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A Treatise on Fractures, Luxations, and other Affections of the Bones

A Treatise on Fractures, Luxations, and other Affections of the Bones
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Title: A Treatise on Fractures, Luxations, and other Affections of the Bones
Release Date: 2019-01-03
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Copyright Status: Public domain in the USA.
Date added: 27 March 2019
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A TREATISEONFRACTURES, LUXATIONS,AND OTHERAFFECTIONS OF THE BONES,

BY P. J. DESAULT,
SURGEON IN CHIEF TO THE HOTEL-DIEU OF PARIS,
WHEREIN HIS OPINIONS AND PRACTICE, IN SUCH CASES,
ARE STATED AND EXEMPLIFIED.
EDITED BY XAV. BICHAT;
WITH PLATES.

TRANSLATED FROM THE FRENCH,
BY CHARLES CALDWELL, M. D.

WITH NOTES, AND AN APPENDIX CONTAINING SEVERAL
LATE IMPROVEMENTS IN SURGERY.

PHILADELPHIA:
PRINTED BY FRY AND KAMMERER, LÆTITIA COURT.

1805.

District of Pennsylvania, to wit:

BE IT REMEMBERED, That on the twentiethday of February, in the twenty-ninth year of the independenceof the United States of America, A. D. 1805,Charles Caldwell, M. D. of the said district, hath deposited inthis Office, the Title of a Book, the Right whereof he claimsas proprietor, in the words following to wit:

“A Treatise on Fractures, Luxations, and other Affectionsof the Bones, by P. J. Desault, surgeon in chief to the Hotel-Dieuof Paris, wherein his Opinions and Practice, in suchcases, are stated and exemplified. Edited by Xav. Bichat;with Plates. Translated from the French, by Charles Caldwell,M. D. With Notes, and an Appendix containing severallate improvements in surgery.”

In conformity to the act of the Congress of the United States,intituled, “An act for the encouragement of learning, by securingthe copies of maps, charts, and books, to the authors and proprietorsof such copies during the times therein mentioned:”And also to the act, entitled, “An act supplementary to an act,entitled, “An act for the encouragement of learning, by securingthe copies of maps, charts, and books, to the authors and proprietorsof such copies during the times therein mentioned,” andextending the benefits thereof to the arts of designing, engravingand etching historical and other prints.”

D. CALDWELL,   
Clerk of the District of Pennsylvania.


CONTENTS.


  MEMOIR I.PAGE
On the Fracture of the Condyls of the lower Jaw,
MEMOIR II.
On the Fracture of the Clavicle,
Explanation of the first Plate,
MEMOIR III.
On the Luxation of the Clavicle,
 Luxation of the Sternal extremity,
         of the Humeral extremity,
MEMOIR IV.
On Fractures of the Acromion, and of the lower angle of the Scapula,
  Fracture of the Acromion,
      of the lower angle of the Scapula,
MEMOIR V.
On the Fractures of the upper end or neck of the Humerus,
MEMOIR VI.
On the Fracture of the lower extremity of the Humerus, with a separation of the Condyls,
MEMOIR VII.
On the Luxation of the Humerus,
MEMOIR VIII.
On the Fracture of the bones of the Fore-arm,
    Fracture of the Radius,
        of the Ulna,
        of the Olecranon,
MEMOIR IX.
On the Luxation of the Fore-arm,
MEMOIR X.
On the Luxations of the Radius over the Ulna,
    Luxation of the lower extremity of the Radius,
MEMOIR XI.
On the Fractures of the Thigh,
    Fractures of the body of the Os Femoris,
         of the upper end of the Os Femoris,
         of the great Trochanter,
         of the neck of the Os Femoris,
         of the lower extremity of the Os Femoris,
Explanation of the second Plate,
Thoughts on Luxations of the Os Femoris upward and forward,
MEMOIR XII.
On spontaneous Luxations of the Os Femoris,299
MEMOIR XIII.
On the Fracture of the Rotula,
MEMOIR XIV.
On the formation of foreign bodies in the joint of the knee,
Observations and Reflections on forms of Apparatus1 for fractures of the leg,
MEMOIR XV.
On the Division of the Tendo Achillis,
MEMOIR XVI.
On the Fracture of the Os Calcis,
MEMOIR XVII.
On complicated Luxations of the Foot,
APPENDIX.
ARTICLE I.
Dr. Physick’s new and successful method of treating an old and obstinate fracture of the os humeri,
ARTICLE II.
An account of Dr. Physick’s improvement of Desault’s apparatus for making permanent extension in oblique fractures of the os femoris,
ARTICLE III.
Explanation of the third Plate,

PREFACE

BY THE TRANSLATOR.


The business of a translator, though verylimited as to its range, may be extensive andimportant in its consequences, and, thoughhumble in its end, is oftentimes extremely difficultin its nature. Prohibited from adding anything to, or in any measure transgressing thebounds of, the meaning of his original, he isobligated to interpret that meaning with faithfulnessand accuracy. In this latter point consiststhe difficulty of his task. If severaldifferent readers oftentimes attach as manydifferent meanings to parts and sentences ofworks written in their own language, howmuch more likely will this be to occur withrespect to such as are written in a foreign language?For readers to differ in the formercase is common, in the latter unavoidable.

The translator of the following work is farfrom affirming, that he has in no instance deviatedfrom the meaning of his original. Tohazard an assertion like this, would be assumingto himself more than is consistent withmodesty or, perhaps, with truth. He trusts,however, that such deviations are very rare,that if they do occur they are but slight inthemselves, and never connected with facts orprinciples of practical importance. He can, atleast, very confidently declare, that they havenever been the offspring of carelessness ordesign.

Should any one open this volume in questof the flowers of fancy, or the embellishmentsof style, he will close it again without beinggratified. Ambitious only of communicatingnew and useful matter, and too intent on thingsto be in any measure choice of his words, thecelebrated original was regardless, perhaps toa fault, of the ornaments of diction. Rich inthe resources of a capacious and exalted intellect,he poured forth his knowledge like preciousore from the mine, leaving to others ofinferior capacities the humbler task of refiningand polishing it.

With such an example before him, thetranslator thought it best to follow in somemeasure the footsteps of his illustrious guide,without venturing to chalk out a new and differenttrack for himself. As his principal object,throughout the work, has been to makehimself clearly understood, and that in as fewwords as practicable, he has never hesitated,when they came in competition, to sacrificeelegance to precision and ornament to perspicuity.He has even in some instances beenguilty of intentional tautology, for the purposeof rendering his meaning the more clear anddefinite. For this he flatters himself he needoffer no apology to those, who prefer utility topleasure and sense to sound. And, as to readersof an opposite cast of mind, should anysuch choose to sit in judgment on him, he neitherdeprecates their censure nor courts theirapprobation.

A circumstantial analysis of the followingmemoirs would constitute a paper too extensiveto be introduced here in the form of apreface, and a mere outline or general characterof them would be altogether useless. Thetranslation is now before the public, and everyreader must judge of its merit for himself.On this point the translator will only observe,that the attention which he has been necessarilyled to bestow on the work, has been tohim the best school of surgery he ever attended,as far as relates to affections of the bones.Should other practitioners throughout theUnited States derive equal benefit from perusinghis translation, he will rejoice in a consciousnessof having, at least in one instance,been of service to his country.

Such are the extent and importance of Desault’simprovements in some branches ofpractical surgery, as to constitute a new epochin the history of the profession. His differentforms of apparatus for fractures and luxationsare certainly more rational in their construction,and more efficacious in their action, thanthose of any other writer. But their excellencedoes not arise from these circumstancesalone. Their cheapness and simplicity, takenin conjunction with the ease and quicknesswith which they may be every where made andapplied, greatly enhance their value, particularlyto practitioners in the country. If theybe not already at hand, they can be easily preparedby the surgeon or his assistants, withoutany material loss of time. The sufferings ofthe patient, therefore, whatever may be theform of fracture or luxation under which helabours, need never be prolonged, by any delayin obtaining the necessary apparatus. It isthus that the means and processes of every artbecome simple and easy, in proportion as theart itself approaches perfection: and thus thatthe truly great artist is known, not by themultiplicity and the complex nature of hisforms of apparatus, but by the numerous endswhich he accomplishes by means the mostsimple and easy of construction.

Several French practitioners, in projectingimprovements on the forms of apparatus ofDesault, have evidently rendered them morecomplex, more expensive, and therefore moredifficult to be constructed or procured, withoutadding in the smallest degree to the efficacyof their action. This is particularly the casewith respect to Boyer, in his attempt to substitutea new apparatus for a fractured clavicle,in place of that invented by Desault. Thelatter can be constructed in a very few minutesby the surgeon or one of his assistants, withoutany expense, whereas the former must bemade by a workman employed for the purpose,and is necessarily attended with both cost anddelay. Nor is it always practicable, particularlyin the country, to procure a workman capableof making this apparatus. But this is notall. On Desault’s plan, the same apparatusfor a fractured clavicle will fit, and may be appliedto, persons of different sizes and figures;whereas, on the plan of Boyer, each patientmust have an apparatus constructed particularlyfor himself. No practitioner, therefore,can hesitate a moment in deciding to which ofthese two forms of apparatus the preference isdue.

Similar remarks may be made respectingBoyer’s apparatus for making permanent extensionin oblique fractures of the os femoris.It is much more complex and difficult to beconstructed than that of Desault. Nor does itpossess a single advantage over it as improvedby Drs. Physick and Hutchinson. In a word,the forms of apparatus of Boyer may answerwell enough in hospitals and in cities, wherethe expence of such articles is not much regarded,and where workmen to make them can bereadily procured. But, as the practitioner inthe country is generally obliged to be himselfthe constructor of the forms of apparatus whichhe uses, and as he is not at all times preparedto meet heavy expenses, it is to those recommendedand employed by Desault that he mustnecessarily have recourse.

With these remarks the translator submitsto the good sense and candour of his countrymenthe following sheets, as the offspring ofsome of his hours of leisure throughout thewinter. He hopes that the appendix subjoinedby himself will not be regarded as either anuseless or an unpleasing addition. Every nativeof the United States, whose bosom glowsas it

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