第 5 节
作者:
莫再讲 更新:2021-05-14 22:31 字数:9322
learned by sight rather than by words; namely; food; drink; heat;
cold; attitude; medicines; dry; liquid; red; dark; white; sour; for
the ulcers; and so with regard to the diet。
Part 37
Displacements (of the vertebrae) from a fall rarely admit of
being rectified; and those above the diaphragm are most difficult to
rectify。 When the accident happens to children; the body does not
grow; with the exception of the legs; the arms; and head。
Excurvation;
in adults; speedily relieves the individual from the disease he is
laboring under; but in time it renews its attack; with the same
symptoms as in children; but of a less serious nature。 Some
individuals have borne this affection well; and have turned out to
be brawny and fat。 But few of them have lived to the age of sixty。
Lateral curvatures also occur; the proximate cause of which is the
attitudes in which these persons lie。 These cases have their
prognostics accordingly。
Part 38
The rule for the reduction and adjustment:…The axle; the
lever; the wedge; pressure above; the axle to separate; the lever to
push aside。 Reduction and adjustment are to be accomplished by
forcible extension; the parts being placed in such a position as
will facilitate the conveying of the displaced bone over the
extremity
of the bone from which it was displaced: this is to be accomplished
either with the hands; or by suspension; or axles; or turned round
something。 With the hands this is to be effected properly; according
to the structure of the parts。 In the case of the wrist and
elbow; the
parts are to be forced asunder; at the wrist in the line of
the elbow;
and the elbow with the fore…arm at a right angle with the
arm; as when
it is suspended in a sling。 When we want to separate the protruding
bones; and force them into place; in the case of the fingers; the
toes; or the wrist; the proper separation may be made by hands;
while the projecting part is forced into its place by pressing down
with the heel or the palm of the hand upon some resisting object;
while something moderately soft is laid under the projecting
part; but
nothing such under the other; and then pressure is to be
made backward
and downward; whether the dislocation be inward or outward。
In lateral
displacement; pressure and counter…pressure must be made on the
opposite sides。 Displacements forward can be reduced neither by
sneezing; nor coughing; nor by the injection of air; nor by the
cupping…instrument; and if anything can do good in such a case; it
is extension。 People are deceived in fractures of the spinal
processes; the pain of which causing the patient to stoop
forward; the
case is taken for dislocation inward; these fractures heal speedily
and easily。 Dislocation outward is to be remedied by succussion;
when high up; toward the feet; and when situated low down; in the
contrary direction; the part is to be pressed back into its place;
either with the foot or a board。 Dislocations to either side; if
they admit of any remedy; are to be treated by extension;
and suitable
attitudes; with regimen。 The whole apparatus should be broad; soft;
and strong; or otherwise; they should be wrapped in rags;
before being
used; they should all be prepared proportionately to the length;
height; and breadth。 In applying extension to the thigh; for
example; the bands should be fastened at the ankle and above
the knee;
these stretching in the same direction; another band to be passed by
the loins; and around the armpits; and by the perineum and thigh;
one end passing up the breast and the other along the back; these
all stretching in the same direction and being fastened either to a
piece of wood resembling a pestle or to an axle。 When this is done
on a couch; either of its feet is to be fastened to the
threshold; and
a strong block of wood is to be laid across the other; and the
pieces of wood resembling a pestle are to be raised on these; to
make extension and counter…extension; the naves of a wheel are to be
fastened in the floor; or a ladder is to be adjusted; so that
extension may be made in both directions。 The thing commonly
used is a
bench six cubits long; two cubits broad; one fathom in thickness;
having two low axles at this end and that; and having at its middle
two moderate sized pillars; to which is to be adjusted a transverse
piece of wood like the step of a ladder; which is to receive
the piece
of wood tied below the limb; as is done in dislocation at the
shoulder; and the bench is to have excavations like trays; smooth;
four inches in breadth and depth; and at such an interval as to
leave room for the lever used to reduce the limb。 In the
middle of the
bench a square hole is to be scooped out to receive a small pillar;
which; being adjusted to the perineum; will obviate the tendency of
the body to slip downward; and being rather loose may act somewhat
as a lever。 In certain occasions a piece of wood is
required; which is
inserted into a hole scooped out of the wall; the other end of it is
then to be pressed down; something moderately soft being placed
under it。
Part 39
In those cases where the bone of the palate has exfoliated;
the nose sinks in its middle。 In contusions of the head without a
wound; either from a fall; a fracture; or pressure; in certain of
these cases acrid humors descend from the head to the
throat; and from
the wound in the head to the liver and thigh。
Part 40
The symptoms of subluxations and luxations; and where; and
how; and how much these differ from one another。 And the cases in
which the articular cavity has been broke off; and in which the
ligament has been torn; and in which the epiphysis has broken in
which; and how; when the limb consists of two bones; one or both are
broken: in consequence of these the dangers; chances in
which bad; and
when the injuries will result in death; and when in recovery。 What
cases are to be reduced or attempted; and when; and which; and when
not; the hopes and dangers in these cases。 Which and when congenital
dislocations are to be undertaken: the parts in a state of
growth; the
parts fully grown; and why sooner; or slower: and why a part becomes
maimed; and how; and how not: and why a certain part is
atrophied; and
where; and how; and in what cases to a less extent。 And why
fractured parts unite sooner or slower; how distortions and
callosities form; and the remedy for them。 In what cases there are
external wounds; either at first or afterwards: in what fractures
the bones are shortened; and in what not: in what cases the
fractured bones protrude; and when they protrude most: in what cases
dislocated bones protrude。 That physicians are deceived; and by what
means; in what they see; and in what they devise; regarding
affections; and regarding cures。 Established rules with regard to
bandaging: preparation; presentation of the part; extension;
adjustment; friction; bandaging; suspension and placing of the limb;
attitude; seasons; diet。 The more porous parts heal fastest; and
vice versa。 Distortions; where the bones are crooked。 Flesh and
tendons wasted on the side of the dislocation。 The force used in
reduction to be applied at as great a distance as possible from the
seat of the displacement。 Of nerves (ligaments?); those which are in
motion and in humidity (flabby?) are of a yielding nature; those
that are not; less so。 In every dislocation the most speedy
reduction is best。 Reduction not to be made while the patient is in
a febrile state; nor on the fourth or fifth day; and least of all;
in those of the elbow; and all cases which induce torpor; the
soonest the best; provided the inflammatory stage be avoided。 Parts
torn asunder; whether nerves; or cartilages; or epiphyses; or parts
separated at symphyses; cannot possibly be restored to their former
state; but callus is quickly formed in most cases; yet the use of
the limb is preserved。 Of luxations; those nearest the
extremities are
least dangerous。 Those joints which are most easily
dislocated are the
least subject to inflammation。 Those which have been least inflamed;
and have not been subjected to after…treatment; are most liable to
be dislocated anew。 Extension should be made in the position most
calculated to enable the one bone to clear the extremity of
the other;
attention being paid to configuration and place。 Adjustment
to be made
in the direction of the displacement; to push the displaced limb
straight backward and sideways。 Parts suddenly drawn aside are to be
suddenly drawn back by a rotatory motion。 Articulations which have
been oftenest dislocated are the most easily reduced; the
cause is the
conformation of the nerves (ligaments?) or of the bones; of the
ligaments that they are long and yielding; and of the bones; the
shallowness of the articular cavity; and roundness of the
head 'of the
bone that enters it'。 Usage; by its friction; forms a new socket。
The cause…the disposition; and habit; and age。 A part somewhat
mucous is not subject to inflammation。
Part 41
In those cases where there are wounds; either at first; or
from protrusion of the bones; or afterwards; from pruritus; or
irritation; in the latter case you are