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On The Articulations   


rags, especially at the parts of them which are to be applied, and
in this state they are to be used as bands. In the second place, the
patient is to be comfortably laid on the strongest and largest couch
that is at hand, and the feet of the couch, either those at the
(patient's?) head, or those at the feet, are to be fastened to the
threshold, either within or without, as is most suitable; and a square
piece of wood is to be laid across, and extending from the one foot to
the other; and if this piece of wood be slender, it should be bound to
the feet of the couch, but, not withstanding, if it be thick, there
will be no necessity for this; then the heads of the ligatures, both
of those at the head and those at the feet, are to be fastened to a
pestle, or some such piece of wood, difficult to reduce at either end;
the ligatures should run along the line of the body, or be a little
elevated above it, and it should be stretched proportionally to the
pestles, so that, standing erect, the one may be fastened to the
threshold, and the other to the transverse piece of wood. Extension is
then to be made by bending back the ends of the pestles. A ladder,
having strong steps, if laid below the bed, will serve the purpose
of the threshold and the piece of wood laid along (the foot of the
couch?), as the pestles can be fastened to the steps at either end,
and when drawn back they thus make extension of the ligatures.
Dislocation, inward or forward, may be reduced in the following
manner: a ladder is to be fastened in the ground, and the man is to be
seated upon it, and then the sound leg is to be gently stretched along
and bound to it, wherever it is found convenient; and water is to be
poured into an earthen vessel, or stones put into a hamper and slung
from the injured leg, so as to effect the reduction. Another mode of
reduction: a cross-beam is to be fastened between two pillars of
moderate height; and at one part of the cross-beam there should be a
protuberance proportionate to the size of the nates; and having
bound a coverlet round the patient's breast, he is to be seated on the
protuberant part of the cross-beam, and afterward the breast is to
be fastened to the pillar by some broad ligature; then some one is
to hold the sound leg so that he may not fall off, and from the
injured limb is to be suspended some convenient weight, as formerly
described.

79. It should be particularly known that the union of all bones
is, for the most part, by a head and socket (cotyle); in some of these
the place (socket?) is cotyloid and oblong, and in some the socket
is glenoid (shallow?). In all dislocations reduction is to be
effected, if possible, immediately, while still warm, but otherwise,
as quickly as it can be done; for reduction will be a much easier
and quicker process to the operator, and a much less painful one to
the patient, if effected before swelling comes on. But all the
joints when about to be reduced should be first softened, and gently
moved about; for, thus they are more easily reduced. And, in all cases
of reduction at joints, the patient must be put on a spare diet, but
more especially in the case of the greatest joints, and those most
difficult to reduce, and less so in those which are very small and
easily reduced.

80. If any joint of the fingers is dislocated, whether the first,
second, or the third, the same method of reduction is to be applied,
but the largest joints are the most difficult to reduce. There are
four modes of displacement-either upward, downward, or to either side;
most commonly upward, and most rarely laterally, and in consequence of
violent motion. On both sides of its articular cavity there is a
sort of raised border. When the dislocation is upward or downward,
owing to the articular cavity having smoother edges there than at
the sides, if the joint of it be dislocated, it is more easily
reduced. This is the mode of reduction:-The end of the finger is to be
wrapped round with a fillet, or something such, that, when you lay
hold of it and make extension, it will not slip; and when this is

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