Many times one is obliged to treat the ribs of one side as a whole. In
such instances the ribs are almost invariably thrown downward except
on one side of scoliosis of the dorsal region. Several methods may be
employed to raise the ribs. Probably the best method is to have the
patient upon the side and with one hand upon the angles of the ribs and
the other hand holding the wrist of the upper arm of the patient, an
upward lifting movement is given both upon the angles of the ribs and
upon the arm of the patient while the patient inhales. The work upon
the angles of the ribs is to raise the ribs directly; the work upon
the arm is to raise the ribs indirectly, principally by the use of the
serratus magnus. Another effective treatment is to have the patient
upon the back and with one hand over the anterior ends of the ribs and
the other hand over the angles of the ribs an upward movement is given
them by springing the ends of the ribs toward each other and by strong
inhalation on the part of the patient. This treatment is most effective
where the false ribs are at fault and especially in case of hemiplegia.
While the patient is upon the back an assistant may take hold of
the arm and draw it upward over the head of the patient, producing
considerable additional upward tendency of the ribs, and the physician
giving the same treatment of the ends of the ribs as before; or the
physician may take an arm in one hand and raise it above the head of
the patient and with his other hand around the angles of the ribs, and
the patient inhaling deeply, the ribs may be raised.
A treatment used a great deal in raising the ribs as a whole is to have
the patient sit upon a stool, and reaching around the patient from the
front, place the fingers upon the angles of the ribs and raise them
upward on both sides at the same time. This treatment can also be given
by standing behind the patient and reaching around upon the anterior
ends of the ribs and lifting upward while the patient aids you by deep
inhalation. Remember that many times the ribs are drawn downward by
contraction of the muscles, due to atmospherical changes and slumped
postures. One should begin at the upper ribs in all treatments where
the ribs are to be raised, as a whole, and work downward.
To correct the =first= and the =floating ribs= a different treatment
has to be given than the foregoing.
Public-domain text, read in full here on John Shaqi.
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