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 ...

IV. Of Collocation, and the Po∣sture the Member is to be laid in.

LXI. The position, or placing of the Member, is the next Conside∣ration; this according to Hippo∣crates is to be, 1. Soft, lest by pressing or lying hard, it causes

Pain and Inflammation. 2. E∣qual, lest it distort the Member. 3. High, lest by its depending position, the Humors should de∣scend, because even by their own weight they are apt to fall downwards, and flow to the place affected.

LXII. Therefore the Patient is to be laid in Bed, and the fractu∣red Part is to be put upon a Pillow, or soft Bed-cloths, stuft with Flocks or Feathers: Or a Pasteboard may be formed into a Case, the inside of which may be lined with Tow for the Arm, and such Parts as do not oblige the Patient to keep his Bed.

LXIII. But if the Patient is confined to his Bed, nothing can be better than to make a Cap∣sula, or Case of thin Oak, or Deal Boards, and to line or fill it sufficiently with soft Tow or Wooll, that the Part may lye easie in it.

LXIV. As to the posture the Member is to lye in, it ought to be that of a middle figure, in respect both to the Joints, and to the Muscles: And therefore Hippo∣trates de officin. Med. Text. 3. & 30. advises us to heed these three things, 1. Rest 2. Mean∣position. 3. Custom.

LXV. By Rest, is intended such a posture, as a Man is apt to put the Part into, when being free from Business, he reposes him∣self for Rest, Ease and Pleasure.

LXVI. By Mean-position, is meant such a posture, as we natu∣rally lay our Limbs in when we have nothing to do, which is a mean between extream Disten∣tion and close or acute Contra∣ction: The Arm is in such a middle position, when it makes not an acute Angle, nor yet a right in the Elbow, but rather an obtuse Angle, as if it were half way stretched out; for that is the posture when Men are Idle, they hold their Arms in, as being most easie, natural, and free from pain.

LXVII. By Custom, we mean such a posture as Nature and Cu∣stom has given to any Part; for that no habit is so easily born, as that to which Nature and Cu∣stom have given preference: And so by this Rule, a streight posture in the Wrist is only to be chosen.

LXVIII. Hippocrates de Fra∣cturis, lib. 1. adds a fourth, viz. the Course of the Muscle, which is taken from the Ductus of its Fi∣bres: He so figures and places the Muscles, that their Fibres may be direct, and stretched forth in a straight manner.

LXiX. These things being thus all done, and the Patient easie, the rest of the Work, which is the pro∣ducing the Callus, is to be commit∣ted to Nature: Now it is bred of the Nourishment of the Bone, which issuing out of the edges of the Fracture, coagulates and hardens about the fractured Part.

LXX. This tho' it is no Bone, yet it is so hard and strong, that if the Bone should chance to be broken again, it will break ra∣ther in another part, than in that where the Callus is.

LXXI. But tho' the breeding of the Callus is the Work of Nature, yet the Physician ought to assist and

help her in her Operation; and this he may do, if he prevents Inflammations, or other ill Sym∣ptoms; and also by drying Me∣dicaments so disposes the Ali∣ment, that it may the sooner be converted into a Callus.

LXXII. The Food for genera∣ting a Callus, ought to be such as is viscid and glutinous, viz. Bar∣ley hull'd, Rice, and Wheat boil'd in Water, and afterwards mixt with Milk, Gelly of Harts-horn, Sheeps Trotters, Knuc∣kles of Pork and Veal, Calves Feet, Feet and Stomachs of Oxen, boil'd soft, and eaten with good Sawce, or made into Gellies, and so taken; also strong Broths made of the Flesh of Fowls; Beef, Mutton, Veal, &c.

LXXIII. The Internal Medi∣caments which are given in this Case, are chiefly the Pouder and Juice of Agrimony-roots; Pou∣der of Comfrey-roots, and Sy∣rup, but chiefly Blood of Com∣frey; the levigated Pouder of the Osteocolla Stone, which may be given ad ʒi. Morning and Evening, in Syrup of Comfrey, or Blood of Satyrion; or Par∣snip-roots.

LXXIV. In the beginning, a sparing Diet is to be used, till the danger of the Symptome are over; but when they are over, and the Callus begins to grown, which will be about the twelfth day, then •…•…ore plentiful Diet is to be allowed, because it contri∣butes to the more absolute gene∣rating of the Callus.

LXXV. Decoctions or Vulne∣rary Drinks may be prepared from Wound-herbs, as Bugle, Com∣frey Roots, Consound, Dra∣gonwort, Avens, Agrimony, Angelica, Primroses, Sanicle, Savin, Speedwell, Yarrow, &c.

LXXVI. ℞ Roots of Consound and Dragons, A. ℥i. Roots of Angelica, of Comfrey, A. ℥ss. Storksbill, Savin, A. M. i. Speed∣well, Yarrow, Primrose leaves, A. Mss. Galangal, Zedoary, Mace, A. ℥ss. Nutmegs. ʒii. Wine q.s. boil in B.M. and strain; sweeten with white Sugar, and let the Patient drink of it twice a day.

LXXVII. As to Topicks, you may make a Cataplasm of white Starch, and whites of Eggs, which may be applied to Wo∣men and Children.

LXXVIII. To Elder Persons you may apply this of Fabricius Hildanus in Cent. 3. Obs. ••0. ℞ Oil of Earthworms ℥ii. Juice of Earthworms ℥i. Grains of Ju∣niper ℥ss. mix them, and make a Liniment, with which anoint the Fracture.

LXXIX. ℞ Vigo's Plaster for broken Bones, or Catagmaticum, ℥ii. Osteocolla Stone prepared ℥iss. Pouder of Earthworms ℥i. Oxy∣croceum ℥ss. Oil of Earthworms q.s. mix, and make an Empla∣ster, which lay upon the Part affected.

LXXX. The same Fab. Hil∣dames, to hasten the Callus, gives also internally this Preparation of the Osteocolla. ℞ Osteocolla levigated ℥i. Cinnamon in sine pou∣der ʒiv. white Sugar ℥iv. mix them. Dose, ʒii. every Morn∣ing in strong Broth, made of Meat.

LXXXI. Where the Callus is bred to confirm it, you may ap∣ply

this: ℞ Catechu, Terra Si∣gillata, Aloes, Mastich, Myrrh, Olibanum, Laudanum, Nat-galls, Frankincense, Comfrey-roots, A. ℥i. all being in fine pouder, mix it with whites of Eggs, and a little Wheat-flower, and apply it.

LXXXII. Or, ℞ Wax ℥iiiss. Oil of Roses ℥ii. Frankincense, Mastich, Olibanum, A. ℥ss. Ca∣techu ʒiii. fine Bole, Cyprus-nuts, Saffron, A. ʒi. mix, and make a Cerate, which spread upon Lin∣nen and apply: This, when the Callus is bred, and come to its just magnitude, will very much corroborate and confirm it.

LXXXIII. If the Callus is ge∣nerated less than it should be, you may know it by its being less than it should be, or when touched, very little or no Callus can be felt, and the Part being weak in its moti∣on: It is caused from the Pati∣ents using too thin and sparing a Diet, or eating Meats not vis∣cid or thickning enough, or from the Bandage being too straight.

LXXXIV. In this case the Diet must be more plentiful, and stronger, made of strong Broths, Gellies, &c. The Medicaments must be less astringent, the Bandage must be loofer, and the Nourishment must be attracted, by bathing with Water, only Blood-warm, (not hotter, lest opening the Pores, the Humors should per∣spire) till the Part looks red, and swells a little.

LXXXV. If the Callus is too great, (which causes deformity and unaptness for motion) you may know it by handling of it; you will find its magnitude too large; and by pressing the Mus∣cles and nervous Parts it causes pain, and hurts its Function in moving.

LXXXVI. In this case, the Diet must be more thin and sparing, the Bandage must be straighter; and the Callus must be softned and discussed; you may first foment, or bathe, with Decoction of Be∣tony, Bawm, Pellitory, Scabious, Scordium and Speedwell, so long till the Part first grows red and swells, and then abates again, and corrugates; after which you may anoint with Mans, Vipers or Bears Grease, and then ap∣ply Emplast, de Althaea, è muci∣laginibus cum Gummi, de Ranis cum Mercuris, with other things of a resolving and discussive Na∣ture.

LXXXVII. If an Atrophia happens to the Limb, it is caused from too straight Bandage, and poor or hard keeping, or too thin and spating Diet: Here Food of good and strong Nutriment ought to be given, the Patient must feed plentifully, and of Meats succulent and easie of Di∣gestion; his Meat, he must eat with the bloody or red Gravey in it: The Part must be often fomented with strengthning things; and Dropaces or Pitch spread upon Cloth, must be ap∣plied to attract the Juices and Nourishment to the Part; and all these things must be conti∣nued so long till you see a mani∣fest recuperation of the Flesh, and restoration of the strength of the Part.