. On bone-setting, so called, and its relation to the treatment of joints crippled by injury, rheumatism, inflammation, &c. &c. mb, is shifted downso as to make pressure upon any painful spot inthe groin while the flexion is completed. In thisway the pelvis of the patient is fixed to thecouch; and any tilting of his body upwards isprevented. As with other joints, the twist shouldbe made in the direction in which it is mostpainful; and, if the limb is elongated, it shouldbe carried outwards from the median line—ifshortened, inwards, during the act of flexion. In executing these various manipula
. On bone-setting, so called, and its relation to the treatment of joints crippled by injury, rheumatism, inflammation, &c. &c. mb, is shifted downso as to make pressure upon any painful spot inthe groin while the flexion is completed. In thisway the pelvis of the patient is fixed to thecouch; and any tilting of his body upwards isprevented. As with other joints, the twist shouldbe made in the direction in which it is mostpainful; and, if the limb is elongated, it shouldbe carried outwards from the median line—ifshortened, inwards, during the act of flexion. In executing these various manipulations thechief thing necessary is for the operator to haveconfidence and to exert sharply and instan-taneously the full leverage given to him by thelimbs. If he attempt to move them slowly he willprobably, in many cases, stop short of doing good—that is to say, of rupturing adhesions; beingdeterred either by the resistance that he feels orby the pain complained of by the patient. It needs no demonstration that a timid ope-rator may easily do mischief by traction upona joint, which, after all, he fails to relieve, when. Fig. 4. MANIPULATIONS. 91 a bolder and more rapid movement would atonce have set the patient free. I am disposed tothink that much of the fear of articular inflam-mation entertained by surgeons is based, if uponany clinical facts at all, almost entirely upon theresults of passive motion of an inefficient kind ;sufficient to increase the hurtful traction of anadhesion, but at the same time insufficient for itsdestruction. The bone-setters methods of dealing with theknee and hip-joints serve very well to illustratewhat I have already said about the ingenuity ofthe means by which all mechanical or instru-mental aids are dispensed with. In Mr. Brodhursts recent admirable work upondeformities, at pages 139 and 141 respectively,there are drawings of the contrivances to whichhe has had recourse, in cases of false anchylosisof the knee and hip-joints ; but although s
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