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. XLIII. CROOKED FEET and TOES.

I. CRookedness between the Joints, if the Patient be Young, is cured by the like Means and Instruments; but they are commonly fitted to the Part, that they may be serviceable, and not troublesom. See Paraeus, Lib. 23. Cap. 10.

II. If the Feet be Distorted, or turned Inwards, it is called Va∣ris; but if Outwards, Valgus.

III. In Varis, bind the Ancles together, and put Bolsters between the Great Toes: In Valgus, bind them close at the Toes, and put thick Bolsters between the An∣cles and Heels.

IV. If they have been of long standing, you must have half Cases, from above the Knees to the Toes, made of Steel, Brass, Wood or Leather, to which fit Straps and Buckles to fasten them, one at the Gartering place, one a little above the Ancle, and another where the Shoes are tied.

V. We will give you an Exam∣ple of a Cure of this kind, out of the Famous Hildanus, Cent. 6. Obser. 90. A Woman with Child going in Pattens, stumbled, and was out of order after it: When brought to Bed, (which was of a Boy) its right Foot was dis∣torted, so much that his Toes, and all his Foot turned inwards, towards the inside of his An∣cle.

VI. So that the Child when grown big enough to walk, trod more upon the out-part of his An∣cle, than the Sole of his Foot: For this, much means was tryed, but all in vain.

VII. When he was something a∣bove Three Years old, and all the hopes of Restoration were past, they desired my help: I viewed, and considered well; but (to speak Truth) despaired of restoring the Foot, for that the distorti∣on was old and confirmed.

VIII. Yet at the Parents re∣quest, I attempted the Cure; first purging the Child with Manna, and Syrup of Roses Solutive, al∣ternatim; lest by Baths and Fo∣mentations I should attract Hu∣mours to the Part affected.

IX. The Body twice or thrice purged, the following Emollient Decoction was used two or three times a Day, for Ten or Twelve Days together.

X. ℞ Roots of Althaea, Mal∣lows, a. ℥ss. Herbs and Flowers of Betony, Ground-pine, Camomil and Melilot Flowers, a. M. j.

Linseed and Foenugreek-seed, a. ℥j. Broth of Sheeps Feet and Heads q.s. mix, and make a Decoction, for use.

XI. After the Foot and Leg had been somented with the former Decoction, they were a∣nointed with this Ointment: ℞ Oil of white Lilies, of sweet Almonds, a. ℥ss. Oil of Earth∣worms ℥j. Oil of Juniper-berries ℥ij. mix them.

XII. Then the following Em∣plaster was applied; ℞ Empl. de Mucilaginibus ℥ijss. Gum Ammoniacum dissolved in Spirit of Juniper and strained, and boil∣ed again to a thickness ℥j. new Wax ℥ss. Oil of Eggs ℥j. dissolve over a gentle Fire; and mix there∣with Pouder of Betony Flowers, of Ground-pine, and Red Roses, a. ℈ij. Saffron, Pouder of Earth∣worms, Mastich, Olibanum, a. ʒj. mix, and make an Emplaster, S.A. adding a little Oil of Roses, if need be. It wonderfully molli∣fies, and strengthens the Ner∣vous Parts.

XIII. The Foot and other Parts being sufficiently softned, the E∣mollients were left off, and Corro∣boratives applied: But in the mean time, whilst the Emolli∣ents were used, a kind of Boot, or high Shoe was also put on, which shall hereafter be de∣scribed.

XIV. And although the Foot was wonderfully distorted, yet af∣ter the Emollients were for some time used, it were easily reduced into its natural form, and that without pains. But as soon as ever the Hand was off it, it would presently return to its former irregular Figure.

XV. And whenever the Foot was extended, and reduced to its Natural posture, a great hollow∣ness was selt between the inner Ancle, and the Sole of the Foot.

XVI. For the Process of the lower Appendix of the Os Tibiae, which constitutes the inner Ancle, (for that it had rested a long time upon the Os Calcis) was depressed, and stood at a di∣stance from the Os Calcis; and the Process of the Fibula, which makes the outward Ancle, was preternaturally prominent, and twisted the Foot inwards.

XVII. To reduce therefore the Foot to its natural Posture and Form, it was needful to sink the prominence of the Fibula, and a little to prolong the Defect of the Process of the Appendix of the os Tibiae: The former was performed by Art and Pains; the latter, through Natures As∣sistance.

XVIII. That Nature is thus wonderfully solicitous for the pre∣servation of her Individuum, I can demonstrate by an Instance in my Study.

XIX. I have the Skeleton of a Capon, which had broke its left Thigh-bone short off, and the one end of the broken Bone grew over the other by a firm Callus; and therefore that Leg must have been shorter than the other: But provident Nature made the Os Tibiae of that Leg of much longer than the Os Tibiae of the right, so that no Inequality or Defor∣mity was left.

XX. Now if it may be thus in

Brutes, why not so in Children, while they are growing, more es∣pecially if they be of a health∣ful Habit of Body, as this Patient was?

XXI. But to our Cure again: The Foot being thus sufficiently soft∣ned, it was (with the whole Leg) Anointed with this Mix∣ture: ℞ Juice of Earthworms, Aqua Betonicae, waters of Ground∣pine, Sage and Juniper a. q.s. mix them. After which the fol∣lowing Plaster was applied.

XXII. ℞ Emplastrum Slotani (or, in place thereof, Emplast. of Ammoniacum cum Cicuta) ℥iij. fine Gum Elemi, new Wax a. ℥j. Mastich, Olibanum, Earthworms, all in Pouder a. ʒij. Pouder of Red Roses, Balaustians, Cypress-Nuts a. ʒ j. Oil of Earthworms q.s. mix, and make a Cerate, which spread upon Leather, and apply it, renewing it every sixth day.

XXIII. Then having replaced the Foot in its natural Posture, which will be done without pain, the following Instrument was so cleverly applied to the Foot, that it could not get back into its former preternatural Posture, unless the Swaths and Bandage should chance to be loosned.

XXIV. The Instrument. It was made of Iron, shaped like a half Boot, but parted about the mid-leg, and held together by two Iron Pins, running into two Loops, and a Screw between them; to let the lower Part down, or draw it up tight, as occasion should require.

XXV. This lower part was so made, as to take hold of the Foot, and keep it from starting any way, out of its proper place, and was for the outside of the Leg, be∣ing fastned to a piece above the Knee, by a Pin to run on, for the Motion of the Knee.

XXVI. The inside of the Leg was covered with Splints lined with Tow or Cotton, and so the Instrument on the outside, was fastned round the Leg by Strings.

XXVII. The Foot being thus tied strait and fast in this manner, the Prominence of the Fibula was depressed, or at least hin∣dred from starting out.

XXVIII. And the Process of the lower Appendix of the Os Tibiae (since there was a hollow∣ness) might grow out, and so gra∣dually fill up the Emptiness about the inner Ancle. Thus the De∣formity, and ill Position of the Foot was rectified; so that when the Child walked, no fault was perceived.

XXIX. From what has been said, and may be observed in the History of this Cure, 'tis evident, that disaffections of this kind re∣quire long time, much Industry, and great Skill, with gentle Manage∣ment; for Violence does no good, it is Natures Business to correct and mend such Deformi∣ties, joined with a Skilful Artist's help.

XXX. The Child wore the a∣foresaid Instrument a whole Year; and then another was contrived for the Child to wear afterwards; because Children, when they are growing, must have new ones fitted to them, as the old ones are out-grown.

XXXI. And in such like Cases as these are, a Physician must set himself to work, to invent pro∣per Instruments; without which, the very best of Medicines may be used to no purpose.