Part 47
There are many varieties of curvature of the spine even in persons
who are in good health; for it takes place from natural conformation
and from habit, and the spine is liable to be bent from old age, and
from pains. Gibbosities (
or projections backward) from falls generally
take place when one pitches on the nates, or falls on the shoulders.
In this case some one of the vertebrae must necessarily appear higher
than natural, and those on either side to a less degree; but yet no
one generally has started out of the line of the others, but every
one has yielded a little, so that a considerable extent of them is
curved. On this account the spinal marrow easily bears such distortions,
because they are of a circular shape, and not angular. The apparatus
for the reduction in this case must be managed in the following manner:
a strong and broad board, having an oblong furrow in it, is to be
fastened in the ground, or, in place of the board, we may scoop out
an oblong furrow in the wall, about a cubit above the floor, or at
any suitable height, and then something like an oaken bench, of a
quadrangular shape, is to be laid along (the wall?) at a distance
from the wall, which will admit of persons to pass round if necessary,
and the bench is to be covered with robes, or anything else which
is soft, but does not yield much; and the patient is to be stoved
with vapor, if necessary, or bathed with much hot water, and then
he is to be stretched along the board on his face, with his arms laid
along and bound to his body; the middle, then, of a thong which is
soft, sufficiently broad and long, and composed of two cross straps
of leather, is to be twice carried along the middle of the patient's
breast, as near the armpits as possible, then what is over of the
thongs at the armpits is
[p. 244]to be carried round the shoulders, and afterward
the ends of the thong are to be fastened to a piece of wood resembling
a pestle; they are to be adapted to the length of the bench laid below
the patient, and so that the pestle-like piece of wood resting against
this bench may make extension. Another such band is to be applied
above the knees and the ankles, and the ends of the thongs fastened
to a similar piece of wood; and another thong, broad, soft, and strong,
in the form of a swathe, having breadth and length sufficient, is
to be bound tightly round the loins, as near the hips as possible;
and then what remains of this swathelike thong, with the ends of the
thongs, must be fastened to the piece of wood placed at the patient's
feet, and extension in this fashion is to be made upward and downward,
equally and at the same time, in a straight line. For extension thus
made could do no harm, if properly performed, unless one sought to
do mischief purposely. But the physicians, or some person who is strong,
and not uninstructed, should apply the palm of one hand to the hump,
and then, having laid the other hand upon the former, he should make
pressure, attending whether this force should be applied directly
downward, or toward the head, or toward the hips. This method of applying
force is particularly safe; and it is also safe for a person to sit
upon the hump while extension is made, and raising himself up, to
let himself fall again upon the patient. And there is nothing to prevent
a person from placing a foot on the hump, and supporting his weight
on it, and making gentle pressure; one of the men who is practiced
in the palestra would be a proper person for doing this in a suitable
manner. But the most powerful of the mechanical means is this: if
the hole in the wall, or in the piece of wood fastened into the ground,
be made as much below the man's back as may be judged proper, and
if a board, made of limetree, or any other wood, and not too narrow,
be put into the hole, then a rag, folded several times or a small
leather cushion, should be laid on the hump; nothing large, however,
should be laid on the back, but just as much as may prevent the board
from giving unnecessary pain by its hardness; but the hump should
be as much as possible on a line with the hole made in the wall, so
that the board introduced into it may
[p. 245]make pressure more especially
at that spot. When matters are thus adjusted, one
person, or two if necessary, must press down the end of the board,
whilst others at the same time make extension and counter-extension
as along the body, as formerly described. Extension may also be made
with axles, which may either be fastened in the ground beside the
bench, or the post of the axles may be attached to the bench itself,
if you will make them perpendicular and overtopping (
the bench?) a
little at both ends, or at either end of the bench. These powers are
easily regulated, so as to be made stronger or weaker, and they are
of such force, that if one were to have recourse to them for a mischievous
purpose, and not as a remedy, they would operate strongly in this
way also; for by making merely extension and counter-extension longitudinally,
without any additional force, one might make sufficient extension;
and if, without making extension at all, one were only to press down
properly with the board, sufficient force might be applied in this
way. Such powers, then, are excellent which admit of being so regulated,
that they can be made weaker and stronger as required. And the forces
are applied in the natural way; for the pressure above forces the
displaced parts into their place. Natural extension restores parts
which have come too near one another to their natural position. I,
then, am acquainted with no powers which are better or more appropriate
than these; for extension along the spine downward has no proper hold
at the bone called the os sacrum; and extension upward, along the
neck and head, has indeed a hold; but extension thus made is unseemly
to behold, and, besides, if increased, may occasion much mischief
otherwise. I once made trial of the following plan. Having placed
the patient on his back, I put below the hump a bladder, not inflated,
and afterward introduced air into the bladder by means of a brass
pipe connected with it. But the experiment did not succeed; for, when
the man was fairly extended, the bladder yielded, and the air could
not be forced into it; and, besides, the hump of the patient was apt
to slip off the distended bladder when they were pressed together.
But when I did not extend the man strongly, the bladder was swelled
up by the air, and the man became more bent forward
[p. 246] than proper. I
have written this expressly; for it is a valuable piece of knowledge
to learn what things have been tried and have proved ineffectual,
and wherefore they did not succeed.
