Ars chirurgica a compendium of the theory and practice of chirurgery in seven books ... shewing the names, causes, signs, differences, prognosticks, and various intentions of curing all kinds of chirurgick diseases ... : to which is added Pharmacopoeia chirurgica, or, The medical store, Latin and English ... / by William Salmon ...

CHAP. XLI. CROOKEDNESS of the ARMS and LEGS.

I. IT is known by Sight: The Cause is many times Defluxi∣ons of Humours, Rickets, Kings-Evil, Dislocations, and Tumours, hard to be cured, called by Hip∣pocrates, Galangones.

II. The Prognosticks. If it be from a Contraction of the Tendons and Muscles, it is more easily Cured, than if it proceeds from Repletion of the Cavities, by a thick, pituitous and viscous Hu∣mour, which may fall, not only in this, but in other Joints, af∣ter Defluxions, great Pain and Weakness.

III. If also there be a Callus, in or near the Joint, (from an E∣rosion of the two ends of the Bones by some sharp Humour, whereby an intervening Callus makes them grow into one, as in Fractures) then it is in vain to attempt the Cure: For, let the Artist do what he can, it will ever after be stiff and useless.

IV. The Cure. If it be without a Callus, after Ʋniversals have been premised, let the Nerves, Muscles and Tendons be soft∣ned by Emollients, either by Fomenting or Anointing.

V. You may Foment with the Powers of Amber or Aniseeds: If you anoint, you may do it with this. ℞ Oil of bitter Almonds ℥iv. Oleum Succini, Anisi. a. ℥j. mix them: It softens beyond all imagination.

VI. Also, the Disaffected Part ought to be held an hour or two in a hot Bath of warm Water, in

every Gallon of which, ℥iij. of Sal Armoniack is dissolved.

VII. And you may after Bathing, apply this following Cataplasm: ℞ Baked Turneps lbij. Oil of Tur∣pentine and Aniseeds, a. ℥iij. mix, and apply it as hot as can well be indured, letting it lye on all Night.

VIII. Which done, Bathe it a∣gain, as before directed; then a∣noint with the aforementioned Oil, and after apply the afore∣directed Cataplasm again; which course repeat twice a day, so long till you find the contracted Part made somewhat supple and pliant.

IX. Then come to the Applicati∣on of the Instruments, which ought to be so ordered, as, 1. To crush the Prominent and Convex Parts. 2. That it may scarcely touch the hollow, but rather defend it from Compression. 3. That it be so fitted to the Parts, as to hinder motion as little as may be.

X. The Instrument is various, according to the Parts affected; but that which serves for the El∣bow, may serve for the Wrist and Knee, which is thus:

XI. Make a Casket of Wood or Iron, in fashion of a Ring, and of such a breadth as may compass the whole Joint: In that for the Knees, there must be a hollow for the Rotula, in the midst of the Casket must be a Screw, which is to pass into the Ring, the Ring also having Hinges, by which it may open and shut; to the Gasket put straps of Leather to fasten it, both above and be∣low the Joint. The Screw is made, to bring gradually the Joint into form. See the Fi∣gure thereof in Scultetus, Ta∣ble 18. Fig. I. and Table 43. at C.

XII. Immediately, upon the Part affected you must put an E∣mollient or softning Emplaster, with which it must be dressed twice a day; I have found mighty suc∣cess in a Cerecloth made of Empl. de Minio, made with Oil, without Wax, and not boil'd too much; it alone restored a Con∣tracture in the Elbow, of many Years standing.

XIII. Then six the Instrument to it, which let be well guarded with Tow, Cotton, or Lint, to be kept on Night and Day, as you see occasion, or as the Pa∣tient can bear it.

XIV. Every time the Insiru∣ment is taken off, the Part must be bathed, or fomented, anoin∣ted, and a new Emplaster ap∣plied, straitening the Instru∣ment every Day, as you see the disaffection requires it.

XV. By this means the Crooked Limb comes to be extended, which is yet to be done with all gentle∣ness, lest Pain be excited, and evil Symptoms arise.

XVI. If the Contracture is in the Knee, whilst the Instrument is sixt to it, the Patient ought to walk gently upon it, if he be able. But if it be in the Arm, he must then often stirit, sometimes for∣wards, and sometimes back∣wards.

XVII. Hildanus his description of the Instrument for the Thigh. It is a wooden Case or Cradle, made hollow, and fit to receive

the Thigh about the middle; and the Small of the Leg a little above the Ancle.

XVIII. Then there must be an Iron Hoop, fit to receive the Knee, with an Hinge to open and shut, and with a Button, and several holes to straiten or widen it, as there shall be occasion: A Male Screw must be put thro' a hole in the Hoop, just in the Ham, and a hole in the wooden Cra∣dle, which is placed behind, and made fast with strings to the middle of the Thigh, and Small of the Leg. This Male Screw, must rest by a Shoul∣der in the Hoop; then the Fe∣male Screw must screw on be∣hind the wooden Cradle, and thereby the Leg extended, as much as you see needful.

XIX. Hildanus has C•…•…ed Crooked Elbows without this In∣strument, only by the use of Emol∣lients, and causing the Patient every Hour to lift some heavy Mat∣ter with his Hand, as a Pail full of Stones, and to walk about with it; this is an easie Me∣thod, but he says he has found great success in it.

XX. Crookedness of the Legs is also many times remedied by Boots, Splints, Boulsters, and such like, fitted to the Part, u∣sing withal, Emollient Baths, Oils, Ointments, and Empla∣sters.