the Cordelières and Montrouge, like rats in our cachots, when the rains come; and one of the superintendents at the Gobelins was fished up, half-drowned, from a shaft in the Rue Mouffetard.’
‘Do you know his name?’ asked Sainte-Croix eagerly.
‘I can’t say I do,’ returned Galouchet. ‘What rate will you fix your nourriture at, monsieur?’ he continued.
‘I care not,’ said Gaudin; ‘only let it be something that I can eat.’
The day passed on, but the hours lagged so tediously that Time himself appeared to be a prisoner. Little conversation passed between the two inmates of the cell. Exili was occupied in writing nearly the whole day; and Gaudin, who could ill bear the confinement, with his restless and excitable spirit, after the hour’s exercise in the great court allowed to all the prisoners, obtained permission to walk on the ramparts in front of the sentinels. This position commanded a view along the Rue St. Antoine, as well as of the houses in the Rue St. Paul. Towards this point were Gaudin’s eyes constantly directed. He beheld people moving in the streets, and over the plains in the immediate vicinity of the city walls—the coup d’œil was alive with commerce—and the buzz of their voices plainly reached his ear; but he envied them not, nor drew one comparison between their freedom and his state of durance, except when he saw them turn from the great thoroughfare into the small street wherein the Hôtel d’Aubray was situated. He fancied he could pick out the pointed roof of the mansion from amongst the others, and once he imagined that he saw the delicate figure of the Marchioness emerge from the Rue St. Paul, and pass towards the city, without so much as throwing back a glance towards the fortress in which she knew he was confined. And then the hell of jealousy raged in his veins, and he felt the bitterness of captivity. He thought
of the circumstances under which he had found her with Theria the preceding evening; then came back the recollection of the impassioned interview, and her apparent devotion to him, until the struggle of his conflicting feelings to establish what he hoped for, over what he dreaded, nearly maddened him.
At length it got dusk, and he could see no more. The murmur of the peopled city died away; the lights appeared in the embrasures of the Bastille, and the night-wind chilled him. He descended once more to his cell, and found his gaoler there.
‘I was coming to seek you, monsieur,’ he said, ‘for the curfew will soon ring. Mass! your supper is nearly cold. Here is a slice of rôti, a plate of eggs, and a salad; you could not fare better at home.’
‘Have any of my things come?’ asked Gaudin.
‘They are being overlooked in the corps du garde,’ replied the man. ‘By the way, monsieur, my sweetheart, Françoise Roussel, gave me this note for you, when I met her without the walls this afternoon. She did not care that it should be read by the governor.’
Gaudin snatched the note, and discerned the handwriting of the Marchioness. Hastily tearing it open, he read—
‘Be true and patient; all may yet be well, and you will be revenged. Rely on me to aid you; we have gone too far to retract. In life, and after it, yours only, ‘M .’
‘I must put out your light,’ said Galouchet. ‘Last night you were brought in late, and nothing was said; but neither fire nor lamp can be allowed between curfew and sunrise.’
‘You can have it, my good fellow,’ said Gaudin, still quivering with the emotion which the letter had called up. ‘Here—here is some money for you. I will keep your secret. You may retire.’
The man raked out the embers on the grate, and departed. As soon as the clanking of the three doors that shut in the cell had ceased, Exili, who till now had remained quiet, arose from his table, and approaching Sainte-Croix in the darkness, said rapidly—
‘I will now show you some of the mysteries by which my career has, up to yesterday, thriven. But, first—precaution!’
He took his cloak, and by the aid of the forks on the table fixed it so that it covered the window, the position of which could be plainly ascertained by the faint moonlight from without, and then he returned towards the table at which he had been sitting.
‘The clods without think that our light and darkness is subservient to their will alone; but the elements obey not such idiots. The ether which percolates all things—vitalised and inorganic—setting up a communion between them, reveals not itself to the uninitiated. With me, the various elements are as abject slaves, whom I can summons at my bidding.’
As he spoke, he dashed a small rod he held against the wall, and a flame, so bright that Gaudin could hardly look upon it, burst from its extremity. In another moment he had relighted the lamp, and he then shook the blaze amongst the embers on the hearth, which were presently rekindled. Sainte-Croix looked upon his companion with the gaze of one bewildered. Exili read the expression of the other’s features and continued, perceiving his advantage—
‘Life and death are equally within my grasp. Whom shall I call up? Will you see the ghastly corpse of the Croce Bianca, at Milan?’
‘No! No!’ cried Gaudin, covering his eyes with his hand, as if he dreaded to meet the horrid sight.
‘Will that serve to recall its memory as well?’ asked Exili, throwing a phial upon the table.
A glance sufficed to show its nature to Sainte-Croix. It was a small bottle of the terrible Aqua Tofana—the ‘Manna of St. Nicholas de Barri.’
‘That menstruum is powerless, compared to what I am about to show you. But first, look here.’
He stooped beneath the table, and pulled out a species of cage, in which several rats were huddled together, fighting, and scrambling over their fellows.
‘Where did you get those vermin from?’ inquired Gaudin.
‘There are more in the Bastille than are wanted,’ replied Exili. ‘They have been willingly granted by some poor wretch at the base of our tower. Galouchet bought them. I told him they were to study anatomy from.’
He plunged his hand fearlessly amongst them, and drew forth one of the shrieking animals. Then squeezing its throat, he poured a drop or two of the fluid down the mouth. The rat gave a few convulsive throes, and he threw it down, dead, upon the table.
‘You see the effect of the potion,’ he continued. ‘Now, look here.’
Pouring the greater part of the remaining liquid of the phial into a glass, he coolly drank it off before Gaudin could arrest his hand. But no effect supervened. Instead of falling lifeless as Sainte-Croix had anticipated, Exili gazed at him, and, with a short, hollow laugh, threw the empty bottle amongst the embers.
‘Are you man or demon?’ asked Gaudin, scarcely trusting to his senses.
‘Neither,’ said Exili. ‘I have lost the sympathies of the former; the latter I may be hereafter. I have studied poisons, as you see; but I have also studied their antidotes. Have you kept the small phial by you, which you bought of me at Milan?’
‘It has never been out of my keeping until now,’ said Gaudin.
‘With that you could command twenty lives,’ said Exili; ‘and yet my remedies could so blunt and weaken its malignity that I would take it all at one draught. You shall learn more. Attend!’
From his box of carved wood he drew forth a series of test glasses, and half-filled them with water from the prison cruche. He next took a small flacon, and pinched a few atoms of the powder it contained into the first glass, varying the addition in each. Then dropping some colourless fluid into them, one after the other, a precipitate fell down in all, in clouds of the brightest tints, but each different.
‘See how completely these dull minerals do my bidding,’ he exclaimed. ‘To you the potion offers no trace by which its nature could be told; to me there is not an atom suspended in it, in its invisible but imperishable form, which cannot be reproduced before our eyes. Do you believe in me?’
‘I do—I do,’ returned Gaudin. ‘What price do you put upon the revelation of these mysteries?’
‘Nothing—beyond your attention and secrecy.’
‘And yet you love revenge,’ said Sainte-Croix, eyeing him with mistrust.
‘It is my life—my very blood,’ answered Exili. ‘And my revenge— the deepest I can have—is to teach you all I know.’
‘What do you mean?’
‘Simply what I have said. You may call it good for evil if you choose, but still it is my revenge. You have time and leisure before you. Make the best of both.’
Again Exili gazed at Sainte-Croix with the expression of a vulture hovering about its prey, as Gaudin advanced to the table, and, with some curiosity, handled the apparatus which was spread about it. The physician opened a drawer in the box, which was apparently filled with sand. This, however, was but on a false top, which he drew away, and discovered several small bottles, of the size of one’s finger, which he took out.
‘These small messengers have worked great events in their time,’ he said. ‘This,’ taking up one, ‘was the terror of Rome, of Verona, and Milan. I could add much to the records of the Scaliger and Borromeo families, respecting its efficacy. This,’ he added, pointing to another, ‘is so potent that a century and a half has not impaired its power. It is the foam of a dying boar, slain by poison, collected as you see, and was the scourge with which the Borgias swept away their enemies.’
‘Why is one of the phials gilt?’ asked Gaudin.
‘Because its contents are the most precious,’ returned Exili. ‘Its power baffled even the attempts at imitation of Spara and Tofana. It was discovered by a monk in a convent at Palermo, and the secret has remained with me alone.’
‘It is clear as water,’ observed Gaudin, holding it against the light.
‘And like water, without taste or odour. It aided many whose hearts clung to one another,’ he continued, watching Sainte-Croix with his eagle eyes; ‘by clearing away the obstacles that impeded their union.’
Gaudin stretched out his hand, trembling with emotion, and clutched the phial, which he regarded intently, his dilated pupil, parted lips, and short, hurried breathing, showing the conflict of passions that was going on within him. Exili passed a few more of the phials in review before him. From one he let fall a few drops upon the hearth; it hissed and boiled, and the stone remained black
where it had been; into another he dipped a piece of gold, and its yellow and polished surface was changed to a dull gray by the contact.
Then throwing out several of the allusions which he found had most deeply stung his companion the night before, he placed himself by the side of Gaudin, and proceeded to explain to him the rough composition of the different articles the box contained. And as he saw the intense attention, the almost gasping eagerness with which Sainte-Croix followed his instructions, he exclaimed almost unconsciously, ‘Mine—mine for ever!’
CHAPTER XIV.
THE CHATEAU IN THE COUNTRY THE MEETING LE PREMIER PAS
I was a dreary autumnal evening, sixteen months after the events of the last chapter, and the twilight was fast coming upon a vast forest in the province of l’Ile de France, now known as the department of the Oise. The afternoon had been chill and depressing. The wind moaned through the high branches of the trees in a dismal and monotonous wailing, and the constant rustling of the leaves as they fell to the ground showed that the season was far advanced. There were few of the wild flowers left. Two or three, here and there, in sheltered nooks, were all that remained to remind one of the past summer. The delicate heath-bell trembled in the cold breeze, as it rose amidst the dead foliage; but there were few beside. The birds were silent; the tinkling of the cattle-bells on the patches of pastureland was hushed, as the animals huddled together, shrinking from the first approach of cold; and no sound was heard to disturb the general torpidity into which nature seemed about to fall, except the echoing noise from the blows of the axe with which the peasants were cutting down the limbs of the trees for the winter store of firewood.
Yet was the Forêt de l’Aigue a pleasant place in summer, when the sunlight danced upon the turf of its long avenues, darting through the quivering foliage, and the ground was powdered with the bright petals of its flowers, from the primroses spangling its sunny banks, to the gentle violets clustering about the mossy bolls of the fantastic trees, adding their odour to the scent-laden air that swept so warmly through the branches. And during this season alone, it might have been conceived that the chateaux, which were built widely apart upon the forest, were inhabited; for the situation was indeed desolate at other times. But although the autumn was, as we have observed, far advanced, one of the largest of these country houses that a man could come to in a long day’s walk, had not yet been forsaken for the winter by its occupants. This was a large rambling building, with
many windows and turrets, surrounded by a neglected garden, with a few mutilated stone statues, corroded by the rain of many winters, and enclosed by a rude flint wall, with a broken coping. The walks were overgrown with weeds; the ponds were either dry or covered with slime and dead leaves; and water had long ceased to come from the mouths of the misshapen dolphins that formed the fountains. It was of a class of rural buildings which, in France, always appear desolate and uncared for; but this one was especially so.
In one of the large apartments of this house, a bare, uncarpeted room, which the blazing pile of firewood upon the iron ‘dogs’ of the large hearth could not render cheerful, were two persons—an elderly man and a young female. The former was seated at an escritoire, arranging a vast mass of papers bearing official seals and signatures that lay before him. His companion was plunged in a large fauteuil at the side of the fireplace, with her hands pressed against her face, as if to shut out all impressions but her own thoughts. She might have been supposed asleep, but for an occasional rapid shudder which passed through her frame, induced by the vivid recollection of some bygone scene of suffering. These two persons were M. d’Aubray, the lieutenant-civil, and his daughter, the Marchioness of Brinvilliers.
‘The wind is blowing sharply to-night, Marie,’ said the old man, as a gust of unusual violence howled round the chateau, and shook the rattling casements. ‘We must think about returning to Paris.’
‘I have no wish to go, mon père,’ replied his daughter,—‘to be pointed at as an object of pity, scorn, or curiosity. I would sooner remain here with you—for ever.’
She left the fire, and sinking on a low prie-dieu at her father’s side, took his hand in her own, and looked up in his face with a gaze of deep attachment.
‘You have nothing to fear in Paris,’ replied M. d’Aubray. ‘The court has had a thousand objects for its slander since you left; and you have been at Offemont long enough for the whole affair to be forgotten. Besides, you will return acknowledged by me, and with my countenance.’
‘Will the world believe that it is so, Monsieur?’
‘If I maintain it, they will, Marie. The dissolute life your husband is now leading at Paris—his desperate play—the orgies nightly held at
