The lower jaw may be luxated by yawning, blows, falls, chewing hard substances, or the like. It is easily known from the patient’s being unable to shut his mouth, or to eat any thing, as the teeth of the under jaw do not correspond with those of the upper; besides, the chin either hangs down, or is thrown toward one side, and the patient is neither able to speak distinctly, nor to swallow without considerable difficulty.
The usual method of reducing a dislocated jaw, is to set the patient upon a low stool, so as an assistant may hold the head firm by pressing it against his breast. The operator is then to thrust his two thumbs, being first wrapped up with linen cloths that they may not slip, as far back into the patient’s mouth as he can, while his fingers are applied to the jaw externally. After he has got firm hold of the jaw, he is to press it strongly downwards and backwards, by which means the elapsed heads of the jaw may be easily pushed into their former cavities.
The peasants in some parts of the country have a peculiar way of performing this operation. One of them puts a handkerchief under the patient’s chin, then turning his back to that of the patient, pulls him up by the chin so as to suspend him from the ground. This method often succeeds, but we think it a dangerous one, and therefore recommend the former.
DISLOCATION OF THE NECK.
The neck may be dislocated by falls, violent blows, or the like. In this case, if the patient receives no assistance, he soon dies, which makes people imagine the neck was broken; it is, however, for the most part only partially dislocated, and may be reduced by almost any person who has resolution enough to attempt it. A complete dislocation of the neck is instantaneous death.
When the neck is dislocated, the patient is immediately deprived of all sense and motion; his neck swells, his countenance appears bloated; his chin lies upon his breast, and his face is generally turned towards one side.
To reduce this dislocation, the unhappy person should immediately be laid upon his back on the ground, and the operator must place himself behind him so as to be able to lay hold of his head with both hands, while he makes a resistance by placing his knees against the patient’s shoulders. In this posture he must pull the head with considerable force, gently twisting it at the same time, if the face be turned to one side, till he perceives that the joint is replaced, which may be known from the noise which the bones generally make when going in, the patient’s beginning to breathe, and the head continuing in its natural posture.
This is one of those operations which it is more easy to perform than describe. I have known instances of its being happily performed even by women, and often by men of no medical education. After the neck is reduced, the patient ought to be bled, and should be suffered to rest for some days, till the parts recover their proper tone.
DISLOCATION OF THE RIBS.
As the articulation of the ribs with the backbone is very strong, they are not often dislocated. It does however sometimes happen, which is a sufficient reason for our taking notice of it. When a rib is dislocated either upwards or downwards, in order to replace it, the patient should be laid upon his belly on a table, and the operator must endeavour to push the head of the bone into its proper place. Should this method not succeed, the arm of the disordered side may be suspended over a gate or ladder, and, while the ribs are thus stretched asunder, the heads of such as are out of place may be thrust into their former situation.