Part 4
The jaw-bone is often slightly displaced (
subluxated?), and is restored
again; it is dislocated but rarely, especially in gaping; in fact,
the bone is never dislocated unless it slips while the mouth is opened
wide. It slips, however, the more readily from its ligaments being
oblique, supple, and of a yielding nature. The symptoms are: the lower
jaw protrudes, it is distorted to the side opposite the dislocation,
and the patient cannot shut his mouth; when both sides are dislocated,
the jaw projects more, the mouth can be less shut, but there is no
distortion; this is shown by the rows of the teeth in the upper and
lower jaw corresponding with one another. If, then, both sides be
dislocated, and not immediately reduced, the patient for the most
part dies on the tenth day, with symptoms of continued fever, stupor,
and coma, for the muscles there induce such effects; there is disorder
of the bowels attended with scanty and unmixed dejection; and the
vomitings, if any, are of the same character. The other variety is
less troublesome. The method of reduction is the same in both:-The
patient being laid down or seated, the physician is to take hold of
his head, and grasping both sides of the jaw-bone with both hands,
within and without, he must perform three manoeuvres at once,-rectify
the position of the jaw, push it backward, and shut the mouth. The
treatment should consist of soothing applications, position, and applying
a suitable bandage to support the jaw-bone, so as to cooperate with
the reduction.