The apparatus used by the Greek and Romans in the setting of fractures and the reduction of dislocations.

  • Milne, John Stewart, 1871-
Date:
1909
Catalogue details

Licence: In copyright

Credit: The apparatus used by the Greek and Romans in the setting of fractures and the reduction of dislocations. Source: Wellcome Collection.

    31/62 (page 19)
    ceive a part of the head of the humerus. In it there are two holes at three places separated from each other by an interval, and in these soft thongs are inserted. ‘‘This spattle, wound round with a bandage in order that it may not injure by contact, is so applied to the arm at the axilla that its upper end is put under the top of the axilla; then by its thongs it is bound to the arm, at one place a little below the head of the humerus, at an- other a little above the elbow, at a third above the hand—indeed the spaces and holes have been arranged for this purpose. “The arm, tied in this manner, is passed over the step of a poultry ladder at such a height that the man cannot stand and while the body is let down on one side, the arm is made tense on the other, and thus it is brought about that the head of the humerus—impelled into position by the end of the board—is reduced, sometimes audibly, sometimes not so. “Many other methods can be learnt by reading Hippocrates alone but not one has stood the test of experience better.” The Machine of Tabnis. Heliodorus describes the construction of this machine, and its application for the reduction of dislocations of the humerus. Probably it is a machine used by artisans for some such pur- pose as the elevation of large blocks of stone, as it seems unlikely that such a large and cumbrous machine should have been especially in- vented for the single purpose of reducing the dislocation of one joint. Two views of the machine are given, (Fig. 19A). It consists, as will be seen, of two upright posts supported on a heavy base, while inside the posts a frame carrying two upright bars is raised and depressed by the rotation of an axle acting on a system of pulleys. Through the heads of the upright bars there passes another axle carrying a padded projection which is placed in the armpit. The arm is strapped to an ambe in the manner described already and is passed over the axle, the patient standing on tiptoe outside the ma- chine. (Fig. 20.) The arm is maintained at one level by thongs affixed by a clove hitch above the elbow and passing over pulleys above and below. On rotat- ing the lower axle the frame is pushed upwards, forcing the head of the bone into position, while at the same time an assistant forces the head of the bone outwards by a half turn of the upper axle, causing the padded projection to push outwards. Extemporised Apparatus and Substitutes. Having now described the apparatus which was used by practitioners settled permanently in populous places, we may consider the substitutes for these which were used by surgeons on their travels, or under other circumstances where the major apparatus was unavailable. Hippocrates says we must always be ready to make use of whatever happens to be at hand. He says that dislocation inwards at the hip may be reduced in the following manner.