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. VI. Of the general cure of Dislocations.

FOr all that I have heretofore delivered the general method of curing fractures and dislo∣cations, yet it shall not be unprofitable to repeat here in this place,* 1.1 those things which may be accommodated to this Treatise of curing luxations. Now he that will cure dislo∣cations, must have regard to five intentions, which it will be fitting to perform in order. The first is, of holding; the second, of drawing, or extending; the third, of forcing in; the fourth, of pla∣cing in convenient figure and site; the fifth, of correcting the concomitant, or following symptomes.

The first scope, which we said was of holding, is meant either of the whole body,* 1.2 or else of some part thereof only. The whole body must be holden by the strong embracement of your ser∣vant or attendant, when as the shoulder, the vertebrae, or the thigh bones are dislocated. But in the dislocation of the Collar-bone, elbow, hand, knee, or foot and leg, it is sufficient only to hold the part straitly in your hands. There is necessity of holding either the body, or else some part thereof, lest, while the dislocated bone is extended, the whole body follow by continuance of parts, if there be nothing which may hinder: for if the body should follow him that draws or ex∣tends, all the work-masters labour and endeavour to restore it, is to no purpose.* 1.3 The use of the se∣cond scope, that is, of drawing or extending, is, that there may be a free space and distance be∣tween the luxated bones, by which distance the dislocated bone may the more freely be forced in∣to its cavity. But the manner of drawing or extending is different in quantity and manner, accor∣ding to the various strength of the muscles and ligaments, and dislocation of the bones to this or that part: Therefore this work is almost always performed by the hands; which when they can∣not

suffice, we must have the assistance of instruments and engines, whose figures you shall see hereafter delineated;* 1.4 But that you may not do amiss, you may so far use extension, until the head of the bone be brought just against its cavity. When the Surgeon hath brought it to this pass, then must he hasten to the third intention, which is, to put the head of the bone first moved and gently bended, into its cavity: For he must have a special care, that he force it no other way than into its proper cavity; for it would be dangerous, lest he should turn it from one extream into another, and the bone, for examples sake, of the thigh, which was dislocated into the fore∣part by too violent forcing, by exceeding the middle cavity, may be driven and dislocated into the hinder part. To shun this, the bone shall be put back the same way that it fell out, which may easily by done in fresh and late happening dislocations.* 1.5 We understand that the bone is set by the noise, or as it were a popp, or sound like that, which solid and sounding bodies, being fully and forcibly thrust into their cavities, do make; by the similitude and consent in figure, magni∣tude, and all conformation of the affected part with the sound, and lastly, by the mitigation of the pain.* 1.6 The fourth scope, which is of the convenient site of the part, must be so fulfilled, that the bone after it is set may be kept in its cavity, and not fly forth again: Wherefore if the arm be dislocated, it shall be carried bound up in a scarf; if the thigh, knee, leg, or foot be luxated, they shall be fitly laid in a bed; but in the interim the Surgeon, presently after he hath set them, shall have a care, that the affected joint be wrapped about with stoups and clothes, or compresses stee∣ped in rose vinegar, and spred with convenient medicines; then let it be bound with an artificial deligation, rowling the ligatures unto the part contrary to that whereto the dislocated bone flew.* 1.7 For the which purpose thicker boulsters shall be there applied whence the bone came out, otherwise there will be some danger, lest it should be again displaced: when these things are done, he shall for f••ur or five days space meddle with nothing about the dislocation, unless pain, or some such like symptome happen. For then the fifth scope will call us from that cessation and rest, which is, to correct the symptomes and complicate affections, as pain, inflamation, a wound, fracture and others, whereof we have spoken abundantly in our Treatise of Fractures. Before we attempt to set inveterate dislocations,* 1.8 we must endeavour to humect the ligaments, tendons, and muscles by fomentations, cataplasms, emplasters, liniments, and other remedies, that so these parts may be more obedient to the Surgeons hand; then must the dislocated bones be moved with a gentle motion up and down, to and again, that by this means the excrementitious humour, which by continuance of time hath flowed down, may wax hot, be attenuated, resolved or made slippery, and also the fibres of the muscles, ligaments, and nervous bodies, placed about the joint for the defence thereof, may be loosed, that so they may presently be more freely extended: But if a great swelling, pain, and inflamation urge, we must first think of asswaging and curing them; then of the restoring the dislocation.

Notes

• * 1.1

  Five inventi∣ons in curing dislocations.
• * 1.2

  The benefit of holding the member in di∣slocations.
• * 1.3

  The use of ex∣tension.
• * 1.4

  The manner of setting it, or putting it into its place.
• * 1.5

  Signs that the bone is set.
• * 1.6

  The benefit of fit placing the member.
• * 1.7

  The manner of binding up the set joint.
• * 1.8

  The cure of in∣veterate luxa∣tions.