The arm is
held with the elbow a few inches away from the side, and the line of
the arm is seen to slope inwardly toward the shoulder, as compared
with the sound arm.

The injured arm cannot be moved much by the patient, although it can
be lifted up and away from the side by another person, but cannot be
moved so that, with the elbow against the front of the chest, the hand
of the injured arm can be laid on the opposite shoulder. Neither can
the arm, with the elbow at a right angle, be made to touch the side
with the elbow, without causing great pain.

=Treatment.=--One of the simplest methods (Stimson's) of reducing this
dislocation consists in placing the patient on his injured side on a
canvas cot, which should be raised high enough from the floor on
chairs, and allowing the injured arm to hang directly downward toward
the floor through a hole cut in the cot, the hand not touching the
floor. Then a ten-pound weight is attached to the wrist. The gradual
pull produced by this means generally brings the shoulder back into
place without pain and within six minutes. (Fig. 30.)

[Illustration: FIG. 30.

TREATING A DISLOCATED SHOULDER.

(REFERENCE HANDBOOK.)

Patient lying on injured side; note arm hanging through hole in cot
raised from floor on chairs; also weight attached to wrist.]

The more ordinary method consists in putting the patient on his back
on the floor, the operator also sitting on the floor with his
stockinged foot against the patient's side under the armpit of the
injured shoulder and grasping the injured arm at the elbow, he pulls
the arm directly outward (i. e., with the arm at right angles with the
body) and away from the trunk. An assistant may at the same time aid
by lifting the head of the arm bone upward with his fingers in the
patient's armpit and his thumbs over the injured shoulder.

If the arm does not go into place easily by one of these methods it is
unwise to continue making further attempts. Also if the shoulder has
been dislocated several days, or if the patient is very muscular, it
will generally be necessary that a surgeon give ether in order to
reduce the dislocation. It is entirely possible for a skillful surgeon
to secure reduction of a dislocation of the shoulder several weeks
after its occurrence. After the dislocation has been relieved the arm,
above the elbow, should be bandaged to the side of the chest and the
hand of the injured side carried in a sling for ten days.