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

CHAP. XXVII. The sixth manner of restoring a Shoulder, luxated into the Arme-pit.

HIppocrates writes, that this is the best way of all to restore a dislocated Shoulder. You must take a woodden spatula of some foure or five fin∣gers breadth, and some two fingers thicknesse or lesse, but some yard * 1.1 or thereupon long; the one end thereof must bee narrow and thin, with a round head standing up and lightly hollowed, that put under the Arme-pit, it may receive part of the head of the shoulder-bone, the which for that purpose must not bend towards the ribs, but to the top of the Shoulder. This upper part of the spatula must bee wrapped about with a linnen or woollen ragge, * 1.2 or some such soft thing, that it may be the softer, and hurt the lesse; and then it must be so thrust under the Arme-pit, that it may throughly penetrate into the inner part betweene the ribs, and the head of the Shoulder-bone. There must, besides in this spatula, be two holes in three severall places, each alike distant from other, through which let soft strings be put, whereby it may be tyed to the arme, stretched all the length thereof even to the fingers, in one place a little below the head of the shoul∣der-bone, in another a little above the elbow, and the third at the wrest, that so they may hold it firme. Therefore let the distances of the holes bee fitted to this purpose; but principally you must have a care of this, that the upper part of the

spatula reaching beyond the head of the arme, enter even to the innermost Cavity of the arme-pit; then, a crosse pin or piece of wood must be made fast through two postes or a frame, & well fastened thereto, and therupon the Arme with the spatula must be so put over, that the pin may be under the arme-pit, the body weighing one way, and the arme another: which being done, the arme must be drawn down one way, and the body another about the pin. Now this crosse pin must bee put on such a height that the patient may stand on tipp-toes. Now this is the very best way of restoring a shoulder. In stead of two posts or a frame, you may make shift with a ladder, doore, beds postes, and such like things as shall bee there present. I have heard Henry Arvet, a very good surgeon of Orleans say, that he never attempted this manner of putting into joint a shoulder dislocated into the arme-pit without good successe, unlesse by chance (which also is noted by Hippocrates) that the flesh is * 1.3 growne into the cavity, and the head of the bone hath made it selfe another cavity in the place whereinto it is fallen; for in this case the bone will either not bee resto∣red, or else not remaine in its place, but fall backe notwithstanding into the new hol∣lowed cavity, which serves it in stead of its naturall socket or cavity. But I must here admonish young Surgeons, that if the bone be not restored at the first endeavour and onset, that they doe not despaire and presently desist from their entended operati∣on, but they must winde about, and gently move the joint: for so at the length it will bee more easily moved, and enter into the naturall cavity. When it is in, it must bee bound up with compresses and rowlers after the forementioned manner.

To the former figures I have thought good to adde this, which expresseth the maner of restoring a shoulder luxated into the arme-pit with a spatula, after the man∣ner * 1.4 of Hippocrates. This spatula fastened with an iron pin to the standing frame may be turned, lifted up, and pressed downe at your pleasure. A. shewes the wooden spatula. B. The frame or standing postes.

[illustration]

Hippocrates his Glossocomium termed Ambi.

For the more certaine use of this instrument the patient must sit upon a seate which must be somewhat lower than the standing frame, that so the spatula which is * 1.5 thrust into the arme-pit may be the more forcibly deprest, so to force in the head of the shoulder-bone; the patients feete must also be tyed, that hee may not raise him∣selfe up whilest the Surgeon endevours to restore it. Now he shall then endevour to restore it, when he shall have bound the stretched forth arme of the dislocated shoul∣der unto the spatula, & thrust the one end therof under the slipped forth head of the shoulder bone, as wee have formerly shewed; for then by pressing downe the other end of the spatula which goes to the hand, the bone is forced into its cavity. You must diligently observe the wooden spatula, which therefore I have caused to be ex∣pressed

by it selfe, which Hippocrates calleth Ambi, whose head is a little hollowed where it is noted with this letter B. The whole spatula is marked with this letter A. with three strings hanging thereat, provided for the binding of the arme, that it may be kept steddy, as you may perceive by the ensuing figure.

[illustration]

The figure of an Ambi fitted to a dislocated shoulder.

There are other additions to this Ambi, whose figure I now exhibited to your view, by the invention of Nicholas Picart the Duke of Lorrain's Surgion, the use and knowledge whereof, bestowed upon mee by the inventor himselfe, I would not en∣vie the studious reader.

[illustration]

Another figure of an Ambi with the additaments.

[illustration]

AA. Shew the two eares, as it were, stops made to hold and keep in the top of the shoulder, lest it should slippe out when it is put into the frame or supporter.

BB. The frame or supporter whereon the Ambi rests.

CC. The pin or axeltree which fastens the Ambi to the supporter.

DD. Screw-pinnes to fasten the foote of the supporter that it stirre not in the o∣peration.

EE. The holes in the foote of the supporter, whereby you may fasten the screw-pins to the floore.

Notes

• * 1.1

  Sect. 1. lib. 1. de 〈◊〉〈◊〉. sent. 19.
• * 1.2

  The descripti∣on of the Glos∣so••omium termed Am••i.
• * 1.3

  Sect. 1. de art. sent. 21.
• * 1.4

  Hip. sent. 64. 4. de arti••.
• * 1.5

  How to make use of the Ambi.