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. III. Of ACCIDENTS or SYMPTOMS of FRACTƲRES.

I. THO' the Accidents or Symptoms attending Fra∣ctares are manifold, yet these five following are the primary or chief, viz. 1. Pain. 2. Inflammation. 3. Gangrene. 4. Itching. 5. Excoriation.

I. Of Vehement Pain in a Fracture.

II. Pain, whether great or small, •…•…ght to be cased and taken away; for by reason thereof, there may be a Flux of Hunters, whereby manifold Evils may be excited.

III. You are to consider the cause, and accordingly to remove it (causa ablata, ••ossitur effectus) and that, if it is possible, imme∣diately.

IV. If the Pain is from a Bon•• that pricks (which is known from •…•…ndling the Part) you must •…•…osen

the Bandage; and then either put the Bone back again into its place; or (if it may not be) take it forth; or else cut it off.

V. For so it is advised by Cel∣sus, lib. 8. cap. 10. It will be best (says he) to open it, for there is a necessity of cutting off these sharp pricking ands of the Bones.

VI. If the Pain is from over∣hard binding (which is known from the swelling which appears in the Extremity of the Part,) then the Ligature is forthwith to be loosned.

VII. If the Pain comes from an ill situation or posture of the affect∣ed Part, you are so to change the situation, or posture, and so often, till the Sick feels him∣self at ease.

VIII. If the Pain is from an Afflux of Humors, you must cure it altogether in the same way, as if it were an Inflammation.

II. Of an Inflammation in Fra∣ctures.

IX. An Inflammation proceeds from vehement pain, and an Afflux of Humors, and therefore ought to be opposed in the very be∣ginning, and in that manner as we have expressed under its proper Title.

X. The Pain (says Scultetus) is to be abated or eased by Fomen∣ting with Water and Oil; or with a Decoction or Broath of a We∣ther's or Sheeps Head, with Camomil-flowers.

XI. The Inflammation at hand is to be hindred with Anodyn and Repessing Medicaments apply'd out∣wardly to the Part: you may foment with Oil of Roses above, or else with Oil of Roses beaten up with the White of an Egg.

XII. Scultetus commends sharp Wine, Oil of Roses, and the Whites of Eggs mix'd in a fit proportion, and beaten together with a Spa∣tula.

XIII. If the pain is vehement, he leaves out the Whites of Eggs, and mingles the Oil with the Wine in greater quantities; in which Medicament, he also wets his Ligatures, and gently presses them out again.

XIV. For so Avicenna, lib. 4. F. 5. Tract. 1. cap. 5. does ad∣vise in the cure of a Dislocation; and withall, that we should be careful, that they be not laid on hot and dry: because, if hot, they heat, and attract Humors: if dry, they do not stick well together.

XV. You may apply this Cata∣plasm. ℞ Barley-flower ℥iii. Pulp of rotten Apples ℥ii. Pouder of Marsh-Mallow-roots, and of Cammomil-flowers, A. ℥i. Boil in sowre Wine, or in Vinegar, and fair Water, A. q.s. to the consistence of a Cataplasin.

XVI. Now, 'till the Inflamma∣tion ceases, the Part is not to be bound up, or at least it is not to be bound hard; nor Splinters to be imposed, or any other In∣strument, unless to uphold the part, and keep the Medicaments close to.

III. Of a Gangrene in Fractures.

XVII. A Gangrene often hap∣pens unto Fractures, especially if there be Contusion withal: and

it commonly arises either from taking too much Air, or from Inflammation, or from hard Binding, which how it is to be Cured, you may see in the pro∣per places, in lib. 3. cap. 11. and lib. 4. cap. 9. Sect. 22.

XVIII. However, the Part ought to be fomented with Lixivium, in which Te•• ••erfew, Sage, Southernwood, Saxifrage, Scor∣dium, Rue, Tansey and Wormwood have been boiled; mixed also with some Spirit of Wine.

XIX. Or with Spirit of Wine rectified, with which Spirit of Sal Armoniack ℥i. to lbi. of the S.V. is to be mixed; where note, that if the rectified Spirit is wanting, common Brandy or Spirits may do.

XX. Or you may foment with this: ℞ Spirit of Wine, impreg∣nated with the Tinctures of Worm∣wood, Scordium and Saffron, lbi. Camphir ℥iss. mix, and dissolve: It is a famous thing.

XXI. But above all things, nothing is more excellent, nothing more safe; nor any thing more speedy to retrieve the Mischief than Powers of Amber, or Powers of Lavender, of Limons, of Oranges, of Pennyroyal, of Rosemary, of Sage, of Turpentine, or of Wormwood, being fomented upon the Part.

XXII. Or you may use this: Take Powers of Amber ℥iii. Powers of Turpentine ℥ii. of Rose mary, and of Sassasras, A. ℥i. Camphir ʒiiiss. mix them for use.

VI. Of vehement Itching in Fractures.

XXIII. The most simple thing to allay itching, is to wash, bathe, or foment the Part often with warm Water; for it is of good use to wash away the ichorous Sanies, and to dissipate the Hu∣mor, or call it forth.

XXIV. And nothing inferior to Water, is Breast-milk, or the Milk of Asses, Mares, Goats, or Cows; or Whey of Goats or Cows Milk, being often fomen∣ted warm, for some small time.

XXV. Or, Take Rain-water lbii. Oil of Tartar per Deliquium ℥i. mix them, and foment there∣with, as aforesaid, warm; it opens the Pores, draws forth the Humor, and admirably al∣lays the itching.

XXVI. Or, Take fair Water, somewhat more than Blood-warm lbii. Spirit of Wine ℥iii. volatil Sal Armoniack ʒiii. mix them, to foment with.

XXVII. Or, ℞ Juice of Cow∣cumbers lbii. Juice of Lettice lbi. Spirit of Wine ℥iv. Oil of Tartar per deliquium, ℥i. volatil Sal Armoniack ʒii. mix, and foment therewith warm.

V. Of Excoriation in Fractures.

XXVIII. First wash, bathe, or foment the Excoriation very well with warm fair Water, or warm Milk, or Whey, then strew upon it fine pouder of white Starch, or white Starch mixed with very fine pouder of Rice.

XXIX. Or you may first wash it with Aqua Aluminosa, warm, and then strew it over with the afore∣named Pouder, or with fine Bole, or Terra Sigillata, or Catechu, in very subtil pouder.

XXX. Some commend Caput Mortuum of Vitriol, Ceruse, or white Lead; but they are more effectual, after the washing with Dr. Gardner's Aqua Styptica, or some other Styptick Water, of like Virtue and Operation.

XXXI. Some advise to wash first with clarified Juice of Night∣shade or Plantane, blood-warm; and then to anoint with Ʋng. Album Camphoratum, or desicca∣tivum Rubrum, or Rosatum, or Diapompholigos, &c.