Part 7.

2740 Boox V.
again reftored unto their.own places, and there exactly Joyned cogether 3 andthe o-
ther is, chacthe Wound may behealed. The
replacing of the bones is here altogether dif-
ficult, by reafon of che-parcs chat are woun-
ded which without great pain, and fear of a
convulfion,cannor be exrended.Now the way
and means co return chete bones unco their
places again, is, ficft of all by exrending them
dufficiencly, but yet wichouc all kind of vio-
lence: which if ic cannot otherwife fuiftci-
ently bedone, then we muft have ready at
hand firm.and {trong Iron inftruments, (like
unco Bars) fomching different in their bignefs
one fromthe other; ‘ouc of which fome one
of them that is fic and convenient, in the in-
feriour part is to be adminiftred unto the
lowerparc ofthe broken bone, but in the fu-
perior pare unto the upper part of the faid
broken bone, (like unto an [ronSparre or
Leaver) and fo by this means che broken
bones fhall be forced and driven again into
their proper places : touching which Hippo- | crates (inthe 3.B. of Fraéures, Text 39.)
writech inthefe words: If (faith he) the bone. alfo that is fallen forth upon another bone leave
not any fit place for the Iron Sparres or if that
it be fo (harp tbat it ftart away from it, we mufE then with aFile boilore tbe faid broken bone,un- | til there be a place mad? for the lron Sparre, and that it firmely {tick unto it. And the cruth is, | allthefe things areto be doneinftantly, even. the very firft day, before any Inflammation toarife, Forifthis fhould happen, neicher | the extenfion nor fuch putting back of the bones can be fo much as attempted without | very greatdanger. If therefore che Chirur-
geon be not fent for even at the very firft,and
thac he come not until there now plainly ap-
pear to be prefent an Inflammation, he ought
to deferr che putting back of the bones into
their places, unril he find che Inflammation
over and gone. I my felf once on a time was
prefenc ac the Curing of a certain Peafanc,
who getting up intoa Tree cobeac downthe
Acorns, fel down from it,’ and brake his
Leg neer unto the Ankle, infomuch that the
bone fticking out refted itfelf and lay upon
the Anklebone. And he not having in a rea-
dinefs a frt and expert Chirurgeon, an In-
flammation and Gangrene happened, which
wafted and confumed almoft allthe Skin and
Blefh abouc che Ankle. He wasthen car-
ried into the Cicy, where the Gangrene cea-| fing, the bone ftanding forth by the Iron Sparre or leaver was lifted up, and reftored unco its former place; and then after this all things elfe chac were neceffary being per- formed, the Fracture and W ound were hea- led.
But if it happenthac any {mal parc of the |
Of Praétical Phyfick.
‘bone fhall fo ftick our thac it Cannot eafily
be put back again into its proper place, but chat by reafon of its various Fraction one part and portion of the bone be an impedi- mentunto another; ang that likewife ic be not thought fic to attempt any ftronger ex- tenfion of the foft parts, by reafon of the pain and Convulfion that may thence be feared; and chat the bones may in their cenformati- on rent and tear thofe parts that lie neer them, andthereby- produce pain; inal thefe regards Hippocrates (in his 3.B.of Frattures, Tex? 4.) advifech usto cucthem off, either withthe cutting File, or withthe Saw, as ic fhall be thought moft convenient, and as may be done with moft opportunity. And fo likewife, if any portion of the bone break the Flefh, and excite pains, (fo chat we can- not fo muchas atrempt the replacing of them without a greater difruption) and excrucia- ting tortures in the higheft degree, even in thisCafe alfo we ought to cut offthe bone: Buc then withal, left chat what happeneth through neceffity inthe Artificial operation fhould beim puted unto the Error of the Phy-
| f j
fitian, che Pacient andthe by-{tanders are co.
be forecold thac that pare will be fhorcer then before. And this likewile Hippocrates Cin his 3. B. of Prattures, and 46. Textyad- monifheth us of, whiles he faith, Thatit ss alfo fit that we know this, that of neceffity the Bodies muft there be made fhorter, rebere the broken bones are diminifbed, that is tofay. Cus red by being cut off. But now in fuch Fractures as thefe chat are Joyned together withthe Wound of the Skin and Flefh lying upon them, we muft look well to it likewife, (be- fore ever we Joyn the bones together, and alfoafter chatthey are chus Joyned) that no- ching at ail-ftick becwixe the broken bones, which may any Way hinder the Cong!utinati- on:.and if any thing be found tticking there, (whether it be fome {mal parc of a bone, or any thing elfe) ic is forthwith to betaken out; but chismuft not be done with any vio lence, left chat a pain, Inflammation, or Convulfion fhould be exciced. And there- fore if ac the firft, (even inthevery beg'n- ning) chis cannot be performed without vic-~ lence and pain, it will be more advifedly
done of us to defer ic, for Nature her felf wit:
at length chraft forth every thing that is Ex- craneous, andchac fhould not bethere; and yet neverthelefs we ought to help Nature (al we can) with attracting Medicaments.
Buc now as for the manner how Tbe bix- | che binding up of fuch a like Fra- 2) taal 1 &ure witha Wound ought co be in- ovdered.. ) ftitutedand ordered, in this neither
! che Ancients, nor yet the more Mo- dern Authors, do agree among themfelves : for
Chat fos 10 prac was W may fen chi chere a 4 man
reben 3 W means freque! whole
fewer after th then ott and m¢ ber of that W fewer
And fo and dif that mat thaema good dl apply but the wound may pa caments thorow of Won own Met he hath unlefs ch thing elf he defen day, anc ding a tute of th bow muc reth for much the And (a5 the we (lath he then a fa Tealon of 1s & as| Wound, | forth thi ly done anit rhe Dy cerca
=> =
5 a
bone iam
IML)
onion Se
Chap. 2. Of a Fraure with a Wound,
for fome of chem are wonc to bindeup che | moft certain and undoubted truth, chat che Fradute, as otherwife they did when ic. firft binding ought fo to be infticuted,thar the was withouc.a Wound; chac fo the Wound’! wound may not be lefc naked and bares may be likewife covered; and they alfo loo-| but thacitmay be comprehended within the fencthis binding every third day : andfome | {wathe.And therefore the fwathe is ficft.of al there are that row! about che Swathes in fuch | indeed’ to be .caftupon the W oundicfelf amanner, that the Weundis notatall com-' forific be otherwife done; the humors wil prebended within them, but left naked; fo|be prefled forth from the Superior pare that we may from day to day ufe all due |downward toward the wound, and many means for the curing chereof, without any | dangerous Sympcoms are from thence €xciz frequent binding up and loofening of che/red. Andche danger of thus doing we may whole fracture. Others there are chat ufe | fee experimentally even in one chat is found fewer Swathes, and bind up the Fracture | and free from any fuch fraéture. Fot if in after theufual and ordinary manner: out | any fuch perfon you binde any one part bork then others there be that adminifter broader |above and beneath, and leave the middie and more Swarhes; chat fo by che num-| parc untouched, then the faid middle parc ber of the Swathes they may accomplith |by the Humors that are from the adjacenc thac which might have been done wich |Members forced and prefied unto them; i¢ fewer when hard and ftreightly rowled. | lifted upincoa Tumors and fcom the influx And fome there are that alcogether neglect | of che Humors ( as we fee) it foon chang- and difregard the {plincers ; orhers there be |ethits color. Andalbeic chat inthe firft bin that make great ufe of them 3; and of chofe | ding the Member fhali beall of it Wrapt up thacmakeufe of them, fome apply thema|within the Swaches; yet not withitanding good diftance off ftom the woundsbut others | there will noc from hence be any caule to apply them even uponche very wound it felf; {fear che leaft danger 5 in regard that fer che buc chen in thac pate chat lyeth upon the/ firft three daies there floweth forth but very wound they make a hole, that fothe Pys| little either, of Pus or Sanies, that is to fay; may pafs forth thereat, and thac fuch Medi-/chechick orthin Excrements. But herealio caments as are needful may be applyed| even inthis kind of binding it is to be obfer- thorow thefame. CefarMagatusCin his B.| ved, that we areto make ute ofa Swathe thac of Wounds, Chapt. 6. yinfifteth ftilin his| is fomwhat broader chan ordinary, andthen own Method; and here likewife in chis cafe | otherwife when there is no Wound prefent 5 he hath no regard at al uncothe wound 3 and | and that chere be indeed a fufficient compref- unlefs chere happen to follow hereupon any |fion made 3 it being rhento be accounted fuf: thing elfe that may force him to do otherwife | ficient, when it can cecein and keep cogether he deferrech the loofening uncil che fifteenth |the bones: but yet ic muft be fomwhat lefs day, and fomtimes untoche thirty eth, accor. |chen if there were prefenc no Wound; left ding as the quality of che fracture,and the Na- |thact. the wounded part being preffed toges ture of the wound feem co perfwade:and look |ther, a pain and Inflammation fhould thence how much the longer time the fradture requi-|beexcited: and che number of the Swathes rech for che making of it firm and ftrong, fo, may compenfate the more loofe and eafie much the longer doth he defer che loofening. binding and rowling of them 3 fince chat ic is And ( as he writeth)che generating of che Pus fac more fafe to row] about che Swathes inthe wound doth noc at all detec him. For oftner, then any way to hurt the pare by Cfaich he )if it be cured in this manner,cthere is | Compteflion, _ | chen a far lefs quantity thereof generatedby| On the third day the binding is to be reafon of the heat of che ftrengthning Cover- | loofened 3 and then it is again to be ordered ing; & as for tchac which is bred without che | after che firft manner. And then moft ficly wound, hewriterh thac nature expelleth and conveniently there may be a hole cut forth this.And that this may be the more eafi-, chrough the Emplafter or Cataplafm that is ly doue,he openeth and maketh flits(over a-! impofed upon the Fracture ; yea and in che gainft thewound )chorow al the linen Clothes | midit of the very Swathes chere isa holeto by ceccain {mall cuttings; thorow which che | be lefr3(and fo alfoin the Splinters, if there Sanies ( or thin excrement) that is bred may | fhallbe any applied) chat fo there may fic- be driven forth. ting Medicaments be adminiftred unto che Now alcbough chat infuch operations and| Wound; and thac the Wound may alfo be handy-works we may ofrentimes in divers | throughly cleanfedand purged, without any and diffzrent manners attain unto che fame loofening of the Fracture. Andthis way of defircedend; yet notwithftanding both Hip- | binding is lively fer forth uncous by Ambrofe pocrates, and likewife all che more Skilful |Parry, inhis 14. B. Chapt.18.and23. For and experienc-d Chirurgeons, take ic for a | whereasthe broken bones (chat are wotit ro perforate
274%
| . j §
By titanl eky