Part VE

Signs Diagnoflick:
ie
ig
bow ; which kind of Luxation the Arabian Inrer- A Joyne being fallen forch into another place |] 1 In preters cal a disjunction, when the bones gape as | is eaftly known by che fight and couch 5 for chere . | jill a6 were; or by a Diartbrofis with manifeft mo- | appears a Tumor inthe pa rtincto which thejoyne | jailly tion, which Luxation is moft properly focalled. | is fallen, bus a hollownefs in the place from | jit! There is alfoa peculiar kind of Luxation, butim- | whence che joyns is fallen 3 and chat appears fo | jib properly fo called, when the Epiphyfes of che | much the eafier, if che body be not very chick and ) el bones are pulled from che bone on which they | fac, or the place be void of fleth. ‘Again, if che || gfe were placed, which happens chiefly co young Luxation be perfect, thac Members made fhor- |) ¢¢4,bul folk. cer, whenas the joynt no longer included in its |) ; 5) From the Form becaufe the Joynt | Gavicy, bur falling out of it, 1s drawn upwards : | fon it From vel fomcimes wholly fals out of its feac: | yet formrimes the Member becomes longer, as is afa | us refto Form which Luxations called by the general tecwards faid in particular, When then che | ditt | name Exartbrema, or Luxation; but | Member luxared isalwates unlike co che found | 4, Th fomtimes it fals forthonly in part, and cto che | one in {cituation, figure, and Jongitude, we mult [ihmnesar brink of che bofom or hallow, which the Greeks | alwaies compare. che Member affected wich che (Foyt cal Pararthrema, the Lacines a Subluxation 3 to | ike found parc of che fame name, Arm with Arm, Five n0 which kind of Luxacion alfo belongs chat elonga~ | Thigh wich Thigh in the {ame map3_ where yet we ret cau! tion, when the Ligaments being Juxated and made muft obferve, thac che Member with which we |) 5 T longer, the joyne indeed according coche longi- compare it be found, and have no fault. Third= jVofiiela tude doth fomtimes depart from its feat, yet tals | ly, becaufe Arciculations ate made for motion, if | replace, not wholly out of ir. a joynt fal ouc of its natural fear: ic mult needs be |) 6 Th But from the variety of che Scieua- | chat che motion of che joynt is burc; therefore spflamma From tbe \ cion co which the joyat fals forch | where there is afufpicion ofa Luxacion, yer che |ydiob Eee there are fetchc chree differences | motion is not hurt, we muft conclude that chere is |} mob aes chiefly ; The firft is, if che bone | yetno luxation made. Laftly, becsufea joyne Yous, nay which is naturally placed im che up- | falling forch of its feac doch comprtefs the fenfible | )ijuced per part fal out co the lower 5 or on che contrary | parts into which ic is fallen, as the Tendons, Hip be fo The fecond is, if chat become on the right fide | Nerves, Mufcles, from thence there is raifed a | jj which ought €o be placed on the left; or on che | pain. Hh , 0 contrary it fal from the left co theright, whicho-| And thefe are the figns of a perfect Luxation 5 |}yihaC thers cal outwardly or inwardly. The third is, | but if chece be only a Subluxation, che Signs pro= | log u if that which was placed in che fore part fal coche | pounded wil either be more gentle, or fome of [very hare hinder, and on the contrary that which was plae | chem wil be wanting. Vout pre ced behind fal our co che fore part andthe joynts| Ifcherebea Luxacion ofa joynt joyned by a | 3 7 of fome parts may be luxaced into al chefe diffe- ; Synartbrofis, in which che Bones do gape, it is Uti joy rences, {ome only inco cercain differences, nocal;{ known by the thicknefs of che Member greater | rw fo the elbow, hand, thigh fal forch into four diffe- | chan ufual, and by a greater bunching out than the |} ,, yj; rences, viz. To the inward, outward, forward, | heads of the bones doconfilt of, bled wit backward, but cannot upward; cheknee falsout| As concerning the Caufes, che ex- Be uch tis incochree {cituations, viz. The inward, outward, | Cerna] and violent are apparent by | ig be fans A cotion and hinder pars towards che ham; bur the oppofi- | the relation of che Parient, and the Cites Hip tion of the pace] bone hinders its falling ouc cothe | Luxation proceeding from therce } ted | fore part, of which fhal be {poke hereafter in the | happen fuddenly 5 but if the Luxation be by reas | he Vell hi i!) ) Luxations of the parcicular parts. fon of che loofnefs of the Ligaments, ic happens by Vadthen Be kis. # The Difference is taken from’ the | degrees 5 and the luxaced Member is moved and | hindered at Fromthe | Efficient Caufe, becaufe che Luxati- | corters up and down with mordinate motions; and }) 10 Ai ae Efficient on is {omcimes from external Caufes, | whiles che poyntis forced into its fear, the Mems | aby tb iy Caufe | as fals, blows,jumpings, running, and | ber indeed acquires is natural longitude, which | icin Bie th from a violent diftorfion, excenfion, and impulfi- being leralone again prefently it becomes lon- | tuo Hi onof the parr, butfomeimes from internal caufes, | ger. 1) Welt NM as whilea humor fliding into the cavity of che| Alfo if che head of che Bone luxaced be chruft | pool ao
with che fingers co the contrary pact, tt eaftly re- coil back 3 every where about the joyne Chere isa Caviey begorten, that if che finger be chruft into Te che joyne ic eafily goes in, no body refitting, as if |),
yoynt drives ic Out Of its place.
an ya hi: | | Fbere are alfo certain improper | i Improper ea Differences |
Differences, or rather complications of other pretesnacural Affects with
Pat pany, | é eau Ft ' Luxations, as that an Inflammation, | al wece empty. a likes
ae fragtute, wound, or fomwharelfe isjoynedwuh| When fome Epipbyfis is pulled off from its | tsa,
i ars . F
Pye the Luxatson. being, icis know n by cbe impotency of motion, | }j, rn ‘ ae and by che crackling, when chey are handled and | bhtoeis
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Of Luxations in general.
Chap. 1. “4 (Jen forth of their feats is called ton artbron embole | Prognofticks. 7 ‘and.arebrembole. Buc che replacing of loxated 1. In the Bodies of Children and yong folks, | Bones is compleated three waies; either by the and chofe chat are fofcer the bones Juxated are hands of the Chirurgeon and his Servants, which eafily reftored, yec being reftored are noc fo) isthemoft fimple, and is called Paleftrical, be- faithfully retained; the contrary happens in riper.) caufe cwas ufed in che wreftling places if at any
~ anene a
and harder bodies.
2. The Joynts which are dedicated to fewer | differences of motions are more difficulcly repla- | ced, but becter contained.
| {ime the Fencers Limbs were juxated 3 and *cié convenienr in {oft bodies, and where the evil is frefh ; orby fome vulgar inftruments che joynts
| are forced into their feats, as by the help of reins;
3. By how much che further the joynt is fallen | {wathes, ropes, ladders, feats, cwo leav’d doors;
from itsbofom, by fo much the more difficulcly | ‘cis reftored3 by how much che neerer, by fo} much the fooner.
4. The Luxations in whichthe brows of the, bones are broken are worft of al; for though che| joynts bereftored co their places, yer they con» tinue not long, but fal out again upon che fleigh- teft caule.
5- The joynts which are fallen forth by reafon’ of the Laxnefs of che Ligaments, though they be, replaced, yet doeafily fal forch again. |
6. Thofe Luxations which havea greag pain, | inflammation, or wound happen on chem, are | hard to be cured, and wane nog chet danger, and | cannot be reftored without danger of Convulfi- ons, nay of death. Wherefore if che bone being | reduced the Nerves be diftended, ic muft prefenc- ly be forced out again, as Celfus doth coun-|
fe}. |
+, Old Luxations and which ate grown hard | witha Callus, and which have a clammy bumor | filling up the Cavities of che Bones, ace never or very hardly cured ; therefore every Luxation muft preiently be replaced.
8. They who in thet Childhood have had cheir joynté fal forch, and are not replaced, they prow Jefs chan others.
9g» What Member alfo foever hath been trou- bled wich a long continued Luxation, by how much cis the leis able co be moved by a nacural | motion, by fo much che more ’cis excenuated and wafted, both becaufe by, intermiffion of motion the Nacive beac of che partis dulled, and becaufe the Veflels are compreft by the luxaced joynt, | and che neceffary influence of blood and {pirics is | hindered.
10. A Luxation of the head brings death, by reafon of the compreffion of the Spinai Marrow prefently at its firft rife, and the probibition of che influx of animal Spirits.
We thal afterwards {peak in particular of che
Prognofticks of the-reft of chejoynts. |
The Cure.
| Operations
Ar Thar 9
| che
which is called the Methodical way, and is conves nienc for children, women, and che ftronger males, and for old luxations; or cis performed by inftru- ments and cercain fingular engines, and cs called organical, and tis applied co ftronger bodies and old Luxations, and altogether co thofe which can-= not bereftored the cwo former waies. Buc con- cerning fuch Engines fee Hippocrates de artic. ef frattur.and Oribafius de machin:Ochers bold on- ly cwo.waies, the Palzftrical, and Phyfical; and under Phyfical comprehend the Methodical and Orxganical, : But what way foever the refticuti= How many | on of che Juxated bone is performed, | four operations are neceflary to its | Extenficn, Replacing, Rowling, and Confirming & pacing of che Member reduced: for firft of al; whenas che | Mufcles are contracted, as we have { Fradtuces, there is need of extending che luxated member, which muft be done prefencly C
are required 10 the redu- cing of luxa- ted parts.
atcer che Luxacion is made 5 or if che Chirurgeon | be called late, when the fear of Inflammation fs o=
| ver ; and fo far ic muft be made, chac Extenfion: | fome free {pace may be lefc between | ghe bones, Jeft the goyne or head of bone be rafed, or che brows of che bofome be oken 3 andin the Excenfion a convenient figuteé of the part muft be obferved, andthe Mufcles an one parc muft be kept whole, and noc be diftort= ed, co wit, left the Head of che Mujcle be in the ine ternal parc, and the end of it in che excernal.- But Exten{ion is made either by the hands of che Chie rurgeon, or hisfervants; oc with Reins, Ropes, and Swathes, or with Inftruments and Engines, as was faid before. Sufficient extenfion being made, the Replacing { bone which-is fallen out of its place ) | muft be replaced in it; which labor che Greeks cal Mochlia, and Mochleufir, viz. che compulfion of the bone Juxated and extended into its feat : but chat chis operation may be done right- ly, both che nature of Articulations, and how al che bones in the body are joyned together, and the
The Bone luxated, and whichis fallen out of \ differences of Luxations ought tobe Known; for
its natural feat, fhews a repofitiom co us natural
place 5 and this Indication is fatisfied, and Lux- |
ations are cured by ftrainingand forcing them.co the pare oppofice co thac change is made 5 which replacing of che joynts fal-
Y
from whence che |
the Chirurgeon wil ngt know certainly into what place he oughe co forcethe luxated bone, if hedo not rightly know beforesout of what natural place icisfallens for che Chirurgeon ought co confider from whence the Joyar hach firft falleny whac pro-
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2672 Book V. 1 AGE Prattical Phyfick.
grefs ic hach made in ats fa), and whither "cis come at Jatt; and from che‘end of its fal, the fame way by which ic fel forth, co force it back again to che Joynt from whence it fel: asif'a Joyne be fallen forth from: the lefccowards the rigbr, he ought ro force ic cowards the left ; if i¢ be fallen from che right cowards the lefc, chem cowards che right; that which is fallen cowards the foreparc muft be fore ced co the binder parc; chat flipe forch co the hin- der parctowardschefore part. Andchereare fo many waies of chis reduction, as there are Joynts ; forexamplefake, the Shoulder is one way, che Foor another, andthe Vertebre another way re- duced intocheir places and the Shoulder other wife when “is fallen into the Arm-pit hole, other- wife whentoche fore parc. But che bone muft be forced into ics place gently, and ifmeed be ap- plying firft of al laxative &cmollefying Medicines, heft there bea contufion or grating of the head and bofom upon one another, or a pain or Inflammati- on becaufed; and we muft avoid wheeling about che head of che bone, left it brezk.
But we fhal know chat the Joyne is rightly re- duced, if che member and juncture recover its na= cural figure, longitude, and loft motion, and it wholly agree wich che like named found member, andthe pain which was prefenc before doceafe. There is wont alfo for che moft parcco be heard a cectain crackling and found when the bone returns into its Cavity, but we muft noc truft co chis fign alone, for fomeimes there is a crackling made, and a noife heard by reafon of che breaking off of che brows of the bone,which may be,when the head of the bone is fo ftruck againft che brows, chat fom- what of them is broke off ; and then whenas chat part of the brow broken off doth fooner get into the bofom chen che Joynr, the replacing cannot be right. A cracklingand noife allo may be caufed, whenin a violent reducingcthe zoyne or head of tlie bone hics againft che bofom, and canruferh it, whence the Cartilageis feparaced from che reft of the bone, and there isa difficulty of motion; ther- fore all che other figns muft be joyned coge- ther.
_ ‘Fhe Joynt being reduced inco its Binding: | feat, che diftention muft be bated, and we muft fuffer che Mufcles co return tothem(elves, and afterwards che member muft be fo ftrengthened that the Joynt cannot again go out of its place ;: which is done almoft afcer che fame manner asin Fractures 5 for firft of al before binding up be ordered, aftringent medicines muft be laid on, which hinder 2 flux ofbumors and In+ flammacion, and contract che Ligaments relaxe, and frrengthen the part; of Bole, Sanguis Dra- con#s, Pomegranate Pils, Pomegranate flowers, Rofes, Frankincenfe, fine-Flour, and che like, mixt wich che white ofan Epps if che pain be great chofe chings alfo which together withan aftringent faculcy do mitigate pain, as Oy! of Rofes,Maftick, andtheliké. Or,
Pare VE.
Aa $$$ —$—— tS,
Take of the greater Comfrey, Bean flour, Bole armenick, of each three ounces 3 fteepthem in Vi= negar and dry them: afterwards :
Take of Litharge, Wax, Rofin, of eachtbree ounces, melt them over the fire and add the things forementioned fteeped in Vinegar ; and lafk. of al tro ounces of Tragacanth. ‘Makea Plaie fier. Or,
Take of new Wax three ounces, Miftleto of the Oak, Maftick, Rofin of Pine, of each half aw ounces mix them.
Then the Member muft be conveniently bound up, with Rowlers and Bolfters, as we faid’concer- ning Fractures. And Gabriel Fallopius teach- eth at large, Tratt. de Luxat.c.$. chat che bone may bekept in its place, and che flux of humors: hindred. Ifneed be, and the figure and natuce of che part wil fuffer ic, Splints muft. be laid on of Paftboard, or Leather, or fome other convenient matter.
Laft of al, the member muft be ple- | ced gently, evenly, and that the pofi- tion keep amiddleand natural figure, left pain be caufed, and ic muft be kepr |
Placing of tt:
funmaved cil the fourth or feventhday, unlefs an
icching, pain, or ocher Symptom do urge ; and af- cecward ic muft be firengthened with conveniens Medicines,
Chap. 2. Ofa Luxation with Pain, Inflammation, Wound, Fractures.
Uc it happens fometimesthacche Luxation ts notalone, buc other preternatural Affects, Pain, Inflammation, Wound, and Fraétures are joyned with ic. Buc if before the Phyfician be cale Jed Pain and Inflammation bach already feized
on the pact affected, we muft noctry co reftore | the luxated Joynt, tilche Pain and Inflammati- |
on are allaied 5 forif chat be cried before chis 1s done, it is to be feared, left by the diftenfion of the Nervesa Convulfion, or fome other dangerous Evil arife; cherefore before che replacing of che Joyne be actempted the pain muft firft be miti-
gated, and the Inflammation allaied, by thofeme= || If after | the Joyne be replaced, and the binding be loofen=- |
dicines which are formerly mencioned.
ed, there be an Itching, the place mutt befprinkled with warm Water, chac |
Itching: che humor the caufe of Itching may be
difcuft, and the pain abated; otherwife if chere |
be no Itching we muft forbear warm {prinklings, left che Ligaments be relaxt ; or rather when che binding is loofened, the place muft be fomented with fome ftrengthening Decoétion. As )
Take of the Leaves of Myrtle, Oak, Worm- wood, of each one bandfull, red Rofe flowers
half abandful, Pomegranate rind one ounce, | ‘a 1 eee
| 4 "VOund Hf ||,
Pomegranate flowers, Mifsleto of the Oak, of each balf abandful ; Boy! them in bar{a Wine.
|
| Lo er
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| Paty jj ecal le by! 1} Nerves | whence by wba Vedan | § ysneesel | gait |} binding 1) ningon! / olla 1) ately b
) Feet» |} doneve |} sheress here 18
1 fammat | moresst |) Hippo 1) Form | | with a || thejoy or onto shen (a knom,t ard the arefer
1} that wh 1] sbaphe 1 do gang f telth 1 Text 2! and allo lene a 1) Ocome 17 whethe with mx
|) tndure we muf firma lof | Joyne cin ded datper, todeter Id, ane Nation the feye hero / Nathar | Fat by © ned if the ref
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' whence a Luxation of the Shoulder and Thigh
Chap. 2. Ifa Wound be joyned with the.
= hia | Luxition, chat is very dangerous and |
: ofrencimes kils che man, whenas. from | wounds ° 3 : | servi diftencion of che Netves and Muicles, |
a Pain, Inflammation, Convulfion, acute Fevers | are caufed; and che danger 1 by fo much che great= er, by how much the Member is greater, and che | Nerves and Mufcles abour ic are che greater 3 |
wicba Wound for the moft pare brings deach : and che danger is the preacer by how mruch the Wound isneerer the Joync; and cherefore Hippocrates 1s againft che reducing of luxaced bones and thei bindings up, and commands co ufe at the begin- ning only things that affwage pain, and take away Inflammation, and chinks chat none of thefe can} fafely be reduced, befides the Fingers,Hands, and Feet ; & in chefe alfo he commaids al things co be done very diligencly ; for neither a Finger Cin wch there is leaft of danger) ought to be replaced when there is an Inflammation, bur either before che In- flammation comes, or after risallated. But much more is this co be done in other Joynts, of al which Hippocrates ( Accic. # Text. 16. and 17. ) faith, For in whomfoever the bones of the Leg luxated
- pith awound made, do wholly bang forth from
the joynts of the foot, wbetber they tend inwardly or outveardly, they are nottobereduced , but let them fuffer be that vil to replace them; for ye may know, that if they remain reduced they fbal die, and their life fhal be of very fero dates, for there are fevo of them which pafi thefeventh day, for that which kills them is a Convulfton, moreover it happens alfo, that both the Leg and the Foot do gangrene. We wsuft know for certain that thee things wil fo come to pafs. And there alfo Text 28,29, 31. which places chere you may fee, and allo Galens Comment. And theretore pres {ently ac che beginning, and before an Inflammati- on come ina Fracture with a wound,we mult try whether the joynt may be reftored into its feat with moderate extenfion (for it canby no means endure ftrong) which if 1¢ fucceed co your mind we muft labor chiefly in this co keep off an In- flammation; butif che joynt being replaced an Inflammation cr Convulfion doth happen, the joynt muft be thruft out of its place again, Cif ic can bedone without violence) or if we fear this danger, ’cis fafer (efpecially m che greater joynts) codefer the reducing til che Inflammation 1s cea- fed, and the fear of ic is paft. _Whenche Inflam- mation is now ceafed, which is wons to be about the feventh or ninth day, both mutt be fignified && forecold co the ftanders by ; and the danger which is ac band by the reducing, and the weaknels of che parc, by which the man is rendered Jame and mai- med if the joyne be not reftored : and if chey urge the reftitucion of che joynr, ic muft be accempted without any violences. afterwards the Cure of the Wound muft be ordeced asin a fracture with a wound, but the member it felf muft be fo placed
Of 4 Luxation witha Pain, Inflammation, @&¢,
chat che Pacient.(as muchas may be ) may be free from pain, See Fizppacrates of chefe chings inthe place before alleadged. Someimesalfo it happens thaca Fra@ture is joyned with a Luxacion, there= fore the Chitargeon muft be wary3and if che Braz Ctuce offer it {elf neer che Joynt, lec hint confider whether. the Joynct be whole or luxared, left while hecure che Fracture he negleét che Luxation: Thus I remember a Neighbors Child, a Boy abouc nine yeers of ages whenas a Veffel inco which chey were wont co pour their hot Drink after it was boyled, felupon his Thigh, and his Thigh- bone was broke, ar the Joync of the fame luxa~ ted, which when the Chirugeon obferved sor, and only Cured the Fracture and reftored not the Hip-joynt, the Boy became Jame. But if there be a luxation with a Fracture, che Member muft be extended the common way, and the luxated Joynt muft be reduced into ics pro- pec place, and.che broken bones muft be conform- ed and compofed ; and ficft of all indeed the luxaced Joyne mutt be replaced if it may be done, then the Fracture muft be Cured, and fic Medicines muft be laid on chem both, of which we have {poken already ; and convenient binding up muft be ordered ; but ifthe Joynt cannot be ree ftored to its place without danger before che Fra- ture becured, chen the Fracture muft be cured ficft ; afterward when che callusis generated, we muft endeavor that the luxated Joyne allio be re= ftored.
Laft of a), ifa Luxation by reafon of an Inflammation coming upon it, ora Wound or Fracture joynd with ir, cannot prefently be reftored, bur there isa callous hardnefs contracted abour the Joyne, the place mult be fomenced eicher with plain warm wacer, or witha mollefying Decotti-
| on made of Marfh-mallows, Maltows, Camomile flowers, Fenugreek feeds, and che like; but after che Fomentation the Joynt muft be anoynted with Oyntment of Dialtbaa, or fome other mole lefier, or this hike Cataplaim muft be laid upon it.
Take of Marfb-mallow roots, wild Comcum-~ ber, of eacbébree ounces; ‘allows, ‘Marfb- mallovs leaves, of each abandful: Boyl them til they are foft, and fearce them through a bair Searce 3 add of the Flour of Fenugreek, Flax feed, of each balf an ounce;Oyl of frveet Almonds,
| The Cure of anold Litue tion.
Hogs greafe, as much as ws fufficient; make a Cay
taplajm. If che bardnefs be greater, add co the things
| boyled, wild Coweumber root,and lay on it Dia- .
| chylum magnum. When the Member fhal be fufficiently mollefied if need be Digefters may bejapplied 3; as Betony, Sage, Hyfop, Grouindpine, che Plaifter of Beto-
ny,andthe likes OrSuffumigacions wish a fire= .
ftone ox Mil-ftone, or Bituminous and Sulpbu- rous Baths, if chey may be bad; Laftly, wher whatfoever was hardis mollefied and difculled,
k the
2674 4
‘ill
h 4 | : iN | Bi | Fi Hi Lal 1 \ ie ;
a a Oe ee eS ee
3S
- 2€74 Book V.
che joyne in convenient manner muft be reftored co its place, and che reft muft be performed as was faid above, Chap. 1.
Chap. 3. Of 4 Luxation of the
Mandible.
Nd let icfuffice cobave faid this briefly of 4» Luxations in general; now we muft fay fomwhat in pariicular of che Luxations of the chief joynts.
And firft of a] as concerning the Luxation of the Mandible; whenas Nature hath made only the low- ec jaw movable in al creatures,the River Croccdile excepted, (which as Ariffotle witneffeth, 1. Hitt, Animal, c. 11. and 3, Eift. Animal. c.7. moves atsupper Jaw) i is eafily apparene thac that only can futter a Luxation. The which notwithftan-
ding isnot eafily luxared, by reafon of the moft|
{
ble may be luxated, its ftcu€ure and infertion do |
ficaight coarciculation of ic with the bones of che head,and the exceeding ftrength of theMufcles that draw it upwards; buc into what part the Mandi-
Of Prattical Phy fick.
| cae 5 aie : ie hiiame ns ; mouth being fhutic returns into its place again 5
ROR rns Ey
Pare VI.
buc chis Luxation is made either in one fide only, when only ics right or Jefe pace flips forth 5 or: in both fides togecher, when che whol bone of the lower jaw on both fides is fallen out of its feac.
Ihe (aufes.
But che moft common Caufe of this Luxation, nay almoft che only Caufe, ische coo much open- ling and gaping of che mouth, whether ac be by yawning, ot by taking fome heavy burden in the | Teeth, and lifting ic on high, fo chat the forena- med procefs becomes lower than the Os Fugale, as | was faid, and withal be curned afide 5 for its re“ | urn into its feac is noc prohibiced uolets ic be cui- nedafide. Yer this very ching happens feldom and hardly, and che Jaw is feldom luxated, by reafon of che ftrength of che Mufcles by which ’cis tiedco the upward pars. For from both pro- cefles of che lower jaw arife Nervous and moft ftsong Tendons, wich which the Mutcles are in- wrapped which are called Crotapbite and Maffe-
NDF teres. plainly teach us: For as concerning its ftructure,
at hath two proceffes in its hinder pare on each fide; che former of which drawn forward being | That the jaw is fallen out of its feat may be
broad and chin ends as ir were ina point 5 bur che known in general, becaufe che lower j EY ate ; er jaw hangs a 2 ie tre Gare ane ge: aCe wi forth co che fae part, and the procefs of the Si niverfe heads that is infected into the Os Fu like coa beak ftands out by thejaw. For if che fale, but this is fitted to the fecond bofom ingca- procefs refembling a beak fal out of the Or Fugale Bea eet apie bots x ic muft needs be that chere alfo it hang forth, The Differences. which ina mannot very fac is eafily known boch From which ic doth manifeftly appear thac che | by fighe and couch. The mouth remains open, Jower Mandible cannot be Juxaced coche binder | whence che fpeech is hindred, and che fpitcle flows part, becaufe the Teat-like proceifes of the Tem- | forth involuntarily. ple bone dohinder it; nortocheright (efpecial-| If the jaw be luxated on one part, that with the Jy in thofe of ripe age) becaufe che lefc head of che | chin is inclined co the contrary parc which is noe Jaw hinders; nortochelefr, becaufe the head of | luxated; che mouth is diftoited, whence the the Jaw in theright fide binders thar. In chofe| Teeth cannot bejoyned, neither do they anfwer Of ripe age I faid, fortis wel known by Anaco- | co their equals, but thedog-ceesh are under the my chac che lower Mandiblein Infancs is cleft,and | Cutcers. In the luxated part there is perceived in che midft of che Chin is joyned with a great | only a certain bunching out, and the cemporal deal of Cartilage; which Cartilage if ic be relaxc| Mufcle appears ftiff. Bucif che jawbe luxated by a flux of humors, orthe Chin be ftruck, thar} on boch fides, al of it with che chin hangs forth, the bone be feparated from che Cartilage, per-| and chat ftraight out cowards the fore part or to haps che Jaw may be Juxated tothe right or lefc| the Breaft; chelower Teeth go further out than fide, che which yet feldom happens, and therefore | the upper, yet they anfwer one to another, the isnotconfidered. Butin che riper aged becaufe | Cuccers co Cutters, che Dog-ceeth to Dog-ceeths that Cartilage hach fodegeneraced intoa bony na- | neer che Cheeks on borh fides chere appears a cer- ture, shat ic can by no means be feparated, no| tain eminency, which che acute beak-like proce(s not by boyling, nay not che leaft foorftep almoft | doth make; the cemporal Mufcles,;whofe Tendons remains of a line, or any feam, buc ic appears one| thisprocefs doth receive,(yea is wholly compailed ‘continued bone, Phyficians do rightly affirm char| by chem) appear ftrecche, ftiff, and hard. ithe luxation can be made only coche fore pare. ; 'Bur this Luxacion happens, ee econ Prognojticks | frarp proce(s, like to a Beak, which by che| 1, The Luxation of the Mandible is a dangerous | Greeks is called Corone, do flide forch below che} evil; and ajaw luxated (as Hippocrates ceachecth Os jugale, that it becomes{o much lower chen|2.de Art. and Galen in his Comment ) muft ir, that ic cap no more ceturn upwards apain| {peedily be replacedsfince thae the cemporal mul- tinco its place; for otherwife chough this procefs| cles and che Nerves infected ia chem (and confe- Ibe lec lower: then the Os jugale, yer chere| quently che brainic felf) areealily drawn into is not prefently «a Luxasion made, bus che! | confene
Signs Diagnoftick.
| fe 1 Ch . se | L conf |] nto 1T font enc 1H contin |} often |} wont t 1) they Wd
replac 1) fides, | 1) des we
fended
1) The! 1} duced 11 bedon 1 and 16 ‘| [eadof 1) jam, | ently a 1) gen bot | to flirt 1} movest | holding |) woled 1) mt be 1) off of
mf at
vite nat || mards, 11 pout bis || mdeed i
by other 1) Phyfick
rot, one tit of )) ard,
© |) pion my
Ly alittle
1) the je |) lelaveted bath
|) haus
9 ptderghe ) Cuthion athe ba ) lisbac, Cates ip | Weld fa eum After hi Thu qh NW Ou "yan: 1A allen | 1 Aay th
Kathy, |
N Ans ; i OPK k
Lott,
Nt) DOK
open, iy
eno &
OF a Luxation
confent. For che cemporal Mufcles have che grea- teft confenc with the brain, and do receive nerves from che brain of the chird conjugation, from whence do arife not only pains, inflammations, continual feavers, dul fleeps, bic alfo death ic felf is often haftened about che cénth day.
2. Thofe whofe Mandible is not reduced, are wont to void by ftool filchy and chin Choler; and if chey vomit, the vomit is pure.
3. Yet chereis greater danger inftant 3 and the replacingishardec if che jaws be luxaced on both fides, then ifonly on one fide, whenas a} che Muf- cles wich which the jaw is contained ace then dix
ftended. C The Cure.
Chap. A.
The Mandible luxared fhews thar it muff be re- |
duced into its {eacagain ; which how it ought to be done, Hippocrates teacheth 2. de Artic. t. 15. and 16. inchefe words. One ought to bold the bead of bim that is luxated, another the lower jaw, the man gaping as much as be can conveni- énily, and taking it about the chin with bis fin- gers both within and without, firft a little vobile to fir it up and down, and then with bis band to move it afide, and to command the Patient spat
holding the luxated jaw be further it, and be ve*
ry obedient to bim moving it. ben endeavor | mutt be ufed, that at once of a fudden we firike it | off of its tbree figurations; for the lower yaw
muft at once be promoted from tis diftorfion to its natural pofition, and it muft be driven back; wards, and the Patient obeying thefe ought to fout bis mouth, not to gape any longer; and thw indeed is the reducing of it, vobich cannot be done by other figurations 35 but afterwards @ little Phy fick wil fuffice, a bolfter laid on with a Ce- rote, we apply a loofe binding up, yet we perform this office more fafely if the man be bended back ward, and bis bead {upported with a leather Cu- foion wel (iuffed put under it, that it may yield as little as may be.
For we mutt fee firft whether the |
If the jaw 4 44w be luxated to both fides or one;
pe Haste if both parts of the jaw are fallen On 0010 ete - eae parts forth, lec the Patient be placed on
! fome low feat, and let his head be ur~ ped either co the wal, putting becween fome hard Cuthion; or ler it be held faft by a fervane placed at the back of the Patienc, or the Pactenc lying on his back, as you may fee by che figute in Hippo- crates in the place alleadged, cext 17. Jec it be held faft by a fervanc ftanding at his head; and kept unmovable.
Afterwards the Chirurgeon cughe co put both his Fhumbs wrapt up in linen on che grinders, but wich the reft of his fingers to lay hold on the jaw outwardly about the chin, andery co reduee it by amanner and motion contrary to that which i fallen forch ; which he may do, if firft of al be
draw the jaw downwards 7 becaufe che cemporal | nifeft Gavity 5 chereisalfo'a a ha ti 8 a ‘ :
of the Channel Boiié.
Mufcles have {naccht the acuce procefs wpwards; fecondly becaufe the jaw is fallen co the fore pare he muft force the fame co the hinder pare 5 third> ly becaufe ic was drawn downwards he muft drive ic upwards; al which operations a skilful Chirur- geon may {péeedily’andin a momenc perform, © —
Buc if the jaw be fallen-ouc of its
feat only on one fide, the way of redu=}° 7p ox cing ic as the fame, chis only muft be one fide peculiarly objerved, that che Jaw be-.
ing drawn downwards and forced backwards, af= cecwards alfo muft be ftirred to the oppofice fides and ac once thruft upwards.
Reduction being made, a Cerore of Wax and | Oy] of Rofes muft be applied co the heads ‘of the | Jaw or Temples; and if chere were ftrong excen- fion made, tohinder an Inflammation aftringent | Medicines muft be baid on wich the whice of an | Ege, or others, asin other Luxactions. | Ac laft convenienc binding up muft ‘be made; | which muft begin from che Chin, and rend tow- ards the crown of the Head, and ic muft noc be loofed béforethe thirdday. Let the Patient’ fors
eat from much talk, opening of his mouths and | gaping, and chewing of hard meats, and tec him | be contenc with Liquids.
If an Inflammation or other grievous Sympé tom be at hand, chat muft be conveniently oppo= fed, ashath been often faid 3 @nd if there be zoy= ned a pain of the Eyes and Neck, we mutt le¢
lood in the Acm, as Celfus advifechs b, 8.0. 116 and che Temples and Neck muft be anginced with Oy] of Rofes and Worms.
Chap.4 Of aLuxation of the Chai
nel Bone, |
ms Fe Channel bone alfo is fomtimes moved out of ics fear, which Galen proves by his owa example, in I. Hzppoc. de artic. com. 1. tex. 6% where he reckons up at large, how when he was thircy five yeers old in the wraftling place this joynet was fo luxated chac between che top of che fhoulder- blade and the throat there was chree fine gers {pace, and what was done about it. Buc the Channel Bone is luxaced eicher-againie the Breaft bone, or againft che cop of che fhouldér bone; yec both of them feldom happens, by reas fon of its firm conjunction with both bones.
Signs Diagnoftick.
Bue a Luxacion of this Bone is not eafily known; and Ambrofe Parry writess |, 15. 1k That he hath known many Chirurgeons, who be= ing deceived have taken a Luxation of the Tbroag for a Luxacion of the cop of che Shoulder, Bur it is Known, becaute the top as ik were of che fhoulder doth {wel, and in the place from whence che Channel Bone 1s departed chexe appeatsa mae,
2675
—
a eS Se r
DSS WENE Ne ag FIRS NY
‘ i"
Wh is hi iM iy Wy ih aul ha ny a, Dt |, ! } | i if 1 Waid? i | i
2676. Book V. ~
_ and animpotency to move and lift up che Arm,
Of Praétical Phy/ick.
Pare VL
andtoother motions that are performed by the help of che Shoulder. ;
Prognofticks.
1. fhis bone is hardly reduced and returned in-
. toits natural fear, but-for che moft parc hangs
forthmore or lels. from che upper pact.
2. Bue unlefs t.be.reftored che Patient wil fail in fome-motion of bis Arm, and cannot Move his Hand neither co.his Head, nor Mouth.
The Cure.
This Bone-according co the variety of che Luxa- tion requires divers, Reftitutions. . In general, che Arm-muft be.extended , and the channel bone chruft back 19:0 1s place,which ts done, it helie on bis back wth a bard Cufhion puc under his Shoule ders, thac the Shouldec and Breaft may bunch forth outwardly, and by litting up, preffing down, or drawing tbe Arm forward, and back- ward, as need requires, and prefling ic wich the palm of the band, this bonemay be torced into ats feat, afcerwards fic Medicines and many bolfters muft be laid on, and the pace muft be bound ftreighcly 3 which ftrict binding few men can en- dure yet Galen writes chat he fuffered fuch
fewed toa Scomacher made of Linen or Bumbatt, that when it is put on ic may comprehend che pace affected. This Scomacher muft be tied with Sccings, in other parts moderately, buc abcus che part affected very ftraighc, chat the Place may compreis che bunchiug Vertebre: and if che Lux- ation be inche Vertebre of the Loyns, chis Scoma- cher ought tocomprehend not only che Beeaft, but al che lower Belly alfo, to the Privities.
Such a. Plaifter may be made.
Take of common Oyl, Hogs grease, of each three ounces; Deers fuet one ounce and bal Ts melt them and mix them over. the fire, then caftin two ounces of red Lead: Let them boyl with continual ftirring ttl they begin to look black and grow tbicks by and by addtwo ounces of Pitch : Afterwards by degrees fire in two ounces of white Virriol poudrered, then add two ounces of Litbarge: and at length rben they are almoft boyled to a juft thicknef,, add one ounce and half of Tacamabacca ; ftir them again and boyl them to the confiftence of a Plaifter.
Gulielmus Fabricius Centur. §, Obfery. 67. propounds (uch a one.
) Take of the Plaifter Slotanum balf an ounce, | new Wax two ounces , Ofteocolla one ounce,Pou - | der of the roots of the greater Comfrey, Terra Si
ftrange binding, thac he could perceive the motion gillata, of each three ounces 5 Pouder of Pome-
of the Arteries under his Throat.
Chap. 5. Of a Luxation of the Back bone and Ribs.
Frentimes alfo the Vertebre of the Back O bone are luxated, and eipecially thofe which arein the Back, whencetsa bunch in che back; but whereas I have treaced of this,/.2. par.2. cb. 41. -I-wilnordo it over again, but fend the Reader tothat place; twochingsonly Tadd, che firft concecninga Fracture whicb is made-on the outer parts; ificbe new, and made by a violent caufe, ic muft prefently be replaced by che help of aChiturgeon, of which bufinefs dotreac Hippo- crates, |. 4. de art. Galen in bis Comment. Pau- lus Egineta; |. 6.c,177-Orzbafius de mach. ¢.35. Celfus-l.-8.c. 14. Parry,l.15.c. 15. and 16.
But becaufe chis Evil fteals by de- grees upon Infants, and ’tis oftentimes hereducary, for the moft part ic is in- curable: yet if there remain any hope of recovery, the Cure is done by con- venient Plasfiers which bind and ftrengthen the
aet affected, on.whichan Iron Place muft be laid, which by degrees may force the Vertebre in- cocheir place. Butchat Place oughe co be fo Jong and broad, chac it comprehend che whole bunch ; and that ic may prefsicthe fkcGnger, che inward part whica isnext the bunch oughe co be filled with Cotien clajely bumbafted, and covered over with-Linensbur chis Place mult be fo fattened and
A Luxati- on, of the Verrebrz ontwards: |
| granate flowers, Cyprefs Nuts red Rofes,of each | one ounce 5 Oy! of Rofes or Maftich as much as woilfuffice 5 mix tbem. |
Buc betore fuch Plaifters and Places be laid on it wil be good for fome cime before co foment the part wich the following Decoction,and to anoyne 1¢ comollefie ic, ifany ching be hard, chat ic may berendered more fit cobereplaced. As,
Take of Sage, Marfh-mallows, Flowers of | Camomile, Melilote, St. Fobns-veort, of each one handful; let them be boyled for a Fomenta= tion.
Take of Oyl of Worms, of Orrace, of rbite’ Lilies, of each one ounce, Oyntment of Agrip- pa balf anounce, Dialtbeea one ounces mix them.
Secondly, if the Vertebra be Juxa- ted inwards, the refticution of chem 1s altogether more difficult 5 yet inten- | te Vow der bodies, if che Evilbenew. fome } 4.
3 5 1 wards
Plaifter firmly flicking to the Skin |
| }
| A Luxation
tray be applied co the place affected’; and the |
Juxaced Vertebra may be drawn forth thither, In thoie of riper age Guil, Fabricius, Cent. 5. Obferv. 69. thinks an excream Remedy is rather co be accenipred, thenco relinquifh che Pacienr, who other wile muft lead the miferable life of the Difeafe, or die. To wit (as Fabricius ceacheth), Incifion muft be made with a Kiusfe even to che defcending appendix ot che Vertebra;chen thrcugh che fame Wound putcing in che Katie again, two Incificns more mut be made, one co the right, the other wo che left fide of the Appendix; chen the , | Appendix:
outly
MB wreache Washer cul
im applied,
afeerwat fome hot mutt be
A rot fore
iB beapp
ibe frot Hoth a
aut be
ia
ments Ther
imutt eq
i
H moreove
lneiltons Append ieeed fron Vertebre petation Hhilerh
A eted i
Mors og
Bakes ratent
thenh (> i nich 10
tobe hot Hor fourth place mut ony Pry Mts and
HOME thin
| Tys.and
| #'0n chek | Wand | Hadley.
Mf ' i . QUGS,
{ dave,
[
bi i Dat
twit El
OL the te May ¢ Luy. Df Omge
NCes. of ve
inces of
alu ndhy f
=u
fy q Yh then
Vy, 67,
ounce, ‘
Pu “(ta Gia
Ponte |
of eth CD.
lad o, neat the OT cI gay
pert of
ach one mente
Lyralien
he Vete
rlyp : [We VS &
het,
Cent. $i g rach Prien sof te chet) 0 it prc ty (Wo i, he ku Ni
cor fourth day
EME } petacion i ; : me I which few wil fubmic 5 although Guil, Fabrics
ws wich Celfus b. 2. C> 33> /maccer,
Of Luxations of the fhoulder.
A ppendix being laid bold on by Inftrumencs fat ; which is che only one 3 and he thinks rhis operation
for this purpofe, w¢ muft be drawn upwards, and | is not fo. dangerous, fince that inthe middle of the the Vertebra replaced in ics natural feac: bue in | Back there are no preat Veffels of Veins and Arte!
che interim whiles chefe chings are done, 1¢ muft ries, befides che Nerves in che
Appendixes are
needs be that che Back bone be extended, forthe |{mal.
Vertebra wil the eafter.ftare into.ics natural pofi- cion. The Wound muft be fal or great according
ro the greane(s of the diflocation; for if only one |
Vertebra be pret in, afmal Wound wil {uffice, bur
if Cwo OF More,iC muft needs be great, that borh che | luxated Vertebre may be Jaid hold on. Ifa Flux |
of blood do hinder, fo that the opetacion cannot be
done prefently after Incifion is made;.ic muft be |
ftopt with Hurds clofely wreathed up, and wet with che Whice of an Egg, and ftrewed with a pouder to ftop blood’; where this nuft be obfer- ved,chat che whole W ound,efpeciall) id of che Appendix be moft carefully filled up with
ul chofe Hurd; bur char this may be done commodi- “rt
;
oufly, many liccle pillows muft be made of Hurds |
wreathed up into chis fafhion,and foone after ano- cher mutt be thruft into che Wound,cal 1c be filled.
¥ 3 afcerwards let fome Plaifter chac wil fick faft be. dleticbe bound witha Rowlers after :
: d ay appalet 3 ao r : fomehours when the blood is ftopr, che Hurds
muft be taken ouc gently, chac the blood break © afterwards the Inftrument miunft ;
not forch again; alt | be applied as was faid, bus che Inftrumenc muft
be ftcong and cootbed, as we ufe
muft be laid hold on, and that with cwo Ioftru- ments. : There muft.cherefore be ewo Chirurgeons, who mutt equally and with one confenc draw upwards; raat san Rava ze at: moreover let che Chirurgeon have a care, chat the Incifions be not made too ee che eis che eal Nerves which pro- Appendix, by reaton of the Nerves which p
Vertebre ; moreover it4s neceffary, that this peration be done at the beginning of the Difeafe, while the ftrengch is firm, and before the pace af- fected is pofleft-with an Inflammation and Tu- mor; neither makesac any matter whether the Parienc be wachouc Speech or Underftanding, which fomtimes happens. But if che Chirurge= on be not called at the beginning, the fecond,thitd, , at leaft before the operation che oted with che Decoction of Be- tony, Primrofe, 94ge). Camomile, Melilore, ie fes and Juniper .bextics; ¢o which he may a ‘ dome things mollefying as Mallows, Mat ma
Jows,and thencry co reduce thems after the opera- tion che Back mutt be anoynted with Oyl of Ro- fesand Worms, and che Wound alfo muft be handled aicec the manner of other contufed
sands.
ae writ in the place alleadged, thac chis o- ems to me not fafe enough, and co
place muft be fome
affirms, chat ic makes no whethec _ che
} {
ron each fide |
in drawing | 2 B ASCE pig a forth a Scone, if two Vertebre be luxated, both
| ~ Of the Luxation of che Ribs harh been fpoken, iD. 2» Pe Ze Co 25-
| Chap. 6, Of a Luxation of the | Shoulder.
Ph es Shoulder bone wich its round “head | Bed every Where with a Cart!
iche bofom af the neck of che Shoulder: mft perfect manner of Articulation, commodious for che undergoing ‘and ‘performing ofall motions, and when as this befor isnot d
S na aL
ANA matt GE 1nd
enough engraved co receive the head of t der, leftthis Joynt fhould be: fub oD Luxations, provident Nature ‘hath provided by {trong Ligaments and a peculiar procefs, and ‘mareovec. befides the Cartilage wich whict
tie 1664 0 )
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0 of
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foynt falls ourdowawards ( for the arc of under che Arm-picdh few jders the Causes of his bufinels, 72 rex. 2, ) there ate fix places about every earciculation, Above and Below, Before and Be= hind, Withour and Within, che aaner part of his
1OUr a 1%
r Le 4%
slesfor w
hJoyne by which it tends plainly upwards hatha
: ) we t a H I ceed from the {pinal marrow fo che fidés of the |
efhy parc of. a Mufcle caft over it, which by fome
1 is called Deltosdes from its hikenefs to the Greek ecrer 45 but by that parc ic declines cowards
ithe Neck ic hath che back of che Shoulder-blade,
Remedy be fafe or not, | anc
where by the conjunction with the Neck-bone the cop of che Shoulder is made which 1s called the Acromion 3 where it looks inward, thac procefs meets with che Shoulder-blade, which for its fa fhion {ome cal the Anchor-hike, {ome the Cornicué lar procefs, which wholly forbids chat che Joyne fal forth intothat parc. But chac it may fal anta che hinder parr, whenas there it leans on the Shoulder-blade; ‘Who is there amongft us thar can fomuch as conceive ic? There are four pares then remaining, which want a Guard, into which ic is likely che Joyne may fall. Hippocrates in che alleadged place admits of no other Species of Luxation of the Shoulder but under the Arm-pit5 nay he plainly denies chat iccan fal forth to the fore paces yet Galen hach feen tt five times, once in Afia, and four times at Rome; and no wonder, whenas in the Cities where ‘Hippocrat. lived there were {carce fo many Men,as in one Screec at Rome; d cherefore chere were more Examples of Dif- Bip pe fo eee
in Jes ——— re ees et a
Gb A, a) : ! his >. id AG 1 { } | EH i A rit mean K | Mg! Ne | ini \\ ; : j 7
RSENS CET gt
SRS RN Tce ETA eS
M2678. Book V.
_ thoulder blade.
eafes, ef{pecially the wraftling place coming 1000 \ the head of the fhoulder is diftorred tow
ufe, by which cheir Limbs were diverfly diftorted | and perverted. Parry,}.15. ¢.21. 29. and 36. | adds two differences more, viz. upwards and) outwards, burchofe are very rare, and you may | fee che places alleadged concerning them. |
But cis doubced whether che fhoulder can fuf-} fer only a perfect Luxation, or alfo.a Subluxaci- on. Hippoc.1.de artic. tex.22, denies 1c, and not without caufe and reafon; for whenas the head of this joyne is round, and infexted into Cavities which have their brims round, it cannot ftay 1n| chem 3 and chis is alrogether crue, if che Luxaci- onhappen from an external violent caufe; but if che chick humors flow into the bofom of the fhoulder-blade, and chece by cheir long ftay do| ftick concreted and hardened, they may by de- grees thruft the head of che fhoulder out of its jear, and caufe an imperfect Luxation; yet this happens feldom in the fhoulder, more ofcen in the
Hip. The Caujfes.
From which it appears now chat the Caufe of a perfect Luxacion of che fhoulder is a violent caufe, afal, a blow, vehement excenfion or die ftorfion of che Arm; but checaufe of a Subluxa- tion is a thick humor fallen intoche bofom of the fhoulder-biade.
Signs Diagnoftick.
Thatthe fhoulder is tallen under che Arm-pic iseafily known, and it is moft certainly fhewn by its proper and infeparable fign, viz. fomwhat round and hard under the Arme=pit is fenfibly ob- vious coche touch, to which notwithftanding o- ther figns al{o are added, not proper,but common 3 for there appears an unufual Cavicy acche top of the fhoulder, but chat ts a common fign,both of the fhoulder fallen forth, and of the broad bone of the In which chings that Phyfitians are often deceived Galen ceacheth ac large both by hisown and others example, 1. de artic. tex. 61. che fame falling forth of che fhoulder is fhewed by ats unlikenefs compared wich che found one, bya fharp bunching out asic were of the upper pro- cefs of the fhoulder-blade, by a deparcing of the Elbow from the Ribs more chan ufual, and che difficult and painful bringing of i¢ co chem’ and the exceeding length and inequality of the fame compared with the found one Cunlefs the fhoul- der fallen downwards be neverchelefs drawn up by the Mufcles) andche imporency of che Arm ctoa- ny-motion; which fign alfo is not infeparable, whenas the Mufcles about che fhoulders what way foever burt whether by a Luxation, or by any o- ther Caule, are uafic for motions
If the fhoulder be faller forth co che fore part, there is feen an unufual Cavity in the hinder pace, and ceo great a buncaing ous in the fore pare,
Of Prattical Phyficks —
Breaft, the Elbow tends to che hinder ate a is with difficulctly ftreccht out to the fore parts and the figns are wanting of a fhoulder Juxaced mee che Arm. pit.
Prognofticks
1. The head of the fhoulder fallento the fore pare is eafier reduced than if it be fallen into the Arm-pit. : 4
2. An old Luxition of the fhoulder ; bardly reduced, and being replaced it fals fake 2aine
3. They who have their fhoulder reduced (which ts true alfo of other joynts) the pacts ad= joy ning being affected with no Inflammation may prefently ufe their fheulder withouc any pain’ and thefe think they have no need of any furche? care or providence, but tis che Phyficians Part to correct their opinion 3 whenas thefe have cheic
1oulder more eafily fal forch again, then thafa whofe neighboring parttsare poflefled with an Tn- flammation, forchefe cannot ufe their joynes,
4. They whofe head of the fhoulder could not be reduced, if chey grow ftil, thar fhoulder is not equally augmented as the found ones and chouoh it be augmented fomwhar, yet it 1s rendered fhor= certhanthe other; which happens by reafon of the compreffion of che Mufcles and Veins, and be- caufe the whol joynt is immovable; but in chofe who at ripe age have the head of the fhoulder break forth, and ’cis not reftored, the parc which
th ae
more flender babiced.
The Cure
\the Arm-pic may be reftored into ics fear from which ic fel, three things muft be done, as ceachech, 1. deartic. text.§. ‘Firft che head of the fhoulder is to be forced to the fore parc, then to the upper part, ac laft to che hinder part, to wit that a contrary way tothe Luxaction may be un= dercaken 5 for the head of che fhoulder deparcing {rom its proper bofom ‘is firft forced to the fore parc, fecondly by its weight cis carried down- wards, thirdly ’tis drawn backward to che Arm= | pichole by the Mufcles. Bue if the fhoulder be pale forth tothe fore patc, ic muft be forced a
be freed from the Mufcles with which ic is Getain=
fhoulder made, yec bue little. But che waies of reducing ic, as we may fee in | ‘Hippocrates. 1.de artic, and other Auchars, are
|Vatious, Of which we wil reckon up che chief and
moft ufual, and chofe which require Jeaft pre- patation, and are moft fafe.
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