The workes of that famous chirurgion Ambrose Parey translated out of Latin and compared with the French. by Tho: Johnson. Whereunto are added three tractates our of Adrianus Spigelius of the veines, arteries, & nerves, with large figures. Also a table of the bookes and chapters.

CHAP. XVII. Of a Fracture of the Shoulder, or Arm-bone.

THe Arm-bone is round, hollow, full of marrow, rising up with an indifferent neck,* 1.1 and ending on the upper part into somewhat a thick head. On the lower part it hath two processes, the one before, the other behinde; between which there is (as it were) an half-circle, or the cavity of a pulley, each end whereof leads into its cavity, of which one is interior, another exterior; that by these (as it were) hollow stops, the bending and extension of the arm might be limited, lest that the bone of the cubit, if the circle should have been per∣fect, sliding equally this way and that way, might, by its turning, have gone quite round, as a rope runs in a pulley; which thing would much have confused the motion of the cubit: For so the extension, or bending it back, would have been equal to the necessary bending it inwards. It is very expedient that a Surgeon know these things, that so he may the better know how to restore the fractures and luxations of this part.* 1.2 If one of the fragments of this broken bone shall lye much over the other, and the Patient have a good strong body, then the arm shall be much extended, the Patient being so set upon a low seat, that he may not rise when the fracture shall be a setting, and so hinder the begun work; and also, that so the Surgeon may the more easily perform his operation upon the Patient seated under him; yet Hippocrates regarding another thing, would have the Patient to sit higher: But you must have a care that the shoulder-bone it self be drawn directly downwards, and the cubit so bended, as when you put it into a scarf. For if any one set this bone, lifting the arm upwards, or otherwise extending it, then must it be kept in that posture; for otherwise, if the figure be changed, the setting will quickly be spoiled, when as you come to put the arm in a scarf: Wherefore the Surgeon must diligently and carefully

observe,* 1.3 that in setting a broken arm, he put it in such a posture, that resting on the breast, it look down towards the girdle. You must have a care in laying the splints, and rowling your li∣gatures, that they hurt not, nor press too hard upon the joints. For, in the opinion of Hippocrates, by the pressure of parts which are nervous, fleshless, and consequently endued with exquisite sense; by the splints there is danger of most grievous pain, inflammation, denudation both of the bone and nerve; but chiefly, if such compression hurt the inner part, towards which the arm is bended; wherefore the splints made for this place must be the shorter: Therefore after the arm-bone is set, the arm shall be laid upon the breast in a right angle, and there bound up in a scarf, lest that the Patient, when he hath need to stir, spoil and undo the setting, and figure of the broken bone:* 1.4 But the arm must be kept in quiet, untill such time as the fragments shall be confirmed with a Callus, which usually is in forty dayes, sooner or later, according to the diffe∣rent constitutions of bodies.

Notes

• * 1.1

  The description of the arm, or shoulder-bone.
• * 1.2

  The cure.
• * 1.3

  How the arm must be placed when the bone is set. Sect. 3. offic. sect. 1. de fract.
• * 1.4

  In what time it will knit.