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On The Articulations   


done, some person is to grasp the arm at the wrist, and another is
to take hold of the finger which is wrapped in the fillet, and then
each is to make considerable extension toward himself, and at the same
time the projecting bone is to be pushed into its place. But, if the
dislocation be lateral, the same mode of reduction is to be used;
but when you think that the extremity of the bone has cleared the rim,
at the same time that extension is made, the bone is to be pushed
direct into its place, while another person on the other side of the
finger is to take care and make counter-pressure, so that it may not
again slip out there. The twisted nooses formed from palm-shoots are
convenient for effecting reduction, if you will make extension and
counter-extension by holding the twisted string in the one hand and
the wrist in the other. When reduced, you must bind the part as
quickly as possible with bandages; these are to be very slender and
waxed with cerate, neither very soft nor very hard, but of middle
consistence; for that which is hard drops off from the finger, while
that which is soft and liquid is melted and lost by the increased heat
of the finger. The bandage is to be loosed on the third or fourth day;
but on the whole, if inflamed, it is to be the more frequently loosed,
and if otherwise, more rarely; this I say respecting all the joints.
The articulation of a finger is restored in fourteen days. The
treatment of the fingers and of the toes is the same.

81. After all reductions of joints the patient should be confined to
a restricted diet and abstinence until the seventh day; and if there
be inflammation, the bandages are to be the more frequently loosed,
but otherwise, less frequently, and the pained joint is to be kept
constantly in a state of rest, and is to be laid in the most
convenient position possible.

82. Accidents at the knee are more mild than at the elbow, from
its being compact, regular, and elegant in its construction; and,
therefore, it is more readily dislocated and reduced. It is most
frequently dislocated inward, but also outward and backward. The modes
of reduction are these: by flexion at the knee, or by sudden
calcitration, or having rolled a swathe into a ball, and fixed it in
the ham, the patient's body is to be suddenly dropped on its bended
knees. Dislocation backward, also, as in the case of the elbow, may be
reduced by moderate extension, and to either side, either by flexion
or calcitration, but also by moderate extension. The adjustment is the
same in all cases. In dislocations backward which are not reduced, the
patient cannot bend the joint, but neither can he, to any great
extent, in the other varieties; the thigh and leg are wasted in front;
but if inward the patients become bow-legged, and the external parts
are wasted; but if outward they become more bandy-legged, but the
impediment is less, for the body is supported on the larger of the
bones, and the inner parts are wasted. When these accidents happen
at birth or during adolescence, they follow the rule formerly stated.

83. Dislocations at the ankle-joints require strong extension,
either with the hands or some such means; and adjustment, which at the
same time effects both purposes, as is common in all cases.

84. Injuries of the foot are to be remedied like those of the hand.

85. The bones connected with the leg, and which are dislocated,
either at birth or during adolescence, follow the same course as those
in the hand.

86. When persons jumping from a height pitch on the heel, so as to
occasion separation (diastasis) of the bones, ecchymosis of the veins,
and contusion of the nerves; when these symptoms are very violent
there is danger of sphacelus, and that the case may give trouble
during life, for the bones are so constructed as to slip from one

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