The principles of surgery / by James Miller.

  • James Miller
Date:
1853
Catalogue details

Licence: Public Domain Mark

Credit: The principles of surgery / by James Miller. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

    724/798 page 706
    perineum, or over the chest—according as it is the upper or lower extremity that is injured—and is secured behind to some fixed point on the wall or floor ; in order that thus counter-extension may be sure, and the patient fixed in his place. A laque, or noose, is put upon the affected limb; a damp towel having been previously wrapped tightly round the part, to prevent excoriation. This laque usually consists of a stout band of worsted, secured by what is termed the clove hitch; the advantage of which is, that, while it holds a firm grasp, it cannot be tightened by pulling so as unduly to constrict the limb. To the laque, the pulleys and rope are attached by a hook ; the other hook is secured to a fixed point opposite the patient; and then the rope is steadily pulled, as the surgeon may direct. Instead of the laque, a circular band may be adapted to the part, and tightened by a screw ; but the former is more convenient, and fully as efficient. A question may arise as to the point of its application. If attached to the distal end of the hone affected—as above the knee, in dislocation of the hip— Fig. 238. extending force is doubtless exerted moi'e directly, and with greater power, on the displacement; and, from bending of the leg being per- mitted, the desired rotatory movements of the head of the bone can be more readily and powerfully performed. Yet it may be, that a near application of the noose may have the same effect as too early attempts at coaptation ; stimulating the implicated muscles to resistance of the extending power. If attached to the distal extremity of the limh, on the contrary—as above the ankle, in the example referred to Fig. 237. The clove-hitch; shown on a coil of rope. Fig. 238. Mode of reducing dislocation shewn. At a, counter extension made ; at h, the laque attached to the tliigh ; at c, the pulleys. \
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