按键盘上方向键 ← 或 → 可快速上下翻页，按键盘上的 Enter 键可回到本书目录页，按键盘上方向键 ↑ 可回到本页顶部！
————未阅读完？加入书签已便下次继续阅读！
will be no necessity for this； then the heads of the ligatures； both
of those at the head and those at the feet； are to be fastened to a
pestle； or some such piece of wood； difficult to reduce at either end；
the ligatures should run along the line of the body； or be a little
elevated above it； and it should be stretched proportionally to the
pestles； so that； standing erect； the one may be fastened to the
threshold； and the other to the transverse piece of wood。 Extension is
then to be made by bending back the ends of the pestles。 A ladder；
having strong steps； if laid below the bed； will serve the purpose
of the threshold and the piece of wood laid along （the foot of the
couch？）； as the pestles can be fastened to the steps at either end；
and when drawn back they thus make extension of the ligatures。
Dislocation； inward or forward； may be reduced in the following
manner： a ladder is to be fastened in the ground； and the man is to be
seated upon it； and then the sound leg is to be gently stretched along
and bound to it； wherever it is found convenient； and water is to be
poured into an earthen vessel； or stones put into a hamper and slung
from the injured leg； so as to effect the reduction。 Another mode of
reduction： a cross…beam is to be fastened between two pillars of
moderate height； and at one part of the cross…beam there should be a
protuberance proportionate to the size of the nates； and having
bound a coverlet round the patient's breast； he is to be seated on the
protuberant part of the cross…beam； and afterward the breast is to
be fastened to the pillar by some broad ligature； then some one is
to hold the sound leg so that he may not fall off； and from the
injured limb is to be suspended some convenient weight； as formerly
described。
79。 It should be particularly known that the union of all bones
is； for the most part； by a head and socket （cotyle）； in some of these
the place （socket？） is cotyloid and oblong； and in some the socket
is glenoid （shallow？）。 In all dislocations reduction is to be
effected； if possible； immediately； while still warm； but otherwise；
as quickly as it can be done； for reduction will be a much easier
and quicker process to the operator； and a much less painful one to
the patient； if effected before swelling comes on。 But all the
joints when about to be reduced should be first softened； and gently
moved about； for； thus they are more easily reduced。 And； in all cases
of reduction at joints； the patient must be put on a spare diet； but
more especially in the case of the greatest joints； and those most
difficult to reduce； and less so in those which are very small and
easily reduced。
80。 If any joint of the fingers is dislocated； whether the first；
second； or the third； the same method of reduction is to be applied；
but the largest joints are the most difficult to reduce。 There are
four modes of displacement…either upward； downward； or to either side；
most commonly upward； and most rarely laterally； and in consequence of
violent motion。 On both sides of its articular cavity there is a
sort of raised border。 When the dislocation is upward or downward；
owing to the articular cavity having smoother edges there than at
the sides； if the joint of it be dislocated； it is more easily
reduced。 This is the mode of reduction：…The end of the finger is to be
wrapped round with a fillet； or something such； that； when you lay
hold of it and make extension； it will not slip； and when this is
done； some person is to grasp the arm at the wrist； and another is
to take hold of the finger which is wrapped in the fillet； and then
each is to make considerable extension toward himself； and at the same
time the projecting bone is to be pushed into its place。 But； if the
dislocation be lateral； the same mode of reduction is to be used；
but when you think that the extremity of the bone has cleared the rim；
at the same time that extension is made； the bone is to be pushed
direct into its place； while another person on the other side of the
finger is to take care and make counter…pressure； so that it may not
again slip out there。 The twisted nooses formed from palm…shoots are
convenient for effecting reduction； if you will make extension and
counter…extension by holding the twisted string in the one hand and
the wrist in the other。 When reduced； you must bind the part as
quickly as possible with bandages； these are to be very slender and
waxed with cerate； neither very soft nor very hard； but of middle
consistence； for that which is hard drops off from the finger； while
that which is soft and liquid is melted and lost by the increased heat
of the finger。 The bandage is to be loosed on the third or fourth day；
but on the whole； if inflamed； it is to be the more frequently loosed；
and if otherwise； more rarely； this I say respecting all the joints。
The articulation of a finger is restored in fourteen days。 The
treatment of the fingers and of the toes is the same。
81。 After all reductions of joints the patient should be confined to
a restricted diet and abstinence until the seventh day； and if there
be inflammation； the bandages are to be the more frequently loosed；
but otherwise； less frequently； and the pained joint is to be kept
constantly in a state of rest； and is to be laid in the most
convenient position possible。
82。 Accidents at the knee are more mild than at the elbow； from
its being compact； regular； and elegant in its construction； and；
therefore； it is more readily dislocated and reduced。 It is most
frequently dislocated inward； but also outward and backward。 The modes
of reduction are these： by flexion at the knee； or by sudden
calcitration； or having rolled a swathe into a ball； and fixed it in
the ham； the patient's body is to be suddenly dropped on its bended
knees。 Dislocation backward； also； as in the case of the elbow； may be
reduced by moderate extension； and to either side； either by flexion
or calcitration； but also by moderate extension。 The adjustment is the
same in all cases。 In dislocations backward which are not reduced； the
patient cannot bend the joint； but neither can he； to any great
extent； in the other varieties； the thigh and leg are wasted in front；
but if inward the patients become bow…legged； and the external parts
are wasted； but if outward they become more bandy…legged； but the
impediment is less； for the body is supported on the larger of the
bones； and the inner parts are wasted。 When these accidents happen
at birth or during adolescence； they follow the rule formerly stated。
83。 Dislocations at the ankle…joints require strong extension；
either with the hands or some such means； and adjustment； which at the
same time effects both purposes； as is common in all cases。
84。 Injuries of the foot are to be remedied like those of the hand。
85。 The bones connected with the leg； and which are dislocated；
either at birth or during adolescence； follow the same course as those
in the hand。
86。 When persons jumping from a height pitch on the heel； so as to
occasion separation （diastasis） of the bones； ecchymosis of the veins；
and contusion of the nerves； when these s