Nine books of physick and chirurgery written by that great and learned physitian, Dr Sennertus. The first five being his Institutions of the whole body of physick: the other four of fevers and agues: with their differences, signs, and cures.

CHAP II. Of putting together, and binding in generall.

POsition is that operation of Chyrurgery whereby the parts, are joyned together, * 1.1 which were seperated contra∣ry to nature.

Deligation or binding is necessary to this as also for the most part to other Chyrurgicall operations, to which belongs fascia∣tion, or Swathing-bands, and the putting in of Tents, fitting of Splints to bind about wounds, and the action it selfe or putting in of a round string to cleanse the wound, aright or true placing of the part bound.

Of Swadling.

A Swath is a long and broad band (or list:) * 1.2 fasciation is a convenient circumduction and convolution of the swa∣thing-band about the member to be cured, the most conve∣nient bands are linnen, which are cleane, light, soft, which have neither seames, nor knots.

The differences of Swathing-bands are various, * 1.3 which are taken from their figure, length, and breadth, they differ in respect of figure, because some are rolled up thick, long and equally broad, and rolled up into a round circle, others are rent, or broken, which consists only of one linnen cloath, but that cut or parted, either in the middle or outsides, others are sowed together, which are Swathing-bands and Ligatures ending in divers heads, and representing severall figures; Swadlings differ in longitude, because some are longer, others shorter, and so it is of latitude.

There are two kinds of deligation, the one simple, * 1.4 the other compound or manifold, the simple is either equall or une∣quall, the simple that is equall, is only round, which incom∣passeth

the affected member, in a round circle, alike every way, without declination, unto either part, but is simple e∣quall, binding is divided into Asciam, and Simam, which only differ in respect of more and lesse, because Asciadeclines a little from a round, but Sima, much of severall wayes of swathing are many differences, taken from the similitude of the parts which are bound, or from the similitude of cer∣taine Animalls or other things, of which Galen in his Book of swathing.

As for what belongs to the manner, * 1.5 sometimes the bind∣ing, is to be begun from the part affected, other times from a sound part, neerest to the part affected, sometimes from the opposite part, moreover sometimes swathing is to begin, at the end of the swathing-band, sometimes at the middle, thirdly swathing-bands should neither presse the part too hard, nor suffer it to be loose, for when tis too loose, it doth not sufficiently containe the part, and when it is too hard it causeth paine and inflamation.

The use of swathing is twofold, one by its selfe, which is to draw together the disjoyned parts, to contract thedilated, to direct the distorted, to containe the member framed and the adjunct parts, to resist a humour flowing; or to represse a humour which is already flowne, or to force blood to extenua∣ted parts; but that which begins in a place affected re∣presseth from the part, that which begins from a sound or opposite, forces towards the part, the other is by accident, which is to keep on medicines applyed to any part.

Of Cerots or Bolsters.

SPlenia, * 1.6 are Plaisters so called, from the figure of the Spleen, the Ancients calls them, Plumaccoli, but now they are called Pulvilli, Plagulae, they are linnen rags folded up together, which are put to the part, some according to longi∣tude right, others oblique, others transverse, and some doub∣led, fome threefold, others fourefold, sometimes single, and sometimes more, according to the use which they are put for to strengthen, the binding members, unequall in thicknesse, or thin and hollow parts are to be equalled, and filled up; that the whole dilagation may be equall, the parts also

are to be defended from the paine of the swathings and bands, and the Sanies, and thin matter, is to be expressed and imbibed.

Of Splents.

SPlentors, or splents, * 1.7 which are wont to be fitted to broken bones, and such as are out of joynt, after they are set, which were prepared by the Ancients, of wooden-slips of a cane, but now they are prepared of the wood, of Firre, or splentors of some other wood, or of the Barks of Trees, or Paistboard, and hard Leather, which may answer to the parts greivously wounded, or broken, or put out of joynt, especially to the hands, sometimes to the chest of the body, so made up, of light wood, that they may answer to the figure of the member, or of white thin plates of Iron, or tough skin, or shell, Paper glued together, and fitted, so that they may containe, the parts drawn and joyned together, least that they shake or totter, and slip out againe, and slide out of their places.

Of Binders.

LAqueus, * 1.8 is a band or binder so knit together that being drawn in or prest by weight, is shut, or closed, the use there∣of is to extend broken limbs, or such as are out of joynt, to continue such as are put right in their places, to bind the parts and draw them in straight, also to bind the heads of vessells out of which blood flowes, the differences of them may be seene, in Oribasius de Laqueis.

Of fit placing of a member that is bound.

THe convenient placing of a part that is bound consists in this, that it may have that position, which may pre∣serve its naturall figure, and may be without paine, and may be convenient for the cure of a disease. A member shall be so

placed if all its parts, bones, muscles, nerves, veines, and arteries, may enjoy that position whereby they neither are distended, nor pressed; if the member be set or placed softly, and equally; if the orifice in a hallow ulcer, or wound, tend downeward as much as may be, that the quitture may be purged out; lastly if moderation be observed in ordering of the binding so that it be neither too straight nor too loose.

But collocation is made either by putting in, or by sus∣pending; a member is fitly restored, when tis underpropt with certaine stayes, with feathers, wooll, or soft rags, that it may be quiet and leaning or resting on somewhat, it should lye allwayes even, and soft, least it either should be shaken by motion, or extended by reason of flux, or least the sanies and thin matter should be retained in it: the member is suspended, either when the sick keepes his bed, or newly be∣gins to walke, and especially the hand, and the arme are to be kept in a Swath, which Celsus calls, Mitellam.

Notes

• * 1.1

  Setting or putting to¦gether. Finding.
• * 1.2

  Swathing.
• * 1.3

  Differences of it.
• * 1.4

  Differences of deliga∣tion.
• * 1.5

  The man∣ner.
• * 1.6

  Splents made up with Lin∣nen.
• * 1.7

  Splents.
• * 1.8

  Swathing∣bands.