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On The Articulations   


feet. This mode of reduction is particularly appropriate to this
variety of dislocation, and at the same time is very strong. But
perhaps, instead of the board, it might be sufficient to have a person
sitting (on the seat of luxation ?), or pressing with his hands, or
with his foot, and suddenly raising himself up, along with the
extension. None of the other aforementioned modes of reduction are
natural in this form of dislocation.

76. In dislocation forward, the same mode of extension should be
made; but a person who has very strong hands, and is well trained,
should place the palm of the one hand on the groin, and taking hold of
this hand with the other, is at the same time to push the dislocated
part downward, and at the same time to the fore part of the knee. This
method of reduction is most especially conformable to this mode of
dislocation. And the mode of suspension is also not far removed from
being natural, but the person suspended should be well trained, so
that his arm may not act as a lever upon the joint, but that the force
of the suspension may act about the middle of the perineum, and at the
os sacrum.

77. Reduction by the bladder is also celebrated in dislocations at
this joint, and I have seen certain persons who, from ignorance,
attempted to reduce both dislocations outward and backward
therewith, not knowing that they were rather displacing than replacing
the parts; it is clear, however, that he who first invented this
method intended it for dislocation inward. It is proper, then, to know
how the bladder should be used, if it is to be used, and it should
be understood that many other methods are more powerful than it. The
bladder should be placed between the thighs uninflated, so that it may
be carried as far up the perineum as possible, and the thighs
beginning at the patella are to be bound together with a swathe, as
far up as the middle of the thigh, and then a brass pipe is to be
introduced into one of the loose feet of the bladder, and air forced
into it, the patient is to lie on his side with the injured limb
uppermost. This, then, is the preparation; some, however, do the thing
worse than as I have described, for they do not bind the thighs
together to any extent, but only at the knees, neither do they make
extension, whereas extension should be made, and yet some people by
having the good fortune to meet with a favorable case, have
succeeded in making reduction. But it is not a convenient method of
applying force, for the bladder, when inflated, does not present its
most prominent part to the articular extremity of the femur, which
is the place that ought to be more especially pressed outward, but its
middle, which probably corresponds with the middle of the thigh, or
still lower down, for the thighs are naturally curved, being fleshy,
and in contact above, and becoming smaller downward, so that the
natural configuration of the parts forces the bladder from the most
proper place. And if a small bladder be introduced, its power will
be small, and unable to overcome the resistance of the articular bone.
But if the bladder must be used, the thighs are to be bound together
to a considerable extent, and the bladder is to be inflated along with
the extension of the body, and in this method of reduction both legs
are to be bound together at their extremity.

78. The prime object of the physician in the whole art of medicine
should be to cure that which is diseased; and if this can be
accomplished in various ways, the least troublesome should be
selected; for this is more becoming a good man, and one well skilled
in the art, who does not covet popular coin of base alloy. With regard
to the subject now on hand, the following are domestic means of making
extension of the body, so that it is easy to choose from among the
things at hand:-In the first place, when soft and supple thongs are
not at hand for ligatures, either iron chains, or cords, or cables
of ships, are to be wrapped round with scarfs or pieces of woolen

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