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b' T he figure of ,he Caw uCed io amput3tiog ,he limb•.
T he hng'h of ,he handl. and fa,v OlOuld be aboul Ceven,eeo
-inches.
o r L U X A T ION S.
ABoNE is Ca;d ' o ue luxated or diOoea,ed, wheo i, j.
moved out of irs place or articulation, fa as to impedc iu
prop:!r mo~ion and alnce.
LUXAT' ON · if Ihe No...
1T Cometimes happeos. ,ha, ,he bones of ,he note
..are Ceparated from each otherJ or dirtoned out of lheir na~
,ural plaees, by Come violeo, blow or foil. •When Cueh an
accident happens, it is fevcral Wttys difcovered: as, ( l .)
lly ,he fi~hr, when we behold ,he dcformed poli,ion of rhe
naCe; or, (2.) Byfeeling; or lallly, (3.) By ,he ear, whm
perceive wi,h what drl!ieulty ,he pa,ien, draIVs his brealh
.Ihrough his noll,-ils.
When ,his happen., ,he patien' is 'o be Cpeedily
plaeed in a high ehair, ,ha, on alliltan, may lland 'behtnd
2nd hold his head firm, in a proper poflure : Ihe {urgeon is
(hen to introduce wilh ene. hand, a thick plobe, a goofe–
quill, or li,de llick fl13ped for ,he p. 'poCe, up ,he nollril
io<ernally, by whieh mean, ,he deprelfed pa", of rhe noCe
may be ,hrull iry'o ,heir place,: in ,he mean ,ime he applies
h is other h:lnd externally, to guide and direé[ the pans
which are moved from wilhin: this being done, there ji
fearee any ,h ing e1Ce required bu, 'o let a bi, 01 llickiog
,pl.ill<r lie upon ,he noCe a' ,he fame ,in,..
Oja Dr SLOCA Tl ON Dj lhe L ow.. l AW.
T HE lower jaw is indeed fcldom lux:ued, becaufc iI is
held Co firln by Ilrong ligaruent9 aod muCcles, by wlloCe
affirl.mcc iI is retaincd in t\Vo Gnufes in the b:t(is of the era·
nillm: but when it js by accident foreed OUt {rom thence,
it may chance 10 be 00 ane fide ooly, or el(e 00 botb, it
being ,hen ,brull direélly forwards : aod ,hi, happeo, 1'0011
frequently from openiDg the mouth 100 wide in yawoing;
¡hough it has (ometimes b.een occafioned by a violenl blow
or fall. Ir i, be luxa,ed 00 bo,h fides, ,he ehi Dwill inclioe
dowoward, and che jJW will be tbrull very forward: bu t
jf ollly on ane Gde, [he chin \ViII be iocJ;ned toward lhe
oppofire fide: ,he eJapCed liule head of ,he jaw DO' being
capahle of diOocation hU I foreward and inward; ror che
procdTes of the hones of lhe cranium preveDt the jaw (rom
bei_Po d.Ooeared baekward•.
Tho lower j.w i. ohieAy known 10 be luxated on ooe fide,
,vhen ,he chiD is dillorted 00 ,he oppofite fide: for rhat p"t
to which the chin inclines, is the found; but that from
'\vheoce it recedts, is the luxi\ted one: tite mouth in this
cafc gapes wider than ufual, fo that the patient cannot {hUl
ir, nor cat with his teatl, ; (he Jowtr range of teeth being
projeéled beyood, aod on one fide ,he upper: bu, \Vhen ,he
jaw is l:.5xated on both fiJes, then the momh not only gapes
wlde :iilod open, but Ihe chin alfo hang~ do'Vo, :iilnd is throWD
direétly for\\'ards ; (o that Ihe p.\liel1t canllOI {hUt his moulh,
{peak dillinélly, or even Cwallow any ,hiog wi,hou, mueh
tliftieulty .
\ '1hen ,he jaw is ou , nnly on ooe_fide, .nd ,he caCe re–
.cenl. Ihe cure is ufually not fo ver y ddlicult; but when
borh heods are diOoe",d, and 00' prefenrly refiorcJ to ,heir
}.Iaces, i, ah':.,s oecalioos the worn of CyOlp'OOlS. as pains,
E R Y.
inBammations, convulGoos, fevtrs, vomilings, 2nd at lengtb
dtath i,C<lf.
Whtn this kind of luxatioDhappens, the patitnt is [O be
direélly feated 00 a low Uool, lo ,ha, ao al6Uan, may hold
hi. hcad firm baek agator! hlS Then ,he Curgeoo i.
to thruH his t\Yo thunlbs as b:ack into lhe p.uient's mouth
as he well can ; but thty are lidt \1, rappc:d round in a hand–
kcrchief. to prevenl th(m from n,pping Or b'l'l ng hurt; and
his odH::r Gng(rs are to be ...pplteo to lhe jaw t:xternally:
when he,has ti0t hrm ho!d of thl! jdW, it is tO be Hrongly
prelfed, firU downw"ds, ,hen b.ckw"d., aod lalUy up'
wards, bUl lo as that lhey m:ly be all done in one inflant :
by which me.n, ,he eI. pfed he.d, of ,he jaw may be ycry
earily fhoved lOtO lheir former cavi ties.
Ir ,he jaw be our 00 one lide only, every ,hing mull be
done in the [aate manner: but the luxated fide of the ja-"
murt be foreed more rtrongly downward and b&ckward ,haD
lhe [aund one.
Oj LUXATIONS if Ihe HEAD Itnd SP INE.
THE lux~rio". which happen ir> ,hej'pine and
of ,he baek are geoerally imperfet\ OOts . For i, 'ppear.
from In accu rate confideration ofthe flruéttne Ind articula–
tion of lhefe' banes, that none of the verldrte can be entire·
Iy diCplactd wi,holl' beong fraélllred, and alCo eomprdJiDl:
or \Vounding the IpinaJ marrow, which muaproduce daDgtr
of inllan~ dea,h. Eveo ,he impcrleél luxatioos of ,hefe
bones are very dJngerous : which happen either between
the IWO [uperior verlebr4 of tbe neck aod the head, or elfe
between the ren of {he vtrltÓrlC, wheD they are torced frona
ea€h otber.
Sueh as haYe a lu"atioD betw«n ,he head aDd upper tltr–
I.bra, feldom eCeape bein~ carried off by a Ipecdy aod Cod–
den death : for jn l.hís cale che under medul/Il which joins
irnmedialely wnh the braio, and is lodged iDthe [pine, the
brdin ¡,[elE, and (he neTves whlch arife bCD~ath the occ¡put,
are too much di!tended. comprdI'cd, or lacerated ; tbe t"O
eonqyloide proeelfcs of ,lre ocápul ~rually ntp ou, of ,heir
glenoide finu$" in the (idl vaJ~br¡r of the necic, whl"n a
perCoo fall. I¡e.dlong from a high pl..e, Irom off a ladder,
Iro01 on horfeback, or whtn he recun!l ¡ violent bJow up·
on his neck: thry dyinS nry fuddenly in this cafe, are
vulguly faid to hdV( órel( tbtir lila. th(\ugh th~re is ge–
nerally DO more than a Iux¡ttion: )c::t il fOnletiml's happeos
,ha, ,he " of ,he ocrk are really rraélured. Ir Jife
Ihould renlain fuch a Ju x1uion, which very rartly hap–
pe' s, the patient's he¡¡¡d is comrnonJy ddlorted wilh his chin
cloCe dowo 'o his brcoU , lo ,h", he ran nei,h" fwallow aoy
thing, Dor fpea l,;" nor eHn move any part Ih~t is bduw his
oeck: ,herefore, iC fpccdy allillaoee be no' had, dearh en–
fues. flom the compldTure or hun of the 1IIrdulla.
Hut to repulre th:5 unwelcome rndfenger, ,he patient is
to be Immcd,ately laid fldt upon lhe wound or floor: lhcn
the furgton knec:lir'lg dOW8 witb his knecs againlt the pad .
enes Ihoulders, is 10 bring tht'rn togcther fa as to
the patitnt's nl"ck lJetwccn theOl:. Ihis dor.e. he qu
lays holJ of rhe patiel1r ', hcad wirh bo,h ~)i, hand" and
firongly pulling ór exten"ing it, ht' gently moves il from
on~ lide tO Ihe ocher; uH he tinds, ?y a noife, the n;uural
pollure of tht' ned.) and thl! renllílion of the fymptams,
,h" ,he dillocarioo is properly reduced: by rhi, rncrbod
the furgeon retains lhe palient firm betwcen his~nc(5t "nd
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