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On The Articulations   


dislocations are reduced; and the cause of this was also stated
formerly in treating of the shoulder. In some the thigh is reduced
with no preparation, with slight extension, directed by the hands, and
with slight movement; and in some the reduction is effected by bending
the limb at the joint, and making rotation. But much more frequently
it does not yield to any ordinary apparatus, and therefore one
should be acquainted with the most powerful means which can be applied
in each case, and use whatever maybe judged most proper under all
circumstances. The modes of extension have been described in the
former parts of the work, so that one may make use of whatever may
happen to be at hand. For, extension and counter-extension are to be
made in the direction of the limb and the body; and if this be
properly effected, the head of the thigh-bone will be raised above its
ancient seat; and if thus raised, it will not be easy to prevent it
from settling in its place, so that any ordinary impulse with the
lever and adjustment will be quite sufficient; but some apply
insufficient extension, and hence the reduction gives much trouble.
The bands then should be fastened, not only at the foot, but also
above the knee, so that the force of the extension may not be expended
on the knee-joint more than upon the hip-joint. The extension in the
direction of the foot is to be thus contrived. But the
counter-extension is not only to be managed by means of something
carried round the chest and armpits, but also by a long, double,
strong, and supple thong applied to the perineum, and carried behind
along the spine, and in front along the collar-bone and fixed to the
point from which counter-extension is made; and then force is to be so
applied, by means of this extension and counter-extension, that the
thong at the perineum may not pass over the head of the thigh-bone,
but between it and the perineum; and during the extension one should
strike the head of the femur with the fist, so as to drive it outward.
And when the patient is raised up by the stretching, you should pass a
hand through (between the legs?) and grasp it with the other hand,
so as at the same time to make extension, and force the dislocated
limb outward; while some other person sitting by the knee quietly
directs it inward.

72. It has been formerly stated by us that it will be of
importance for any person who practices medicine in a populous city to
get prepared a quadrangular board, about six cubits or a little more
in length, and about two cubits in breadth; a fathom will be
sufficient thickness for it; and then along it from the one end to the
other, an excavation must be made, so that the working of the levers
may not be higher than is proper; then at both sides we are to raise
short, strong, and strongly-fixed posts, having axles; and in the
middle of the bench five or six long grooves are to be scooped out
about four inches distant from one another, three inches will be a
sufficient breadth for them, and the depth in like manner; and
although the number of grooves I have mentioned will be sufficient,
there is nothing to prevent their being made all over the bench. And
the bench should have in its middle a pretty deep hole, of a square
shape, and of about three inches in size; and into this hole, when
judged necessary, is to be adjusted a corresponding piece of wood,
rounded above, which, at the proper time, is to be adjusted between
the perineum and the head of the thigh-bone. This upright piece of
wood prevents the body from yielding to the force dragging downward by
the feet; for sometimes this piece of wood serves the purpose of
counter-extension upward; and sometimes, too, when extension and
counter-extension are made, this piece of wood, if susceptible of some
motion to this side or that, will serve the purpose of a lever for
pushing the head of the thigh-bone outward. It is on this account that
several grooves are scooped out on the bench, so that this piece of
wood, being erected at the one which answers, may act as a lever,
either on the sides of the articular heads of bones, or may make
pressure direct on the heads along with the extension, according as it

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