2. Capitis luxatio vel cranii. Luxation of the head. A separation of the bones of the cranium from the hydrocephalus is by some called a luxation of the head; but in general, is meant a luxation of the upper vertebra of the neck. In this case, the patient being seated.upon the ground, and supported by an assistant, the surgeon standing behind should raise the head from the breast. The assistant should press down the shoulders, and the head be gradually drawn up, till the dislocation is reduced. If this does not happen with moderate extension, it may, at the same time, be gently moved from side to side. A sudden crack or noise is heard on the reduction being completed. See Bell's Surgery, vol. vi. p. 183, 195.

3. Carpi luxatio. Luxation of the wrist. One or two of the bones in the wrist are sometimes removed from their place, which is discovered, as usual, by a tumour and a cavity, with violent pain. If the luxation is recent, it must be treated as a luxation of the hand. Bell's Surgery, vol. vi. p. 89, 246. White's Surgery, p. 163.

4. Claviculae luxatio. Luxation of the clavicle. When this accident happens, the sooner the reduction is performed the better; for long continued luxations of the clavicle are rarely cured.

The clavicle may slip from the sternum either outward or inward; in the first case a preternatural tumour is observed about the joining of the bones: in the latter case a sinus is observed in the part affected, the aspera arteria, the carotids, the contiguous nerve, and the oesophagus, are compressed. The general directions recommended, in case of a fractured clavicle, when the accident hath happened near the breast bone, are sufficient in this as well as with respect to a luxation happening next the acromion. The last is sometimes not easily distinguished from a luxated humerus. Pare observes, that in this case the upper part of the clavicle starts upwards, and a hollow cavity is observed where the clavicle is separated from the acromion: the pain is violent, and the patient cannot move the arm upwards. If the reduction is not speedily effected, the arm will soon become paralytic.

The greatest care is required in the use of bandages, lest a stiff or a luxated arm should remain. If the bone is luxated near the sternum, and is started outward, besides bolsters to depress the end of the bone, the capelline bandage should be applied; but if inward, the stellate bandage is preferable, on account of its keeping the shoulder back. If the luxation is next the scapula, the spica with two heads may be used. If both clavicles are displaced, the double spica must be employed, as directed in luxations of the humerus and scapula. See Bell's Surgery, vol. vi. p. 204; White's Surgery, p. 157.

5. Coccygis ossis luxatio. Luxation of the os coccygis. This bone may be forced inward by a blow, or outward by a difficult birth. In this case, the pain is felt in the lower part of the spine, and inflammation, sometimes with suppuration, in the rectum, is produced. Independent of these symptoms, the sight and touch will discover the disease. In the latter case the bone may be replaced by pressure with the thumb: in the former the fore finger dipped in oil must be introduced up the anus, to press the bone outward, while the other fingers, applied externally, guide it to a proper place.

The T bandage is necessary, and the patient must be kept in bed; and, when he rises, sit in a perforated chair. See Bell's Surgery, vol. vi. p. 201; White's Surgery, p. 157.

6. Colli luxatio. Luxation of the neck. A luxation between the head and the upper vertebra of the neck is immediate death, from the pressure on the medulla oblongata, or medulla spinalis. When a man is said to have broken his neck, there is a partial luxation of the first or second vertebra only; and in this case the chin is fixed to the breast, which prevents his speaking, swallowing, or moving the parts below. If an assistant is at hand, he must follow the directions given for the luxation of the head; or, to gain more power, he should immediately turn the patient on his back, and setting his feet against his shoulders (being, himself seated on the ground), place his hands below the patient's ears, and draw the head towards him, gradually increasing the force with which he pulls, and, in pulling, move the head from side to side.

After reduction, the part should be bathed with spirit of wine. White's Surgery, p. 186.

7. Costarum luxatio. Luxation of the ribs. If a rib is forced inwards, the pleura is injured, and excruciating pains, inflammation, difficulty of breathing, cough, ulcers, and immobility of the body, follow. These complaints, with the external appearance of the side, evidently discover the misfortune. This luxation happens between the rib and the spine.

Luxations internally are with difficulty reduced, because neither the hands nor any instrument can be applied to elevate them. The patient may be laid on his belly over some cylindrical body, and the anterior part of the rib being moved gently towards the back, or shook a little, the head may probably recover its situation. If this fails, the method proposed for fractures of the ribs, when they are forced inwards, and a splinter offends the pleura, may be employed. But, if the symptoms are not urgent, nor the heads of the ribs much removed, every violence should be avoided, as luxated ribs have often remained so without danger.

The bandage should be a napkin and scapulary, and compresses squeezed out of camphorated spirit of wine applied. See Bell's Surgery, vol. vi. p. 208.

8. Digitorum manus luxatio. Luxation of the fingers. The joints of the fingers may be luxated in every direction; but an easy extension, and gentle pressure with the finger and thumb will readily reduce them. See Luxatio metacarpi 16; Bell's Surgery, vol. vi. p.. 249; White's Surgery, p. 163.

9. Digitorum pedis, et ossium pedis luxatio. Luxation of the toes and bones of the feet. A dislocation of these bones produces great pain, inflammations, and sometimes convulsions, if speedy assistance is not obtained. They are reduced as directed in the case of bones in the hand being the subjects of this accident. The toes are treated as directed for the fingers. See White's Surgery, p. 167.