of the humerus, or scapula, so
should this member of the fracture apparatus be adapted, as well to
obviate this pressure upon these structures, as to give the needful
support to the limb in reference to the clavicle, &c. The habitual use,
for weeks or more, of a hard, resisting fulcrum in the axilla, must act
in some degree like the pad of a tourniquet, arresting the flow of a
vigorous circulation, which is so essential to the speedy union of all
lesions of bones. And it should never be lost sight of, that all
grievously coercive apparatus, which incommode the suffering patient,
under treatment, are those very instruments which impede the curative
process of Nature herself.

The anatomical mechanism of the human body, considered as a whole, or
divisible into regions, forms a study so closely bearing upon practice,
that the surgeon, if he be not also a mechanician, and fully capable of
making his anatomical knowledge suit with the common principles of
mechanics, while devising methods for furthering the efforts, of Nature
curatively, may be said to have studied anatomy to little or no purpose.
The shoulder apparatus, when studied through the principle of mechanics,
derives an interest of practical import which all the laboured
description of the schools could never supply to it, except when
illustrating this principle.

The disposal of the muscular around the osseous elements of the shoulder
apparatus, forms a study for the surgeon as well in the abnormal
condition of these parts, as in their normal arrangement; for in
practice he discovers that that very mechanical principle upon which
both orders of structures (the osseous and muscular) are grouped
together for normal articular action, becomes, when the parts are
deranged by fracture or, other accident, the chief cause whereby
rearrangement is prevented, and the process of reunion obstructed. When
a fracture happens in the shaft of the humerus, above or below the
insertions of the pectoral and latissimus dorsi muscles, these are the
very agents which when the bone possessed its integrity rendered it
functionally fitting, and which, now that the bone is severed, produce
the displacement of the lower fragment from the upper one. To counteract
this source of derangement, the surgeon becomes the mechanician, and
now, for the first time, he recognises the necessity of the study of
topographical anatomy.

When a bone is fractured, or dislocated to a false position and re