With regard to the construction of bones The brief description of the bones given in this paragraph is evidently condensed from a larger work on the subject. A considerable portion of the matter which is found here in an abridged form, is taken from the preceding treatises, On Fractures and On the Articulations, but not the whole of it. , the bones and joints of the fingers are simple, the bones of the hand and foot are numerous, and articulated in various ways; the uppermost are the largest; the heel consists of one bone which is seen to project outward, and the back tendons are attached to it. The leg consists of two bones, united together above and below, but slightly separated in the middle; the external bone ( fibula ), where it comes into proximity with the little toe, is but slightly smaller than the other, more so where they are separated, and at the knee, the outer hamstring arises from it The tendon of the biceps. ; these bones have a common epiphysis below, with which the foot is moved, and another epiphys is above It will be here perceived that by epiphysis is merely meant a close union of the two bones by means of a ligament. Ther term in this paragraph is not always used in this sense. Strictly speaking, its signification would appear to be a protuberance of a bone. It is applied to the malleoli, to the head of the tibia, to the head and neck of the femur, to the spinous processes of the vertebrae, to the upper and lower extremities of the humerus and to the lower extremity of the radius. in which is moved the articular extremity of the femur, which is simple and light in proportion to its length, in the form of a condyle, and having the patella (connected with it?), the femur itself bends outward and forward; its head is a round epiphysis which gives origin to ligament inserted in the acetabulum of the hip-joint Allusion is evidently made to the ligamentum teres. . This bone is articulated somewhat obliquely, but less so than the humerus. The ischium is united to the great vertebra contiguous to the os sacrum by a cartilaginous ligament It will readily perceived that the term ischium is not used here exactly as applied by modern anatomists. It is applied in this place to the ilium where it is articulated with the os sacrum. By the great verebra, as stated in the preceding work, is meant the last vertebra of the loins. . The spine, from the os sacrum to the great vertebra, is curved backward; in this quarter are situated the bladder, the organs of generation, and the inclined portion of the rectum; from this to the diaphragm it proceeds in a straight line inclining forward, and the psoae are situated there; from this point, to the great vertebra above the tops of the shoulders, it rises in a line that is curved backward, and the curvature appears greater than it is in reality, for the posterior processes of the spine are there highest; the articulation of the neck inclines forward. The vertebrae on the inside Meaning before, that is to say, at their anterior part. are regularly placed upon one another, but behind they are connected by a cartilaginous ligament; they are articulated in the form of synarthrosis at the back part of the spinal marrow; behind they have a sharp process having a cartilaginous epiphysis, whence proceeds the roots of nerves running downward, as also muscles extending from the neck to the loins, and filling the space between the ribs and the spine. The ribs are connected to all the intervertebral spaces on the inside, from the neck to the lumbar region, by a small ligament, and before to the sternum, their extremities being spongy and soft; their form is the most arched in man of all animals; for in this part, man is, of all animals, the narrowest in proportion to his bulk. The ribs are united to each vertebra by a small ligament at the place from which the short and broad lateral processes ( transverse processes? ) arise. The sternum is one continuous bone, having lateral pits for the insertion of the ribs; it is of a spongy and cartilaginous structure. The clavicles are rounded in front, having some slight movements at the sternum, but more free at the acromion. The acromion, in man, arises from the scapula differently from most other animals. The scapula is cartilaginous toward the spine, and spongy elsewhere, having an irregular figure externally; its neck and articular cavity cartilaginous; it does not interfere with the movements of the ribs, and is free of all connection with the other bones, except the humerus. The head of the humerus is articulated with its ( glenoid? ) cavity, by means of a small ligament, and it consists of a rounded epiphysis composed of spongy cartilage, the humerus itself is bent outward and forward, and it is articulated with its ( glenoid? ) cavity by its side, and not in a straight line. At the elbow it is broad, and has condyles and cavities, and is of a solid consistence; behind it is a cavity in which the coronoid process ( olecranon? ) of the ulna is lodged, when the arm is extended; here, too, is inserted the benumbling nerve, which arises from between the two bones of the forearm at their junction, and terminates there. When the nose is fractured, the parts should be modeled instantly, if possible. If the fracture be in its cartilaginous part, introduce into the nostrils a tent formed of caddis, inclosed in the outer skin of a Carthaginian hide, or anything else which does not irritate; the skin is to be glued to the parts displaced, which are to be thus rectified. Bandaging in this case does mischief. The treatment is to consist of flour with manna, or of sulphur with cerate. You will immediately adjust the fragments, and afterward retain them in place with your fingers introduced into the nostrils, and turning the parts into place; then the Carthaginian skin is to be used. Callius forms even when there is a wound; and the same things are to be done, even when there is to be exfoliation of the bones, for this is not of a serious nature. In fractures of the ears, neither bandages nor cataplasms should be used; or, if any bandage be used, it should be put on very tight; the cerate and sulphur should be applied to agglutinate the bandages. When matter forms in the ears, it is found to be more deeply seated than might be supposed, for all parts that are pulpy, and consist of juicy flesh, prove deceptious in such a case. But no harm will result from making an opening, for the parts are lean, watery, and full of mucus. No mention is here made of the places and circumstances which render it fatal to make an opening. The cure is soonest effected by transfixing the ear with a cautery; but the ear is maimed and diminished in size, if burned across. If opened, one of the gentle medicines for flesh wounds should be used as a dressing. The jaw-bone is often slightly displaced ( subluxated? ), and is restored again; it is dislocated but rarely, especially in gaping; in fact, the bone is never dislocated unless it slips while the mouth is opened wide. It slips, however, the more readily from its ligaments being oblique, supple, and of a yielding nature. The symptoms are: the lower jaw protrudes, it is distorted to the side opposite the dislocation, and the patient cannot shut his mouth; when both sides are dislocated, the jaw projects more, the mouth can be less shut, but there is no distortion; this is shown by the rows of the teeth in the upper and lower jaw corresponding with one another. If, then, both sides be dislocated, and not immediately reduced, the patient for the most part dies on the tenth day, with symptoms of continued fever, stupor, and coma, for the muscles there induce such effects; there is disorder of the bowels attended with scanty and unmixed dejection; and the vomitings, if any, are of the same character. The other variety is less troublesome. The method of reduction is the same in both:—The patient being laid down or seated, the physician is to take hold of his head, and grasping both sides of the jaw-bone with both hands, within and without, he must perform three manoeuvres at once,-rectify the position of the jaw, push it backward, and shut the mouth. The treatment should consist of soothing applications, position, and applying a suitable bandage to support the jaw-bone, so as to cooperate with the reduction. The bone of the shoulder is dislocated downward. I have never heard of any other mode. The parts put on the appearance of dislocation forward, when the flesh about the joint is wasted during consumption, as also seems to be the case with cattle when in a state of leanness after winter. Those persons are most liable to dislocations who are thin, slender, and have humidities about their joints without inflammation, for it knits the joints. Those who attempt to reduce and rectify dislocations in oxen, commit a blunder, as forgetting that the symptoms arise from the manner in which the ox uses the limb, and that the appearance is the same in a man who is in a similar condition, and forgetting also that Homer has said, that oxen are most lean at that season. In this dislocation, then, when not reduced, the patient cannot perform any of those acts which others do, by raising the arm from the side. I have thus stated who are the persons most subject to this dislocation, and how they are affected. In congenital dislocations the nearest bones are most shortened, as is the case with persons who are weasel-armed ; the fore-arm less so, and the hand still less; the bones above are not affected. And the parts (near the seat of the injury) are most wasted in flesh; and this happens more especially on the side of the arm opposite the dislocation, and that during adolescence, yet in a somewhat less degree than in congenital cases. The deep-seated suppurations occur most frequently to new-born infants about the joint of the shoulder, and these produce the same consequences as dislocations. In adults, the bones are not so diminished in size, and justly, seeing that the others will not increase as in the former case; but wasting of the flesh takes place, for it is increased, and is diminished every day, and at all ages. And attention should be paid to the force of habit, and to the symptom produced by the tearing away of the acromion, whereby a void is left, which makes people suppose that the humerus is dislocated. The head of the humerus is felt in the armpit, and the patient cannot raise his arm, nor swing it to this side and that, as formerly. The other shoulder shows the difference. Modes of reduction:—The patient himself having placed his fist in the arm pit, pushes up the head of the humerus with it, and brings the hand forward to the breast. Another:—Force it backward, so that you may turn it round. Another:—Apply your head to the acromion, and your hands to the armpit, separate the head of the humerus ( from the side? ), and push the elbow in the opposite direction; or, instead of your knees, another person may turn aside the elbow, as formerly directed. Or, place the patient on your shoulder, with the shoulder in his armpit. Or, with the heel, something being introduced to fill up the hollow of the armpit, and using the right foot to the right shoulder. Or, with a pestle. Or, with the step of a ladder. Or, by rotation made with piece of wood stretched below the arm. Treatment:—As to attitude, the arm placed by the side, the hand and shoulder raised; the bandaging and adjustment of the parts while in this attitude. If not reduced, the top of the shoulder becomes attenuated.