VOL. LI.J PHILOSOPHICAL TRANSACTIONS. 483 



on the 'lOth of March 1759, his foot slipping, he fell backwards; his breech on 

 the pavement, and the load of wheat on his belly and thighs. The servants 

 carried him into the house, and laid him on a bed, where he remained in the 

 most racking torture, when Mr. W. came to him, which was about 2 hours 

 after the accident happened. He found his right buttock as large again as the 

 other; the knee and foot of the same side turned inwards; and the thigh much 

 shortened. On endeavouring to make the thigh perform its rotatory motion, 

 there was not the least crackling to be heard. This convinced him that the 

 head of the bone was thrown out of the acetabulum ; and on examination he 

 could distinctly feel it under the glutaei muscles: to which situation of it, and 

 not to any bruise, he was now satisfied that the size of the buttock was owing. 



He soon reduced it by the following easy and very simple method: some nap- 

 kins being first wrapped round one of the posts at the foot of the bed, to prevent 

 its galling him, he ordered the patient to be laid on his back, with one leg on 

 each side the post, and then directed 3 or 4 assistants to pull at the dislocated 

 limb, the post now placed to his groin being a fixed point to pull against. While 

 they were making this extension, Mr. W. clapped his left hand on the head of 

 the bone, to help it into its place ; and at the same instant, with his right hand, 

 turning the knee outwards, threw the bone into the socket with the greatest 

 facility imaginable, but with such an uncommonly loud noise as greatly asto- 

 nished all who were present. 



He was perfectly easy from that moment; the enlargement of the buttock en- 

 tirely subsided. In a fortnight he was able to move about without assistance; 

 and in 2 months afterwards walked as far as Manchester, being then quite sound; 

 and the limb that had been dislocated of the same length with the other. 



Remarks. Both ancients and moderns have fallen into great errors in regard to 

 the treatment of accidents that have happened to the hip joint. The ancients, 

 who for want of frequent opportunities of dissecting bodies, were ignorant that 

 the neck of the femur was often broken, always imagined it to be luxated. Their 

 patients were therefore sometimes tormented (in hopes of a reduction) without 

 any advantage; and this want of success made the surgeons at other times aban- 

 don their patients when they might have been relieved. The moderns have 

 fallen into a contrary extreme, but attended with as bad consequences. Boer- 

 haave in particular was of opinion that there never was a dislocation of the thigh 

 bone by any external violence, but that the head of it was commonly broken off 

 at its neck near the great trochanter. The opinion of so learned a man has had 

 such weight with the generality of the profession, that it has been taken for 

 granted that in these cases the neck of the bone was always broken; consequently 

 the reduction was seldom attempted, and the unfortunate patients remained 



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