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Chap. 6. Of Luxations of the Shoulder.
Tee firk | the head of che fhoulder about tne | fhoulder is moved up and down, in che threrim Ao iced = neck of che fhoulder-blade, co wit, | found Acm is moft (trongly drawn downwards ag Tixated when the Chiturgeon puts his hand | the tsmetime by a fervanc on the oppofite fide, fooulder moft ftraightly under che Arm-pit, | and thé foo: ftool together is drawn trom under | and wheels aboue the fhoulder wich! che feet of the Pacienc, thar he remains banging on the other hand, that the middle joynts of the fin- the Ledder, and by chis means the thoulder is res gers force icinto its Cavity 3 which way indeed | ftored: . wants nor itsdanger; for by the circumvolution| The foiirch way differs nor much | not Only the nervous and membranous bodies, buc | feom' this, which is performed by a | The foxrjé alfo che brows of chebofom may be razed, hay | Peftil. To wit, che Peftil is wrapt up | way che Cartilage compafling the bofom cannot ezfily wich fome foft Swathe, and is chruft ! be pulled or hurt without great dammapes yet ic | becWeen che fide and the head of the thoulder; bitz hach ics place in children and other fofter bodies, it muft be of thac length that che man ftanding fo chat the Chirurgeon do exercife it warily. May almoft hang upon it 5 bur if icbe fhotter, lec The fecond way is by the heel, after | the man fic fo that he can {carce caft his fhoulder The fecond this manner: The Patient mutt be | over the Peftil, chen Jecche fhoulder and arm be way laid with bis back on the ground, and | excended along che Peftil, buc Jec another force | becween the hollow of the Arm. pits | bis body the other Way, flinging his hands aboue the head of che fhoulder andthe ribs, a bal of a/ his Neck neer che Throat ; buc chis way is noc {¢ middle fize made of Leather or fome other matter | fafe, whenas the Peftil under the Arm may ealily not very foft muft be fitced core 5 bue che Chirur- | give way, and chere is danger left chat che body geon ficcing right againft the Patient let himap-'! flide co chis or chat parc upon extenfion tadé on ply bis right hee lif che right fhoulder be luxated, | both fides, or his lefc bel if the lefc, upon the bal putucder| The fifth way feems more comme: ep the Arm-pit, and wich both bands lec him dtaw | dious,which is done by puteing under the fifil the fhoulder downwards (when the head of it is | a fhoulder, (they ca] ic Subbumerati- rapt upwards by che firengch of the Mufcles) but} on or under-fhouldering) after chis Manner ; lé¢ wich his heel lec him drive the fhoulder at onceto! a {trong iervanc and of cal flacure put che pit of the fore part and upwards; and ac laft Jec him| the Patiencs Arm over the fharp parc 6f his fhoul= force backwards the head of the fhoulder into the| der, and let him draw che luxared fhoulder tow- Cavity of che blade 5 the which he may eaftly do, | ards his Breaft moft quickly and ftrongly,thac che whenas the Mufcles do not only much help this} Patienc may as ic were hang on his fhoulder , by motion, buc ofcentimes alone do wholly perfeét | which means both che Arm wil be extehded and it, Two Servancs may make this way of redu-‘ the head of che Shoulder moved co che fore pact ; cing eafier, che one of which with a {wathe or rein | in che interim let anocher Servane ftanding at the may draw the thoulder-blade upwards cowards | back of the Pacienc prefs the top of the fhoulder the head of che Patient, and by this means facili- | chac the fhoulder-blade follow nog with irs lee tate the motion downwards, bue lec hin prefs | him thakeir, and fo rule thofe violent motions with hisfoot che cop of the thoulder, and fo he |-wich bis hands that che luxaced Shoulder be redit wil hinder the fhoulde.-blade from following, | ced inco its Cavity ingraved in the fhoulder=blade: whiles the Chirurgeon draws the fhoulder down- | If che Paciént be light, lec a Boy of fome othed
/ wards; but lec che other hold che oppofite found | heavy wéight be hanged’at his back 5 left upon the
Acm, and by chis means he flial binder thac the | excenfion of the Shoulder the whol body do fol? whol body do not follow upon the excenfion | low, and al the operation of the Chirurgeon be made by che Chirurgeon on the affected fide. And | hindered.
this way becaule itisdone by a way contrary to| Thefixth way, whichby ‘Hippo= . the falling forch of che bone, and with excenfion | crates is cotinted che moft commodi- | tbe rth too, is almoft nacural, fafe, and not fo Jabortous : | cus, is defcribed by him, 1.de artic. 1 4
yec becaule ic wanes an impulfe, Galen thinks ic | tex.19. which Ambrofe Parry makes in x i recedes trom a convenient manner. yec more commodious, |. 15. c 27. caine iy The third way is by a Ladder, and | which may be feen there: co which Shoulder The third { 7cis alfo fafe and commodious enough; | way yet fome Are may be added, if way towita Ladder 1s raifed up firm and | che Patiéne tic immovable ona bench, and there be | faft, upon whode uppermoit ftep chere | two pieces of wood four or five fingers broad, two muft be bound fome round body, which muft be fingers chick one being erected perpendicular ficted co che Arm-pit of che Patient, and may | muft be faftened to 5 Bafis, which muft be fathi- drive forth the head of che fhoulder 5 at che bore} oned coche form of a Ccofs, of chat lengeb chag if tom of the Ladder a footftep is placed which the |1t be fet on che bench on which he fits, ic may al-. Patient gets upon; afrerwards his Armepit is pla- |moft reach under his Armpit; which inthe up= eed over thac round body, the luxated Arm is [per part mutt have a point according to’ its loner N Ppp 2 tudez
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268) Book V;
tude, inco which che other may be put; but let
ithe other be almoft three Ells long, and at one | fore pare, ’cis reftored almoft the (ame end lec ic have another piece of wood prefixe a- | waies as when 7cis fallen into che
crofs almoft half an El] long. Let chis wood bea licele hollowed an El long from its end to which che other wood is prefixr, chat ic may be inferced toche other piece of wood that as erected, but with che other end couch che bench. Now let the Patienc {it unmoved cn che Bench, and let chat long piece of wood refting on the ocher erected perpendicular be fomovedco him chat that crofs piece of wood may be ftraighcly fec under che Arm- pit of che Patient, in which pare the Luxa- tionis; lesche Patient extend the Arm that 1s hurt upon thac crofs piece of wood cowards the bench; chen letaf{wache or rope be caft about the affected Arm about the Elbow (a long Towel is moft comaiodioully ufed ) and les che Arm be wrapped withic cil below che Elbow, fothac che {wache end in twohandles, on each fide of che Airm and crofs piece of wood; now lecthe draw ing Engine which refts on the bench, fuch as are ufed todraw upcrofs bones,be applied co the end of the crofs piece of wood 5 for which caufe lec that crofs piece of wood witha wooden ftake be driven in a crois not far from che end, andthe cwo hooks of that drawing inftrument in its upper pare be laid hold on with che cwo handles of the rope or towel ;. which when cis done chat Engine muft be brought about, as is wonc co be done in binding ofabone. For fothe Arm is extended by de- grees, and is drawn downwards, and che joynt fallen forch is promoted into its place, into which itis dcawnand {lips eicher of its own accord by the motion of its Mufcles, or by help of che Chie rurgeon it mult be forced chither wich his hand. Which way differs trom che draft of the Ambi defcribed by Parry, inchiss ficft of al thac in- ftead of the Pillar B. made with two pieces of wood, hereis a pillar of one piece, which in its upper part hach a point, which is fent into the boiom of che Spatba A. hollowed in the lower parc ; next of al in place of chat Spatha or Am- bt chere is a piece of wood which reacheth from the Shoulder evento the Bench on which the Patient fics.
Of Prattical Phyfick. —