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 the Fracture of the Cubit, or the Ell and Wand.

* 1.1IT sometimes happeneth, that the cubit and wand are broken together and at once, and other∣whiles that but the one of them is fractured. Now they are broken either in their midst or ends; their ends (I say) which are either towards the elbow, or else towards the wrist. That fracture is worst of all, wherein both the bones are broken, for then the member is made wholly impotent to perform any sort of action, and the cure is also more difficult; for the mem∣ber cannot so easily be contained in its state: for that bone which remains whole, serves for a stay to the arm, and hinders the muscles from being drawn back, which usually draw back and shrink up themselves, whensoever both bones are broken: Hence it is, that that fracture is judged the worst,* 1.2 wherein the cubit or ell-bone is broken; But that is easiest of all, wherein only the wand is broken, for so the fractured part is sustained by the ell-bone: when both the bones are broken, there must be made a stronger extension, for that the muscles are the more con∣tracted: Therefore, whensoever either of them remains whole, it doth more service in sustaining the other, then any either ligatures or splints, for that it keeps the muscles right in their places: Wherefore, after the bones shall be set and rowled up with ligatures and splints, the arm must be so carryed up in a scarf put about the neck, that the hand may not be much higher than the elbow, lest the blood and other humours may fall down thereinto: But the hand shall be set in that posture which is between prone and supine, for so the wand shall lye directly under the ell,* 1.3 as we have read it observed by Hippocrates: The reason is, for that by a supine figure or situa∣tion, both the bone and muscles are perverted: for first, for the bone, the Apophysis, styloides and Olecranum of the cubit, ought to be in an equal plain, and to be seated each against other; which is not so in a supine figure, as wherein the Processus styloides of the cubit is set against the inner process of the arm-bone. But in muscles, for that, like as the insertion and site of the head of a muscle is, such also is the site of the belly thereof: and lastly, such the insertion of the tail thereof; but by a supine figure, the muscles arising from the inner process of the arm-bone, and bending the cubit, shall have the tail placed in an higher and more exteriour site. In the interim, you must not omit, but that the Patients arm

[illustration]

The figure of a fractured Arm, with a wound bound up, and seated, as is fit.

may, with as little pain as possible you can, be bended and extended now and then, lest by the too long rest of the tyed up part, and the in∣termission of its proper function, the bones of the joint may be sowdred together by the interposition, and as it were glue of the defluxion which falls abundantly into the joint of the el∣bow, and neighbouring parts, whence the stifness & unmoveableness there∣of, as if there were a Callus grown there: from whence it may happen that the arm thereafter may neither be bended, nor extended, which I have observed to have happened to many:* 1.4 Whereof also Galen makes mention, and calls this kind of vitiated con∣formation Ancyle and Ancylosis. If a wound also associate a fracture of the arm, then see that you put about it Plates of Latin, or Past-board, and make a convenient ligature, and that the fragments of the bones be kept in the same state wherein they were set and resto∣red: Moreover, let him lay his arm upon a soft pillow, or cushion, as the precedent figure shewes you.

Notes

• * 1.1

  The differences.
• * 1.2

  The cure.
• * 1.3

  Sent. 3. sect. 1. de fract.
• * 1.4

  Com. in lib. de art.