Domestic Encyclopædia (1802)/Shoulder

SHOULDER, is the joint which connects the arm with the body. The principal affection of this limb is luxation, or dislocation (see vol. iii. p. 136), when the head of the upper arm-bone is forced from its socket. Such injury may be discovered by the swelling of the part; the inability to raise the arm; and violent pain attending the attempt: farther, the dislocated arm will be of a different length from the other; the head of the bone may be felt to be displaced from its natural situation; and a vacuity be perceived under the anterior part of the shoulder-blade.

In treating this complaint, the principal object will be to reduce the dislocated limb, with the greatest possible ease and expedition; in order to prevent a watery-swelling, which is apt to arise in neglected cases of long standing. Various means have been devised for restoring the joint to its former position; such as suspending the patient by the luxated arm over the step of a ladder, or the top of a door; and which have, in many instances, been attended with success, by the sudden jerk thus produced: but, by either of these expedients, the soft parts are liable to be lacerated, and the head of the bone to be fractured.

A more eligible method, therefore, is the following: after the patient is seated on a chair, his body must be secured by a strong belt passed around it, and held by assistants. The elbow should be bent, in order to relax the muscles. A firm leather bandage, from four to five inches broad, with strong straps, is next to be tied round the arm, immediately above the elbow; when the arm should be gradually extended by assistants, pulling these straps, while another person withdraws the shoulder-blade. The extension and counter-extension must be regulated by the situation of the head of the bone. As soon as the latter has passed the margin of the socket, it will be returned to its place by the action of the muscles; an effect which is indicated by a loud crack. If, however, violent inflammatory symptoms should ensue after the operation, recourse must be had to fomentations with Arquebusade or Goulard-water, and the application of leeches.—At all events, the arm ought to be retained for some time in a state of rest, by a proper bandage, till it acquire its former vigour; especially if a new dislocation of the joint be apprehended. To obviate such an accident, blisters, frictions, and stimulants, applied to the shoulders, have frequently proved beneficial.