Treatment of vertebral displacement

With a dislocation anterior to the back, there is little hope and treatment is rarely successful. As for a dislocation posteriorly, you need to firmly squeeze the patient with your knees, as the bathhouse attendant does, and forcefully press on the vertebra, or put the patient on his stomach and step on the vertebra with his heel , or knead it forcefully with a rolling pin, like a baker kneads a lump of dough. If the matter is more serious than this and the dislocation is fresh, then, as Hippocrates says, you should take a board of such size in length and width that the patient can fit on it, or place a bench of such size along the wall, so that its distance from the wall is no more feet, and place a soft bedding on it for the patient’s body. Then the patient is bathed in a bathhouse and stretched out on a board or bench face down, then the patient’s chest is wrapped twice with a belt, the ends of which come out of the armpits, and tied between the shoulders. The ends of the belt are attached to a long stick, similar to a mortar pestle, and this stick is placed vertically on the ground at the end of a board or bench placed under the patient. The stick is given to a servant standing at the head of the patient so that he can hold it and so that its lower end rests against something, and the servant standing at the head pulls the upper end of the stick at the time when such a stretch should be performed. The patient's legs are also tied together with another belt, above the knees and above the feet, another rope is used to tie the places located above the place where the thighs meet. The ends of these bandages are collected and tied to another stick, similar to a pestle, similar to the stick mentioned earlier, and they place it at the end of the placed board that is located near the patient’s feet, in the same way as they placed the first stick. Then the assistants are ordered to pull these sticks in different directions.

Some people use other apparatus for such traction, that is, arrows on a stick standing at the end of a large board or bench - I want to say at the two ends adjacent to the head and legs of the patient, when these arrows are turned, the belts pulling the vertebra are wound around them. When performing traction in this way, we should press on the hump with the bases of our hands; if we need to sit on it, we do so without fear of anything.

If the vertebrae cannot be straightened with such devices and the patient endures strong pressure, then a longitudinal notch, similar to a groove, should be hollowed out in the nearest wall, opposite the hump, of such a size that the length of the hole is about one elbow. The hole should not be much higher or lower than the patient’s dislocated vertebra; on the contrary, the hole should be made after first determining its level. It is for this reason that we said at the beginning that the board should be placed close to the wall. Then we take another medium-sized board and strengthen one end of it in the recess in the wall, and with the middle or the place that reaches the hump, we place it on the hump, and after that we push the other end of the board down until we see that the vertebra has straightened clearly way. Hippocrates mentions that traction alone, without a board, also corrects this deficiency, and also says that kneading with a board produces such an effect. If this is true, then it is a good idea to do traction without kneading for the type of injury we mentioned at the beginning, called anterior displacement of the vertebra. And when the vertebra is straightened, you should take a wooden board about three fingers wide and such a length that it covers the hump and part of the healthy vertebrae, wrap it in a linen rag or tow so that it is not too hard, place it on the vertebra and attach it with an appropriate bandage. The patient should eat light food.

If after this a remnant of the hump remains, then treatment with relaxing tissues and emollient drugs is used and for a long time they use the board that we described; some people also use a plate made of lead.

If a vertebra is dislocated on one side, it is straightened using one or two splints and a bandage.

As for the dislocation of a vertebra in the back of the neck - and this is a curable dislocation - then you should put the patient on his back and carefully pull his head up, straightening the vertebra by pressing and stroking; when the vertebra is straightened, a bandage with strengthening drugs is applied to it and covered with rags on top, and on top of them splints are tied the entire length and width of the neck. The splints are tied to the head and chest so that the bandage does not move back, and after a few days they are removed. The cords used to secure the bandage are given the appearance of braid at the edges of the clothing, because round ones cause suffering.