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