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On The Articulations   


blackening in the leg, the bones of the leg, as far as they were
denuded, separated at its middle on the sixtieth day. But the
separation of denuded bones is quicker or slower, according to the
mode of treatment; something, too, depends upon whether the
compression be stronger or weaker, and whether the nerves, flesh,
arteries, and veins are quicker or slower in becoming blackened and in
dying; since, when the parts are not strongly compressed, the
separation is more superficial, and does not go the length of laying
the bones bare, and in some cases it is still more superficial, so
as not even to expose the nerves. For the reasons now stated, it is
impossible to define accurately the time at which each of these
cases will terminate. The treatment of such cases, however, is to be
readily undertaken, for they are more formidable to look at than to
treat; and a mild treatment is sufficient in all such cases, for
they come to a crisis of themselves; only the diet must be attended
to, so that it may be as little calculated to create fever as
possible, and the body is to be placed in the proper positions:
these are, neither raised very high up, nor inclined much downward,
but rather upward, until the separation be completed; for at that time
there is most danger of hemorrhage; on this account, wounds should not
be laid in a declining position, but the contrary. But after a
while, and when the sores have become clean, the same positions will
no longer be appropriate; but a straight position, and one inclining
downward, may be proper; and in the course of time, in some of these
cases, abscesses form, and require bandages. One may also expect
that such patients will be attacked with dysentery; for dysentery
usually supervenes in cases of mortification and of hemorrhage from
wounds; it comes on generally when the blackening and hemorrhage
have arrived at a crisis, and is profuse and intense, but does not
last many days; neither is it of a fatal nature, for such patients
do not usually lose their appetite, nor is it proper to put them on
a restricted diet.

70. Dislocation inward at the hip-joint is to be reduced in the
following manner: (it is a good, proper, and natural mode of
reduction, and has something of display in it, if any one takes
delight in such ostentatious modes of procedure). The patient is to be
suspended by the feet from a cross-beam with a strong, soft, and broad
cord; the feet are to be about four inches or less from one another;
and a broad and soft leather collar connected with the cross-beam is
to be put on above the knees; and the affected leg should be so
extended as to moved be two inches longer than the other; the head
should be about two cubits from the ground, or a little more or
less; and the arms should be stretched along the sides, and bound with
something soft; all these preparations should be made while he is
lying on his back, so that he may be suspended for as short a time
as possible. But when the patient is suspended, a person properly
instructed and not weak, having introduced his arm between his thighs,
is to place his fore-arm between the perineum and the dislocated
head of the os femoris; and then, having joined the other hand to
the one thus passed through the thighs, he is to stand by the side
of the suspended patient, and suddenly suspend and swing himself in
the air as perpendicularly as possible. This method comprises all
the conditions which are natural; for the body being suspended by
its weight, produces extension, and the person suspended from him,
along with the extension, forces the head of the thigh-bone to rise up
above the acetabulum; and at the same time he uses the bone of the
fore-arm as a lever, and forces the os femoris to slip into its old
seat. The cords should be properly prepared, and care should be
taken that the person suspended along with the patient have a
sufficiently strong hold.

71. Wherefore, as formerly stated, men's constitutions differ much
from one another as to the facility or difficulty with which

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