56。Therearepersonswho，frombirthorfromdisease，havedislocationsoutwardofboththethighs；inthem，then，thebonesareaffectedinlikemanner，butthefleshypartsintheircaselosetheirstrengthless；thelegs，too，areplumpandfleshy，exceptthatthereissomelittledeficiencyattheinside，andtheyareplumpbecausetheyhavetheequaluseofboththeirlegs，forinwalkingtheytotterequallytothissidethat。Theirnatesappearveryprominent，fromthedisplacementofthebonesofthejoint。Butifintheircasethebonesdonotsphacelate（becomecarious？）andiftheydonotbecomebentabovethehip—joint，ifnothingofthiskindhappentothem，theybecomeotherwisesufficientlyhealthy，butthegrowthofalltherestofthebody，withtheexceptionofthehead，isarrested。
57。Indislocationsoftheheadofthefemurbackward，whichrarelyoccur，thepatientcannotextendtheleg，eitheratthedislocatedjoint，orattheham，toanyextent，andofallthedislocations，thisisthevarietyinwhichthepatientshavetheleastpowerofmakingextensionatthegroinandtheham。But，moreover，thisalsoshouldbeknown（foritisavaluablepieceofknowledge，andofmuchimportance，andyetmostyetmostpeopleareignorantofit），thatpersonsinhealthcannotextendthejointattheham，iftheydonotextendthejointatthegroinatthesametime，unlesstheyraisethefootveryhigh，forinthiswaytheycoulddoit；
neitheralsocouldtheybendthejointattheham，butwithmuchgreaterdifficulty，iftheydonotbendthejointatthegroinatthesametime。Therearemanyotherthingsinthebodywhichhavesimilarconnections，bothwithregardtothecontractionsofnerves（ligaments？），andthepositionsofmuscles，andmanyofthemmoreworthyofbeingknownthanisgenerallysupposed，andwithregardtothenatureoftheintestineandthatofthewholeinternalcavity，andwithregardtothedisplacementsandcontractionsoftheuterus；butallthesethingswillbetreatedofelsewhere，inaworkakintothepresentone。Butwithregardtothematteronhand，theycannotmakeextension，ashasbeenalreadystated；andthelimbappearsshortened，fortworeasons—first，becauseitcannotbeextended，andalsobecausethebonehasslippedintothefleshofthenates；fortheheadandneckofthefemur，inthisdislocation，arecarrieddownwardfromtheirnaturalsituation，totheoutsideofthenates。Butyettheycanbendthelimb，unlesspreventedbypain，andthelegandfootappearprettystraight，andnotmuchinclinedtowardeitherside，butatthegrointheflesh，whenfelt，appearslooser，fromtheboneofthejointhavingslippedtotheotherside，butatthenatestheheadofthefemurmaybefelttobemoreprominentthannatural。Sucharethesymptomsaccompanyingdislocationofthethighbackward。
58。Whenthisdislocationoccursinanadult，andisnotreduced，hecanwalk，indeed，afteratime，andwhenthepainhasabated，andwhenhehasbeenaccustomedtorotatethearticularboneintheflesh；hefindsitnecessary，however，tomakestrongflexionatthegroininwalking，fortworeasons，bothbecausethelimb，forthecausesalreadystated，becomesmuchshorter，andheisfarfromtouchingthegroundwithhisheel，andhecanbarelyreachitwiththeballofhisfoot，andnoteventhus，unlesshebendhimselfatthegroins，andalsobendwiththeotherlegattheham。Andinthiscase，heisunderthenecessityofsupportingtheupperpartofthethighwithhishandateachstep：thisalsocontributes，inacertaindegree，tomakehimbendthebodyatthegroins；for，duringtheshiftingofthefeetinwalking，thebodycannotbesupportedontheunsoundbesupportedontheunsoundlimb，unlessitbepressedtothegroundbythehand，—theendofthefemurnotbeingplacedproperlyunderthebody，buthavingslippedbackwardtothenates；andifheshouldtrytoresttheweightofhisbodyforalittle，uponthefoot，withoutanyothersupport，hewouldfallbackward，fortherewouldbeagreatinclinationinthisdirection，fromthehipshavingprotrudedbackwardfarbeyondthelineofthefoot，andthespineincliningtowardthehips。Suchpersonscanwalk，indeed，withoutastaff，ifsoaccustomed，forbecausethesoleofthefootisinitsoldline，andisnotinclinedoutward，theydonotrequireanythingtobalancethem。Such，however，as，insteadofgraspingthethigh，preferrestingtheirweightuponastaffintroducedintothearmpitoftheaffectedside，these，iftheyusealongerstaff，willwalk，indeed，moreerect，butwillnotbeabletoreachthegroundwiththefoot，oriftheywishtorestuponthefoot，theymusttakeashorterstaff，andwillrequiretobendthebodyatthegroins。Thewastingofthefleshypartsisanalogoustowhathappensinthecasesformerlydescribed，forthewastingisgreatestinthosecasesinwhichthepatientskeepthelimbup，anddonotexerciseit，whilstthosewhopracticewalking，havetheleastatrophy。Thesoundleg，however，isnotbenefited，butisratherrenderedmoredeformed，iftheinjuredlimbbeappliedtotheground，foritisforcedtocooperatewiththeother，beingprotrudedatthehip，andbentattheham。Butifthepatientdoesnotusetheinjuredlimbbyapplyingittotheground，butcarriesitup，andrestsuponastaff，thesoundlegtherebygainsstrength，foritisemployedinitsnaturalposition，andfurther，theexercisegivesitstrength。Butitmaybesaid，thesethingsareforeigntomedicine；forwhatistheuseofenlarginguponcaseswhicharealreadypastremedy？Thisisfarfrombeingthecase，foritbelongstotheknowledgeofmedicinetobeacquaintedalsowiththese，andtheycannotpossiblybeseparatedfromoneanother；fortosuchasarecurable，meansaretobeusedtopreventthemfrombecomingincurable，studyinghowtheymaybestbepreventedfromgettingintoanincurablestate。Andincurablecasesshouldbeknown，thattheymaynotbeaggravatedbyuselessapplications，andsplendidandcreditableprognosticsaremadebyknowingwhere，how，andwheneverycasewillterminate，andwhetheritwillbeconvertedintoacurableoranincurabledisease。Whenthen，frombirth，orduringone’syouth，thisdislocationbackwardoccurs，andisnotreduced，whetheritbeconnectedwithviolenceordisease（formanysuchdislocationsoccurindiseases，butthenatureofthediseasesinwhichdislocationstakeplace，willbedescribedafterward）；if，then，thedislocatedlimbbenotreduced，theboneofthethighbecomesshortened，thewholelimbisimpaired，isarrestedinitsgrowth，andlosesitsfleshfromwantofuse；thearticulationatthehamisalsoimpaired，forthenerves（ligaments？）becomestretched，fromcasesformerlystated，whereforethosewhohavethisdislocation，cannotmakeextensionattheknee—joint。Inaword，allpartsofthebodywhichweremadeforactiveuse，ifmoderatelyusedandexercisedatthelabortowhichtheyarehabituated，becomehealthy，increaseinbulk，andbeartheiragewell，butwhennotused，andwhenleftwithoutexercise，theybecomediseased，theirgrowthisarrested，andtheysoonbecomeold。Amongthesepartsthejointsandnerves（ligaments？），ifnotused，arenottheleastliabletobesoaffected；
theyareimpaired，then，forthereasonswehavestated，moreinthisvarietyofdislocationthanintheothers，forthewholelimbiswasted，bothinitsbonesandinitsfleshyparts。Suchpersons，then，whentheyattaintheirfullgrowth，keepthelimbraisedandflexed，resttheweightofthebodyontheotherleg，andsupportthemselveswithastaff，somewithone，andotherswithtwo。
59。Indislocationsoftheheadofthethigh—boneforward（theyareofrareoccurrence），thepatientscannotextendthelegcompletely，butleastofallcantheybenditatthegroin；theyarepained，also，ifforcedtobendthelimbattheham。Thelengthoftheleg，ifcomparedattheheel，isthesameasthatoftheother；buttheextremityofthefootinclineslesstoprojectforward。Butthewholelimbhasitsnaturaldirection，andinclinesneithertothissidenortothat。Thesecasesareparticularlyattendedwithseverepain，andtheyaremoreapttobeaccompaniedwithretentionofurineatfirstthananyoftheotherdislocations；fortheheadofthethigh—boneislodgedveryneartoimportantnerves。Andtheregionofthegroinappearsswelledoutandstretched，whilethatofthenatesismorewrinkledandflabby。Thesymptomsnowstatedarethosewhichattendthisdislocationofthethigh—bone。
60。Whenpersonshaveattainedtheirfullgrowthbeforemeetingwiththisdislocation，andwhenithasnotbeenreduced，uponthesubsidenceofthepain，andwhentheboneofthejointhasbeenaccustomedtoberotatedintheplacewhereitislodged，thesepersonscanwalkalmosterectwithoutastaff，andwiththeinjuredlegalmostquitestraight，asitdoesnotadmitofeasyflexionatthegroinandtheham；owing，then，tothiswantofflexionatthegroin，theykeepthelimbmorestraightinwalkingthantheydothesoundone。Andsometimestheydragthefootalongtheground，asnotbeingabletobendtheupperpartofthelimb，andtheywalkwiththewholefootontheground；forinwalkingtheyrestnolessontheheelthanontheforepartofthefoot；andiftheycouldtakegreatsteps，theywouldrestentirelyontheheelinwalking；forpersonswhoselimbsaresound，thegreaterthestepstheytakeinwalking，restsomuchthemoreontheheel，whiletheyareputtingdowntheonefootandraisingtheopposite。Inthisformofdislocation，personsresttheirweightmoreontheheelthanontheanteriorpartofthefoot，fortheforepartofthefootcannotbebentforwardequallywellwhentherestofthelimbisextendedaswhenitisinastateofflexion；neither，again，canthefootbearchedtothesamedegreethelimbisbentaswhenitisextended。Thenaturalstateofmattersissuchashasbeennowdescribed；andinanunreduceddislocation，personswalkinthemannerdescribed，forthereasonswhichhavebeenstated。Thelimb，moreover，islessfleshythantheother，atthenates，thecalfoftheleg，andthewholeofitsposteriorpart。Whenthisdislocationoccursininfancy，andisnotreduced，orwhenitiscongenital，inthesecasestheboneofthethighismoreatrophiedthanthoseofthelegandfoot；buttheatrophyofthethigh—boneisleastofallinthisformofdislocation。
Thefleshyparts，however，areeverywhereattenuated，moreespeciallybehind，ashasbeenstatedabove。Ifproperlytrained，suchpersons，whentheygrowup，canusethelimb，whichisonlyalittleshorterthantheother，andyettheysupportthemselvesonastaffattheaffectedside。For，notbeingabletouseproperlytheballofthefootwithouttheheel，nortoputitdownassomecanintheothervarietiesofdislocation（thecauseofwhichhasbeenjustnowstated），onthisaccounttheyrequireastaff。Butthosewhoareneglected，andarenotinthepracticeofputtingtheirfoottotheground，butkeepthelimbup，havethebonesmoreatrophiedthanthosewhousethelimb；and，atthearticulations，thelimbismoremaimedinthedirectlinethanintheotherformsofdislocation。
61。Inaword，luxationsandsubluxationstakeplaceindifferentdegrees，beingsometimesgreaterandsometimesless；andthosecasesinwhichthebonehasslippedorbeendisplacedtoamuchgreaterextent，areingeneralmoredifficulttorectifythanotherwise；andifnotreduced，suchcaseshavegreaterandmorestrikingimpairmentandlesionofthebones，fleshyparts，andattitudes；butwhenthebonehasslipped，orbeendisplacedtoalessextent，itiseasiertoreducesuchcasesthantheother；andiftheattemptsatreductionhavefailed，orhavebeenneglected，theimpairmentinsuchcasesisless，andproveslessinjuriousthaninthecasesjustmentioned。Theotherjointspresentgreatdifferencesastotheextentofthedisplacementswhichtheyaresubjectto。Buttheheadsofthefemurandhumerusareverysimilartooneanotherastotheirdislocations。Fortheheadsofthebonesareroundedandsmooth，andthesocketswhichreceivetheheadsarealsocircular，andadaptedtotheheads；theydonotadmitthenofbeingdislocatedinanyintermediatedegree，but，notwithstanding，fromtheirroundedshape，thebonesslipeitheroutwardorinward。Inthecasewearenowtreatingof，then，thereiseitheracompletedislocationornoneatall，andyetthesebonesadmitofbeingdisplacedtoagreaterorlessextent；andthethighismoresubjecttothesedifferencesthanthearm。
62。Wherefore，then，someofthesecongenitaldisplacements，iftoasmallextent，maybereducedtotheirnaturalcondition，andespeciallythoseattheankle—joint。Mostcasesofcongenitalclub—footareremediable，unlessthedeclinationbeverygreat，orwhentheaffectionoccursatanadvancedperiodofyouth。Thebestplan，then，istotreatsuchcasesatasearlyaperiodaspossible，beforethedeficiencyofthebonesofthefootisverygreat，andbeforethereisanygreatwastingofthefleshoftheleg。Thereismorethanonevarietyofclub—foot，themostofthembeingnotcompletedislocations，butimpairmentsconnectedwiththehabitualmaintenanceofthelimbinacertainposition。Inconductingthetreatment，attentionmustbepaidtothefollowingpoints：topushbackandrectifytheboneofthelegattheanklefromwithoutinward，andtomakecounter—pressureontheboneoftheheelinanoutwarddirection，soastobringitbringitintoline，inorderthatthedisplacedbonesmaymeetatthemiddleandsideofthefoot；andthemassofthetoes，withthegreattoe，aretobeinclinedinward，andretainedso；andthepartsaretobesecured，withceratecontainingafullproportionofresin，withcompresses，andsoftbandagesinsufficientquantity，butnotappliedtootight；andtheturnsofthebandagesshouldbeinthesamedirectionastherectifyingofthefootwiththehand，sothatthefootmayappeartoinclinealittleoutward。Andasolemadeofleathernotveryhard，oroflead，istobeboundon，anditisnottobeappliedtotheskinbutwhenyouareabouttomakethelastturnsofthebandages。Andwhenitisallbandaged，youmustattachtheendofoneofthebandagesthatareusedtothebandagesappliedtotheinferiorpartofthefootonthelineofthelittletoe；andthenthisbandageistoberolledupwardinwhatisconsideredtobeasufficientdegree，toabovethecalfoftheleg，sothatitmayremainfirmwhenthusarranged。Inaword，asifmouldingawaxmodel，youmustbringtotheirnaturalpositionthepartswhichwereabnormallydisplacedandcontractedtogether，sorectifyingthemwithyourhands，andwiththebandaginginlikemanner，astobringthemintotheirposition，notbyforce，butgently；andthebandagesaretobestitchedsoastosuitthepositioninwhichthelimbistobeplaced，fordifferentmodesofthedeformityrequiredifferentpositions。Andasmallshoemadeofleadistobeboundonexternallytothebandaging，havingthesameshapeastheChianslippershad。Butthereisnonecessityforitifthepartsbeproperlyadjustedwiththehands，properlysecuredwiththebandages，andproperlydisposedofafterward。This，then，isthemodeofcure，anditneitherrequirescutting，burning，noranyothercomplexmeans，forsuchcasesyieldsoonertotreatmentthanonewouldbelieve。However，theyaretobefairlymasteredonlybytime，andnotuntilthebodyhasgrownupinthenaturalshape；whenrecourseishadtoashoe，themostsuitablearethebuskins，whichderivetheirnamefrombeingusedintravelingthroughmud；forthissortofshoedoesnotyieldtothefoot，butthefootyieldstoit。
AshoeshapedliketheCretanisalsosuitable。
63。Incasesofcompletedislocationattheankle—joint，complicatedwithanexternalwound，whetherthedisplacementbeinwardoroutward，youarenottoreducetheparts，butletanyotherphysicianreducethemifhechoose。Forthisyoushouldknowforcertain，thatthepatientwilldieifthepartsareallowedtoremainreduced，andthathewillnotsurvivemorethanafewdays，forfewofthempasstheseventhday，beingcutoffbyconvulsions，andsometimesthelegandfootareseizedwithgangrene。Itshouldbewellknownthatsuchwillbetheresults；anditdoesnotappeartomethathelleborewilldoanygood，thoughadministeredthesameday，andthedraughtrepeated，andyetitisthemostlikelymeans，ifanysuchtherebe；
butIamofopinionthatnotevenitwillbeofservice。Butifnotreduced，noranyattemptsatfirstmadetoreducethem，mostofsuchcasesrecover。Thelegandfootaretobearrangedasthepatientwishes，onlytheymustnotbeputinadependentposition，normovedabout；andtheyaretobetreatedwithpitchedcerate，afewcompressesdippedinwine，andnotverycold，forcoldinsuchcasesinducesconvulsions；theleavesalsoofbeet，orofcolt’sfoot，ofanysuch，whenboiledindark—coloredausterewine，formasuitableapplicationtothewoundandthesurroundingparts；andthewoundmayfurtherbeanointedwithcerateinatepidstate。Butifitbethewinterseason，thepartistobecoveredwithunscouredwool，whichistobesprinkledfromabovewithtepidwineandoil，butonnoaccountiseitherbandageorcompresstobeapplied；forthisshouldbeknownmostespecially，thatwhatevercompresses，orisheavy，doesmischiefinsuchcases。Andcertainofthedressingsusedtorecentwoundsaresuitableinsuchcases；andwoolmaybelaiduponthesore，andsprinkledwithwine，andallowedtoremainforaconsiderabletime；butthosedressingsforrecentwoundswhichonlylastforafewdays，andintowhichresinentersasaningredient，donotagreewiththem；forthecleansingofthesoresisaslowprocess，andthesorehasacopiousdischargeforalongtime。Certainofthesecasesitmaybeadvantageoustobandage。Itoughtalsotobewellunderstood，thatthepatientmustnecessarilybemuchmaimedanddeformed，forthefootisretractedoutward，andtheboneswhichhavebeendisplacedoutwardprotrude：thesebones，infact，notbeinggenerallylaidbare，unlesstoasmallextent；neitherdotheyexfoliate，buttheyhealbythinandfeeblecicatrices，providedthepatientkeepsquietforalengthoftime；butotherwisethereisdangerthatasmallulcermayremainincurable。Andyetinthecasewearetreatingof，thosewhoarethustreatedaresaved；whereas，whenthepartsarereducedandallowedtoremaininplace，thepatientsdie。
64。Thesameruleappliestodislocationsatthewrist，attendedwithawoundandprojectionofthebone，whetherthebonesofthearmbedisplacedinwardoroutward。Forthisshouldbewellunderstood，thatthepatientwilldieinthecourseofafewdays，bythesamemodeofdeathasformerlydescribed，ifthebonebereduced，andallowedtoremainso。Butinthosecasesinwhichtheyarenotreduced，noranyattemptmadetoreducethem，thepatients，forthemostpart，recover；andthesamemodeoftreatmentashasbeendescribedwillbeapplicable；butthedeformityandimpedimentofthelimbmustnecessarilybegreat，andthefingersofthehandwillbeweakanduseless；foriftheboneshaveslippedinward，theycannotbendthefingers，orifoutward，theycannotextendthem。
65。Whentheostibiae，havingmadeawoundattheknee，hasprotrudedthroughtheskin，whetherthedislocationbeoutwardorinward，insuchacase，ifthebonebereduced，deathwillbeevenmorespeedythanintheothercases，althoughspeedyalsointhem。Buttheonlyhopeofrecoveryisifyoutreatthemwithoutreduction。
Thesecasesaremoredangerousthantheothers，asbeingsomuchhigherup，asbeingsomuchstrongerjoints，anddisplacedfromboneswhicharesomuchstronger。Butiftheosfemorisformawoundattheknee，andslipthroughit，provideditbereducedandleftso，itwilloccasionastillmoreviolentandspeedydeaththaninthecasesformerlydescribed；butifnotreduced，itwillbemuchmoredangerousthanthosecasesmentionedbefore，andyetthisistheonlyhopeofrecovery。
66。Thesameruleappliestotheelbow—joint，andwithregardtothebonesofthefore—armandarm。Forwhenthesebonesprotrudethroughawoundwhichtheyhavemadeintheskin，allcasesinwhichtheyarereducedprovefatal；butifnotreduced，thereisachanceofrecovery；buttothosethatsurvivethereiscertainimpediment。Andifinanyinstancethebonesoftheupperarticulations（shoulder—joint？），shouldbedislocated，andprojectthroughawoundwhichtheyhavemadeintheskin，these，ifreduced，arefollowedbymorespeedydeath；andifnotreduced，theyaremoredangerousthantheothers。Butthemodeoftreatmentwhichappearstomemostsuitablehasbeenalreadydescribed。
67。Whenthejointsofthetoesorhandsaredislocated，andthebonesprotrudethroughawoundwhichtheyhavemade，andwhenthereisnofractureofthebone，butmerelydisplacementofthejoint，inthesecases，ifthereductionbemadeandallowedtoremain，thereissomedangerofspasms（tetanus？）ifnotproperlytreated，andyetitmaybeworthwhiletoreducethem，havingwarnedthepatientbeforehandthatmuchcautionandcarewillberequired。Theeasiest，themostefficientmethod，andtheonemostconformabletoart，isthatbythelever，asformerlydescribedwhentreatingofboneswhichhavebeenfracturedandprotruded；thenthepatientmustbeasquietaspossible，lieinarecumbentposition，andobservearestrictedregimen。Anditwillbebetteralsothatheshouldgetsomegentleemetics。Thesoreistobetreatedwithdressingsforfreshwounds，whichpermitofallusions，orwiththeleavesofcamomile，orwiththeapplicationsforfracturedbonesofthehead，butnothingverycoldmustbeapplied。Thefirst（mostdistant？）jointsareleastdangerous，butthosestillhigher，aremoreso。Reductionshouldbemadethesameday，orthenext，butbynomeansonthethirdorfourth，foritisonthefourthdaythatexacerbationsespeciallyattack。Inthosecases，then，whereimmediatereductioncannotbeaccomplished，wemustwaituntilaftertheaforesaiddays；forwhateveryoureducewithintendays，maybeexpectedtoinducespasm。Butifthespasmsuperveneonitsbeingreduced，thejointshouldbequicklydisplaced，andbathedfrequentlywithwarmwater，andthewholebodyshouldbekeptinawarm，soft，andeasycondition，andmoreespeciallyaboutthejoints，forthewholebodyshouldratherbeinabentthaninanextendedstate。Moreover，itistobeexpected，thatthearticularextremitiesofthebonesofthefingerswillforthisgenerallyhappens，ifeventheleastdegreeofinflammationtakeplace，sothatifitwerenotthatthephysicianwouldbeexposedtocensure，owingtotheignoranceofthecommonpeople，noreductionshouldbemadeatall。Thereductionofthebonesofjointswhichhaveprotrudedthroughtheskin，isattendedwiththedangerswhichhavebeendescribed。
68。Whenthearticularbonesofthefingersarefairlychoppedoff，thesecasesaremostlyunattendedwithdanger，unlessdeliquiumcomeoninconsequenceoftheinjury，andordinarytreatmentwillbesufficienttosuchsores。Butwhenresectionismade，notatthearticulations，butatsomeotherpointinthebones，thesecasesalsoarefreefromdanger，andarestillmoreeasilycuredthantheothers；andthefracturedbonesofthefingerswhichprotrudeotherwisethanatthejointadmitofreductionwithoutdanger。
Completeresectionsofbonesatthejoints，whetherthefoot，thehand，theleg，theankle，theforearm，thewrist，forthemostpart，arenotunattendedwithdanger，unlessonebecutoffatoncebydeliquiumanimi，orifcontinualfeversuperveneonthefourthday。
69。Withregardtothesphacelusoffleshyparts，ittakesplaceinwoundswheretherearelargeblood—vessels，whichhavebeenstronglycompressed，andinfracturesofboneswhichhavebeenboundtootight，andinothercasesofimmoderateconstriction，whenthepartswhichhavebeenstrangulatedgenerallydropoff；andthemostofsuchpatientsrecover，evenwhenaportionofthethighcomesaway，orofthearm，bothbonesandflesh，butlesssointhiscase；andwhenthefore—armandlegdropoff，thepatientsreadilyrecover。Incasesthen，offractureofthebones，whenstrangulationandblackeningofthepartstakeplaceatfirst，theseparationofthedeadandlivingpartsquicklyoccurs，andthepartsspeedilydropoff，astheboneshavealreadygivenway；butwhentheblackening（mortification）takesplacewhilethebonesareentire，thefleshyparts，inthiscase，alsoquicklydie，butthebonesareslowinseparatingattheboundaryoftheblackening，andwherethebonesarelaidbare。Thosepartsofthebodywhicharebelowtheboundariesoftheblackeningaretoberemovedatthejoint，assoonastheyarefairlydeadandhavelosttheirsensibility；carebeingtakennottowoundanylivingpart；forifthepartwhichiscutoffgivepain，andifitprovenottobequitedead，thereisgreatdangerlestthepatientmayswoonawayfromthepain，andsuchswooningsoftenareimmediatelyfatal。Ihaveknownthethigh—bones，whendenudedinthismanner，dropoffontheeightiethday；butinthecaseofthispatient，thepartsbelowwereseparatedatthekneeonthetwentiethday，and，asIthought，tooearly，foritappearedtomethatthisshouldbedonemoreguardedly。InacasewhichIhadofsuchblackeningintheleg，thebonesoftheleg，asfarastheyweredenuded，separatedatitsmiddleonthesixtiethday。Buttheseparationofdenudedbonesisquickerorslower，accordingtothemodeoftreatment；something，too，dependsuponwhetherthecompressionbestrongerorweaker，andwhetherthenerves，flesh，arteries，andveinsarequickerorslowerinbecomingblackenedandindying；since，whenthepartsarenotstronglycompressed，theseparationismoresuperficial，anddoesnotgothelengthoflayingthebonesbare，andinsomecasesitisstillmoresuperficial，soasnoteventoexposethenerves。Forthereasonsnowstated，itisimpossibletodefineaccuratelythetimeatwhicheachofthesecaseswillterminate。Thetreatmentofsuchcases，however，istobereadilyundertaken，fortheyaremoreformidabletolookatthantotreat；andamildtreatmentissufficientinallsuchcases，fortheycometoacrisisofthemselves；onlythedietmustbeattendedto，sothatitmaybeaslittlecalculatedtocreatefeveraspossible，andthebodyistobeplacedintheproperpositions：
theseare，neitherraisedveryhighup，norinclinedmuchdownward，butratherupward，untiltheseparationbecompleted；foratthattimethereismostdangerofhemorrhage；onthisaccount，woundsshouldnotbelaidinadecliningposition，butthecontrary。Butafterawhile，andwhenthesoreshavebecomeclean，thesamepositionswillnolongerbeappropriate；butastraightposition，andoneincliningdownward，maybeproper；andinthecourseoftime，insomeofthesecases，abscessesform，andrequirebandages。Onemayalsoexpectthatsuchpatientswillbeattackedwithdysentery；fordysenteryusuallysupervenesincasesofmortificationandofhemorrhagefromwounds；itcomesongenerallywhentheblackeningandhemorrhagehavearrivedatacrisis，andisprofuseandintense，butdoesnotlastmanydays；neitherisitofafatalnature，forsuchpatientsdonotusuallylosetheirappetite，norisitpropertoputthemonarestricteddiet。
70。Dislocationinwardatthehip—jointistobereducedinthefollowingmanner：（itisagood，proper，andnaturalmodeofreduction，andhassomethingofdisplayinit，ifanyonetakesdelightinsuchostentatiousmodesofprocedure）。Thepatientistobesuspendedbythefeetfromacross—beamwithastrong，soft，andbroadcord；thefeetaretobeaboutfourinchesorlessfromoneanother；
andabroadandsoftleathercollarconnectedwiththecross—beamistobeputonabovetheknees；andtheaffectedlegshouldbesoextendedastomovedbetwoincheslongerthantheother；theheadshouldbeabouttwocubitsfromtheground，oralittlemoreorless；andthearmsshouldbestretchedalongthesides，andboundwithsomethingsoft；allthesepreparationsshouldbemadewhileheislyingonhisback，sothathemaybesuspendedforasshortatimeaspossible。Butwhenthepatientissuspended，apersonproperlyinstructedandnotweak，havingintroducedhisarmbetweenhisthighs，istoplacehisfore—armbetweentheperineumandthedislocatedheadoftheosfemoris；andthen，havingjoinedtheotherhandtotheonethuspassedthroughthethighs，heistostandbythesideofthesuspendedpatient，andsuddenlysuspendandswinghimselfintheairasperpendicularlyaspossible。Thismethodcomprisesalltheconditionswhicharenatural；forthebodybeingsuspendedbyitsweight，producesextension，andthepersonsuspendedfromhim，alongwiththeextension，forcestheheadofthethigh—bonetoriseupabovetheacetabulum；andatthesametimeheusestheboneofthefore—armasalever，andforcestheosfemoristoslipintoitsoldseat。Thecordsshouldbeproperlyprepared，andcareshouldbetakenthatthepersonsuspendedalongwiththepatienthaveasufficientlystronghold。
71。Wherefore，asformerlystated，men’sconstitutionsdiffermuchfromoneanotherastothefacilityordifficultywithwhichdislocationsarereduced；andthecauseofthiswasalsostatedformerlyintreatingoftheshoulder。Insomethethighisreducedwithnopreparation，withslightextension，directedbythehands，andwithslightmovement；andinsomethereductioniseffectedbybendingthelimbatthejoint，andmakingrotation。Butmuchmorefrequentlyitdoesnotyieldtoanyordinaryapparatus，andthereforeoneshouldbeacquaintedwiththemostpowerfulmeanswhichcanbeappliedineachcase，andusewhatevermaybejudgedmostproperunderallcircumstances。Themodesofextensionhavebeendescribedintheformerpartsofthework，sothatonemaymakeuseofwhatevermayhappentobeathand。For，extensionandcounter—extensionaretobemadeinthedirectionofthelimbandthebody；andifthisbeproperlyeffected，theheadofthethigh—bonewillberaisedaboveitsancientseat；andifthusraised，itwillnotbeeasytopreventitfromsettlinginitsplace，sothatanyordinaryimpulsewiththeleverandadjustmentwillbequitesufficient；butsomeapplyinsufficientextension，andhencethereductiongivesmuchtrouble。
Thebandsthenshouldbefastened，notonlyatthefoot，butalsoabovetheknee，sothattheforceoftheextensionmaynotbeexpendedontheknee—jointmorethanuponthehip—joint。Theextensioninthedirectionofthefootistobethuscontrived。Butthecounter—extensionisnotonlytobemanagedbymeansofsomethingcarriedroundthechestandarmpits，butalsobyalong，double，strong，andsupplethongappliedtotheperineum，andcarriedbehindalongthespine，andinfrontalongthecollar—boneandfixedtothepointfromwhichcounter—extensionismade；andthenforceistobesoapplied，bymeansofthisextensionandcounter—extension，thatthethongattheperineummaynotpassovertheheadofthethigh—bone，butbetweenitandtheperineum；andduringtheextensiononeshouldstriketheheadofthefemurwiththefist，soastodriveitoutward。
Andwhenthepatientisraisedupbythestretching，youshouldpassahandthrough（betweenthelegs？）andgraspitwiththeotherhand，soasatthesametimetomakeextension，andforcethedislocatedlimboutward；whilesomeotherpersonsittingbythekneequietlydirectsitinward。
72。Ithasbeenformerlystatedbyusthatitwillbeofimportanceforanypersonwhopracticesmedicineinapopulouscitytogetpreparedaquadrangularboard，aboutsixcubitsoralittlemoreinlength，andabouttwocubitsinbreadth；afathomwillbesufficientthicknessforit；andthenalongitfromtheoneendtotheother，anexcavationmustbemade，sothattheworkingoftheleversmaynotbehigherthanisproper；thenatbothsideswearetoraiseshort，strong，andstrongly—fixedposts，havingaxles；andinthemiddleofthebenchfiveorsixlonggroovesaretobescoopedoutaboutfourinchesdistantfromoneanother，threeincheswillbeasufficientbreadthforthem，andthedepthinlikemanner；andalthoughthenumberofgroovesIhavementionedwillbesufficient，thereisnothingtopreventtheirbeingmadealloverthebench。Andthebenchshouldhaveinitsmiddleaprettydeephole，ofasquareshape，andofaboutthreeinchesinsize；andintothishole，whenjudgednecessary，istobeadjustedacorrespondingpieceofwood，roundedabove，which，atthepropertime，istobeadjustedbetweentheperineumandtheheadofthethigh—bone。Thisuprightpieceofwoodpreventsthebodyfromyieldingtotheforcedraggingdownwardbythefeet；forsometimesthispieceofwoodservesthepurposeofcounter—extensionupward；andsometimes，too，whenextensionandcounter—extensionaremade，thispieceofwood，ifsusceptibleofsomemotiontothissideorthat，willservethepurposeofaleverforpushingtheheadofthethigh—boneoutward。Itisonthisaccountthatseveralgroovesarescoopedoutonthebench，sothatthispieceofwood，beingerectedattheonewhichanswers，mayactasalever，eitheronthesidesofthearticularheadsofbones，ormaymakepressuredirectontheheadsalongwiththeextension，accordingasitmaysuittopushinwardoroutwardwiththelever；andthelevermaybeeitherofaroundorbroadform，asmaybejudgedproper；forsometimestheoneformandsometimestheothersuitswiththearticulation。Thismodeofapplyingtheleveralongwithextensionisapplicableinthereductionofalldislocationsofthethigh。Inthecasenowonhand，aroundleverisproper；butindislocationsoutwardaflatleverwillbethesuitableone。Bymeansofsuchmachinesandofsuchpowers，itappearstomethatweneedneverfailinreducinganydislocationatajoint。
73。Andonemightfindoutothermodesofreductionforthisjoint。Ifthelargebenchweretohaveraisedonittwopostsaboutafoot（indiameter？），andofasuitableheight，oneachsidenearitsmiddle，andifatransversepieceofwoodlikethestepofaladder，wereinsertedintheposts，thenifthesoundlegwerecarriedthroughbetweentheposts，andtheinjuredlimbwerebroughtoverthetransversepieceofwood，whichshouldbeexactlyadaptedinheighttothejointwhichisdislocated（anditisaneasymattersotoadjustit，forthestepoftheladdershouldbemadealittlehigherthanrequired，andaconvenientrobe，foldedseveraltimes，istobelaidbelowthepatient’sbody），thenapieceofwood，ofsuitablebreadthandlength，istobelaidbelowthelimb，anditshouldreachfromtheankletobeyondtheheadofthethigh—bone，andshouldbeboundmoderatelytighttothelimb。Thenthelimbbeingextended，eitherbymeansofthepestle—likepieceofwood（formerlydescribed），orbyanyoftheothermethodsofextension，thelimbwhichiscarriedoverthestepwiththepieceofwoodattachedtoit，istobeforceddownward，whilesomebodygraspsthepatientabovethehip—joint。Inthismannertheextensionwillcarrytheheadofthethighboneabovetheacetabulum，whiletheleverpowerthatisexercisedwillpushtheheadofthethigh—boneintoitsnaturalseat。Alltheabove—mentionedpowersarestrong，andmorethansufficienttorectifytheaccident，ifproperlyandskillfullyapplied。For，asformerlystated，inmostcasesreductionmaybeeffectedbymuchweakerextension，andaninferiorapparatus。
74。Iftheheadoftheboneslipoutward，extensionandcounter—extensionmustbemadeasdescribed，orinasimilarmanner。
Butalongwiththeextensionabroadleveristobeusedtoforcethebonefromwithoutinward，theleverbeingplacedatthenatesoralittlefartherup，andsomepersonistosteadythepatient’sbody，sothatitmaynotyield，eitherbygraspinghimatthebuttockswithhishands，orthismaybeeffectedbymeansofanothersimilarlever，adjustedtooneofthegrooves，whilethepatienthassomethinglaidbelowhim，andheissecured，andthedislocatedthighistobeturnedgentlyfromwithinoutwardattheknee。Suspensionwillnotanswerinthisformofdislocation，for，inthisinstance，thearmofthepersonsuspendedfromhim，wouldpushtheheadofthethigh—bonefromtheacetabulum。Butonemightusethepieceofwoodplacedbelowhimasalever，insuchamannerasmightsuitwiththismodeofdislocation；itmustworkfromwithout。Butwhatuseisthereformorewords？Foriftheextensionbewellandproperlydone，andiftheleverbeproperlyused，whatdislocationofthejointcouldoccur，thatmightnotbethusreduced？
75。Indislocationofthethigh，backward，extensionandcounter—extensionshouldbemadeashasbeendescribed；andhavinglaidonthebenchaclothwhichhasbeenfoldedseveraltimes，sothatthepatientmayliesoft，heistobelaidonhisface，andextensionthusmade，and，alongwiththeextension，pressureistobemadewithaboard，asinthecaseofhumpback，theboardbeingplacedontheregionofthenates，andratherbelowthanabovethehip—joint；andtheholemadeinthewallfortheboardshouldnotbedirectover，butshouldbeinclinedalittledownward，towardthefeet。Thismodeofreductionisparticularlyappropriatetothisvarietyofdislocation，andatthesametimeisverystrong。Butperhaps，insteadoftheboard，itmightbesufficienttohaveapersonsitting（ontheseatofluxation？），orpressingwithhishands，orwithhisfoot，andsuddenlyraisinghimselfup，alongwiththeextension。Noneoftheotheraforementionedmodesofreductionarenaturalinthisformofdislocation。
76。Indislocationforward，thesamemodeofextensionshouldbemade；butapersonwhohasverystronghands，andiswelltrained，shouldplacethepalmoftheonehandonthegroin，andtakingholdofthishandwiththeother，isatthesametimetopushthedislocatedpartdownward，andatthesametimetotheforepartoftheknee。Thismethodofreductionismostespeciallyconformabletothismodeofdislocation。Andthemodeofsuspensionisalsonotfarremovedfrombeingnatural，butthepersonsuspendedshouldbewelltrained，sothathisarmmaynotactasaleveruponthejoint，butthattheforceofthesuspensionmayactaboutthemiddleoftheperineum，andattheossacrum。
77。Reductionbythebladderisalsocelebratedindislocationsatthisjoint，andIhaveseencertainpersonswho，fromignorance，attemptedtoreducebothdislocationsoutwardandbackwardtherewith，notknowingthattheywereratherdisplacingthanreplacingtheparts；itisclear，however，thathewhofirstinventedthismethodintendeditfordislocationinward。Itisproper，then，toknowhowthebladdershouldbeused，ifitistobeused，anditshouldbeunderstoodthatmanyothermethodsaremorepowerfulthanit。Thebladdershouldbeplacedbetweenthethighsuninflated，sothatitmaybecarriedasfaruptheperineumaspossible，andthethighsbeginningatthepatellaaretobeboundtogetherwithaswathe，asfarupasthemiddleofthethigh，andthenabrasspipeistobeintroducedintooneoftheloosefeetofthebladder，andairforcedintoit，thepatientistolieonhissidewiththeinjuredlimbuppermost。This，then，isthepreparation；some，however，dothethingworsethanasIhavedescribed，fortheydonotbindthethighstogethertoanyextent，butonlyattheknees，neitherdotheymakeextension，whereasextensionshouldbemade，andyetsomepeoplebyhavingthegoodfortunetomeetwithafavorablecase，havesucceededinmakingreduction。Butitisnotaconvenientmethodofapplyingforce，forthebladder，wheninflated，doesnotpresentitsmostprominentparttothearticularextremityofthefemur，whichistheplacethatoughttobemoreespeciallypressedoutward，butitsmiddle，whichprobablycorrespondswiththemiddleofthethigh，orstilllowerdown，forthethighsarenaturallycurved，beingfleshy，andincontactabove，andbecomingsmallerdownward，sothatthenaturalconfigurationofthepartsforcesthebladderfromthemostproperplace。Andifasmallbladderbeintroduced，itspowerwillbesmall，andunabletoovercometheresistanceofthearticularbone。
Butifthebladdermustbeused，thethighsaretobeboundtogethertoaconsiderableextent，andthebladderistobeinflatedalongwiththeextensionofthebody，andinthismethodofreductionbothlegsaretobeboundtogetherattheirextremity。
78。Theprimeobjectofthephysicianinthewholeartofmedicineshouldbetocurethatwhichisdiseased；andifthiscanbeaccomplishedinvariousways，theleasttroublesomeshouldbeselected；forthisismorebecomingagoodman，andonewellskilledintheart，whodoesnotcovetpopularcoinofbasealloy。Withregardtothesubjectnowonhand，thefollowingaredomesticmeansofmakingextensionofthebody，sothatitiseasytochoosefromamongthethingsathand：—Inthefirstplace，whensoftandsupplethongsarenotathandforligatures，eitherironchains，orcords，orcablesofships，aretobewrappedroundwithscarfsorpiecesofwoolenrags，especiallyatthepartsofthemwhicharetobeapplied，andinthisstatetheyaretobeusedasbands。Inthesecondplace，thepatientistobecomfortablylaidonthestrongestandlargestcouchthatisathand，andthefeetofthecouch，eitherthoseatthe（patient’s？）head，orthoseatthefeet，aretobefastenedtothethreshold，eitherwithinorwithout，asismostsuitable；andasquarepieceofwoodistobelaidacross，andextendingfromtheonefoottotheother；andifthispieceofwoodbeslender，itshouldbeboundtothefeetofthecouch，but，notwithstanding，ifitbethick，therewillbenonecessityforthis；thentheheadsoftheligatures，bothofthoseattheheadandthoseatthefeet，aretobefastenedtoapestle，orsomesuchpieceofwood，difficulttoreduceateitherend；
theligaturesshouldrunalongthelineofthebody，orbealittleelevatedaboveit，anditshouldbestretchedproportionallytothepestles，sothat，standingerect，theonemaybefastenedtothethreshold，andtheothertothetransversepieceofwood。Extensionisthentobemadebybendingbacktheendsofthepestles。Aladder，havingstrongsteps，iflaidbelowthebed，willservethepurposeofthethresholdandthepieceofwoodlaidalong（thefootofthecouch？），asthepestlescanbefastenedtothestepsateitherend，andwhendrawnbacktheythusmakeextensionoftheligatures。
Dislocation，inwardorforward，maybereducedinthefollowingmanner：aladderistobefastenedintheground，andthemanistobeseateduponit，andthenthesoundlegistobegentlystretchedalongandboundtoit，whereveritisfoundconvenient；andwateristobepouredintoanearthenvessel，orstonesputintoahamperandslungfromtheinjuredleg，soastoeffectthereduction。Anothermodeofreduction：across—beamistobefastenedbetweentwopillarsofmoderateheight；andatonepartofthecross—beamthereshouldbeaprotuberanceproportionatetothesizeofthenates；andhavingboundacoverletroundthepatient’sbreast，heistobeseatedontheprotuberantpartofthecross—beam，andafterwardthebreastistobefastenedtothepillarbysomebroadligature；thensomeoneistoholdthesoundlegsothathemaynotfalloff，andfromtheinjuredlimbistobesuspendedsomeconvenientweight，asformerlydescribed。
79。Itshouldbeparticularlyknownthattheunionofallbonesis，forthemostpart，byaheadandsocket（cotyle）；insomeofthesetheplace（socket？）iscotyloidandoblong，andinsomethesocketisglenoid（shallow？）。Inalldislocationsreductionistobeeffected，ifpossible，immediately，whilestillwarm，butotherwise，asquicklyasitcanbedone；forreductionwillbeamucheasierandquickerprocesstotheoperator，andamuchlesspainfulonetothepatient，ifeffectedbeforeswellingcomeson。Butallthejointswhenabouttobereducedshouldbefirstsoftened，andgentlymovedabout；for，thustheyaremoreeasilyreduced。And，inallcasesofreductionatjoints，thepatientmustbeputonasparediet，butmoreespeciallyinthecaseofthegreatestjoints，andthosemostdifficulttoreduce，andlesssointhosewhichareverysmallandeasilyreduced。
80。Ifanyjointofthefingersisdislocated，whetherthefirst，second，orthethird，thesamemethodofreductionistobeapplied，butthelargestjointsarethemostdifficulttoreduce。Therearefourmodesofdisplacement—eitherupward，downward，ortoeitherside；
mostcommonlyupward，andmostrarelylaterally，andinconsequenceofviolentmotion。Onbothsidesofitsarticularcavitythereisasortofraisedborder。Whenthedislocationisupwardordownward，owingtothearticularcavityhavingsmootheredgestherethanatthesides，ifthejointofitbedislocated，itismoreeasilyreduced。Thisisthemodeofreduction：—Theendofthefingeristobewrappedroundwithafillet，orsomethingsuch，that，whenyoulayholdofitandmakeextension，itwillnotslip；andwhenthisisdone，somepersonistograspthearmatthewrist，andanotheristotakeholdofthefingerwhichiswrappedinthefillet，andtheneachistomakeconsiderableextensiontowardhimself，andatthesametimetheprojectingboneistobepushedintoitsplace。But，ifthedislocationbelateral，thesamemodeofreductionistobeused；
butwhenyouthinkthattheextremityofthebonehasclearedtherim，atthesametimethatextensionismade，theboneistobepusheddirectintoitsplace，whileanotherpersonontheothersideofthefingeristotakecareandmakecounter—pressure，sothatitmaynotagainslipoutthere。Thetwistednoosesformedfrompalm—shootsareconvenientforeffectingreduction，ifyouwillmakeextensionandcounter—extensionbyholdingthetwistedstringintheonehandandthewristintheother。Whenreduced，youmustbindthepartasquicklyaspossiblewithbandages；thesearetobeveryslenderandwaxedwithcerate，neitherverysoftnorveryhard，butofmiddleconsistence；forthatwhichisharddropsofffromthefinger，whilethatwhichissoftandliquidismeltedandlostbytheincreasedheatofthefinger。Thebandageistobeloosedonthethirdorfourthday；
butonthewhole，ifinflamed，itistobethemorefrequentlyloosed，andifotherwise，morerarely；thisIsayrespectingallthejoints。
Thearticulationofafingerisrestoredinfourteendays。Thetreatmentofthefingersandofthetoesisthesame。
81。Afterallreductionsofjointsthepatientshouldbeconfinedtoarestricteddietandabstinenceuntiltheseventhday；andiftherebeinflammation，thebandagesaretobethemorefrequentlyloosed，butotherwise，lessfrequently，andthepainedjointistobekeptconstantlyinastateofrest，andistobelaidinthemostconvenientpositionpossible。
82。Accidentsatthekneearemoremildthanattheelbow，fromitsbeingcompact，regular，andelegantinitsconstruction；and，therefore，itismorereadilydislocatedandreduced。Itismostfrequentlydislocatedinward，butalsooutwardandbackward。Themodesofreductionarethese：byflexionattheknee，orbysuddencalcitration，orhavingrolledaswatheintoaball，andfixeditintheham，thepatient’sbodyistobesuddenlydroppedonitsbendedknees。Dislocationbackward，also，asinthecaseoftheelbow，maybereducedbymoderateextension，andtoeitherside，eitherbyflexionorcalcitration，butalsobymoderateextension。Theadjustmentisthesameinallcases。Indislocationsbackwardwhicharenotreduced，thepatientcannotbendthejoint，butneithercanhe，toanygreatextent，intheothervarieties；thethighandlegarewastedinfront；
butifinwardthepatientsbecomebow—legged，andtheexternalpartsarewasted；butifoutwardtheybecomemorebandy—legged，buttheimpedimentisless，forthebodyissupportedonthelargerofthebones，andtheinnerpartsarewasted。Whentheseaccidentshappenatbirthorduringadolescence，theyfollowtheruleformerlystated。
83。Dislocationsattheankle—jointsrequirestrongextension，eitherwiththehandsorsomesuchmeans；andadjustment，whichatthesametimeeffectsbothpurposes，asiscommoninallcases。
84。Injuriesofthefootaretoberemediedlikethoseofthehand。
85。Thebonesconnectedwiththeleg，andwhicharedislocated，eitheratbirthorduringadolescence，followthesamecourseasthoseinthehand。
86。Whenpersonsjumpingfromaheightpitchontheheel，soastooccasionseparation（diastasis）ofthebones，ecchymosisoftheveins，andcontusionofthenerves；whenthesesymptomsareveryviolentthereisdangerofsphacelus，andthatthecasemaygivetroubleduringlife，forthebonesaresoconstructedastoslipfromoneanother，andthenervescommunicatetogether。And，indeed，incasesoffracture，eitherfromaninjuryinthelegorthigh，orinparalysisofthenerves（tendons？）connectedwiththeseparts，orfromneglectduringconfinementtobed，whentheheelgetsblackenedthemostseriousconsequencesresulttherefrom。Sometimes，inadditiontothesphacelus，therecomeonacutefeversaccompaniedwithhiccup，aberrationofintellect，andspeedydeath，withlividitiesofthelargeblood—vessels。Withregardtothesymptomsattendingexacerbations，iftheecchymosedandblackenedpartsandthosearoundbesomewhathardandred，andifalongwiththehardnesstherebelividity，mortificationistobeapprehended；butifthepartsbeslightlylivid，orevenverylivid，andtheswellingdiffused，orifgreenishandsoft，theseappearances，insuchcases，areallfavorable。Thetreatment，ifnofeverbepresent，consistsintheadministrationofhellebore，butotherwise（itisnottobegiven，butoxyglyky（decoctionofhoneycombsandvinegar）istobegivenfordrink，ifrequired。Bandagingasintheotherarticulations：
aboveall，moreespeciallyincontusions，thebandagesshouldbenumerousandsofterthanusual，butthecompressionshouldbeless；
mostturnsshouldbemadearoundtheheel。Position，likethebandaging，shouldbesoregulatedasnottodeterminetotheheel。
Splintsarenottobeused。
87。Whenthefootisdislocated，eitheraloneoralongwithitsepiphysis，thedisplacementis，forthemostpart，totheinside。Ifnotreduced，inthecourseoftime，thehip，thethigh，andthesideofthelegoppositethedislocation，becomeatrophied。Reductionisthesameasinthewrist，buttheextensionrequirestobeverypowerful。Treatment，agreeablytothegeneralruleforjoints。
Exacerbationsdooccur，butlessfrequentlythanindislocationsatthewrist，providedthepartsgetrest。Whiletheyremainatrestthedietshouldberestricted。Thosewhichoccuratbirth，orduringadolescence，followtheruleformerlystated。