Fig. 20A. Setting a fractured humerus in the manner described by Hippocrates. After Vidius.
Figs. 21 and 22. Portable winch, known as the plinthium of Nileus, for affixing to a ladder.
“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 another 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 Fabrus. 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 purpose as the elevation of large blocks of stone, as it seems unlikely that such a large and cumbrous machine should have been especially invented 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 ambè in the manner described already and is passed over the axle, the patient standing on tiptoe outside the machine. ([Fig. 20.])