[p. 214]rest of
the body may be raised upon tip-toes. This is by far the most powerful
method of effecting reduction of the shoulder; for one thus operates
with the lever upon the most correct principles, provided only the
piece of wood be placed as much as possible within the head of the
humerus, and thus also the counter-balancing weights will be most
properly adjusted, and safely applied to the bone of the arm. Wherefore
recent cases in this way may be reduced more quickly than could be
believed, before even extension would appear to be applied; and this
is the only mode of reduction capable of replacing old dislocations,
and this it will effect, unless flesh has already filled up the (glenoid)
cavity, and the head of the humerus has formed a socket for itself
in the place to which it has been displaced; and even in such an old
case of dislocation, it appears to me that we could effect reduction
(for what object would a lever power properly applied not it move?),
but it would not remain in its place, but would be again displaced
as formerly. The same thing may be effected by means of the ladder,
by preparing it in the same manner. If the dislocation be recent,
a large Thessalian chair may be sufficient to accomplish this purpose;
the wood, however, should be dressed up as described before; but the
patient should be seated sideways on the chair, and then the arm,
with the piece of wood attached to it, is to be brought over the back
of the chair, and force is to be applied to the arm, with the wood
on the one side, and the body on the other side. The same means may
be applied with a double door. One should always use what happens
to be at hand.
Part 8
Wherefore it should be known that one constitution differs much from
another as to the facility with which dislocations in them may be
reduced, and one articular cavity differs much from another, the one
being so constructed that the bone readily leaps out and another less
so; but the greatest difference regards the binding together of the
parts by the nerves (ligaments?) which are slack in some and tight
in others. For the humidity in the joints of men is connected with
the state of the ligaments, when they are slack and yielding; for
you may see many people who are so humid (flabby?) that when they
choose they can disarticulate their joints without pain, and reduce
them in like manner. The
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