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 ...

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Title
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 ...
Author
Salmon, William, 1644-1713.
Publication
London : Printed for J. Dawks ... and sold by S. Sprint [and 6 others] ...,
M.DC.XCVIII [1698]
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Subject terms
Medicine -- 15th-18th centuries.
Link to this Item
http://name.umdl.umich.edu/A60561.0001.001
Cite this Item
"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 ..." In the digital collection Early English Books Online 2. https://name.umdl.umich.edu/A60561.0001.001. University of Michigan Library Digital Collections. Accessed October 31, 2024.

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CHAP. X. Of a DISLOCATION of the JAW-BONE.

I. IT is called in Greek, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. in Latin. Dislocatio vel Luxatio Maxillae seu Mandibulae; and in English, A Dislocation of the Jaw-bone.

II. the low Jaw-bone being on∣ly moveable, it is that only which can suffer a Luxation; which yet seldom happens, for that the head of the Jaw-bone which is contained in the Cavity, is

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encompassed on every side with Bones.

III. Besides, its strait coarticu∣lation, it has many strong Muscles which keep it in its place, and draw it upwards: and it has two heads, which are not so apt to slip out as one is.

IV. And on each side it has two Processes in its hinder part, the former of which drawn forwards, being broad and thin, ends in a point: but the latter is carried backwards, and makes a long and transverse head: the for∣mer is inserted into the Os Ju∣gale, but the latter is fixed to the second Sinus, which is made in the Temple-bone.

V. The Jaw-bone (except in young Children) can scarcely be dislocated any other way than for∣wards; nor can it ever go out of Joint, unless its acute Pro∣cess slips under the Os Jugale, and so can't get back again.

VI. From which it is manifest, that it cannot be luxated to the hinder part; because the Teat-like Processes of the Os Temporis do hinder it: nor can it be luxated to the Right Hand (especially in those of ripe Age) because the left head of the Jaw hinders it: nor to the Left Hand, be∣cause the head of the Jaw, on the right side hinders it.

VII. Nor can it be luxated up∣wards, except in a Distortion of the Mouth; nor yet downwards, unless the Mouth gape very wide.

VIII. The Cause. It may be from a frequent and constant mo∣tion of the Jaw-bone, both in Mastication or Chawing, and Speaking, whereby the Muscles being tired are debilitated, and so make way for the Luxation thereof.

IX. But the most common Cause, yea, almost the only Cause, says Sennertus, is the too wide opening and gaping of the Mouth, whe∣ther it be by gaping, or striving to take some very great thing between the Teeth.

X. And tho' sometimes it may be luxated from the laxity of the Ligaments; yet it is seldom cau∣sed from a debility of the Muscles; because that from both Processes of the lower Jaw, arise strong and nervous Tendons, with which the Muscles Crotaphitae and Masseteres are infolded.

XI. The Signs, It is known by the nether Jaw sticking out foremost, and the Process sticking out by the said Jaw; as also, be∣cause the Mouth continues al∣ways open, and the Spittle comes forth involuntarily.

XII. For if the Process resem∣bling a Beak or Bill, falls out of the Os Jugale, it follows, that it must also hang forth, which in one that is not very Fat, is known both by sight and touch.

XIII. If the Dislocation is but on one side of the Face, it stands awry, and the Chin is turned to∣wards the hurt side, having a prominency withal: the Teeth stand not directly under one another, nor can they be brought together, for which reason the Mouth remains open.

XIV. If it is dislocated on both sides of the Face, then does it fall forwards, the Mouth stands open, both the Apophyses are

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prominent, the lower Teeth stand farther out than the upper, and the Temporal Muscles are dis∣tended, stiff, and hard.

XV. The Prognosticks. If it is dislocated but on one side, it is easily restored; but if in both, it is much more difficult to re∣duce, sometimes very dange∣rous, and oftentimes mortal, because the Muscles on both sides are distended.

XVI. And Hippocrates says, that unless it is reduced presently, there will arise Continual Fevers, Sleepiness, Inflammation, Pain, Convulsion, voiding of Choler, and usually on the tenth day Death: and this may be reasonable to be thought, because the Muscles and Nerves (being primarily affected) affect the Brain by consent; Branches of Nerves being derived to those Muscles from the third Conjugation of the Brain.

XVII. The Cure. Where the Bone is out on one side only, the Re∣position must be made by motions contrary to them, which made it slip out of its Cavity: as if it slipt out forwards, it must be thrust backwards: as in opening the Mouth it is drawn downwards, so it must be forced upwards: and as the Muscles draw the acute Process upwards, so the Jaw-bone must be drawn down∣wards: which done, at once, with a blow of the Hand upon the luxated Bone, it will be re∣duced into its natural place.

XVIII. Being reduced, apply Hippocrates his Ceratum Rosa∣ceum (made of Oil of Roses ℥ii. Wax ℥i. melted together) to the heads of the Jaw and Temple: and if there was a strong Exten∣sion, you must apply things to hinder Inflammation.

XIX. Then a fit Bandage must be made, beginning from the Chin, and passing towards the Crown of the Head, which Binding must not be loosed before the third day, the Sick all this while for∣bearing to talk, gape, or chew hard things.

XX. If the Jaw-bone is out on both sides, let the Sick be placed on a low seat, and let one hold his Head firmly, or let it be held a∣gainst the Wall, and putting both your Thumbs wrapt up in Lin∣nen Rags into the Mouth upon the Grinders, the other Fingers laying hold of the Jaw out∣wardly, and a couple of small pieces of Wood upon the Grin∣ders on either side, that the Fingers of the Artist may not be hurt, upon the Bones return∣ing to its place; let the Jaw-bone be extended or drawn first downwards: Secondly, thrust backwards: Thirdly, lifted up∣wards; thus will it be easily and quickly replaced.

XXI. Or, a Band or Strap may be put under the Chin, and an Assistant having his Knees upon the Patients Shoulders, he may draw the Strap upwards, to fa∣cilitate the Extension; which the Artist does in the mean season make with his Hands, and at the same time thrusting also the Bone again into its place.

XXII. The Bone being replaced, Medicines must be applied to the heads of the Jaw-bone, viz. to the Temples, such as Ceratum

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Rosaceum; and where the Ex∣tension was violent, you may interpose Stups wet in whites of Eggs, mixt with some Astrin∣gent Ponders.

XXIII. And the whole Temporal Muscle may be anointed with Oil of Roses mixed with Oil of Whelps, or Oil of Earth-worms.

XXIV. Then it is to be bound up after this manner. The Swath must be applied to the Chin, where it mst be slit a little, that it may take hold on the Chin, on both sides; then on each side the Ears, the Rowler must be slit again, and the Ear must be drawn through; and then the Rowler is to be fastned upon the crown of the Head.

XXV. The Patient is thus to be kept for two or three days, or 'till the luxated Part is strength∣ned; forbearing any Action (as aforesaid) which may hurt or disturb the Operation.

XXVI. At second Dressing, apply things which may agglutinate, and strengthen the Ligaments: as, ℞ Fine Bole, Catechu, Sanguis Draconis, fine Flower, Mastich, Rosin, Pitch, A. ℥ ss. whites of Eggs, enough to make a Cata∣plasm.

XXVII. Afterwards you may apply Diapalma, or Empl. Album, malaxed with Oil of Roses; and other things strengthning, as you find the occasion requires.

XXVIII. If it has been disloca∣ted some few days before it is reduced, you must use emollient and relaxing Medicines: but when the Bone is put into the Joint, you must apply Oil of Roses mixt with whites of Eggs, to ease the Pain; and then put on Cloths dipt in Oxycrate: after which, you must pursue the Cure according to the Method afore∣going.

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