54. To proceed to the reduction of a luxation of the humerus, it is necessary to have such a number of assistants as to be able, according to the resistance of the parts, to increase the force intended to overcome it. But two are commonly sufficient. They should furnish themselves with a linen ball, thick enough to project beyond the level of the pectoralis major and the latissimus dorsi, when placed in the axilla, and two straps, one formed of flannel doubled several times, four inches broad, and eight or nine feet long, the other of a napkin regularly folded. This latter is not often absolutely necessary. Every thing being properly arranged, the patient is seated on a chair of a moderate height, or else laid on a table firmly fixed and covered with a simple mattress, in order that the trunk, by being in a horizontal position, may not prevent the motions communicated to the arm from being directed downwards. 55. Desault continued, for a long time, to place the patient in the first of these positions, which, though employed by practitioners generally, is by no means the most favourable. By adopting it indeed the arm may be very well drawn in a transverse direction; but if, as oftentimes happens, it becomes necessary to direct extension upwards or downwards, the assistant, then, being obliged to elevate himself, or to stoop, cannot, in either of these attitudes, exert his strength to advantage, but is confined and embarrassed, and cannot with ease vary, at the pleasure of the surgeon, the direction in which the arm is drawn. As far as relates to the patient, that situation in which the body is only in part supported, is much more fatiguing than one where the whole of it reposes equally on a horizontal plain. Perhaps, in relation to the surgeon, it would be more advantageous, in enabling him to accomplish the process of conformation[16]; but, as will be presently observed, this process is always useless. These considerations induced Desault, in the last years of his practice, to renounce the first position, and have recourse only to the second. [16] That is, to draw, or otherwise force the head of the os humeri, with his hands, towards the glenoid cavity, while the assistants are making extension and counter-extension. In doing this, he must pull the head upwards, if it be lodged in the axilla, backward if it be under the upper part of the pectoralis major, &c. Desault, however, contends that this assistance from the surgeon is unnecessary, and that extension and counter-extension are alone sufficient to effect the reduction. TRANS.