第 9 节
作者:没事找事      更新:2021-10-16 18:43      字数:9322
  generation; and the loose portion of the rectum; are situated there。
  From this; to the attachment of the diaphragm; the spine inclines
  inward; and this portion alone; from the internal parts; gives
  origin to muscles; which are called psoae。 From this to the great
  vertebra (seventh cervical?) which is above the tops of the shoulders;
  it is convex behind lengthways; but it is more in appearance than it
  really is; for the spinous processes are highest in the middle; and
  less so above and below。 The region of the neck is convex before。
  46。 In cases of displacement backward along the vertebrae; it does
  not often happen; in fact; it is very rare; that one or more vertebrae
  are torn from one another and displaced。 For such injuries do not
  readily occur; as the spine could not easily be displaced backward but
  by a severe injury on the fore part through the belly (which would
  prove fatal); or if a person falling from a height should pitch on the
  nates; or shoulders (and even in this case he would die; but not
  immediately); and it also would not readily happen that such a
  displacement could take place forward; unless some very heavy weight
  should fall upon it behind; for each of the posterior spinal processes
  is so constructed; that it would sooner be broken than undergo any
  great inclination forward from a force which would have to overcome
  the ligaments and the articulations mutually connecting them。 And
  the spinal marrow would suffer; if from the displacement of a vertebra
  it were to be bent even to a small extent; for the displaced
  vertebra would compress the spinal marrow; if it did not break it; and
  if compressed and strangled; it would induce insensibility of many
  great and important parts; so that the physician need not give himself
  any concern about rectifying the displacement of the vertebra;
  accompanied; as it is; by many other ill consequences of a serious
  nature。 It is evident; then; that such a case could not be reduced
  either by succussion or by any other method; unless one were to cut
  open the patient; and then; having introduced the hand into one of the
  great cavities; were to push outward from within; which one might do
  on the dead body; but not at all on the living。 Wherefore; then; do
  I write all this? Because certain persons fancy that they have cured
  patients in whom the vertebra had undergone complete dislocation
  forward。 Some; indeed; suppose that this is the easiest of all these
  dislocations to be recovered from; and that such cases do not stand in
  need of reduction; but get well spontaneously。 Many are ignorant;
  and profit by their ignorance; for they obtain credit from those about
  them。 These are deceived in this way; for they suppose the spinous
  processes to be the vertebrae themselves; because every one of them
  appears round to the touch; not knowing that these bones are processes
  from the vertebrae; as formerly stated; but the vertebrae are at a
  considerable distance before them; for of all animals; man; in
  proportion to his bulk; has the belly (internal cavity?) the narrowest
  from behind to before; especially at the breast。 When; therefore;
  any of these processes are severely fractured; whether one or more;
  the part there appears lower than on either side; and for that
  reason they are deceived; supposing that the vertebrae are displaced
  inward。 And the patient contribute also to deceive them; for if they
  attempt to put themselves into a bent position; they are pained;
  from the skin being stretched at the seat of the injury; and at the
  same time the fragments of the bones wound the skin still more; but if
  they bend forward; they feel easier; for the skin at the wound is thus
  relaxed; and the bones are less disposed to hurt them; and if touched;
  they shrink and bend forward; and the part which is touched appears
  empty and soft。 All the circumstances now mentioned contribute to
  deceive the physician。 Such patients speedily get well without any bad
  effects; for callus readily forms in all such bones as are porous。
  47。 There are many varieties of curvature of the spine even in
  persons who are in good health; for it takes place from natural
  conformation and from habit; and the spine is liable to be bent from
  old age; and from pains。 Gibbosities (or projections backward) from
  falls generally take place when one pitches on the nates; or falls
  on the shoulders。 In this case some one of the vertebrae must
  necessarily appear higher than natural; and those on either side to
  a less degree; but yet no one generally has started out of the line of
  the others; but every one has yielded a little; so that a considerable
  extent of them is curved。 On this account the spinal marrow easily
  bears such distortions; because they are of a circular shape; and
  not angular。 The apparatus for the reduction in this case must be
  managed in the following manner: a strong and broad board; having an
  oblong furrow in it; is to be fastened in the ground; or; in place
  of the board; we may scoop out an oblong furrow in the wall; about a
  cubit above the floor; or at any suitable height; and then something
  like an oaken bench; of a quadrangular shape; is to be laid along (the
  wall?) at a distance from the wall; which will admit of persons to
  pass round if necessary; and the bench is to be covered with robes; or
  anything else which is soft; but does not yield much; and the
  patient is to be stoved with vapor; if necessary; or bathed with
  much hot water; and then he is to be stretched along the board on
  his face; with his arms laid along and bound to his body; the
  middle; then; of a thong which is soft; sufficiently broad and long;
  and composed of two cross straps of leather; is to be twice carried
  along the middle of the patient's breast; as near the armpits as
  possible; then what is over of the thongs at the armpits is to be
  carried round the shoulders; and afterward the ends of the thong are
  to be fastened to a piece of wood resembling a pestle; they are to
  be adapted to the length of the bench laid below the patient; and so
  that the pestle…like piece of wood resting against this bench may make
  extension。 Another such band is to be applied above the knees and
  the ankles; and the ends of the thongs fastened to a similar piece
  of wood; and another thong; broad; soft; and strong; in the form of
  a swathe; having breadth and length sufficient; is to be bound tightly
  round the loins; as near the hips as possible; and then what remains
  of this swathelike thong; with the ends of the thongs; must be
  fastened to the piece of wood placed at the patient's feet; and
  extension in this fashion is to be made upward and downward; equally
  and at the same time; in a straight line。 For extension thus made
  could do no harm; if properly performed; unless one sought to do
  mischief purposely。 But the physicians; or some person who is
  strong; and not uninstructed; should apply the palm of one hand to the
  hump; and then; having laid the other hand upon the former; he
  should make pressure; attending whether this force should be applied
  directly downward; or toward the head; or toward the hips。 This method
  of applying force is particularly safe; and it is also safe for a
  person to sit upon the hump while extension is made; and raising
  himself up; to let himself fall again upon the patient。 And there is
  nothing to prevent a person from placing a foot on the hump; and
  supporting his weight on it; and making gentle pressure; one of the
  men who is practiced in the palestra would be a proper person for
  doing this in a suitable manner。 But the most powerful of the
  mechanical means is this: if the hole in the wall; or in the piece
  of wood fastened into the ground; be made as much below the man's back
  as may be judged proper; and if a board; made of limetree; or any
  other wood; and not too narrow; be put into the hole; then a rag;
  folded several times or a small leather cushion; should be laid on the
  hump; nothing large; however; should be laid on the back; but just
  as much as may prevent the board from giving unnecessary pain by its
  hardness; but the hump should be as much as possible on a line with
  the hole made in the wall; so that the board introduced into it may
  make pressure more especially at that especially at that spot。 When
  matters are thus adjusted; one person; or two if necessary; must press
  down the end of the board; whilst others at the same time make
  extension and counter…extension as along the body; as formerly
  described。 Extension may also be made with axles; which may either
  be fastened in the ground beside the bench; or the post of the axles
  may be attached to the bench itself; if you will make them
  perpendicular and overtopping (the bench?) a little at both ends; or
  at either end of the bench。 These powers are easily regulated; so as
  to be made stronger or weaker; and they are of such force; that if one
  were to have recourse to them for a mischievous purpose; and not as
  a remedy; they would operate strongly in this way also; for by
  making merely extension and counter…extension longitudinally;
  without any additional force; one might make sufficient extension; and
  if; without making extension at all; one were only to press down
  properl