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On The Articulations   


pressure on the nerve, which occasions numbness; next to it is the
dislocation forward; the treatment is the same; reduction in
dislocation backward is by extension and adaptation; the symptom of
this variety-loss of the power of extension; of dislocation
forward-loss of the power of flexion, and in this case reduction is to
be accomplished by placing a hard ball (in the bend of the elbow), and
bending the fore-arm about it, along with sudden extension.

20. Diastasis of the bones may be recognized by examining the part
where the vein that runs along the arm divides.

21. In those cases callus is quickly formed. In congenital
dislocations the bones below the seat of the injury are shorter than
natural, and, mostly, those nearest to the place; namely, the bones of
the fore-arm, next those of the hand; and, third, those of the
fingers. The arm and shoulder are stronger, owing to the nourishment
which they receive, and the other arm, from the additional work
which it has to perform, is still more strong. Wasting of the flesh
takes place on the inside if the dislocation be on the outside; or
otherwise, on the side opposite the dislocation.

22. When the elbow is dislocated either inward or outward, extension
is to be made with the fore-arm at a right angle to the arm; the
arm, suspended by means of a shawl passed through the armpit, and a
weight attached to the extremity of the elbow; or force may be applied
with the hands; when the articular extremity has been cleared, the
displaced parts are to be rectified with the palms of the hand, as
in dislocations of the hands. It is to be bandaged, suspended in a
sling, and placed while in this attitude.

23. Dislocations backward are to be rectified by the palms of the
hands, along with sudden extension; the two acts are to be performed
together, as in other cases of the kind. But in dislocation forward
the arm is to be bent around a ball of cloth of proper size, and at
the same time replaced.

24. But if the displacement be on the other side, both these
operations are to be performed in effecting the adjustment. For
conducting the treatment, the position and bandaging are the same as
in the other cases. But all these cases may be reduced by ordinary
distention.

25. Of the methods of reduction, some operate by raising up the
part, some by extension, and some by rotation: the last consists in
rapidly turning the fore-arm to this side and that.

26. The joint of the hand is dislocated either inward or outward,
most frequently inward. The symptoms are easily recognized: if inward,
the patient cannot at all bend his fingers; and if outward, he
cannot extend them. With regard to the reduction,-by placing the
fingers above a table, extension and counter-extension are to be
made by other persons, while with the palm or heel of the hand on
the projecting bone one pushes forward, and another from behind on the
other bone; some soft substance is to be applied to it, and the arm is
to be turned to the prone position if the dislocation was forward, but
to the supine, if backward. The treatment is to be conducted with
bandages.

27. The whole hand is dislocated either inward or outward, or to
this side or that, but more especially inward; and sometimes the
epiphysis is displaced, and sometimes the other of these bones is
separated. In these cases strong extension is to be applied, and
pressure is to be made on the projecting bone, and counter-pressure on
the opposite side, both at the same time, behind and at the side, with

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