I. The mechanism of dislocations and fracture of the hip : II. Litholapaxy, or, Rapid lithotrity with evacuation / by Henry Jacob Bigelow.

Henry Jacob Bigelow

Date:: 1900

Credit: I. The mechanism of dislocations and fracture of the hip : II. Litholapaxy, or, Rapid lithotrity with evacuation / by Henry Jacob Bigelow. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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$limb was at first attributed to the muscles, which when fully extended are capable of considerable resistance in the dead subject as well as in the living one; but it was supposed that the action of their complicated mechanism would hardly repay the labor of its study. In the spring of 1861, having been led to expose a joint, the luxation of which had been the subject of a lecture, I was agreeably surprised to observe the simple action of the ligament, — a simplicity which subsequent experience has confirmed, and which strikingly explains the phenomena observed in the living subject.^ The dislocated joint alluded to presented on examination the following appearances : — 1. Great laceration of the muscles about the joint. 2. The ligamentum teres broken. 3. Laceration of the innei;, outer, and lower parts of the capsule. 4. The anterior and upper parts of the capsule uninjured, and presenting a strong fibrous band, fan-shaped, and slightly forked. The remaining tendinous and muscular fibres about the joint being now completely divided, with the exception of the strong fibrous band above alluded to, it was found that the four commonly described dislocations of the hip could still be exhibited without difficulty, and that in each of them the anterior portion of the capsular ligament, whicli alone 1 Of the figtu'es accompanying this paper, those of the Y ligament num- bered 1, 6, 7, 8,19, 24, 25, 27, 29, 31, and of the impacted fracture, 1, 2, 3, were reproduced, in the spring of 1861, from photographs made from this hip after dissection. In June, 18(il, a paper upon the subject was read before the Boston Society for ]\Iedical Improvement; a second paper before the ^lassachusetts Medical Society, in iNIay, 186-4; another, in .June, 1865, before the American jMedical Association. In the present paper the rarer forms of dislocation have been added, with references to the more interesting reported cases.$