2 CULPEPER’s ENGLISH PHYSICIAN, 
tient ought to be bled, and fhould be fuffered to reft for fome days, till the parts 
recover their proper tone. * 
DishocatTion oF THE SHOULDER.---The humerus or upper bone of the arm may 
be diflovated in various directions: it happens however moft frequently down- 
wards, but very feldom directly upwards. From the nature of its articulation, as 
well as from its expofure to external injuries, this bone is the moft fubject to difle- 
cation of any in the body. A diflocation of the humerus may be known by a de- 
_ preffion or cavity on the top of the fhoulder, and an inability to move the arm. 
When the diflocation is downward or forward, the arm is elongated, anda ball 
or lump is perceived under the arm-pit; but when it is backward, there appears a 
protuberance behind the fhoulder, and the arm is thrown forwards toward the 
breaft. The ufual method of reducing diflocations of the fhoulder is to feat the - 
patient upon a low ftool, and to caufe an affiftant to hold his body fo that it may 
not give way to'the extenfion, while another lays hold of the arm a little above the 
elbow, and gradually extends it. The operator then puts a napkin under the pa- 
tient’s arm, and catifes it to be tied behind his own neck ; by this, while a fufii- 
cient extenfion is made, he lifts up the head of the bone, and with his hands direéts 
it into its proper place. There are various machines invented for facilitating this 
operation, but the hand of an expert furgeon is always more fafe. In young and 
delicate patients, it is a very eafy matter to reduce the fhoulder by extending the 
arm with one hand, and thrufting in the head of the bone with the other. In mak- 
ing the extenfion, the arm ought always to be.a little bent. _ 
Distocation oF tue Exsow. ---The bones of the fines may be diflocatea 
in any dire€tion. When this is the- ‘cafe, a_protuberance may be-obferved on that 
_ fide of the arm towards which the bone is pufhed, from which, and the patient’s ‘in- 
ability to bend his arm, a diflocation of this joint may eafily be known. Two af- 
_ fiftants are generally neceffary for reducing a-diflocation of the elbow ; one of them 
muft lay hold of the arm above, and the other below, the joint, and make a pretty 
ftrong extenfion, while the operator returns the bones into their proper place. Af- 
terwards the arm muft be bent, and fufpended for fome time with a fling about the . 
ec — of the wrift and fingers are to be reduced i in. athe fame manner as 
| te and foot are- eviad out, and clas leg is longer than the other ; 
‘but, when it is difplac ed backward, it is ufually pufhed upward at the fame time, 
‘by which means the limb i is thortened, and the foot is turned inwards. “When the 
er bone is Saisse orware and Goward, he patient, in order to have at 
. reduced, 
