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CHAP. VI. Of the generall cure of Dislocations.
FOr all that I have heretofore delivered the generall methode of curing * 1.1 Fractures and dislocations, yet it shall not bee unprofitable to repeat here in this place, those things which may be accommodated to this Treatise of curing Luxations. Now he that will cure Dislocati∣ons, must have regard to five intentions, which it will be fitting to performe in order. The first is, of Holding; The second, of Drawing or Extending; The third, of Forcing in; The fourth, of Placing in convenient figure and site; The fifth, of Correcting the concomitant, or following symptomes.
The first scope, which we said was of Holding, is meant eyther of the whole bo∣dy, * 1.2 or else of some part thereof only. The whole bodie must bee holden by the strong embracement of your servant or attendant, when as the shoulder, the ver∣tebrae, or the thigh-bones are dislocated. But in the dislocation of the Collar-bone, elbow, hand, knee, or foote and legge, it is sufficient onely to hold the part straitly in your hands. There is necessitie of holding eyther the bodie, or else some part thereof, lest, while the dislocated bone is extended, the whole bodie follow by continuance of parts, if there be nothing which may hinder: for if the bodie should follow him that drawes or extends, all the work-masters labour and endeavour to restore it, is to no purpose. The use of the second scope, that is, of Drawing or Ex∣tending, * 1.3 is, that there may be a free space and distance betweene the luxated bones, by which distance the dislocated bone may the more freely be forced into its cavi∣tie. But the manner of drawing or extending is different in quantity and manner, according to the various strength of the muscles and ligaments, and dislocation of the bones to this or that part. Therefore this worke is almost alwaies performed by the hands; which when they cannot suffice, we must use the assistance of instru∣ments and engins, whose figures you shall see hereafter delineated. But that you may not doe amisse, you may so farre use extension, untill the head of the bone be brought just against its cavitie. When the Surgeon hath brought it to this passe, then must he hasten to the third intention, which is, to put the head of the bone first mo∣ved * 1.4 and gently bended, into its cavitie. For hee must have a speciall care, that hee force it no other way than into its proper cavity: for it would be dangerous, lest he should turne it from one extreme into another, and the bone, for examples sake, of the thigh, which was dislocated into the forepart by too violent forcing, by excee∣ding the middle cavitie, may be driven and dislocated into the hinder part. To shun this, the bone shall be put backe the same way that it fell out, which may bee easily done in fresh and late happening dislocations. We understand that the bone is set * 1.5 by the noyse, or as it were a popp, or sound like that, which solid and sounding bo∣dies, being fully and forcibly thrust into their cavities, do make; by the similitude and consent in figure, magnitude and all conformation of the affected part with the sound, and lastly, by the mitigation of the paine. The fourth scope, which is of the * 1.6 convenient site of the part, must bee so fulfilled, that the bone after it is set may bee kept in its cavity, and not flye forth againe. Wherefore if the arme be dislocated, it shall be carried bound up in a scarfe: if the thigh, knee, legge, or foote be luxated, they shall be fitly layd in a bed; but in the interim the Surgeon, presently after hee hath set them, shall have a care, that the affected joynt be wrapped about with stoups and clothes, or compresses steeped in rose vinegar, and spred with convenient me∣dicines, then let it be bound with an artificiall deligation, rowling the ligatures un∣to the part contrary to that whereto the dislocated bone flew. For the which pur∣pose * 1.7 thicker boulsters shall be there applied whence the bone came out, otherwise there will be some danger, lest it should be againe displaced: when these things are done, he shall for foure or five dayes space meddle with nothing about the Dislo∣cation, unlesse paine, or some such like symptome happen. For then the fifth scope * 1.8 will call us from that cessation and rest, which is, to correct the symptomes and