CHAP. XIII. Of the fracture of the Vertebrae, or Rack-bones of the backe, and of their processes.
THe Vertebrae are some-whiles broken, otherwhiles bruised, or strained * 1.1 on the inside, wherby it commeth to passe, that the membranes which invest the spinall marrow, as also the spinall marrow its selfe, are com∣pressed and straitened, which cause many maligne accidents; which, whether they be curable or not, may be certainly foretold by their magnitude. A∣mongst these symptomes, are the stupidity, or numnesse and palsie of the armes, legges, fundament and bladder, which diminish, or else take away from them the facultie of sense and motion; so that their urine and excrements come from them a∣gainst their wils and knowledge, or else are wholly supprest. Which when they happen (saith Hippocrates) you may fore-tell that death is at hand, by reason that * 1.2 the spinall marrow is hurt. Having made such a prognosticke, you may make an * 1.3 incision, so to take forth the splinters of the broken vertebrae, which, driven in, presse the spinall marrow, and the nerves thereof. If you cannot doe this, at least you shall apply such medicines as may asswage paine, and hinder inflammation; and then the broken bones shall be restored to their places, and contained therein by those meanes which we shall mention when we come to treat of the luxation of the spine. But if that the processes onely of the vertebrae be broken, the fragments * 1.4 shall be put in their places, unlesse they bee quite severed from their periostium. But if they bee severed, you shall open the skinne and take them forth, and then dresse the wound as is fit. Wee understand, that onely the processes of the vertebrae are * 1.5 broken, if, in the absence of the fore-mentioned symptomes of numnes and the pal∣sey, you, laying your finger upon the grieved part, feele something, as a bony frag∣ment, shaking and moving thereunder, with a certaine crackling noyse, and cavitie, and depression; and then, if when the Patient holds downe his head, and bends his backe, hee feele farre more paine, than when hee stands up straight on his feete. For in stooping, the skinne of the backe is somewhat stretched forth, and extended, and also forced upon the sharpe Splinters of the fragments, whence proceedes a dolorificke solution of continuitie, and a pricking: in stan∣ding straight up, on the contrary, the stretched skinne is relaxed, and consequent∣ly lesse molested by the sharpe fragments. The fractured processes of the verte∣brae easily heale, unlesse they bee associated with some other more grievous symp∣tome which may hinder; such as is a certaine great contusion, and the like. For, as wee formerly sayd out of Hippocrates, All rare and spongie bones are knit by a Callus within a few dayes.