would hinder the restoring thereof. This manner of extension is common to four kinds of luxation of the thigh-bone. But the manner of forcing the bone into its cavity must be varied in each, according to the different condition of the parts whereunto the head incli∣neth; to wit, it must be forced outwards if it be fallen inwards, and contrary in the rest, as the kind of the dislocation shall be. Some too clownish and ignorant knot knitters fasten the lower ligature below the ankle, and thus the joints of the foot and knee are more ex∣tended then that of hip or huckle-bone, for they are nearer to the ligature, and consequent∣ly to the active sorce: but they ought to do otherwise; therefore in a dislocated shoulder you shall not fallen the ligatures to the hand or wrist, but above the elbow. But if the hands shall not be sufficient for this work, then must you make use of engines. Wherefore then the Patient b••ing placed as is fit, and the affected part firmly held, some round thing shall be put into the groin, and the Patients knee, together with his whole leg shall be drawn violently inwards, towards the other leg. And in the mean while the head of the thigh shall be strongly forced towards the cavity of the huckle-bone, and so at length re∣stored, as the following figure shews:
When the head of the thigh by just extension is freed from the muscles wherewith it was infolded, and the muscles also extended that they may give way and yield themselves more pliant, then must the rope be somewhat slacked, and then you must also desist from tending, otherwise the restituion cannot be performed, for that the stronger extension of the engine will resist the hand of the Surgeon, thrusting and forcing it into the cavity. This precept must be observed in the restoring of this and other dislocations. You shall know that the thigh is restored by the equality of the legs, by the free and painless extension and inflection of the lame leg. Lastly, by the application of agglutinative medicines (whereof ws have formerly spoken) the restored bone shall be confirmed in its place; to which pur∣pose ligation shall be made, the ligature being first cast upon the place whereinto the head of the th gh fell, and thence brought to the opposite or sound side by the belly and loyns. In the mean while the cavitie of the groin must be filled with somewhat a thick bolster which may keep the head of the bone in the cavity. Neither must you omit junks stretched down even to the ankles, as we have observed in the fracture of the thigh. Then must both the thighs be bound together, whereby the dislocated member may be unmoveable, and more and more strengthened. Neither must this dressing be loosed until four or five days be passed, unless peradventure the sudden happening of some other more grievous sym∣ptom shall perswade otherwise. To conclude, the Patient must be kept in his bed for the space of a month, that the relaxed muscles, nerves, and ligaments may have space to recover their former strength, otherwise there is danger lest the bone may again fall out by the too forward and speedy walking upon it. For the site of the thigh it must be placed and kept in a middle figure, yet this middle figure consists in the extension, not in the flexion, as it is de∣monsrated by Hippocrates, for that such a figure is accustomable to the leg.