Mochlicus (36-40)

Displacement of the spine, if inward, threatens immediate death, attended with retention of urine and loss of sensibility. Outward, the accident is free from most of these bad effects, much more so than where there is merely concussion without displacement; the effects in the former case being confined to the spot affected, whereas in the latter they are further communicated to the whole body, and are of a mortal character. In like manner, when the ribs are fractured, whether one or more, provided there be no splinters, there is rarely fever, spitting of blood, and sphacelus, and ordinary treatment without evacuation will suffice, provided there be no fever;-bandaging, according to rule; and the callus forms in twenty days, the bone being of a porous nature. But in cases of contusion, tubercles form, along with cough, suppurating sores, and sphacelus of the ribs, for nerves from all the parts run along each rib. In many of these cases haemoptysis and empyema also take place. The management of this case consists in careful treatment, bandaging according to rule, diet at first restricted, but afterward more liberal, quiet, silence, position, bowels, and venereal matters regulated. Even when there is no spitting of blood, these contusions are more painful than fractures, and are more subject in time to relapses; and when any mucous collection is left in the part, it makes itself be felt in disorders of the body. Treatment:—burning, when the bone is

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.

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

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.

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: