1000000031

67 6

caure there are rever. 1 infianees where the luxated ribs have

TC'talned

lheir

dlflocated

lI atÍons

withcut

any

hurt :

but a–

bove .11, eare m" fl he t.ken to lay on • eomprer. dipped in

warm

SI' . V ino

SI'. Vino Ca1lJph.

T hc clavicles may be diOoeated either from the tap of

thcjler

nuT1I,

procrJ/iu ncromion

thefenpu/a,

Come

externa( violence. as a {alf, blow,

the

l1fting fome greac

wcight, or lhe ilke.

Oí

LUXAT t ON

oj'lh.

HU" HU' ,

TH&

hU1IIerul,

from

the Icogth and laxity of

itl

liga.

ments. (h.e largeners of ir,

motian,

and the ChallowntCs of

the cavity in

tho:/cdPula.

ioto which

is aniculated, is

Ihereby rendered of alJ bones the moll rubje<'l to be Iuxaled.

T he head of this bone may often be dino, ated under the

arm-pit, fomctimes forwards,

fome times

backwards .. and

even below the

fpaculo;

b.t reldom perpeodleularly dowo·

wards, and nc\'er direétl y upwards unlefs (he

acromion

aod

coracoide

procelfes of the

[copula

(houJd cbance

be frac–

tu red

(he fame time : befides, as Jopg :is the firong

d~llojd~

and

hicip ilal

murcies of lhe

humeruJ

remainenti re,

théy gre. tly refin •• d keep down Ihe

hUIH<rus

from being

]uxated upwards.

' Vilen the

hllm<rus ¡s luxoluf J''1JJnwords,

(l.)

T bere

fuddenly '

ppe.rs

• e.vity, .nd upon preffi. c with the 6n·

gers you will perceive a

jinuJ;

but under (he ..

(here

mufi be a tumour. becaule the head of tbe. bone

¡,

thrull:

Ihere,

(2 .)

The

proa.l!us IlCromion

.,iJl reem tO Uiek out

further th. n uru. I, beeau fe oF tbe adj aeentjinus,

(3 .)

The

The luxated arOl will be long,er than the other, aod it can.

not be: lifted up towa.rds the head without violent pain,

an~

{ontet imes il can.not be lifted up al al! , or ev en extendeo.

B Ul when the

hum~ruJ

ÍJ

/uxat~d

flr'WllráJ

as well ""

dowo·

wards, there \ViII be obfc:rved the fame

jintU

under the

prociful acromion

as before. and a tumoa r will appeu

from tbe head of the

humerul

projeéting towards ,he brean,

under

theaxi/la :

the arm itrelf alrocaonOt be mOyea

Wilh~

out exciting the

0100

acute pain. LaUly. When

th~ hu~

1n~rUI

luxa/~d

!Jad'Wflrt/¡.

the

cubí/UJ

is thrown fo r·

ward, towards the

·pr~,ordill.

and th'e head of the bone

rn¡kes a protubera nce in the fhoulder: the um ¡tfelfcannot.

be bent nor extended. nor even ptllled oUlwuds from (he

brean, without occafioning the moH violent pains : but no

Juxation of

lh~s

limb is :1uended with fuch dancerou.

fymptoms, as when

is diClocated forwards or inwards¡ be·

cau(e the lux.loled

he.ld

of the

hlilnuUJ

canoot avoid ¡oja.

ring the lar&eartcries and nen es of (he arm ; in eoofcquenee

of which, various fymptoms will arife.

As {oon thercfore as the luxuioD is

diC~overed

io the

hIIlIlUUJ,

the Cafen way will be tO

fe~t

the palient on the

'floor, or on a low noo!. T wo firong affi(hnts are to be placed

on eaeh fide the patient : ooe of whieh (holtld feeure his bo·

dy,

.nd, if poffible, the

fel1pull1

toO, th.t i! m. y not giYe

w.y tO the extenfioo ; while the other lay. 6rm hold of the

Juxated arm .wilh bot h his h;¡ncls, a liule ¡bove tbe

cubi/uJ,

gradu.Uy

.na Oroncl,y extending it, Bot before that ex·

tenfoon be

m.de

, the fu rgeon himrelf (hould have • JorCe

napkin, of a fufficient length, tied at the ends. and hung

about his ncck {o lhat lhe knot may be behind; but the

Qther paTl of the napkin mufl h,mg over his brean: then

tbe paticnt's arm mur! be pUL through the napkin up to lhe

lItoulder, and the furceon

the

r.me

time lays hold o(the

bead of tAc

hUl/urus.

with bolh biS hands: thi. done, h.e

orders !he

affifi.nl

to extend Ibe limb ruRiciently, and in

the mean time he himfelF elevates the htad of che palienc'.

hrwurUJ

by the napkin about his neck, direéti ng it wit.h

his h.nds, tiJl

Clip ioto ilS former

C¿VIIY

iD the

fcopu/IZ .

Oí "

LUX4Tt ON

oj' Ih.

CUBtTU S ,

TH¡

cuhirUJ,

confiUi ng of two bones, (he

ul"a

and the

radiuJ,

is articulaced by

gíngljrlllUI .

The conneéeion of

thefe bones is fa ch. tbfl.t the

u/na

cubuUJ,

as bein: the

largefl:

b~ne,

and fcaud io the infenor pan of the arm,

doe. of " relf perform the whole fl ,tlion and extenfion of.

~he

arm;

y~t

it cannOI

~erf~r.m

that

morion

without carry.

log the

raJluJ

along wuh n ; fo that the

rtldiuJ

always

follow&Ibe

u/"a

in ftc:étion and exten60o: bUI, on the athcr

hand, the

radiul

may be turDed along with the hand both

inward and olltw..rd, without at 2011 moving or bending the ·

ulna

as when the pronacion and fllpi nation of che hand is

maJe thereby..

Both [hefe bODes of the

rubi/uJ

are fa 2orti.

culated. wah the lower h:ad of the

hU"l(ri~

thlt large

protuberances are receivc:d ¡mo deep cavi tres or groo"e,.

. nd the whole IOvefi<d aod fa fiened with exeeeding OroDg

ligaments

fo.that Dotwilhnandmg lhe

rubí/uJ

Rlay be lux.

ated .in aU.four diretlions, olHward, inward, forwa rd, and

hackward, yel it ¡s

b~t

Celdom thu it fuffers a perfea or

entire diClocation. unlefs the upper pan of the

u/na,

called

tI/uranon.

be broken. or tbe ligaments of'rhe

cubiluJ

much

weakened, by fome very great external vjolence.

I f !he

cubilul b, luxal.¿ bl1cl'1JJard.

whieb is the" mon

freq uent of 2011 olhers, then the arm becolllcs crooked and

Iborter, and it caonOI be extended.

the inward part of

the bend of the .rm, the he.d of the

hum<rus

may be ob·

ferved to fiick out ; in Ihe baek part of the

f.me,

tbe head

of ,he

u/na

o/~cranon

will be protuberaot. and between

botl> bones will ' ppe.r

' jinus

or cavity. Bu! it .v<ry fd,

dom happeAs Ihat the

cubilUJ

Iuxauáfor1JJllrd.

(roro the

IarCeners of the

ol"ro11on:

uoler, th.t be fratl ured at the

fame time. B ut if thi. (hould h.ppeo, the he.d

i>f

the

hu,

1JurJu

will flick out behind, aod that of tbe

cuhi/UJ

before ;

anM here will be a cavity more or lefs io proportion

the·

degree of the luxation. Wheo

the .cubi/uJ

luxa/ed

~x·

l~r"4/1y.

the protuberance appears on the out6de of the

cu/Ji/uJ;

and che coDtrary when lux:ued inwards. T o con–

clude, unleCs the ligaments and mufcles of che

,ubi/uJ

are

quite broken in two.

is fo far from being capable of fuf–

fering a perfeét diClocaüoo, that no more can happeo to

¡.

Ihan a fubluxation,

i. ~.

it can bUI recede but a very liule

way out of its right place : but wb>tever of this kind hlP'

pens, the care m. y be very e.fily underOood,

feeJing

and infpc:l'ting the part. if there be no tumor; bOl jf che

joint be much fwelled, it

very ddIicult tO be dif¡;o\'Cred.

Be the luxatioD, however, more or lefs, the pa.tieru mull:

be rpeedily pl.eed iD •

eh.ir

; and both p.rts of the Itmb,

the

humeruJ

and the

rubi/uJ,

mua be extended in opp ...fi te

diretlions by two nOU! affill,nts, tiJl the mufcles are found

preny fight, with a free fpace betweeD the bones : ,he" ,he

luxated bODe mun be replaced with che furgeon's bare hands,

or together with bandages

and that the proceffls may

'otU

ioto thc:ir

filt:J(a .

{he

cu!Ji/uJ

muO: be af,c:rw:¡rds fudJcnly

bent. But if the tendons 311d I:g.t01ents are fo

vlol~ndy

nrained, thu they can fcaree pedorm cheir utn..:e; it wdJ

noc be impropt'r tO anoint them wcll

h em ,Ihent uds,

ointments; or t1,e

fa.l

anim.ds

, or tO apply ClDlJlhcnl fu·

lI\entations and cata.1arms,