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On The Articulations   


not often happen, in fact, it is very rare, that one or more vertebrae
are torn from one another and displaced. For such injuries do not
readily occur, as the spine could not easily be displaced backward but
by a severe injury on the fore part through the belly (which would
prove fatal), or if a person falling from a height should pitch on the
nates, or shoulders (and even in this case he would die, but not
immediately); and it also would not readily happen that such a
displacement could take place forward, unless some very heavy weight
should fall upon it behind; for each of the posterior spinal processes
is so constructed, that it would sooner be broken than undergo any
great inclination forward from a force which would have to overcome
the ligaments and the articulations mutually connecting them. And
the spinal marrow would suffer, if from the displacement of a vertebra
it were to be bent even to a small extent; for the displaced
vertebra would compress the spinal marrow, if it did not break it; and
if compressed and strangled, it would induce insensibility of many
great and important parts, so that the physician need not give himself
any concern about rectifying the displacement of the vertebra,
accompanied, as it is, by many other ill consequences of a serious
nature. It is evident, then, that such a case could not be reduced
either by succussion or by any other method, unless one were to cut
open the patient, and then, having introduced the hand into one of the
great cavities, were to push outward from within, which one might do
on the dead body, but not at all on the living. Wherefore, then, do
I write all this? Because certain persons fancy that they have cured
patients in whom the vertebra had undergone complete dislocation
forward. Some, indeed, suppose that this is the easiest of all these
dislocations to be recovered from, and that such cases do not stand in
need of reduction, but get well spontaneously. Many are ignorant,
and profit by their ignorance, for they obtain credit from those about
them. These are deceived in this way, for they suppose the spinous
processes to be the vertebrae themselves, because every one of them
appears round to the touch, not knowing that these bones are processes
from the vertebrae, as formerly stated; but the vertebrae are at a
considerable distance before them; for of all animals, man, in
proportion to his bulk, has the belly (internal cavity?) the narrowest
from behind to before, especially at the breast. When, therefore,
any of these processes are severely fractured, whether one or more,
the part there appears lower than on either side, and for that
reason they are deceived, supposing that the vertebrae are displaced
inward. And the patient contribute also to deceive them; for if they
attempt to put themselves into a bent position, they are pained,
from the skin being stretched at the seat of the injury, and at the
same time the fragments of the bones wound the skin still more; but if
they bend forward, they feel easier, for the skin at the wound is thus
relaxed, and the bones are less disposed to hurt them; and if touched,
they shrink and bend forward, and the part which is touched appears
empty and soft. All the circumstances now mentioned contribute to
deceive the physician. Such patients speedily get well without any bad
effects, for callus readily forms in all such bones as are porous.

47. There are many varieties of curvature of the spine even in
persons who are in good health; for it takes place from natural
conformation and from habit, and the spine is liable to be bent from
old age, and from pains. Gibbosities (or projections backward) from
falls generally take place when one pitches on the nates, or falls
on the shoulders. In this case some one of the vertebrae must
necessarily appear higher than natural, and those on either side to
a less degree; but yet no one generally has started out of the line of
the others, but every one has yielded a little, so that a considerable
extent of them is curved. On this account the spinal marrow easily
bears such distortions, because they are of a circular shape, and
not angular. The apparatus for the reduction in this case must be
managed in the following manner: a strong and broad board, having an

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