A practical treatise on fractures and dislocations . gentle-men made counter-extension from the opposite wrist, while Dr. Smithand Dr. Knapp made extension from the wrist of the injured side, atfirst pulling it downwards, but gradually raising it to the horizontal 1 Physick, Amer. Journ. Med. Sci., vol. xix, p. 386, Feb. 1837. Dorseys Ele-ments of Surgery, vol. i, p. 214. Philadelphia, 1813. 2 Smiths Med. and Surg. Memoirs, Baltimore, 1831, p. 337 ; also, Amer. Sci., July, 1861; also, American Med. Times, Nov. 9, 1861 ; paper by StephenRogers, 588 DISLOCATIONS OF THE SHOULDER.
A practical treatise on fractures and dislocations . gentle-men made counter-extension from the opposite wrist, while Dr. Smithand Dr. Knapp made extension from the wrist of the injured side, atfirst pulling it downwards, but gradually raising it to the horizontal 1 Physick, Amer. Journ. Med. Sci., vol. xix, p. 386, Feb. 1837. Dorseys Ele-ments of Surgery, vol. i, p. 214. Philadelphia, 1813. 2 Smiths Med. and Surg. Memoirs, Baltimore, 1831, p. 337 ; also, Amer. Sci., July, 1861; also, American Med. Times, Nov. 9, 1861 ; paper by StephenRogers, 588 DISLOCATIONS OF THE SHOULDER. direction, and then gently depressing the wrist. On the effort beingsteadily continued for two or three minutes, the bone was observed toslip easily into its place. But no position places the scapula so completely under our controlas that in which the arm is carried almost directly upwards, and thefoot is placed upon the top of the scapula. By this method we may suc-ceed generally when every other expedient has failed, yet it is painful; Fig. N. R. Smiths method. and I cannot but think that it increases the laceration of the capsule,and that, even when employed in recent cases, it does sometimes seriousinjury to the muscles about the joint. In Listers case of rupture ofthe axillary artery, and in Agnews case of rupture of the axillary vein,both of which will again be referred to in connection with ancient dislo-cations, the accidents occurred when the arm was drawn upwards. LaMothe was the first to recommend this method,1 but as early as the year1764, Charles White, of Manchester, made fast a set of pulleys in theceiling, and, placing a band around the wrist of the dislocated arm, hedrew the patient up until the whole body was suspended. No pressure, 1 La Motlie, Amor. Jonrn. Med. Sci., vol. xix, p. 387, Nov. 1836, from Melangesde Med. et Chir., Paris, 1812. DISLOCATION OF THE HUMERUS DOWNWARDS. 589 however, was made upon the scapula from above, which is uo doubtthe most
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