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CHAP. LVIII. Of the symptoms and other accidents which may befal a broken or dislocated member.
MAnie things may befal broken or dislocated members by the means of the fra∣cture or dislocation; such as are bruises, great pain, inflammation, a fever, im∣postume, grangrene, mortification, ulcer, fistula, and atrophia, all which require a skilfull and diligent Surgeon for their cure. A contusion happen's by the fall of som heavie thing upon the part, or by a fall from high, whence fol∣low's the effusion of blood poured out under the skin: wich if it bee poured forth in great plentie, must bee speedily evacuated by scarification, and the part eased of that burden, lest it should thence gangrenate. And by how much the blood shall appear more thick, and the skin more dens, by so much the scarification shall be made more deep. You may also for the same purpose apply Leeches.
Concerning pain wee formerly said, that it usually happen's by reason that the bones are mooved out of their places, whence it happeneth that they becom troublesom to the muscles and nervs, by pricking and pressing them. Hence ensue inflammations, as also impostumati∣on and a fever, oft times a gangrene, and in conclusion a mortification, corrupting and rotting the bones; otherwhiles a sinuous ulcer or fistula. But an atrophia and leanness ariseth by the sloth and idelness of the member decaying all the strength thereof, and by too straight ligation intercepting the passages of the blood, otherwise readie to fall and flow thither.
Now the leanness which is occasioned by too straight ligation receive's cure by the flack∣ning of the ligatures wherewith the member was bound. That which proceed's from idle∣ness, is helped by moderate exercise, by extending, bending, lifting up, and depressing the member, if so bee that hee can away with exercise. Otherwise hee shall use frictions and fo∣mentations with warm water. The frictions must be moderate in hardness and gentleness, in length and shortness. The same moderation shall be observed in the warmness of the wa∣ter, and in the time of fomenting. For too long fomenting resolv's the blood that is drawn. But that which is too little or short a space draw's little or nothing at all: after the fo∣mentation, hot and emplastick medicins made of pitch, turpentine, euphorbium, pellito∣rie of Spain, sulphur, and the like, shall bee applied. They shall bee renued every day more often or seldom, as the thing it selfe shall seem to require.
These medicines are termed Dropaces, whose form is thus: ℞ picis nigriae, ammoniaci, bdelii, gummi elemi in aquâ vitae dissolutorum an. ℥ii. olei laurini ℥i. pulveris piperis, zinziberis, granorum paradisi, baccarum lauri & juniperi, an ʒii. fiat emplastrum secundùm artem, extendatur super alutam. It is also good to binde about the opposite sound part with a ligature, yet without pain: as if the right arm shall decay for want of nourishment, the left shall bee bound, beginning your ligation at the hand, and continuing it up to the arm-pit. If this mischance shall seiz upon the right leg, then the left shall bee swathed up from the sole of the foot to the groin. For thus a great portion of the blood is forced back into the vena cava, or hollow vein, and from this being distended and over full, into the part affected and gapeing with the vessels almost empty; beside also it is convenient to keep the sound part in rest, that so it may draw the less nourishment, and by that means there will bee more store to refresh the weak part.
Som wish also to binde up the decaying member with moderate ligation; for thus, say they, the blood is drawn thither: for when as wee intend to let blood by opening a vein with a lancet, wee bind the arm. Also it is good to dip it into water somwhat more than warm, and hold it there util it grow red, and swell; for thus blood is drawn into the veins, as they finde, which use to draw blood of the saphena and salvatella. Now, if when as these things and the like bee don, the lame part grow's hot, red and swollen, then know that health is to bee hoped for; but if the contrary happen, the case is desperate: wherefore you need attempt nothing further,
Furthermore, there is somtimes hardness lest in the joints, after fractures and dislocati∣ons are restored. It is fit to soften this, by resolving the contained humor by fomentations, liniments, cataplasms, emplasters made of the roots of marsh-mallows, brionie, lillies, line seed, fenugreek seed, and the like, and also of gums dissolved in strong vineger, as ammonia∣cum, bdelium, opopanax, labdanum, sagapenum, styrax liquida, and adeps anserinus, gallinaceus, huma∣nus, oleum liliorum, and the like. Also you must wish the patient to moov the part ever now and then, every day; yet so, that it bee not painfull to him, that so the pent up humor may grow hot, bee attenuated, and at length discussed, and lastly the part it self restored as far as art can performe it; for oft-times it cannot bee helped any thing at all. For if the mem∣ber bee weak and lame, by reason that the fracture happend neer the joint, for the residue of his life the motion thereof useth to bee painful and difficult, and oft-times none at all, especially if the callus, which grow's there, bee somwhat thick and great; and lastly, if the joint it self shall bee contused and broken by the stroke, as it oft-times happen's in wounds made by gun-shot.