On The Articulations
another, and the nerves communicate together. And, indeed, in cases of
fracture, either from an injury in the leg or thigh, or in paralysis
of the nerves (tendons?) connected with these parts, or from neglect
during confinement to bed, when the heel gets blackened the most
serious consequences result therefrom. Sometimes, in addition to the
sphacelus, there come on acute fevers accompanied with hiccup,
aberration of intellect, and speedy death, with lividities of the
large blood-vessels. With regard to the symptoms attending
exacerbations, if the ecchymosed and blackened parts and those
around be somewhat hard and red, and if along with the hardness
there be lividity, mortification is to be apprehended; but if the
parts be slightly livid, or even very livid, and the swelling
diffused, or if greenish and soft, these appearances, in such cases,
are all favorable. The treatment, if no fever be present, consists
in the administration of hellebore, but otherwise (it is not to be
given, but oxyglyky (decoction of honeycombs and vinegar) is to be
given for drink, if required. Bandaging as in the other articulations:
above all, more especially in contusions, the bandages should be
numerous and softer than usual, but the compression should be less;
most turns should be made around the heel. Position, like the
bandaging, should be so regulated as not to determine to the heel.
Splints are not to be used.
87. When the foot is dislocated, either alone or along with its
epiphysis, the displacement is, for the most part, to the inside. If
not reduced, in the course of time, the hip, the thigh, and the side
of the leg opposite the dislocation, become atrophied. Reduction is
the same as in the wrist, but the extension requires to be very
powerful. Treatment, agreeably to the general rule for joints.
Exacerbations do occur, but less frequently than in dislocations at
the wrist, provided the parts get rest. While they remain at rest
the diet should be restricted. Those which occur at birth, or during
adolescence, follow the rule formerly stated.