[p. 206]standing a great obstacle,-
in such a violent displacement the part (olecranon?) which passes
above the prominent part of the bones is large, and the stretching
of the nerves (ligaments?) is intense; and yet the parts have been
so dislocated in certain cases. The following is the symptom of such
a displacement: the arm cannot be bent in the least degree at the
elbow, and upon feeling the joint the nature of the accident becomes
obvious. If, then, it is not speedily reduced, strong and violent
inflammation, attended with fever, will come on, but if one happen
to be on the spot at the time it is easily reduced. A piece of hard
linen cloth (or a piece of hard linen, not very large, rolled up in
a ball, will be sufficient) is to be placed across the bend of the
elbow, and the arm is then to be suddenly bent at the elbow, and the
hand brought up to the shoulder. This mode of reduction is sufficient
in such displacements; and extension in the straight line can rectify
this manner of dislocation, but we must use at the same time the palms
of the hands, applying the one to the projecting part of the humerus
at the bend of the arm for the purpose of pushing it back, and applying
the other below to the sharp extremity of the elbow, to make counter-pressure,
and incline the parts into the straight line. And one may use with
advantage in this form of dislocation the method of extension formerly
described, for the application of the bandages in the case of fracture
of the arm; but when extension is made, the parts are to be adjusted,
as has been also described above.
Part 43
But if the arm be dislocated backward (but this very rarely happens,
and it is the most painful of all, and the most subject to bilious
fevers of the continual type, which prove fatal in the course of a
few days), in such a case the patient cannot extend the arm. If you
are quickly present, by forcible extension the parts may return to
their place of their own accord; but if fever have previously come
on, you must no longer attempt reduction, for the pain will be rendered
more intense by any such violent attempt. In a word, no joint whatever
should be reduced during the prevalence of fever, and least of all
the elbow-joint.
Part 44
There are also other troublesome injuries connected with
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