660 PHILOSOPHICAL TRANSACTIONS. [ANNO 1742-3. 



Hippocrates. Sect. 6, p. 783, Fcesii. The arm is tied to this horizontal piece, 

 and then the assistant bears upon the scapula and the clavicula, as is seen in 

 the figures of Scultetus, pi. 21, while another presses down the lever, and thus 

 makes the bone come into its place again. 



And after noticing M. Petit's remarks (in his Treatise on the Diseases of the 

 Bones) on this subject, he proceeds to state, that the capital defect in the 

 ambe of Hippocrates, is that it pushes the head of the bone into its cavity, be- 

 fore the extension and counter extension are made. The dangerous conse- 

 quences of this defect, are, according to M. Petit, 1st, that the reduction is 

 very difficult, because the bone is not conducted by the same way it took in lux- 

 ating itself, and that obstacles are met with from the parts that surround it, 

 even the scapula itself, on which it articulates. 2dly, in making such efforts 

 for surmounting those obstacles, we run the risk of turning inwards the carti- 

 laginous edge of the cavity of the scapula, or the capsula ligamentosa. The 

 second defect of the ambe of Hippocrates is, that it cannot move the luxated 

 bone but from below upwards ; consequently this machine is only proper in lux- 

 ations directly downwards ; and yet it is certain, that the arm luxates itself 

 both outwards and inwards ; and even it is known to all practitioners, that 

 luxations forwards are very frequent. Here we have a great number of luxa- 

 tions of the arm, where the ambe becomes useless. Now, if the ambe of Hip- 

 pocrates be useless in all luxations outwards, and in luxations inwards, which 

 are very frequent, if it be dangerous in luxations downwards, the only ones it 

 is fit for, it must be owned that this machine, so much cried up by Hippocrates, 

 is yet very imperfect. 



These imperfections are real ones, but the advantages it has are so constant, 

 and so superior to those of any other practice, that one naturally inclines not to 

 part with it, but becomes desirous to remove those defects it has, without which 

 it would certainly be, as Hippocrates asserts, the most perfect of all machines 

 used in reducing a luxated arm. For supposing an ambe, which makes a suf- 

 ficient extension and counter-extension, before it leads the bone into the ca- 

 vity, or at the same time it does so, and which also might lead it from the 

 right to the left, and from the left to the right, as well as from below upwards, 

 it is certain there can be no method to be compared to this ; because there is 

 none in which concur at once so much force and expedition, joined to such 

 simplicity, regularity, and safety, that are quite singular. For that method in 

 which a surgeon only employs his own strength, and that of his assistants, is 

 commonly insufficient ; and the other, in which he helps himself with the 

 pulley, is perplexed with a great apparatus, is long, and still very much wants 

 the hands of the surgeon, and of his assistants : all which are circumstances 

 that render the method more complicated, and less sure. 



