CHAP. XX. Of the Luxation of the Ribs.
THe Ribs may by a great and bruising stroake bee dislocated, and fall * 1.1 from the vertebrae whereto they are articulated, and they may bee dri∣ven inwards, or side-waies. Of which kinde of Luxation, though there be no particular mention made by the Ancients, yet they con∣fesse, that all the bones may fall, or be removed from their seats or cavities, wher∣in they are received and articulated. The signe of a Rib dislocated and slipped on * 1.2 one side, is, a manifest inequality, which here makes a hollownesse, and there a bunching forth; but it is a signe that it is driven in, when as there is only a depres∣sed cavitie where it is knit and fastened to the vertebrae. Such dislocations cause di∣vers symptomes, as difficulty of breathing, the hurt rib hindring the free moving of the chest; a painfulnesse in bowing downe, or lifting up the bodie, occasioned by a paine counterfeiting a pleurisie; the rising or pu••••ing up of the musculous flesh about the rib, by a mucous and flatulent humor there generated: the reasons where∣of we formerly mentioned in our Treatise of Fractures. To withstand all these, the * 1.3 dislocation must bee forthwith restored, then the puffing up of the flesh must bee helped. Wherefore, if the dislocated. Rib shall fall upon the upper side of the ver∣tebrae, the Patient shall be set upright, hanging by his armes upon the toppe of some high doore or window: then the head of the rib, where it stands forth, shalbe pres∣sed downe, untill it be put into its cavity. Againe, if the rib shall fall out upon the lower side of the vertebra, it will be requisite, that the Patient bend his face do 〈◊〉〈◊〉∣wards, setting his hands upon his knees; then the dislocation may be restored by pressing or thrusting in the knot or bunch which stands forth. But if the luxated rib fall inwards, it can no more be restored or drawn forth by the hand of the Surgeon, than a vertebra which is dislocated towards the inside, for the reasons formerly de∣livered. * 1.4