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. XV. Of a DISLOCATION or SINKING of the STERNON.

I. IT is called in Greek, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. in Latin, Luxatio Ossis Sterni, vel Mucronati; and in English, A Luxation, or Sinking of the Sternum, or Brest-Bone.

II. A Description of this Bone we have already given you in Lib. 6. Cap. 25. Sect. 2, 3, & 4. afore∣going; so that no more need be said of it as to the matter here: our Business now is to shew how it may be luxated, or made to sink.

III. It may be prest in, and made to sink at the top, where it is joined to the Clavicula: or it may be dislocated from the Ribs on either side; to which it is joined by Arthrodia.

IV. The Causes. It may be caused by a Fall from a high place, falling upon a Stone, or stump of a Tree; or by a very great Blow or Stroak, with a great Stone; or the end of some great and heavy Stick.

V. The signs. It is known both by Sight and Touch: besides, the Patient has a vchement Pain within, and shortness of Breath, and for the most part a Vomi∣ting, and Spitting of Blood.

VI. There a Fever withal, and the Patient seems to have all the Symptoms of a Peripneumony, or of a Pleurisy: and if it sticks on the top, under the Clavicula, the Sick is as if he were ready to be choaked.

VII. The Prognosticks. It is of very evil consequence, and if not soon raised up again into its place, by the vehement Pains which it brings along with it, it will be apt to induce Inflammations, Pleurisies, Convulsions, and a Delirium, with Fainting and Swooning Fits; and if not restored in due time, it certainly induces Death.

VIII. If it is sunk a little, and not restored, the Patient has al∣ways a Pain and Sickness at Stomach, and is apt to Fain•• away: and by the continuation of it, it causes at first a Pining only; then it brings into a deep Consumption, which is always mortal.

IX. The same thing is to be understood, if the Xiphoid Carti∣lage at the bottom of the Sternon turns its point inward: for if it cannot be reduced, the Patient grows sick and out of order, looks pale like Death, is trou∣bled with Sick and Fainting

Fits, and so consumes away, and dies.

X. The Cure. Whether it be sunk in on the top, or on the side, you must fix to the part or side sunk down, a strong sticking Em∣plaster; which when it is fast, the Patient is to be laid upon his Back with a convex Body un∣derneath, and two Assistants on each side are to press down the Shoulders or Sides, according as the Luxation or Sinking may be, on each side; and the Artist is forcibly to draw up the Sternum, by the help of the Plaster, which when he sees it is pluck'd up high enough, the Assistants are to give way to the Clavicula or Ribs, that they may fall into their right places or Sinus's again.

XI. To raise up the Xiphoid Cartilage, it ought to be Embro∣cated for some time with Oil of Turpentine, mix'd with an equal quantity of Palm Oil; then the Patient is to be laid upon his Back, with a convex Body un∣derneath, and the Shoulders and sides of the Brest, are to be pressed, to lift up the Cartilage.

XII. If you find that this is not enough to reduce it, you must apply Cupping Glasses without scarification, till the Part is suf∣ficiently drawn up; and then a strengthning Emplaster is to be laid upon it.