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第4章

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.

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