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On The Articulations   


and the wrist, so that it may be particularly well secured; but
great pains should be taken that the extremity of this piece of wood
should be introduced as far as possible into the armpit, and that it
is carried past the head of the humerus. Then a cross-beam is to be
securely fastened between two pillars, and afterward the arm with
the piece of wood attached to it is to be brought over this
cross-beam, so that the arm may be on the one side of it and the
body on the other, and the cross-beam in the armpit; and then the
arm with the piece of wood is to be forced down on the one side of the
cross-beam, and the rest of the body on the other. The cross-beam is
to be bound so high that the 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.

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 habit of the body also occasions a certain
difference, for in those who are in a state of embonpoint and fleshy
the joint is rarely dislocated, but is more difficult to reduce; but
when they are more attenuated and leaner than usual, then they are
subject to dislocations which are more easily reduced. And the
following observation is a proof that matters are so; for in cattle
the thighs are most apt to be dislocated at the hip-joint, when they
are most particularly lean, which they are at the end of winter, at
which time then they are particularly subject to dislocations (if I
may be allowed to make such an observation while treating of a medical
subject); and therefore Homer has well remarked, that of all beasts
oxen suffer the most at that season, and especially those employed
at the plow as being worked in the winter season. In them,
therefore, dislocations happen most frequently, as being at that
time most particularly reduced in flesh. And other cattle can crop the
grass when it is short, but the ox cannot do so until it becomes long;
for, in the others, the projection of the lip is slender, and so is

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