The Art of the Bone-Setter: A Testimony and a Vindication

by George Matthews Bennett

Fractures.	Dislocations.
Crepitus.	No crepitus.
Unnaturally movable.	More or less fixed.
Easily replaced.	Replaced with difficulty.
Limb often shortened.	Limb may be shortened or lengthened.
Seat of injury in the shaft or body of the bone.	Seat of injury at a joint.

Dislocations are partial or complete. Partial dislocations are most common and most difficult to understand, as the ordinary signs are not so clear as in complete dislocations, and may be overlooked or misunderstood, but as Mr. Jackson has before pointed out to the experienced Bone-setter, symptoms, which cannot be described appear; and motions, or want of motions equally unexplainable, are felt, so that he has very little difficulty in determining the nature of the injury.

Partial dislocations, displacements of tendons, and other injuries of a similar character, may sometimes be rectified a considerable time after the injury has been sustained, but should be attended to within a short time after the accident—at least, within a few days. Much, however, depends upon the nature of the injury, that no definite time can be given which the patient may take before seeking proper advice.

Many of the cases so graphically described in “Chambers’ Journal” and Dr. Hood’s book were evidently not complete dislocations, but partial dislocations of joints or displaced ligaments, etc., which admitted of being rectified by dexterous manipulation.

In plate II., figs. 1 and 2, I have given the appearances of a dislocated thumb and a dislocated finger (2) a very common form of accident; fig. 3 shows the radius of the arm fixed forward; fig. 4 shows the dislocation of the radius at the elbow-joint; and fig. 5 the dislocation of the humerus or upper arm-bone at the shoulder joint; figs. 6 and 7 the appearances of a dislocated shoulder-joint; fig. 8 shows the radius dislocated forward a dislocated elbow; fig. 9 is a painful and yet not uncommon accident, and one that frequently comes under the Bone-setter’s care, whilst fig. 8 shows the dislocation of the radius forward; fig. 10, plate III, page 35, shows its appearance backward.

The dislocation of the jaw is a laughable accident to all but the sufferer (fig. 11), unfortunately it is liable to recur at any time when the patient is laughing or gaping.

The hip is likely to be dislocated by the jerking of the body. Figs. 12 and 13 show two modes in which this accident may present itself when the “hip is out.” It is as well to lay the patient on the bed and pack the knee with cushions or pillows so as to relieve the pain. The manner of packing will depend upon the form of dislocation or injury, but the position in which the patient lies the easiest is best, and in that position it should be supported. Bran poultices should be applied; scald the bran in hot water, or steam it, then put it into a bag and lay it upon the hip as warm as it can be borne, and repeat it until advice can be procured.

Plate IV, page 68, gives representations of five varieties of dislocation. The dislocated shoulder joint is shown at fig. 14. If the elbow hangs off from the side, which will be the case if the dislocation is downwards, it is well to place a small cushion between the elbows and the sides and place the arm in a sling. The dislocations of the first, inwards or outwards (figures 15 and 16), are very painful and are frequently accompanied with sprains. Figs. 17 and 18 show the dislocation of the knee and elbow joint and fig. 29, a curious dislocation of the vertebræ of the neck and arm.

In treating of fractures, two points have to be considered; 1.—To reduce the fractured ends or portions to their natural positions; secondly, to retain them there immovable till nature has effected a permanent cure, or otherwise the result will be similar to fig. 19, plate V. It should be borne in mind that there is no urgency in treating a broken limb, provided no attempt is made to remove the person, but if the patient must be moved in the absence of a skilled “Bone-setter,” it is an absolute necessity to secure the limb by putting it in splints, which can be easily extemporised in the manner taught in the ambulance classes of the Order of St. John of Jerusalem.

A stretcher is the only safe means of conveyance for cases of fracture. Unskilful handling may cause either serious mischief or even loss of life; the dangers are pressing the sharp ends through the flesh, blood-vessels, nerves, or into some internal organ, such as the lungs.