on the articulations-第8部分

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dysentery　when　it　becomes　chronic。　And　when　the　gibbosity　occurs　in
youth　before　the　body　has　attained　its　full　growth；　in　these　cases　the
body　does　not　usually　grow　along　the　spine；　but　the　legs　and　the
arms　are　fully　developed；　whilst　the　parts　（about　the　back）　are
arrested　in　their　development。　And　in　those　cases　where　the
gibbosity　is　above　the　diaphragm；　the　ribs　do　not　usually　expand
properly　in　width；　but　forward；　and　the　chest　becomes　sharp…pointed
and　not　broad；　and　they　become　affected　with　difficulty　of　breathing
and　hoarseness；　for　the　cavities　which　inspire　and　expire　the　breath
do　not　attain　their　proper　capacity。　And　they　are　under　the
necessity　of　keeping　the　neck　bent　forward　at　the　great　vertebra；　in
order　that　their　head　may　not　hang　downward；　this；　therefore；
occasions　great　contraction　of　the　pharynx　by　its　inclination
inward；　for；　even　in　those　who　are　erect　in　stature；　dyspnoea　is
induced　by　this　bone　inclining　inward；　until　it　be　restored　to　its
place。　From　this　frame　of　body；　such　persons　appear　to　have　appear
to　have　more　prominent　necks　than　persons　in　good　health；　and　they
generally　have　hard　and　unconcocted　tubercles　in　the　lungs；　for　the
gibbosity　and　the　distension　are　produced　mostly　by　such　tubercles；
with　which　the　neighboring　nerves　communicate。　When　the　gibbosity　is
below　the　diaphragm；　in　some　of　these　cases　nephritic　diseases　and
affections　of　the　bladder　supervene；　but　abscesses　of　a　chronic
nature；　and　difficult　to　cure；　occur　in　the　loins　and　groins；　and
neither　of　these　carries　off　the　gibbosity；　and　in　these　cases　the
hips　are　more　emaciated　than　when　the　gibbosity　is　seated　higher　up；
but　the　whole　spine　is　more　elongated　in　them　than　in　those　who　have
the　gibbosity　seated　higher　up；　the　hair　of　the　pubes　and　chin　is　of
slower　growth　and　less　developed；　and　they　are　less　capable　of
generation　than　those　who　have　the　gibbosity　higher　up。　When　the
gibbosity　seizes　persons　who　have　already　attained　their　full
growth；　it　usually　occasions　a　crisis　of　the　then　existing　disease；
but　in　the　course　of　time　some　of　them　attack；　as　in　the　case　of
younger　persons；　to　a　greater　or　less　degree；　but；　not　withstanding；
for　the　most　part；　all　these　diseases　are　less　malignant。　And　yet　many
have　borne　the　affection　well；　and　have　enjoyed　good　health　until
old　age；　more　especially　those　persons　whose　body　is　inclined　to　be
plump　and　fat；　and　a　few　of　them　have　lived　to　beyond　sixty　years　of
age；　but　the　most　of　them　are　more　short…lived。　In　some　cases　the
curvature　of　the　spine　is　lateral；　that　is　to　say；　either　to　the　one
side　or　the　other；　the　most　of　such　cases　are　connected　with　tubercles
（abscesses？）　within　the　spine；　and　in　some；　the　positions　in　which
they　have　been　accustomed　to　lie　cooperate　with　the　disease。　But　these
will　be　treated　of　among　the　chronic　affections　of　the　lungs；　for
these　the　most　suitable　prognostics　of　what　will　happen　in　these　cases
are　given。

　　42。　When　the　spine　protrudes　backward；　in　consequence　of　a　fall；
it　seldom　happens　that　one　succeeds　in　straightening　it。　Wherefore
succussion　on　a　ladder　has　never　straightened　anybody；　as　far　as　I
know；　but　it　is　principally　practiced　by　those　physicians　who　seek
to　astonish　the　mob…for　to　such　persons　these　things　appear　wonderful；
for　example；　if　they　see　a　man　suspended　or　thrown　down；　or　the
like；　and　they　always　extol　such　practices；　and　never　give
themselves　any　concern　whatever　may　result　from　the　experiment；
whether　bad　or　good。　But　the　physicians　who　follow　such　practices；
as　far　as　I　have　known　them；　are　all　stupid。　The　device；　however；　is
an　old　one；　and　I　give　great　praise　to　him　who　first　invented　this；
and　any　other　mechanical　contrivance　which　is　according　to　nature。　For
neither　would　I　despair；　but　that　if　succussion　were　properly　gone
about；　the　spine；　in　certain　cases；　might　be　thereby　rectified。　But；
indeed；　for　my　own　part；　I　have　been　ashamed　to　treat　all　such　cases
in　this　way；　because　such　modes　of　procedure　are　generally　practiced
by　charlatans。

　　43　Those　cases　in　which　the　gibbosity　is　near　the　neck；　are　less
likely　to　be　benefited　by　these　succussions　with　the　head　downward；
for　the　weight　of　the　head；　and　tops　of　the　shoulders；　when　allowed　to
hang　down；　is　but　small；　and　such　cases　are　more　likely　to　be　made
straight　by　succussion　applied　with　the　feet　hanging　down；　since　the
inclination　downward　is　greater　in　this　way。　When　the　hump　is　lower
down；　it　is　more　likely　in　this　case　that　succussion　with　the　head
downward　should　do　good。　If　one；　then；　should　think　of　trying
succussion；　it　may　be　applied　in　the　following　manner：…The　ladder　is
to　be　padded　with　leather　lined　cushions；　laid　across；　and　well
secured　to　one　another；　to　a　somewhat　greater　extent；　both　in　length
and　breadth；　than　the　space　which　the　man's　body　will　occupy；　he　is
then　to　be　laid　on　the　ladder　upon　his　back；　and　the　feet；　at　the
ankles；　are　to　be　fastened；　at　no　great　distance　from　one　another；
to　the　ladder；　with　some　firm　but　soft　band；　and　he　is　further　to　be
secured；　in　like　manner；　both　above　and　below　the　knee；　and　also　at
the　nates；　and　at　the　groins　and　chest　loose　shawls　are　to　be　put
round　in　such　a　fashion　as　not　to　interfere　with　the　effect　of　the
succussion；　and　his　arms　are　to　be　fastened　along　his　sides　to　his　own
body；　and　not　to　the　ladder。　When　you　have　arranged　these　matters
thus；　you　must　hoist　up　the　ladder；　either　to　a　high　tower　or　to　the
gable…end　of　a　house；　but　the　place　where　you　make　the　succussion
should　be　firm；　and　those　who　perform　the　extension　should　be　well
instructed；　so　that　they　may　let　go　their　hold　equally　to　the　same
extent；　and　suddenly；　and　that　the　ladder　may　neither　tumble　to　the
ground　on　either　side；　nor　they　themselves　fall　forward。　But；　if　the
ladder　be　let　go　from　a　tower；　or　the　mast　of　a　ship；　fastened　into
the　ground　with　its　cordage；　it　will　be　better；　so　that　the　ropes
run　upon　a　pulley　or　axle…tree。　But　it　is　disagreeable　even　to　enlarge
upon　these　matters；　and　yet；　by　the　contrivances　now　described；　the
proper　succussion　may　be　made。

　　44。　But　if　the　hump　be　situated　very　high　up；　and　if　succussion　be
by　all　means　to　be　used；　it　will　be　better　to　do　it　with　the　feet
downward；　as　has　been　said；　for　the　force　downward　will　be　the　greater
in　this　case。　The　patient　is　to　be　well　fastened　to　the　ladder　by
cords　at　the　breast；　at　the　neck　by　means　of　a　very　loose　shawl　so
as　merely　to　keep　the　part　properly　on　the　ladder；　and　the　head　is
to　be　fastened　to　the　ladder　at　the　forehead；　the　arms　are　to　be
stretched　along　and　attached　to　the　patient's　body；　and　not　to　the
ladder；　and　the　rest　of　the　body　is　not　to　be　bound；　except　so　as　to
keep　it　in　place　by　means　of　a　loose　shawl　wrapped　round　it　and　the
ladder；　attention；　moreover；　should　be　paid　that　these　ligatures　do
not　interfere　with　the　force　of　the　succussion；　and　the　legs　are　not
to　be　fastened　to　the　ladder；　but　should　be　placed　near　one　another；
so　as　to　be　in　line　with　the　spine。　These　matters　should　be　thus
arranged；　if　recourse　is　to　be　had　at　all　to　succussion　on　a　ladder；
for　it　is　disgraceful　in　every　art；　and　more　especially　in　medicine；
after　much　trouble；　much　display；　and　much　talk；　to　do　no　good　after
all。

　　45。　In　the　first　place；　the　structure　of　the　spine　known；　for　this
knowledge　is　requisite　in　many　diseases。　Wherefore；　on　the　side　turned
to　the　belly　（the　anterior？）　the　vertebrae　are　in　a　regular　line；
and　are　united　together　by　a　pulpy　and　nervous　band　of　connection；
originating　from　the　cartilages；　and　extending　to　the　spinal　marrow。
There　are　certain　other　nervous　cords　which　decussate；　are　attached
（to　the　vertebrae？）；　and　are　extended　from　both　sides　of　them。　But
we　will　describe　in　another　work　the　connections　of　the　veins　and
arteries；　their　numbers；　their　qualities；　their　origin；　their
functional　offices　in　particular　parts；　in　what　sort　of　sheaths　the
spinal　marrow　is　inclosed；　where　they　arise；　where　they　terminate；　how
they　communicate；　and　what　their　uses。　On　the　opposite　side
（behind？）　the　vertebrae　are　connected　together　by　a　ginglymoid
articulation。　Common　cords　（nerves？）　are　extended　to　all　parts；　both
those　within　and　without。　There　is　an　osseous　process　from　the
posterior　part　of　all　and　each　of　the　vertebra；　whether　greater　or
smaller；　and　upon　these　processes　there　are　cartilaginous　epiphyses；
and　from　them　arise　nervous　productions　（ligaments？）；　akin　to　the
external　nerves　（tonoi）。　The　ribs　are　united　to　them；　having　their
heads　inclined　rather　to　the　inside　than　the　out；　and　every　one　of
them　is　articulated　with　the　vertebrae；　and　the　ribs　in　man　are　very
curved；　and；　as　it　were；　arched。　The　space　between　the　ribs　and　the
processes　of　the　vertebrae　is　filled　on　both　sides　by　muscles；　which
arise　from　the　neck　and　extend　to　the　loins　（？）。　The　spine；
longitudinally；　is　a　straight　line　slightly　curved；　from　the　os　sacrum
to　the　great　vertebra　which　is　connected　with　the　articulation　of
the　femur；　the　spine　inclines　backward；　for　the　bladder；　the　organs　of
generation；　and　the　loose　portion　of　the　rectum；　are　situated　there。
From　this；　to　the　attachment　of