1000000031

perrorm. ,he extenGon .nd reduélion betwecn his hands.

will

be proper, in order to prevent a tumor, and re–

flo re: lhe flrelchcd

ligaments

of the neck to thcir formcr vi–

CDUT, l O

bathc

wlth

&'1 '

l l une

ar.Jp

VIn . cOlllph.

or fome

o¡hcr ll rcnglhtnior.

fpin e

appllcd warm,

.¡,J ro

comprcCfcs

dipF,d i" ,he fallle : ,he

i', lI<nt

fhould bleed, 3nd rd!

&ently (Ol" ' fome day., ..U the ncek be (ound fullicieotly

~trong

aod well.

\ Vlth " rpeél 'o the ren o( the

w rl,br.<

o( ,he bock, they

are fc.ldom moved quite

OUt

of lheír pl"ces, unlcfs

thcyl

arc~

fra{turcd ,

th~y

being' r('taiced. for lhe

crcatdl

parl,

-adherin,!!

.tO

lhe adjaccDt

ligamcms

and

Dlufclcs:

thereJoTe

l he IUlCii.tions which happcn among thcm are ufually impcr.

fcét;

more bcing difpJaced t,han lheir

tWO

upper or

low~r

procelfc::s, i1nd they often but on ene fide ; and this happcDs

fomctimes to one

lhe

fpinal

vU ld rtC,

and fometimes to

more:. But it is

h~re

tO be: britBy obfen cd , lhal it is ufual

to iDelude amaDg the number of luxated

verlebrte,

that

which is fou nd and firmo but iAterCepted by others which

are DOt fa : thus

wheD~vc:r

the ·uppe:r

verlej,~

of the loins

from the lan o( the back, and lowermoll

verl,br~

o( the

loia, nc:xt the

f acrum,

are luxated,

cOOlmonly (ay and

reckon there are fi ye

vtrtebrte

Out of their places ; when,

Jlritlly fpe.king. ooly the tWO outermon or Ihe.uppermon

u d

lowermofl of thofe

vulebr,e

are dinurbed , ,be ,hree

middle ones relaining their Datural fitu:uion and cooneétioD.

The figns common lo luxa,ion. io the

[pina

d.r¡;

are

chieOy the (oUowing : ,he back i,fel ( is (ound to be crook,d

or uoequaf, :.fter lhe external "iolence bas beco iDHitled ;

.he paticot can nei,her nand oor walk, and hi. whole body

(eems

be paratytie ; the par" whicb are beoeath the lux–

atc:d

vtrltbree

are nearly without

all

fenfe and

mOlion

;

lhe

excrcmeDl$ aDd urine canDOI be difcharged, or

elfe

they are

rometimes emiued involuDlarily; the lowereXlremilies grow

d ead by degrees

and, a' length, death itfelf foll ows : but

. hefe fymptoms vary ,io proportio!> to the degree o( violeoce

lhe Juxation.

LuxatioDs of thé (pinal

verJehree

are "ery difficult to re·

duce. T he followiog feems to be the mon fuitable melhod

o( reduciog luxatioos o( Ihe

vu ltbr«:

when the

apophyft,

of lhe

verlehr"

are diflocated on hOlh Cides, the patlent is

to be laid Ie:aning upon his belly OTer

c:a{k, drum, or fome

o ,her gibbous body ; then , wo allinants zrc nrongly to pref,

d own both Ihe end, o( ,he luxated fpi ne, on each fide ; by

which mean, Ihe booes o( the fpine \ViII ·be f« (ree (rom

e:ach other, hfttd or po(hcd up in the (orm of an arch, and

(o graduaUy e"teoded . T his done, the (urgeon precres dowo

the Jux¡ted

'tI.trlebr~,

and

the: fame lime nimbly pu(hes

,he fu perior part of the body·upward. : and by , hit mean.

the luxated

'vulehrte

are rometimes commodiou{ly reduced

into thtir rigbt ,places ;

but,

ir fuccef, nlould nOI . uend

the

fir l1

tiOle, ,he

melhod

(bould be repealt:d

uvo

or lhree

times

more.

Ceems proper', after the

Vtrl(úr~

are re:duce:d, to hathe

. he fpine wi,h

(p.

vino

or to

lay

on compr<cres dipped iD

¡ p.

vino

ca1nph.

Afterw~HIs, the

patient is tObe líil:id iD a

foft and even bed; bleed1Dg. and balhinc the we<.lk parts

with flrcnglhening Cpírits, are to be ufcd as lhere.m:ay be

occafioD,

Of L uXAT'ONS

o/ Ih,

O s Co ccvx , and R ,n s.

T u

01 COCC) X

fD.ly

be Ihrutl ínwu d!"

hy ¡ violent

(:tll

blaw. and it is o(,en pun,od aU;'lIards in hanl "ir'.h. \ Vhoo

VO L. III .

1'0

97.

~his

happc.ns,

it is ufually attended

Wilh

violent pain

~nd

mfh m01atlon about lhe 10"'l:r part o( the fpine,

abrcell~,

furm in lhe

in1dlintl1.'/

rrflum,

and lhe

¡;zar

~re

confbpa.

ted or rupprdrcd.

~ro

difcover the luxation of this bone

lhe

more readlly, we ha\'L recourfe to

lhe

Hrc:

of our

lu.n~ls

and

eyes, ilS well as

lhe koowledge of tlle

furl!mcndon.:~

fymptonts: nor

the replacing this bone very difncuh,

anempted by a careful and expert furgc:on; for

thruíl: outwards, it mun be deprelfed ¡;uo

its

right place by

the thumb, a(ter "'hich may be . ppliod coclprdf:s diF?';¡

in warm

winc,

in fpi nt, ntade

broad

~bove,

and narro\',

below, lO

611

up the poHccior

jinlll

01'

lhe!

r..'JI~I;

anel

thef!!

may be hdd ou by the T band3ge ; but 1:' 3t par! o( ,hi s

b.ndage which comes betw« n tbe thighs fhoulJ be O" , 3nd

placed fo tbat the palient nuy go

11001

"'it!lOll t undo:ng

the baodagc, and

prevent the bODe from

bc:ing

lhat

mean. difplaced agaio.

Whcn the

cocc)x

happeDS la be

lux~t~d

inwards, the

6ríl: finger is

be iouoduced iDto the

anul.

After it has

had its nail cut and becn dipped

oil,

muO be thr_uO as

fu as poOible, lhat it may lhe more rcadlIy Jrive

OUt

the

deprecred bone; the other finge " being applied extern,lIy,

are to eoodua the bODe into iu . right poflu re : when Ihis

h¡s been done, it will be proper for the ponien, lo ren fome

tim.! upon the bed ; and when he

{iu

up,

Ihould

be:

in a

chair with a hole io its bottom, leU ,he a[ <éleu par! fh oulll

be olher" if< comprecr,d or d,Uurbed .

The rib, are iodeed fometimes, tnough bu', fd doon, dif·

Jocated

for upon the arraal, of fome external violence, it

nOl UDcommoo for lhe:m

difplaced

eith~

upwards,

dowo\4'ards, inwards, or oUlwards. T hey canDoI be eafil y

Juxated outwards, bccaufe pre:TeDted by the venebral pro·

cecr..: .and refi ned by .ery , bick and rtrol1g murcies: bUI

when lhty are dro.,e into the ca.,¡ty of lhe

Ihorax,

they

DO~

ooly lacerate

the

p!tura,

but do g:nenlly grear injury

the contaioed puts ;

cODfequence whereof "rife nlOn (hup

pains, ínlhmmations, difficulty of

br~athing,

cough , ulcers,

irnmobility, aod many other daogerou. f)'mp,oms o( the like

aature.

Whco the rib is ditlocated either upwards ordownwards,

in order to

replace

it conveniendy, the patient is to be laid

on his belly upon a'table,

and

the (urseon

mua

firive tOre.·

duce the luxated r}b ioro íts righl place with bis hands : or,

the aron o( Ihe diford<red fide' may be fu(peoded over a g>te

or ladder, and while the ribs

are:

thUJ:lr<.'lehed

from C.lch

olher, the heads of fuch

are luxatt'd

rna)'

he purllcd

iota

their former real.

But thore Juxu ions wherein lhe hClds of the

rib$

;\re

{oreed ioto lhe

Ihorox,

are ce:nerally round

be much

the

moO diflicult lOreduce ; finee neithet lhe hand.

nar

any

o·

ther

inftru mcnt,

can be

appliccl internally

eli re8 the )\Jxa·

ted heads of lhe ri bs: in tbis

caCe:

it Cccms

~rcp.r

lay

the pl lient on his belIy ova fOOle

gi~b(Jus

cylindric

bod}',

and to

Olove

the (ore pan of the ri b inwdrds to......rJs the

back, f'haking it fome:times ; for thus gcnerally the he:ld of

lhe luxaterl ribs ni ps ioto

ilS

fcrmer pbce:

bUl

if this

mI!·

th od

cure w.l l

.Iv,¡il

nothing, anu

the

dlp:orahll! cont..!: tlcn

of (he puient requircs CpC!ccly

hel l"

\VC

h~ve

no rcmed y

left

bUl

íncdi..:>n, anJ

end~av·ourinJ:

to rep!.tc!

th~

lux.lIcd

head orthe ri b with dlc fi ngcrs, plye rs, or litde hooks.

the mean time. where the

rrml):o:lIs

are not

vcry

llr¡:ent,

a:1d

the

hca~,

the

ribs bUl liu le

dijpl:tccd,

is atl yiíc.!ble

n~i~her

lOcut the! flcnl, nor

vjoh~ntly

fOlce the ribs ;

L..:-

8 H

'1'

«efe