第 8 节
作者:
没事找事 更新:2021-10-16 18:43 字数:9321
dysentery when it becomes chronic。 And when the gibbosity occurs in
youth before the body has attained its full growth; in these cases the
body does not usually grow along the spine; but the legs and the
arms are fully developed; whilst the parts (about the back) are
arrested in their development。 And in those cases where the
gibbosity is above the diaphragm; the ribs do not usually expand
properly in width; but forward; and the chest becomes sharp…pointed
and not broad; and they become affected with difficulty of breathing
and hoarseness; for the cavities which inspire and expire the breath
do not attain their proper capacity。 And they are under the
necessity of keeping the neck bent forward at the great vertebra; in
order that their head may not hang downward; this; therefore;
occasions great contraction of the pharynx by its inclination
inward; for; even in those who are erect in stature; dyspnoea is
induced by this bone inclining inward; until it be restored to its
place。 From this frame of body; such persons appear to have appear
to have more prominent necks than persons in good health; and they
generally have hard and unconcocted tubercles in the lungs; for the
gibbosity and the distension are produced mostly by such tubercles;
with which the neighboring nerves communicate。 When the gibbosity is
below the diaphragm; in some of these cases nephritic diseases and
affections of the bladder supervene; but abscesses of a chronic
nature; and difficult to cure; occur in the loins and groins; and
neither of these carries off the gibbosity; and in these cases the
hips are more emaciated than when the gibbosity is seated higher up;
but the whole spine is more elongated in them than in those who have
the gibbosity seated higher up; the hair of the pubes and chin is of
slower growth and less developed; and they are less capable of
generation than those who have the gibbosity higher up。 When the
gibbosity seizes persons who have already attained their full
growth; it usually occasions a crisis of the then existing disease;
but in the course of time some of them attack; as in the case of
younger persons; to a greater or less degree; but; not withstanding;
for the most part; all these diseases are less malignant。 And yet many
have borne the affection well; and have enjoyed good health until
old age; more especially those persons whose body is inclined to be
plump and fat; and a few of them have lived to beyond sixty years of
age; but the most of them are more short…lived。 In some cases the
curvature of the spine is lateral; that is to say; either to the one
side or the other; the most of such cases are connected with tubercles
(abscesses?) within the spine; and in some; the positions in which
they have been accustomed to lie cooperate with the disease。 But these
will be treated of among the chronic affections of the lungs; for
these the most suitable prognostics of what will happen in these cases
are given。
42。 When the spine protrudes backward; in consequence of a fall;
it seldom happens that one succeeds in straightening it。 Wherefore
succussion on a ladder has never straightened anybody; as far as I
know; but it is principally practiced by those physicians who seek
to astonish the mob…for to such persons these things appear wonderful;
for example; if they see a man suspended or thrown down; or the
like; and they always extol such practices; and never give
themselves any concern whatever may result from the experiment;
whether bad or good。 But the physicians who follow such practices;
as far as I have known them; are all stupid。 The device; however; is
an old one; and I give great praise to him who first invented this;
and any other mechanical contrivance which is according to nature。 For
neither would I despair; but that if succussion were properly gone
about; the spine; in certain cases; might be thereby rectified。 But;
indeed; for my own part; I have been ashamed to treat all such cases
in this way; because such modes of procedure are generally practiced
by charlatans。
43 Those cases in which the gibbosity is near the neck; are less
likely to be benefited by these succussions with the head downward;
for the weight of the head; and tops of the shoulders; when allowed to
hang down; is but small; and such cases are more likely to be made
straight by succussion applied with the feet hanging down; since the
inclination downward is greater in this way。 When the hump is lower
down; it is more likely in this case that succussion with the head
downward should do good。 If one; then; should think of trying
succussion; it may be applied in the following manner:…The ladder is
to be padded with leather lined cushions; laid across; and well
secured to one another; to a somewhat greater extent; both in length
and breadth; than the space which the man's body will occupy; he is
then to be laid on the ladder upon his back; and the feet; at the
ankles; are to be fastened; at no great distance from one another;
to the ladder; with some firm but soft band; and he is further to be
secured; in like manner; both above and below the knee; and also at
the nates; and at the groins and chest loose shawls are to be put
round in such a fashion as not to interfere with the effect of the
succussion; and his arms are to be fastened along his sides to his own
body; and not to the ladder。 When you have arranged these matters
thus; you must hoist up the ladder; either to a high tower or to the
gable…end of a house; but the place where you make the succussion
should be firm; and those who perform the extension should be well
instructed; so that they may let go their hold equally to the same
extent; and suddenly; and that the ladder may neither tumble to the
ground on either side; nor they themselves fall forward。 But; if the
ladder be let go from a tower; or the mast of a ship; fastened into
the ground with its cordage; it will be better; so that the ropes
run upon a pulley or axle…tree。 But it is disagreeable even to enlarge
upon these matters; and yet; by the contrivances now described; the
proper succussion may be made。
44。 But if the hump be situated very high up; and if succussion be
by all means to be used; it will be better to do it with the feet
downward; as has been said; for the force downward will be the greater
in this case。 The patient is to be well fastened to the ladder by
cords at the breast; at the neck by means of a very loose shawl so
as merely to keep the part properly on the ladder; and the head is
to be fastened to the ladder at the forehead; the arms are to be
stretched along and attached to the patient's body; and not to the
ladder; and the rest of the body is not to be bound; except so as to
keep it in place by means of a loose shawl wrapped round it and the
ladder; attention; moreover; should be paid that these ligatures do
not interfere with the force of the succussion; and the legs are not
to be fastened to the ladder; but should be placed near one another;
so as to be in line with the spine。 These matters should be thus
arranged; if recourse is to be had at all to succussion on a ladder;
for it is disgraceful in every art; and more especially in medicine;
after much trouble; much display; and much talk; to do no good after
all。
45。 In the first place; the structure of the spine known; for this
knowledge is requisite in many diseases。 Wherefore; on the side turned
to the belly (the anterior?) the vertebrae are in a regular line;
and are united together by a pulpy and nervous band of connection;
originating from the cartilages; and extending to the spinal marrow。
There are certain other nervous cords which decussate; are attached
(to the vertebrae?); and are extended from both sides of them。 But
we will describe in another work the connections of the veins and
arteries; their numbers; their qualities; their origin; their
functional offices in particular parts; in what sort of sheaths the
spinal marrow is inclosed; where they arise; where they terminate; how
they communicate; and what their uses。 On the opposite side
(behind?) the vertebrae are connected together by a ginglymoid
articulation。 Common cords (nerves?) are extended to all parts; both
those within and without。 There is an osseous process from the
posterior part of all and each of the vertebra; whether greater or
smaller; and upon these processes there are cartilaginous epiphyses;
and from them arise nervous productions (ligaments?); akin to the
external nerves (tonoi)。 The ribs are united to them; having their
heads inclined rather to the inside than the out; and every one of
them is articulated with the vertebrae; and the ribs in man are very
curved; and; as it were; arched。 The space between the ribs and the
processes of the vertebrae is filled on both sides by muscles; which
arise from the neck and extend to the loins (?)。 The spine;
longitudinally; is a straight line slightly curved; from the os sacrum
to the great vertebra which is connected with the articulation of
the femur; the spine inclines backward; for the bladder; the organs of
generation; and the loose portion of the rectum; are situated there。
From this; to the attachment of