Dislocation of the atlo-axoid articulation (_os juguli_) he tells us
threatens speedy death. The mouth of the patient is to be kept open
by a wooden gag, a bandage passed beneath the jaw and held by the
physician, who places his feet upon the shoulders of the patient and
pressing down upon them while he elevates the head by the bandage,
endeavors to restore the displaced bone to its normal position.
Inunctions of various mollitives are then useful.
Dislocations of the lower jaw are recognized by the failure of the
teeth to fit their fellows of the upper jaw, and by the detection of
the condyles of the jaw beneath the ears. The bone is to be grasped
by the rami and dragged down until the teeth resume and retain
their natural position, and the jaw is then to be kept in place by a
suitable bandage.
In dislocation of the humerus the patient is to be bound in the supine
position, a wedge-shaped stone wrapped with yarn placed in the axilla,
and the surgeon, pressing against the padded stone with his foot and
raising the humerus with his hands, reduces the head of the bone to
its natural position. If this method fails, a long crutch-like stick
is prepared to receive at one end the axillary pad, the patient is
placed standing upon a box or bench, the pad and crutch adjusted in
the axilla, and while the surgeon stands ready to guide the dislocated
bone to its place, his assistants remove the bench, leaving the
patient suspended by his shoulder upon the rude crutch. In boys,
Gilbert tells us, no special apparatus is required. The surgeon merely
places his doubled fist in the axilla, with the other hand grasps the
humerus and lifts the boy off the ground, and the head of the bone
slips readily back into place. After we are assured that the reduction
is complete, a strictorium is prepared, consisting of the _pulvis
ruber_, egg-albumen and a little wheat flour, with which the shoulder
is to be rubbed. Finally, when all seems to be going on well, warm
_spata drapum_ (sparadrap) is to be applied upon a bandage, and if
necessary the apostolicon ointment.
Dislocation of the elbow is reduced by passing a bandage around the
bend of the arm, forming in this a loop (_scapham_) into which the
foot of the surgeon is to be placed for counter-extension, while with
the hands extension is to be made upon the forearm until the bones are
drawn into their normal position. Flexion and extension of the joint
are then to be practised three or four times (to assure complete
reduction?), and the forearm flexed and supported by a bandage from
the neck. After a few days, Gilbert tells us, the patient will himself
often try to flex and extend the arm, and the bandage should be so
applied as not to interfere with these movements.
Dislocation of the wrist is reduced by gentle extension from the hand
and counter-extension from the forearm, and dislocation of the fingers
by a similar manipulation.
Public-domain text, read in full here on John Shaqi.
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