[p. 229]to dislocation there;
of nerves (ligaments?) and muscles around joints, or connected with
joints, such as are frequently moved in using the member are the most
yielding to extension, in the same manner as well-dressed hides yield
the most. With regard, then, to the matter on hand, the jaw-bone is
rarely dislocated, but is frequently slackened (partially displaced?)
in gaping, in the same manner as many other derangements of muscles
and tendons arise. Dislocation is particularly recognized by these
symptoms: the lower jaw protrudes forward, there is displacement to
the opposite side, the coronoid process appears more prominent than
natural on the upper jaw, and the patient cannot shut his lower jaw
but with difficulty. The mode of reduction which will apply in such
cases is obvious: one person must secure the patient's head, and another,
taking hold of the lower jaw with his fingers within and without at
the chin, while the patient gapes as much as he can, first moves the
lower jaw about for a time, pushing it to this side and that with
the hand, and directing the patient himself to relax the jaw, to move
it about, and yield as much as possible; then all of a sudden the
operator must open the mouth, while he attends at the same time to
three positions: for the lower jaw is to be moved from the place to
which it is dislocated to its natural position; it is to be pushed
backward, and along with these the jaws are to be brought together
and kept shut. This is the method of reduction, and it cannot be performed
in any other way. A short treatment suffices, a waxed compress is
to be laid on, and bound with a loose bandage. It is safer to operate
with the patient laid on his back, and his head supported on a leather
cushion well filled, so that it may yield as little as possible, but
some person must hold the patient's head.
Part 31
When the jaw is dislocated on both sides, the treatment is the same.
The patients are less able to shut the mouth than in the former variety;
and the jaw protrudes farther in this case, but is not distorted;
the absence of distortion may be recognized by comparing the corresponding
rows of the teeth in the upper and lower jaws. In such cases reduction
should be performed as quickly as possible; the method of reduction
has been described
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