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 ...

V. DIARTHROSIS.

CHAP. XXXIX. Of CROOKEDNESS in General.

I. THis Fifth part of the Art is called by some in Greek, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, Diarthrosis, Arti∣culatio, commissura Artuum; and is intended to rectifie ill Conformation, in reducing it to its natural Figure by right Articulating of it, whence Diar∣throsis, Articulating.

II. But in my Opinion, from the nature of the Intention, it ought ra∣ther to be called 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, Dior∣thosis, emendatio, seu directio, because it is rather a mending, directing, or putting into a right state or situation, what is distorted, crooked, or out of order.

III. It is directed chiefly, 1. To rectifie, or set straight a Crook∣edness of the Back. 2. A Crook∣edness of the Arms and Legs. 3. A Crookedness of the Fingers. 4. Of Feet and Toes.

IV. The Parts affected, and which particularly cause these Dis∣tortions, are, the Muscles, and in them the Nerves and Tendons especially, and sometimes the Bone it self.

V. The Signs. These are so evident, that they need not be de∣clared, being manifest both to Sight and Feeling.

VI. The Causes. Though they arise sometimes from Wounds, Fra∣ctures or Dislocations (whose Cure depends upon the Cure and right Healing of those Diseases) yet they many times are connate from Infancy, and arise from a Rickety Disposition, or from some Cause, inward or outward, which might have been cured, had it not been neglected.

VII. The Prognosticks. If the Cure be attempted, whilst the Pa∣tient is young and tender, the Dis∣tortion may be rectified with ease; for then, the Parts being more flexible, are more apt for a Reduction.

VIII. But if they be grown stiff or callous, and into a kind of a Bony hardness; the Restoration is much to be doubted, if not impossible; more especially if there be Age withal.

IX. The Cure. First, the Parts affected ought to be Fomented, Bathed, or Anointed with Emol∣lients and Softners; as a Bath of Milk, Emollient Oils and Li∣niments; and after them the Application of softning Em∣plasters.

X. A softning Oil. ℞ Oil of sweet Fennel-seeds ℥iss. Oil of Ben.

or of sweet Almonds ℥ivss. mix them; with which anoint Morn∣ing and Evening.

XI. A softning Ointment. ℞ Oil of Aniseeds ℥jss. pure golden coloured and sweet scented Palm Oil ℥iij. mix them, and anoint well therewith, Morning and Evening.

XII. A softning Liniment. ℞ rectified Oil of Vitriol ℥j. Oil Olive ℥iij. mix them: With this anoint once a day; it is much better than any of the former, and resolves more.

XIII. A softning Bath. ℞ Spirit of Nitre ℥j. Spirit of Vi∣triol ℥j. mix them, and there∣with gently bathe the Contorted or Contracted Parts.

XIV. In the intervals of A∣nointing, you ought also to anoint with Neuroticks, of which this is an excellent thing. ℞ Oil of Nutmegs, or Mace by Expression ℥iij. Oil of Lavender and Limons a. ℥ss. mix them.

XV. Or thus. ℞ Earthworms lbss. which cleanse, by washing first in Water, then in Wine, cut them small, and affuse upon them (in a large Receiver) Oil Olive lbss. or rather as much Oil of sweet Almonds, Oil of Limon; ℥ij. and upon warm Embers resolve into Liquor, which strain out strongly by pressing.

XVI. This is an excellent Oil, for the Liquor of the Worms, by its peculiar Vertue, penetrates im∣mediately; and passes to the Nerves and Nervous Parts, Veins, Arteries, &c. moderately warm∣ing, humecting, and strength∣ning them; whilst, mean sea∣son, the Viscous Substance there∣of occludes the Pores, and keeps in the Heat, in order for reso∣lution of the hardned and con∣stricted Parts.

XVII. Afterwards you may apply also Emplasterwise, Myn∣sicht's Galbanum Crocatum, or Ammoniacum cum Cicuta, or de Ranis, with triple quantity of Mercury: For by these various Applications, the Parts will be before-hand prepared for the use of the Instruments.

XVIII. For the whole stress of the Cure seems to lie upon the right Contrivance, Making, and Affixing of the Instruments; with∣out which, nothing can indeed be done; but, in a manner, all your Labour will be in vain.

XIX. Wherefore, fit Instru∣ments being made; and the former softning Medicines used for some time before-hand; you must come to the Application of the Instru∣ment, (using also your softning Medicines as before) together with Splenia, or Bolsters, and proper Bandage; as the Nature, Position, and Form of the Part requires.

CHAP. XL. CROOKEDNESS of the BACK.

I. THIS is thought to proceed mostly from the Rickets; which, while the Patient is young, if not neglected, may be cured, but by the help of In∣struments.

II. There is generally a fulness of one Shoulder, more than in the other, which tends that way, if not prevented, and while it's in beginning, may be helped by constant Swinging.

III. Sometimes it is in the Spine, the Vertebrae being con∣torted, mostly outwards, seldom (if ever) inwards; and also to either side, which is most usual with young Girls, who have generally a debility of the Leg of the same side.

IV. Tho' these kinds of Crook∣edness are many times caused from the Rickets, or a Defluxion of a Morbifick Matter; yet they are many times caused from an ill Conformation in the Womb, or some Pituitous Humour, collect∣ed about the Vertebrae.

V. Sometimes also it is caused, as afore-mentioned, by external Violence, from Falls, Bruises, or a constant ill Posture of the Body, whilst Young and Tender, in sit∣ting, standing, carrying, bow∣ing down forwards, writing, sowing, or making to use their Feet too soon.

VI. Many times also it is the Mothers fault, who striving to have them small in the Waste, by strait lacing, draws their Bodies aside; more especially, if there be any thing in the Cloths on either side, which hurts them: Which ill custom, if the Child escapes Crookedness, it commonly brings other ill Diseases, as Ob∣structions of the Viscera, Green∣sickness, Consumptions, &c.

VII. The Cure. Here Emol∣lient and Discussive Oils, Oint∣ments, Liniments, Balsams, and Emplasters are to be used, (Exam∣ples of which you have in the aforegoing Chapter) before the Application of the Instrument.

VIII. The Instrument is a Steel Compress, or Bodice, fitted to the Body to be reduced: It is to be full of Holes, that it may be the lighter and cooler; and lined with Cotten, that it may not hurt; bunching inwards, an∣swerable to the bunching out of the Back.

IX. This Compress is to be gently and gradually used, being straitned by degrees; for without the use thereof, all other Medi∣cines will be applied in vain; whilst, by the use thereof, some have been restored in about eight or ten Months time, or a Year at farthest.

X. As you perceive the Redu∣ction to come on you must accord∣ingly alter the Compress, viz. for such as are not yet come

to their Growth, where they are to be altered every third Month.

XI. Where the Person was very youthful, I have known this affect Cured by swinging by the Arms and Arm-holes, and sometimes gently by the Chin in a Sling, and the success was wonderful; but this is much better for a Gibbo∣sity in the Shoulder, or where one Shoulder grows higher than another.

XII. If the Patient is come to their full Growth, the means of Cure, and all Tryals of this Ope∣ration is in vain.

XIII. If the Patient be very Young, the Compress, or Bodice, may be made of stiff Whale-bone; so fitted to keep the Back-bone upright, repress the bunching out, and defend the Parts.

XIV. And about the Seventh Vertebra of the Back, some ad∣vise to open an Issue, which is said to intercept the Humour flow∣ing down, if it should seem to affect the Hip, Reins, or Feet.

XV. Hildanus has an Obser∣vation, which I care not if I in∣sert, it is Cent. 5. Observ. 67. paginâ meà 458. of a young Girl about Eighteen Months old, who had the Vertebrae of her Loins beginning to grow bunch∣ed outwards.

XVI. After that some Barbers had for divers Months attempted the Cure, with Ʋnguents, Baths, and Plates of Lead, but all in vain, for that the Spine did bunch out daily more and more; Hildanus was then called, who found the Third and Fourth Vertebrae of the Loins to bunch out, as large as a Ducks Egg, which were gradually followed by the Second and Fifth.

XVII. By which means the Spine being grown into a great Bunch, especially towards the left side; it also made the left Leg much weaker than the right.

XVIII. First, he rubbed the Back, whole Thigh and Leg, with the following Water, to strengthen the Nerves. ℞ Water distilled from Juniper-berries without Wine, Waters of Sage, Betony, and La∣vender a. ℥ij. Pouder of Tormentil-Roots, and Rose-Leaves a. ʒij. make an Infusion, by digesting eight or ten days in a large Vessel, de∣cant the clear, and keep it for use.

XIX. After Chasing, he appli∣ed the following Emplaster. ℞ Emplast. Slotani (or, in place thereof, Ammoniacum cum Cicuta) ℥v. new Wax ℥ij. Osteocolla ℥j. Pouders of Comfrey-Roots, Terrae sigillata a. ʒij. Pouders of Balau∣stians, Cypress-Nuts, Damask-Roses a. ʒj. mix them over a gentle Fire, and make an Em∣plaster, by adding Oil of Roses, or of Mastich q.s.

XX. To repress the Extuberance of the Vertebrae, he made an Iron Plate, a little bent, long and broad enough to cover the whole Gibbosity, and quilted it into a Compress, or Bodice, between Cloths, that it might hurt the Child the less.

XXI. This Compress was worn upon the Naked Body, and so fitted, as to comprehend all her Belly, to the Muliebria: It was tied on with a long Strap over the mid∣dle of the Belly; and about the

Brest, it was gently tied, that it might not straiten the Ribs, or Midriff.

XXII. But below the Bastard Ribs, to the bottom of the Ab∣domen, it was straitly tied, that the Iron Plate might repress the bunching-out Vertebrae.

XXIII. And lest the Compress should have slipt upwards, two Straps, an Inch broad, were fast∣ned on each side the Groin, to go under the Perinaeum, and to turn up again upon the But∣tocks, and so were fastned by Straps to the Compress on either side.

XXIV. He ordered all from the Hip to the Foot, to be Chafed with the aforesaid Water every day; and the Plaster and Chasing upon the Extuberance every Fourth, or Sixth day; by which means, through God's Blessing, the Child was Cured in Six Months: But she wore the Bodice and Plate, by reason of the weak∣ness of the Parts, Two Years; in which time she grew very well.

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.

CHAP. XLII. CROOKEDNESS of the FINGERS.

I. THE same Method that we have prescribed in softning the Contracted Nerves, Tendons, and Muscles of other Parts, must be taken here; after which an Extender ought to be fitted to the Finger or Fingers contract∣ed, to stretch them forth gra∣dually, (if the thing is to be done;) and the use thereof to be continued so long, till the Parts are restored to their natu∣ral Situation, conformation and Use.

II. Hildanus, Cent. 1. Observ. 83. has a famous Example. I had a Patient, (says he) a Child, about fourteen Months old, who, falling into the Fire, burnt his right hand.

III. His four Fingers, and the external Part of the Metacarpus were so burnt, that the ends of his Fingers were drawn back, to their first Articulation or Roots.

IV. The Father of the Child committed the Cure to Ignorant Persons; so that the Skin of the back of the Hand and Fingers was shrunk up, and grown to∣gether into a kind of Globular Form.

V. About Seven Months after

it was healed, the Child was brought to me: I first Purged it with Broth in which Manna was dissolved; then I used the fol∣lowing Emollient Decoction and Ointment, for several days.

VI. The Decoction. ℞ Al∣thaea, the whole Plant, Root and all, Roots of Bryony, of white Li∣lies a. ℥j. Flowers of Camomil, Melilot, Hypericon, Ground-pine, Germander a. M.j. Linseed, Foenu∣greek-seed a. ℥j. Broth made of a Wethers or Calves Feet and Head q.s. mix, and boil them together for a Fomentation.

VII. I anointed the whole Arm and Hand with this Ointment: ℞ Ointment of Marsh-mallows ℥j. Mans-grease, Hens, Goose and Bears-grease a. ℥ij. Mucilage of Earthworms ℥ss. mix, and make an Ointment.

VIII. After Anointing, I wrapt the Hand (says he) in Empla∣strum de Mucilaginibus; by which means the Contracted Sinews, and Callosity of the back of the Hand and Fingers, grown together on the said back of the Hand, were sufficiently mollified.

IX. I then with a Rasour cut away the Callus, between the Fin∣gers and Metacarpus, then I se∣parated the Fingers; after which I strewed on my Pouder to stop Bleeding, and applied Whites of Eggs mixt with Rose and Plantane-water, together with Oil of Roses.

X. Which done, I applied a De∣fensative to the Wrist, and A∣nointed the whole Arm with Oils of Roses, of Myrtles and Earthworms.

XI. The next Day was laid upon the Incisions this Digestive, with soft Lint. ℞ Turpentine wash∣ed in Rose and Plantane-waters ℥j. Oils of Roses and of Eggs, a. ℥ij. Saffron ℈ss. Yolk of one Egg, mix them. And withal, the Arm was Anointed with the a∣forementioned Oils.

XII. The Fifth Day I applied an Instrument, with which, by degrees, the Fingers were drawn and extended to their natural site.

XIII. It was made of a Splint three Inches broad, and long e∣nough to reach nearly from the Elbow to the Wrist: And at the end next the Wrist, it had a stick fastned a-cross it, with four round Pegs standing up.

XIV. The Splint was tied in two places round the Arm, with a Band; which being thus tied on, and well Lined with Lint or Cotton, Finger-stalls of Leather were put upon the Ends of the Fingers, with Strings to fasten them to the Four Pegs before-mentioned.

XV. Every Day they were bent more and more, which that it might be the better done, the Arm and Hand were Anointed with the Ointment at Sect. 7. above, as oft as the Wounds were dressed.

XVI. And that the Fingers might not grow together again, Plates of Lead were put between them: Thus were the Fingers, by little and little, restored to their natural Posture.

XVII. Mean season, the Wounds were healed and Cicatrized; not

with vehement Driers, but with things which were withal a lit∣tle Emollient; whereby, with the Blessing of God, the Hand was perfectly Cured.

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.