DISLOCATION OF THE RIBS, &c.

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bloated, his chin lies upon his breast, and his face is generallyturned towards one side.

To reduce this dislocation, the unhappy person should immedi-ately be laid upon his back on the ground, and the operator mustplace himself behind him, so as to be able to lay hold of his headwith both hands, while he makes a resistance by placing his kneesagainst the patient's shoulder. In this posture he must pull thehead with considerable force, gently twisting it at the same time,if the face be turned to one side, till he perceives that the joint isreplaced, which may be known from the noise which the bonesgenerally make when going in, the patient's beginning to breathe,and the head continumg in its natural posture.

This is one of ihose operations which it is more easy to performthan describe. I have known instances of its being happily per-formed even by women, and often by men of no medical education.After the neck is reduced, the patient ought to be bled, and shouldbe suffered to rest for some days, till the parts recover their propertone.

Dislocation of the Ribs.

As the articulation of the ribs with the back-bone is very strong,they are not often dislocated. It does, however, sometimes hap-pen, which is a sufficient reason for our taking notice of it. Whena rib is dislocated, either upwards or downwards, in order toreplace it, the patient should be laid upon his belly on a table, andthe operator must endeavour to push the head of the bone into itsproper place. Should this method not succeed, the arm of thedisordered side may be suspended over a gate or ladder, and whilethe ribs are thus stretched asunder, the heads of such as are out ofplace may be thrust into their former situation.

Those dislocations wherein the heads of the ribs are forcedinwards, are both more dangerous and the most difficult to reduce,as neither the hand nor any instrument can be applied internallyto direct the luxated heads of the ribs. Almost the only thing thatcan be done is, to lay the patient upon his belly over a cask, orsome gibbous body, and to move the fore-part of the rib inwardtowards the back, sometimes shaking it ; by this means the heads ofthe luxated ribs may slip into their former place.

In a modern work* may be read the particulars of a case, whereall the ribs are said to have been dislocated from the cartilages.The accident arose from the chest being violently compressed be-tween the beam of a mill and the wall. In such a case, there isno means of reduction, except the effect produced by forcible in-spiration ; nor are there any modes of relief but bleeding, and theapplication of a roller round the chest.

Dislocation op the Shoulder.

The humerus or upper-bone of the arm may be dislocated invarious directions : it happens, however, most frequently down-wards, but very seldom directly upwards. From the nature of its

* C, Bell's Surg. Observations, p. V(\,