Scaife ATLAS

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On the Articulations (78-79)

urn:cts:greekLit:tlg0627.tlg010.perseus-eng2:78-79
Refs {'start': {'reference': '78', 'human_reference': 'Section 78'}, 'end': {'reference': '79', 'human_reference': 'Section 79'}}
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The prime object of the physician in the whole art of medicine should be to cure that which is diseased; and if this can be accomplished in various ways, the least troublesome should be selected; for this is more becoming a good man, and one well skilled in the art, who does not covet popular coin of base alloy. With regard to the subject now on hand, the following are domestic means of making extension of the body, so that it is easy to choose from among the things at hand:—In the first place, when soft and supple thongs are not at hand for ligatures, either iron chains, or cords, or cables of ships, are to be wrapped round with scarfs or pieces of woolen rags, especially at the parts of them which are to be applied, and in this state they are to be used as bands. In the second place, the patient is to be comfortably laid on the strongest and largest couch that is at hand, and the feet of the couch, either those at the (patients?) head, or those at the feet, are to be fastened to the threshold, either within or without, as is most suitable; and a square piece of wood is to be laid across, and extending from the one foot to the other; and if this piece of wood be slender, it should be bound to the feet of the couch, but, not withstanding, if it be thick, there will be no necessity for this; then the heads of the ligatures, both of those at the head and those at the feet, are to be fastened to a pestle, or some such piece of wood, difficult to reduce at either end; the ligatures should run along the line of the body, or be a little elevated above it, and it should be stretched proportionally to the pestles, so that, standing erect, the one may be

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fastened to the threshold, and the other to the transverse piece of wood. Extension is then to be made by bending back the ends of the pestles. A ladder, having strong steps, if laid below the bed, will serve the purpose of the threshold and the piece of wood laid along (the foot of the couch?), as the pestles can be fastened to the steps at either end, and when drawn back they thus make extension of the ligatures. Dislocation, inward or forward, may be reduced in the following manner: a ladder is to be fastened in the ground, and the man is to be seated upon it, and then the sound leg is to be gently stretched along and bound to it, wherever it is found convenient; and water is to be poured into an earthen vessel, or stones put into a hamper and slung from the injured leg, so as to effect the reduction. Another mode of reduction: a cross-beam is to be fastened between two pillars of moderate height; and at one part of the cross-beam there should be a protuberance proportionate to the size of the nates; and having bound a coverlet round the patients breast, he is to be seated on the protuberant part of the cross-beam, and afterward the breast is to be fastened to the pillar by some broad ligature; then some one is to hold the sound leg so that he may not fall off, and from the injured limb is to be suspended some convenient weight, as formerly described.

It should be particularly known that the union of all bones is, for the most part, by a head and socket (cotyle); in some of these the place (socket?) is cotyloid and oblong, and in some the socket is glenoid (shallow?). In all dislocations reduction is to be effected, if possible, immediately, while still warm, but otherwise, as quickly as it can be done; for reduction will be a much easier and quicker process to the operator, and a much less painful one to the patient, if effected before swelling comes on. But all the joints when about to be reduced should be first softened, and gently moved about; for, thus they are more easily reduced. And, in all cases of reduction at joints, the patient must be put on a spare diet, but more especially in the case of the greatest joints, and those most difficult to reduce, and less so in those which are very small and easily reduced.

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