The workes of that famous chirurgion Ambrose Parey translated out of Latine and compared with the French. by Th: Johnson

CHAP. XXVII. Certaine Documents concerning the parts, whereon the Patient must necessarily rest, whilest he lyes in his bed.

THose who have their Legge or the like bone broken, because they are hin∣dered by the bitternesse of paine, and also wish for their cure or con∣solidation, * 1.1 are forced to keep themselves without stirring, and upon their backes in their beds for a long time together. In the meane space, the parts whereupon they must necessarily lye, as the heele, backe, holy-bone, rumpe, the muscles of the broken thigh or legge remaine stretched forth and unmoveable, set at libertie from their usuall functions. Whereby it comes to passe, that all their strength decayes, and growes dull by little and little. Moreover also, by the sup∣pression of the fuliginous and acride excrements, and want of perspiration, they grow preternaturally hote; whence defluxion, an abscesse and ulcer, happen to them, but principally to the holy-bone, the rumpe and heele: to the former, for that * 1.2 they are defended with small store of flesh; to the latter, for that it is of more ex∣quisite sense. Now the ulcers of these parts are difficulty healed, yea, and oft-times they cause a gangrene in the flesh, and a rottennesse and mortification in the bones there-under, and for the most part a continued fever, delirium, convulsion, and (by that sympathie which generally accompanies such affects) a hicketing. For the heele and stomacke are two very nervous parts, the latter in the whole bodie

thereof, and by a large portion of the nerves of the sixth conjugation; but the o∣ther by the great tendon passing under it, the which is produced by the meeting, and as it were growing together of the three muscles of the calfe of the legge. All which are deadly, both by dissipation of the native heat by the feverish, and that which is preternaturall; as also by the infection of the noble parts, whose use the life cannot want, by carrion-like vapours. When as I considered all these things with my selfe, and (become more skilfull by the example of others) understood how dangerous they were, I wished them now and then to lift my heele up out of * 1.3 the bed; and taking hold of the rope which hung over my head, I heaved up my selfe, that so the parts, pressed with continuall lying, might transpire, and be venti∣lated. Moreover also I rested these parts upon a round cushion, being open in the middle, and stuffed with soft feathers, and layd under my rumpe and heele, that they might be refreshed by the benefit and gentle breathing of the ayre: and I did oft-times apply linnen clothes, spred over with unguentum rosatum, for the asswa∣ging of the paine and heat. Besides also, I devised a Casse of Lattin, wherein the * 1.4 broken legge being layd, is kept in its place, farre more surely and certainely than by anie Junks; and moreover also, it may all be moved to and againe at the Patients pleasure. This Casse will also hinder the heele from lying with all its bodie and weight upon the bed, putting a soft and thicke boulster under the calfe, in that place where the Casse is hollow: besides also, it armes and defends it against the falling downe and weight of the bed-clothes, having a little arch made over and above, of the same matter. All which shall bee made manifest unto you by the following figure.

[illustration]

The figure of a Casse.

A A. Shew the bottome or belly of the Casse.

B B. The wings or sides to be opened and shut at pleasure:

C. The end of the wings, whereto the sole or arch is fitted.

D D. The Arch.

E E. The Sole.

F F. An open space, whereat the heele hangs forth of the Casse.

Now it remaines, that I tell you what remedies I applyed to the Abscesse which happened upon my wound. When therefore I perceived an Abscesse to breed, I composed a suppurative medicine of the yoalks of egges, common oyle, turpentine, * 1.5

and a little wheat floure, and I used it untill it was opened: then to cleanse it I used this following remedie.

℞. syrupi rosati & terebinth. venetae, an. ℥ii. pulveris radicis ireos florentiae, aloes, * 1.6 mastiches, farinae hordei, an. ʒss. incorporentur omnia simul & fiat mundificativum: but I had a care, that the place, whereat I conjectured the quite severed scales of the bones must breake forth, should be filled with tents made of sponge or flaxe, that so, by this meanes, I might keep the ulcer open at my pleasure. But I put into the * 1.7 bottome of the ulcer catagmatick and cephalicke powders, with a little burnt A∣lum to procure the egresse of the formerly mentioned scales. These at length cast forth, I cicatrized the ulcer with burnt Alum. For, this having a drying and astrin∣gent facultie, confirmes and hardens the flesh, which is loose and spongie, and flow∣ing with liquid sanies, and helps forwards natures endeavour in cicatrization. For, the fragments of the bones, they, by reason of their naturall drinesse and hardness, cannot be joyned and knit together by themselves without a medium: but they need a certaine substance, which, thickning and concreting at their ends, doth at length * 1.8 glue them together, and (as it were) fasten them with soder. This substance hath its matter of the proper substance and marrow of the bones; but the forme from the native heat, and emplastick medicines, which moderately heat. For, on the con∣trarie, these medicines, which, by their too much heat, doe discusse and attenuate, doe (as it were) melt and dissolve the matter of the Callus, and so hinder the knit∣ting. Wherefore for this purpose, I would wish you to make use of the following emplasters, of whose efficacie I have had experience: for, hence they are called knitting or consolidating plaisters.

℞. olei myrtill. & rosarum omphac. an. lb. ss. rad. altheae lb. ii. rad. fraxini, & fol. cjusdem, rad. consolidae majoris & fol. ejusdem, fol. salicis an. m. i. fiat decoctio in suffi∣cienti * 1.9 quantitate vini nigri, & aquaefabrorum, ad medi••tatis consumptionem, adde in co∣latura pulveris myrrhae & thuris an. ℥ss. adipis hirci lb. ss. terebinth. lotae ℥iiii. mesti∣ches ʒiii. lithargyri auri & argenti an. ℥ii. boli armeni••, & terrae sigillata, an. ℥i. ss. minii ʒvi. cerae albae quantum sufficit, fiat emplastrum, ut artis est. In stead hereof you may use the blacke emplaister, where of this is the description.

℞. lithargyri auri lb. i. olei & aceti lb. ii. coquantur simul lento igne donec nigrum & * 1.10 splendens reddatur emplastrum, & non adhaereat digitis. Or else, ℞. olei rosat. & myr∣till. an. ℥ii. nucum cupressi, boli armen. sanguinis drac. pulverisatorum an. ℥. ss. emplastri diachalciteos ℥iiii. liquefaciant simul, & fiat emplastrum secundum artem. In defect of these, you may use a Cere-cloth, or tela Gualteri, whereof this is the description.

℞. pulveris thuris, farinae volatilis, mastiches, boli arm. resinae pini, nucum cupressi, rubiae tinctorum, an. ℥ii. sevi arietini & cerae albae an. lb. ss. fiat emplastrum: into which * 1.11 (whilest it is hote) dip a warme linnen cloth, for the forementioned use. Emplastrum Diacalcithios, by the common consent of all the Ancients, is much commended for fractures: but it must undergoe different preparations, according to the condition of the time, for in summer it must be dissolved in the juice of plantaine and night-shade, lest it should heat more than is fit. It is convenient, in the interim, to have re∣gard to the temper of the affected bodies; for neyther are the bodies of children to be so much dried as these of old men: otherwise, if such drying medicines should be applyed to yong bodies as to old, the matter of the Callus would be dissolved, it would be so farre from concreting; wherefore the Surgeon must take great heede in the choyce of his medicines. For, often times remedies, good of themselves, are by use made not good, because they are used and applyed without judgment: which * 1.12 is the cause that oft times pernicious accidents happen, or else the Callus becomes more soft, hard, slender, crooked, or lastly concretes more slowly by the great error, and to the great shame of the Surgeon.

Notes

• * 1.1

  The naturall fa∣culties languish in the parts by idlenesse, but are strengthe∣ned by action.
• * 1.2

  How, and what ulcers happen upon the fra∣cture of the legge, to the rumpe & heele.
• * 1.3

  Remedies for the prevention of the foresaid ulcers.
• * 1.4

  The use of a Lattin Casse.
• * 1.5

  A suppuratis 〈◊〉〈◊〉 medicine.
• * 1.6

  A d••te: ••ive.
• * 1.7

  Catagmatick powders have power to cast forth the scales of bones.
• * 1.8

  The causes both efficient and materiall of a Callus.
• * 1.9

  Medicines con∣ducing to the generation of a Callus.
• * 1.10

  The black plaister.
• * 1.11

  The descripti∣on of a Spa••a∣drapum or cere-cloth.
• * 1.12

  Medicines good of them∣selves, not good by event.