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

CHAP. LVIII. Of the symptomes, and other accidents which may befall a broken or dislocated member.

MAny things may befall broken or dislocated members by the meanes of the fracture, or dislocation; such as are bruises, great paine, inflam∣mation, a fever, impostume, gangrene, mortification, ulcer, fistula, and atrophia, all which require a skilfull and diligent Surgeon for their cure. A confusion happens by the fall of some heavie thing upon the part, or by a fall from high, whence followes the effusion of bloud poured out un∣der * 1.1 the skinne: which if it be poured forth in great plenty, must be speedily evacua∣ted by scarification, and the part eased of that burden, lest it should thence gangre∣nate. And by how much the bloud shall appear more thick and the skin more dense, by so much the scarification shall be made more deepe. You may also for the same purpose apply leaches.

Concerning paine wee formerly said, that it usually happens by reason that the * 1.2 bones are moved out of their places, whence it happeneth that they become trou∣blesome to the muscles and nerves by pricking and pressing them. Hence ensue in∣flammations, as also impostumation and a feaver, oft times a gangrene, and in con∣clusion a mortification corrupting and rotting the bones; otherwhiles a sinuousul∣cer or fistula. But an Atrophia and leanenesse ariseth by the sloth and idlenesse of the member decaying all the strength therof, and by too strait ligation intercepting the passages of the bloud otherwise ready to fall and flow thither.

Now the leannesse which is occasioned by too strait ligation receives cure by the * 1.3 slackening of the ligatures wherewith the member was bound. That which pro∣ceeds from idlenesse is helped by moderate exercise, by extending, bending, lifting up and depressing the member, if so bee that he can away with exercise. Otherwise he shall use frictions and fomentations with warme water. The frictions must be mo∣derate in hardenesse and gentlenesse, in length and shortnesse. The same moderati∣on shall be observed in the warmness of the water, and in the time of fomenting. For * 1.4 too long fomenting resolves the blood that is drawne. But that which is too little or short a space drawes little or nothing at all: after the fomentation, hot and empla∣stick medicines made of pitch, turpentine, euphorbium, pellitory of Spaine, sulphur, and the like, shall bee applyed. They shall bee renued every day more often or sel∣dome, as the thing it selfe shall seeme to require.

These medicines are termed Dropaces; whose forme is thus. ℞ picis nigrae, ammo∣niaci, bdelii, gummi elemi in aqua vitae dissolutorum an. ℥ii. olei laurini ℥i. pulveris pi∣peris, * 1.5 zinziberis, granorum paradisi, baccarum lauri et juniperi, an. ℥ii. fiat emplastrum secundum artem, extendatur super alutam. It is also good to binde about the opposite * 1.6 sound part with a ligature, yet without pain; as if the right arme shall decay for want of nourishment, the left shall bee bound, beginning your ligation at the hand, and continuing it to the Arme-pit. If this mischance shall seaze upon the right leg, then the left shall be swathed up from the sole of the foote to the groine. For thus a great portion of the bloud is forced back into the vena cava, or hollow veine, and from this being distended and over full, into the part affected and gaping with the vessels al∣most empty; besides also it is convenient to keepe the sound part in rest, that so it may draw the lesse nourishment, and by that meanes there will bee more store to re∣fresh the weake part.

Some wish also to bind up the decaying member with moderate ligation; for * 1.7 thus, say they, the bloud is drawne thither; for when as wee intend to let blood by opening a veine with a lancet, we bind the arme. Also it is good to dip it into water somewhat more than warme, and hold it there untill it grow red and swell; for thus bloud is drawne into the veines, as they find, which use to draw blood of the saphe∣na and salvatella. Now if, when as these things and the like bee done, the lame part grow hot, red and swollen, then know that health is to be hoped for; but if the con∣trary happen, the case is desperate, wherefore you need attempt nothing further.

Furthermore, there is sometimes hardnesse left in the joints, after fractures and * 1.8 dislocations are restored. It is fit to soften this, by resolving the conteined humor by fomentations, liniments, cataplasmes, emplasters made of the roots of Marsh-mal∣lowes, briony, lillies, line seed, fenugreek seed, and the like, and also of gums dissol∣ved in strong vineger, as Ammoniacum, bdelium, opopanax, labdanum. sagapenum, styrax liquida, and Adeps anserinus, gallinaceus, humanus, oleum liliorum, and the like. Also you must wish the patient to move the part ever now and then, every day, yet so, that it be not painefull to him, that so the pent up humour may grow hot, bee atte∣nuated, and at length discussed, and lastly the part it selfe restored as farre as art can perform it; for oft times it cannot be helped any thing at all. For if the member be weake and lame by reason that the fracture happened neere the joint, for the residue of his life the motion thereof useth to bee painefull and difficult, and oft times none at all, especially if the Callus which grows there be somewhat thick and great, and lastly, if the joint it selfe shall bee contused and broken by the stroake, as it oft-times happens in wounds made by Gun-shot.

Notes

• * 1.1

  Remedies for a confusion.
• * 1.2

  What may hap∣pen by paine.
• * 1.3

  Remedies for the leanenesse or Atrophia of any member.
• * 1.4

  What measure to be used in fo∣menting.
• * 1.5

  A dropax.
• * 1.6

  Binding of the sound part op∣posite to the emaciated.
• * 1.7

  How to bind up the emaciated part.
• * 1.8

  Signes that an Atrophia is cure∣able.