CHAP. XXIV. Of some things to be observed in Ligation, when a fracture is associated with a wound.
THis, taken out of the doctrine of the Ancients, ought to bee kept firme and ratified, That Ligation must bee made upon the wound; otherwise * 1.1 the wounded part will presently lift it selfe up into a great tumor, re∣ceiving the humors pressed thither by the force of the Ligation made on this and that side, above and bolow, whence ensue many maligne symptomes. You may make triall hereof upon a sound fleshie part; for if you binde it above and * 1.2 below, not touching that which is in the midst, it will be lifted up into a great tu∣mor, and change the flourishing and native colour into a livide or blackish hue, by reason of the flowing and abundance of the humors pressed forth on everie side from the neighbouring parts. Therefore such things will happen much the rather in a wounded or ulcerated part. But for this cause, the ulcer will remaine unsuppu∣rated and weeping, crude and liquid sanies flowing there-hence, like unto that which usually flowes from inflamed eyes. Such sanies, if it fall upon the bones, and make any stay there, it, with the touch therof, burnes and corrupts them, and so much the more, if they be rare and soft. These will bee the signes of such corruption of * 1.3 the bones; if a greater quantitie, and that more filthie sanies, flow from the ulcer, than was accustomed, or the nature of a simple ulcer requires; if the lippes of the ulcer be inverted; if the flesh be more soft and flaccid about them; if a sorrowfull sense of a beating, and also deepe paine torment the Patient by fitts; if, by search∣ing with your Probe, you perceive the bone to be spoyled of its periostium; and lastly, if you finde it scaily and rough, or also if your Probe bee put downe some-what hard, it runne into the substance of the bone. But we have treated sufficient∣ly hereof in our particular Treatise of the rottennesse of the bones. But certainely such rottennesse will never happen to the bone, if the hurt part be bound up, as is fit, and according to art. Wherefore I judge it not amisse, againe to admonish the Surgeon of this, That as farre as the thing shall suffer, hee make his rowlings upon * 1.4 the wound; unlesse by chance there be such excessive paine and great inflammation, that, through occasion of such symptomes and accidents, he be diverted from this proper and legitimate cure of the disease. Therefore then, because nothing more can be done, let him only doe this, which may be done without offence; that is, let him supply the defect of ligation and rowlers, with a linnen cloth, not too weake, nor too much worne, being twice or thrice doubled, and which may serve to com∣passe the wound and neighbouring parts once about: let him sew the edges there∣of at the sides of the wound, lest he be forced to stirre the fragments of the bones (which once set ought to be kept unmoved) as often as the wound comes to be dres∣sed. For, broken bones doe not require such frequent dressing, as wounds and ulcers doe. By this it appeares, that as want of binding, and too much loosenesse in ab∣sence