CHAP. XXII. Of the first manner of setting a Shoulder, which is with ones Fist.
FIrst, let one of sufficient strength, placed on the opposite side, firmly hold the Patient upon the joint of the shoulder, lest he move up and down with his whole body, at the necessary extension, working and putting it in: then let another, taking hold of his arm above the elbow, so draw and extend it downwards, that the head thereof may be set just against its cavity, hollowed in the blade-bone: Then at last let the Surgeon lift and force up with his fist the head of the
bone into its ca∣vity. Here this is chiefly to be ob∣served, that in fresh luxations, e∣specially in a bo∣dy soft, effeminate, moist, and not over corpulent, that it sometimes comes to pass, that by the only means of just extension, the head of the bone freed from the muscles and other particles wherewith it was, as it were, entan∣gled, will betake it self into its proper cavity; the muscles being by this means restored to their place and figure, and drawing the bone with them, as they draw themselves towards their heads, as it were, with a sudden gird or twitch: wherefore in many, whilest we thought no such thing, it sufficed for restitution only to have extended the arm. But if the luxation be inveterate, and the hand cannot serve, then must the Patients shoulder be fastned to a post with the forementioned ligature, or else committed to ones charge, who may stand at his back and hold him fast: Then the arm shall presently be tyed about, a little above the elbow, with a fillet, whereto a cord shall be fastened; which being put or fastned to the pulley, shall be drawn or stretched forth as much as need shall require. Lastly, the Surgeon, with a towel, or such like ligature, fastned about his neck and hanging down, and so put under the Pa∣tients arm-pit near to the luxation, shall, raising himself upon his feet with the whole strength of his neck, lift up the shoulder, and also at the same time bringing his arm to the Patients breast, shall set the head of the shoulder-bone, forced with both his hands into its cavity, as you may see by the precedent figure: Then must you cover all the adjacent parts with a medicine made
ex farinâ volatili, bolo armenio, myrtillis, pice, resinâ & alumine, beaten into powder, and mixed with the white of an egg. Then must the hollowness under the arm be filled with a clew of woollen or cotten yarn, or a linnen cloth spread over with a little oil of Roses or Myrtles, a little vine∣gar, and
unguentum rosatum, or
refrigerans Galeni, lest it stick to the hairs, if there be any there. The part must afterwards be bound up with a ligature, consisting of two heads, of some five fingers breadth, and two ells long; more or less, according as the body shall require: The midst thereof shall be put immediately under the arm-pit, and then crossed over the lame shoul∣der, and so crossing it as much as shall be fit, it shall be wrapped under the opposite arm. And lastly, the arm shall be laid upon the breast, and put in a scarf, in a middle figure al∣most to right angles, so that by lifting up the hand he may almost touch his sound shoulder, lest the bone newly set, may fall out again: neither shall the first dressing be stirred, untill four or five dayes be past, unless the greatness of some happening symptom divert us from this our purpose.