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. XXVII. Of a FRACTƲRE of the BACK-BONE.

I. IT is called in Greek, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. and in Latin, Fractura Ossium vel Spinarum Dorsi; and in Eng∣lish, A Fracture of the Back-bone.

II. The Signs. Celsus, lib. 8. cap. 9. says, That if any Process of those Bones is broken, it may be discerned by the touch, because that it may be moved this way, and that way: and indeed it may be known by a Cavity in the place, with a Pain and Prick∣ing.

III. If the Sick lyes upon his Fuce, the Pain is so much the greater, because the Skin is ex∣tended, and the Flesh bruised and prickt with the fragments of the Bones, as if they were Thorns or Nails.

IV. But if the Patient stands upright, the fragments of the Bones prick not so much, by reason the Skin is then slackned or loos••ed.

V. The Prognosticks. If an involuntary egestion of Excre∣ments, or a stoppage or suppression of Ʋrine happen in a Fracture of the Vertebrae, the Patient is de∣sperate, and in great danger of his Life.

VI. A Fracture in the Process of the Vertebrae, is easily consoli∣dated and cured; for that those Bones are spongy and thin, un∣less some ill Symptom should intervene.

VII. But if the Spinal Marrow is hurt or prest in, whereby the Arms or Legs of the Sick become sensless, or that he cannot retain his Ʋrine or Excrements, Death com∣monly follows: and this more especially, if the Fracture hap∣pens in the Vertebrae of the Neck; for that with the Spinal Mar∣row, the Nerves and Mem∣branes are also hurt.

VIII. If in a Fracture of the Vertebrae of the Neck, the Sick escapes with Life; yet an inoura∣ble Falsie of the Arms and Hands follows thereupon.

IX. If the Fracture happens in the Vertebrae of the Inferior Parts, and Motion and Sense are not al∣together abolished, there may be some small hope of Recovery; but then by reason the Nerves are hurt, there follows a Palsey of the Thighs, Legs and Feet: if Motion and Sense are whol∣ly lost, Death infallibly suc∣ceeds.

X. The Cure. The in some of these Cases, there may be but lit∣tle hopes of a Cure, yet the poor Patient is not altogether to be de∣serted, but the most proper Means are to be attempted in order to a Cure.

XI. If the Spinous Apophyses are only broken, the Patient is to be laid upon his Belly, and with your Hands you must en∣deavour to raise up the Bone again, and reduce it to its own proper place.

XII. Then you may apply to it on each side a small long Bolster, which may be covered with a Pasteboard of the same shape or form, laying also another Bolster upon each Pasteboard: the Ban∣dage may be made with a Nap∣kin, which you may keep fast by a Scapulary falling from the Shoulders.

XIII. As to Topicals, they are such as are generally applied in Fractures, viz. such as ease Pain, prevent Inflammation, and in∣duce Conglutination.

XIV. If the Process is wholly broken off from the Periosteon, and is loose, you must make an In∣cision, and take it out: so also if fragments of the Vertebrae press upon, or prick the Spinal Mar∣row, or the Nerves; for other∣wise dismal Accidents may hap∣pen, and Life it self may be lost: afterwards the Wound is to be healed according to Art.