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head_n	belly_n	foot_n	knee_n	4,575	5	13.2066	5	true

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ID	Title	Author	Corrected Date of Publication (TCP Date of Publication)	STC	Words	Pages
A59191	The Art of chirurgery explained in six parts part I. Of tumors, in forty six chapters, part II. Of ulcers, in nineteen chapters, part III. Of the skin, hair and nails, in two sections and nineteen chapters, part IV. Of wounds, in twenty four chapters, part V, Of fractures, in twenty two chapters, Part VI. Of luxations, in thirteen chapters : being the whole Fifth book of practical physick / by Daniel Sennertus ... R.W., Nicholas Culpepper ... Abdiah Cole ...	Sennert, Daniel, 1572-1637.	1663 (1663)	Wing S2531; ESTC R31190	817,116	474

together with other running sores out of which when they gaped and were opened either with the Needle or Medicaments there issued forth a thin pituitous or Flegmatick matter wheyish and rotten as also a snotty Sanies and in others this thin pituitous matter was likewise sharp and corroding then the Flesh al of it that was comprehended within the Circumference of the Cupping-Glass being corroded and putrifying sent forth a stinking savour such as is wont to arise from the Telephian Phagedaenical Vlcers Where it was worth observation and to be wondred at in the very beginning that of so many Cupping-Glasses as were affixed some having had ten or there about and others also not above three of these Cupping-Glasses fastened and affixed unto their Flesh only one of them or two at the most of all these brought forth any of the said filth and Corruption the Mother in Law of one Laurentius a Taylor only excepted who of fifteen that were applied had three that produced of the aforesaid impostumated matter You might have seen some of them with their whole bodies all overspread with Pustules or Pushes as we cal them their Face deformed their Countenance sad and dejected their looks terrible and frightful their Back Breast Belly Feet even all places from the Head to the Foot of them polluted and defiled with a scurfie scabbiness and with Crusty Vlcers lifted up a little above the Skin as broad at the Nail of ones Thumb with a red Circle and a white superficies and outside And out of these Vlcers also did continually run a kinde of Fat liquor and other Excrementitious filth and corruption that did more resemble the thin and cleer Sanies then the thicker Excrement that we cal Pus Yea and moreover the scabbiness being removed and cured there stil remayned certain black spots somewhat differing from those that appear in the Impetigo and the Vitiligo which are of a dark Leaden and Duskie colour In the progress of the Disease there grew together in the Head certain Callous or hard Crusts which being with the greatest pain broken or diffected did sweat forth a kinde of matter not unlike unto Honey and very tenacious such a kinde of Juyce as we may see to destil from those Trees that bear a fruit like unto the Pine Apple a certain substance I say thick and clammy and therefore an Argument of the ripening and withering away of the flegm These sordid and filthy impostumes they being indeed of the worst sort of all others were no sooner throughly cleansed and purged with a great deal of trouble and much difficulty and no sooner were those parts grown together with a little flesh brought over them but out there breads a new Symptom The Limbs of the whole Body the Arms Shoulders Shoulder-Blades Elbows Calves of the Legs Ankles and bottom of the Feet they were all extreamly twinged and pulled with a certain kind of pricking like unto stings and as if they had been sawn assunder with some Iron Instrument The members were all of them so heavy by reason of their weight that they needed somthing to underprop them and bear them up yea and many of them also that had a palsie threatened unto them were fain of necessity to be born up and carried upon mens Shoulders And yet for all this they had no rest day nor night being wracked with continual and incessant pains And these tormenting pains were not for a day or two but they lasted commonly for the space of a whole moneth And the Head likewise that was not free For besides the Achores above mentioned together with the Gummy and Callous risings therein not unlike unto great warts it was grievously infested with vehement pains and especially about the hinder Region thereof which by reason of the weakness and decay of the Parties strength as also through the want of due rest and sleep caused many of them to be Mad which said Madness of theirs left them not until for a long while together very much of the aforesaid purulent snot and filth of a most offensive and stinking Savour had run forth from the Head by the Nosethrils And all the whol time that the Disease had its course they took no pleasure at all in the gifts and comforts of Ceres or Bacchus that is say they were not at all delighted with their Food whether Meat or Drink They abhorred likewise and shun'd all manner of converse with others either out of shame or else for Anger and Indignation when they beheld themselves without any desert on their part as they thought quite over spread with a horrible and Contagious Disease and of which they had smal hope to be recovered This Disease continued the whole Winter long even until the spring Equinoctial that is the Suns Entrance into the sign of Aries about which time it manifestly declined and was Judged to be quite ceased about Easter because that after that time there was none found to be wholly overspread with this strange and until then unheard of Disease As touching the rise and original of this Disease there were two Opinions especially For some there were that thought it to be a new kind of the French Disease by Contagion or infection propagated in the hot House or Stove of the Bath but others conceived that this poyson was communicated by the Scarification The Chief Magistrate of the Town made a very diligent and strict enquiry as touching the Cause of this Disease but he could finde very little or nothing of a certainty Johan Sporischius in his Tract before alleadged admits of neither of these Causes before mentioned but he conceiveth that this Malady had its original from a Pituitous and Flegmatick Cacochymy heaped up in the Body by the unhealthy Constitution of that year and withal that overmuch and Unseasonable Scarification drew these vitious Humors unto the Scarified places And that he may the better prove this he writeth many things touching the Scituation of this Town and concerning the Dyet and the Diseases of the inhabitants and from all these put together he proveth that there was collected great store of this Flegmatick Humor And the truth is that it is not altogether so plain and evident from whence that Disease was at first contracted For if it had its original from Scarification then the Cause is not evident wherefore this infection continued only from the Winter until the vernal or Spring Aequinoctial and no longer unless haply any one wil render this for a cause that after this time none durst by reason of the fear they apprehended of a danger make use of these Baths or else because that this Bath was almost destroyed and then again renewed and why all the parts unto which the Scarified Cupping-Glasses were affixed were not exulcerated For in the Histories of the infected Thomas Jordanus taketh notice that a certain person who had five of these Cupping-Glasses affixed unto several places of his Body yet that only two of all

by no Art or means that can be used the ends and extreme parts of them may be brought and made to stick fast together as before and that they lie not directly one against the other this kind of Fracture is in special called Cauludon from the resemblance and likeness that it hath with a broken stalk And Paulus Aegineta writeth that this Cauludon Catagma is likewise called Raphanedon and Sicnedon from the similitude of a broken Raddish and Cucumber But if the bone be not only broken into two parts but that it be likewise shivered into many that Fracture is termed Suntrimma or Comminution and by Galen it is also called Caruedon because that it is made after the manner of broken Nut-shels But if the bones be cleft according to their length like as Wood is cleft it is then called Parameces that is to say properly a right or straight Fissure or Cleft and by Galen it is termed Schidacedon In the Head this species of the solution of Unity hath names peculiar and proper unto it touching which see Hippocrates in his B. of the Wounds of the Head and in his first B. of Practise Part 1. Chap 23. And of these Fractures there are likewise several other differences for some of them are great and some again but smal Fractures some of them simple or single Fractures and all but one alone but then another Fracture there is that is manifold as consisting of many some equal others unequal and the bones are also broken somtimes in one manner and somtimes in another manner and that very different And the truth is the Ancients gave them their names from the Figure and the likeness of other parts and as we told you before they called them Cauledon Raphanedon Sicnedon Catagma and somtimes likewise Alphitedon when the bone is broken and shattered into many smal and thin parrs not unlike unto Meal they cal another sort of Fracture also Calamedon that is to say the breaking of a Reed eis Onucha after the form of a Nayl All which Appellations notwithstanding are for the most part sleighted and neglected by Hippocrates who instead of them hath made use of Names more ordinary and usual as one rather desirous to interpret and choosing rather by speaking of them in more words so to describe them And somtimes al the parts of the broken bone do again Joyn and grow together but somtimes some one or other parts of the broken bone impostumateth and droppeth out There are likewise divers other differences that are taken from the part affected For one is said to be a Fracture of the Shoulder another of the Arm another of the Thigh and so of the other parts And then indeed in the Arm either but one of the two bones or else both of them to wit the Vlna and the Radius bones are broken And in like manner it is also in the Thigh the case being one and the same The bones of the Nose are likewise broken and so are also the Channel bones the Ribbs and the whirl-bone And there are moreover besides these other differences that are meerly accidental when as a bone broken either abideth stil in its own place or else is carried forth thereof and lifted above some other bone and that somtimes the Fracture is but newly made and somtimes it is old and of a long continuance And there are also other differences that are improperly so called as that a Fracture is conjoyned somtimes with a Wound somtimes with a Luxation or disjoynting and somtimes with other affects For somtimes there is a Fracture made the Skin and Flesh lying above it stil remaining sound and whole and somtimes these happen likewise to be hurt and wounded And somtimes also together with the Fracture there happeneth a loosening of the Joynt neer unto it And somtimes unto a Fracture there happen an extraordinary pain a swelling and an Inflammation but somtimes again there are none of al these joyned with or following upon the Fracture The Causes Now all things may be said to break the bones that so endeavour to bow and bend them that they being not flexible must necessarily be broken Galen in his second B. of Fractures and Text 9. reduceth them all unto four Causes whiles he writeth after this manner It is either somthing saith he that can bruise and batter if it be laid on with great force and violence and this without doubt ought to be some Body that is hard of substance and heavy in its weight or else it is somwhat that doth not only divide the Skin or that divideth likewise somthing that lieth under the Skin even unto the very bones but which divideth also the very bones themselves which Malady Hippocrates himself indeed calleth Edra that is to say a Decession in his B. of the Wounds of the Head And moreover also some by leaping from an high place have broken either the Ankle or the Thigh bone which in these persons were drier and not so thick perhaps as in others For I my self also have seen in the common wrastling when in the turning of a man round a Fracture hath happened unto him who having hereby had his Ankle together with the Calf of his Leg broken by the greatness of the Wound the bones have been made naked and bare For this Fracture happened upon his Ankles being gotten under the Leg of his Adversary that wrastled with him in a transverse or overthwart manner so that both the Heads thereof as well that toward the Foot as that above toward the Knee were pressed downward with great violence like as we also see it in Wood which we our selves endeavour by bowing and bending it round to break For if a piece of Wood be put upon ones Thigh and then from both ends or Heads pressed down vehemently with the Hands we shal then soon perceive it to be broken in the middle part But yet notwithstanding even the very Constitution of the bones doth somtimes cause the Fracture of the bones the Constitution of them being somtimes so brittle that it cannot brook the least violence and somtimes again more hard so that it cannot be broken but with a far greater violence and force And rottenness likewise rendereth the bones very frail and weak and especially that which followeth the French Pox and in those that often make use of Mercurial Inunctions Of this strange and wonderful frailty and weakness in the bones there is extant a Memorable History in Marcellus Donatus in his Hist Medic. Mirabil B 4. Chap. 5. And the story is briefly this Vincentius Morellus Coach-man unto that Famous Poet and Noble Patrician D. Dionysius de Pietis sporting and playing the wag with others of his fellow Servants snatcht up half an Orange from off the Table and threw it as hard as he could at the Head of his fellow Servant running before him but as it fel out he did himself more mischief then the other For in that Arm wherewith he threw

to the Pecten and the neck of the Joynt is sustained in its Cavity again on the outer side the buttock appears hollow because the head of the Thigh is fallen to the inner part and the Thigh towards the Knee is forced to look outwards to the outer part in like manner the Leg and Foot whenas in all luxated bones one extreamity alwaies looks to the contrary part to that which is fallen forth They whose joynt is fallen forth after this manner and not reduced when they go they wheel about their Thigh outwardly for whenas the faulty Thigh is made longer and by reason of weakness they cannot readily bend the bone and by reason of pain they refuse to do it it remains that they must bring it about See more of these things in Hippoc. 3. de artic from t. 68. to t. 105. al which for brevities sake I would not transcribe hither Prognosticks 1. There is great danger in the Thigh lest that it be hardly reduced or being reduced that it fall out again Celsus l. 8. c. 20. 2. An old Luxation of the Thigh which hath already contracted a callus and in which the bosom is filled up with humors is judged incurable 3. If by reason of the plenty of the humor collected in the Cavity that Ligament be preternaturally extended that it cause the Thigh to be moved out of its seat or if the same Ligament be so relaxt by the humor that it cannot contain the bone in its seat although the bone be reduced yet it staies not in its place but fals out again viz. if the humor remain but if the humor be dried up the Joynt may remain in its seat of which Hippocrates 6. Aphor. 60. They who being troubled with a long continued pain of the Hip have the head of the Thigh fallen forth of the Hip their Thigh wasteth and becomes lame unless they be burnt 4. The same comes to pass if that Ligament be broken 5. If the luxated Thigh be not reduced the neighboring parts are wasted by degrees for both the Arteries and Veins are streightened and comprest that there is not a free passage open for the blood and spirits to those parts and because the part is not moved after its due manner the heat fadeth whence the nourishment of the part is not rightly accomplisht and the Thigh-bone is not encreased according to the proportion of the rest of the bones The Cure Whereas after the same manner almost as the Shoulder is joyned with the Shoulder-blade so the Thigh is with the Hip-bone so the way of reducing them both is almost the same The Patient must be placed upon a Bench or Table putting a Pillow or Bed under him with his Face downward if the Luxation be made outward or backward with his face upwards if inwards and upon his side if forwards and this reducing is done somtimes only with the Hands without any extension as first of all either let the head of the Thigh be so long wheeled about the Loyns till it come into its Cavity which way notwithstanding is not so safe or secondly to wit in a Luxation made to the inner part let the Thigh most quickly and strongly be bent to the Groyns and by this means let the head of the Thigh fallen forth be forced outward into its place but if no good be done by these waies the Patient must alwaies be so placed that the part into which the head of the Thigh is fallen be uppermost but that from which it is departed lowermost afterwards convenient extension must be made and at length the Thigh must be forced into its Cavity alwaies a way contrary to its falling forth but how a lawfull and convenient extension is to be made either with the hands to wit in soft bodies a new luxation or with Reins Ropes and the like to wi● in strong bodies and an old luxation doth sufficiently appear from those things which are said in the precedent patt c. 11. of the Fracture of the Thigh and truly the extension may be common to the four species of a luxated Thigh but the manner of forcing and restoring the head of the Thigh into its place varies according to the variety of the parts to which it is fallen for that which is fallen inwards must be forced outwards that outwards inwards and so of the rest when the bone is reduced which is known by the free motion of the Thigh and without any pain the Medicines of which we spake formerly in general c. 1. must be laid on the Joynt and with rowling the Joynt must be kep● in its place straw beds also as in Fractures must be applied and both Thighs be kept in its place straw beds also as in fractures must be applied and both Thighs be bound that the luxated Member may be kept in its place and this provision must not be loosed before the fourth day and let the Patient keep himself long enough in bed nor let him walk lest by unseasonable walking the bone fal forth again See more in Hippocrates Paulus Aegineta l. 6. c. 119. Ambrose Parry l. 15. from c. 39. to c. 48. Chap. 10 Of a Luxation of the patel Bone THe Thigh in its lower part hath two eminent heads tending to the hinder part with which it is inserted into two bosoms of the leg-bone only superficial ones and no waies deep and pargetted over with a smooth cartilage it hath moreover in its hinder part a certain bosom into which the bunching forth of the Leg-bone that stands forth betwixt its two bosoms is inserted but lest that by reason of this looser Articulation which is by a Ginglymus the Knee should be subject to frequent Luxations on the fore part the patel bone is set over the bone of the Thigh and Legg and firmly joyned to them by benefit of the thick Tendons of the Muscles extending the Leg besides on the out side of the greater bone stands the Bracer which at its upper part in the inner side hath a bosom covered with a Cartilage by which the little side head is received which subsists at the upper Appendix of the great Bone but at its lower part with its acute angle 't is inserted into the external and oblong bosom of the lower Appendix of the great Bone and makes the outward Ankle whenas therefore here concur many Articulations also many Luxations may happen A Luxation of the Knee-pan And truly first of al The Patel Bone whenas it hath no obstacle on the sides hindering its dislocation may be most easily luxated to the upper lower outward and inner part but never to the hinder part in regard that the bones of the greater Focil and Thigh which it covers do hinder it The Causes The Causes of this Luxation are a fal from on high jumping blows and an undecent distension of the Leg. Signs Diagnostick The Luxation of the Patel Bone is easily known by the sight and touch and the Thigh cannot rightly be

again forced unto some other parts until at length it come unto the weakest which is not able to expel these transmitted humors so that being here left they cause a Tumor For it cannot be that a Tumor should be caused by the matter transmitted and sent from divers places unless we grant as needs we must that there is a part which sends them a part receiving them and the passages by which the humors flow The parts do then transmit when the vigorous faculty by the quality or store of matter is incited to expulsion For unless the faculty were provoked it would never attemp this expulsion and unless it were strong and vigorous it could never effect it And this is likewise much furthered by the external causes exciting the fluxion to wit Heat which attenuates and dissolves the humors and cold that by constriction presseth the parts together and thereby causeth the greater afflux of the said humors Notwithstanding unto these two may be added also a third cause of the defluxion and that is a certain 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 or violent issuing forth of the humor it self as usually it doth appear in persons that have the Dropsie where we find a water through its own weightiness descending into the Feet and Cods which motion notwithstanding is wont to cease in the night time but this would not be if the humor were expelled by Nature and not rather as in truth it is forced down by its own gravity Now as for the humors flowing together from elswhere the parts receiving they are received by such parts as are feeble and through their weakness altogether disposed for the reception of a fluxion For evermore the more vigorous Members send away that which is superfluous unto the weaker The weaker Members we account such as either have contracted a certain debility in their very first formation or being afterward hurt do contract unto themselves a kind of preternatural constitution or else they are such as Nature her self makes and intends for weak and so framed and constituted that they may the more easily receive the excrements of other parts such are the skin and the parts loose and porous For Nature that she might the better preserve the principal and more noble parts from Diseases hath purposely ordained in mans body some certain parts weak and feeble that so the principal parts oppressed and burdened with Humors might into them empty whatever is superfluous and burdensom and these as we have said are the skin and glandulous or kernelly parts And hence it is that the Heart transmits the peccant humors unto the Arm-pits the Brain sends them behind the Ears and the Liver thrusts them forth to the Groyns The parts ready to receive are al those that have any connexion with the part that transmits the humors and which have the passages through which the humors are conveyed alwaies patent and open but as for waies whereby to expel and drive them forth they are either none at al or otherwise such as are exceeding narrow and over streight or else lastly these passages are so scituated that they lie directly under the parts transmitting so that the conveyance of Humors unto them from the abovesaid parts is render'd the more facile and easie As for the waies and passages through which the humors run the passages by which the tumors flow they are either such as lie hid or else such as are open and very manifest For whereas the whol body is confluxile that is to say apt and ready to flow together hence it is that the humors have their fluxion out of one part into another by these occult or hidden passages So the Whey as we may term it being gotten in great abundance into the Abdomen or Cavity of the Belly commonly called the Paunch by these privy Passages descends into the Cods and the Thighs and lifts up the said parts even unto a Tumor or swelling the same which likewise very often happens in other parts Somtimes the humors assembled together betwixt the Skul and skin of the Head descend thence along under the skin into the inferior parts but very seldom and rare it is that from hence any tumors are produced But most an end those humors which excite and raise tumors flow through passages that are patent enough the Veins and Arteries But that we may briefly come to speak of the differences of Tumors arising from Humors the differences of tumors whence they are taken although very many of these differences are accidental yet notwithstanding those by which the tumors proceeding from humors are truly and properly distinguished among themselves are taken from the variety of the containing Cause or the Humor as an efficient cause producing the Tumor Now the Humors are divers Blood Choler Flegm Melancholly black Choler Choler adust and Whey From which likewise various sorts of Tumors are excited and caused And then again one while the humor exciting the tumor is as we use to say simple and sincere from whence also the tumor proceeding therefrom is said to be a pure tumor or assoon again divers humors concur to the making up of one Tumor and from hence the Tumors which we term spurious that is such as are improperly so called take their Original The Signs Diagnostick It is easily known whether the Tumor proceed from the falling down of any part and if this be not the Cause we may then safely conclude that the rise of it is from the afflux of humors unto the part affected But now whether or no the Tumor takes its beginning from congestion or rather from fluxion may by this be discerned to wit that those Tumors which are caused by congestion or the storeing up of humors are a longer while and by degrees arriving at their perfection neither take they up so much room in the part nor lastly was there any the least preceding cause or sign of a defluxion But now if the tumor be generated from a fluxion it wil be discerned by the presence of the contrary signs And certainly if so be there were not in the grieved part any foregoing pain or heat it manifestly shews that the said fluxion is caused by a transmission and not by means of an attraction like as on the other hand a preceding pain or heat of the affected part argues the Tumor to proceed from the attraction of humors For the Signs whereby to discern and understand the times take this advertisement viz. That the beginning of it is then when the part first of al is perceived to be distended and stretch'd forth The increment or growth when as the part appears now to be elevated into an indifferent big swelling and when the Symptoms that accompany al sorts of Tumors are evidently augmented The state or heighth of it is when the swelling and with it together al the symptoms are at their highest pitch The declination is then when both the bulk of the swelling and all the

and I put upon the aforesaid bone Resolutives so that it was for the greatest part resolved and that little remainder thereof was no hinderance at all unto me in the exercise of my natural operations Therefore whensoever thou find the like do as I have said And when thou purgest them do not purge them only with the virtues of Medicines but even with the very proper Medicines themselves And in the number of the better Minerals for the purging of these the Lapis Lazuli is one but without all doubt there is great help to be had from the Load-stone in this case but for my own part I make little or no use of the Load-stone in my practice in regard that the Lapis Lazuli sufficeth me and I commend unto you the operation thereof But yet some there be of the latter Writers that reckon up these Cornua among the Affects of the Head touching which Lanfracus in his Tract 3. Doct. 2. and Chap. 3. thus writeth I have likewise seen saith he manifest eminencies of the Skul like unto Horns For I once saw a man that came unto me for advice that had in his Head seven eminencies one greater than the other and they were in divers places Of which one was as big and acute as the Horn of a Kid a finger long or as long as ones thumb and it much hurt and annoyed the Skin and I admired that the Skin was not exulcerated When therefore I saw that it had its original and root from the head I would by no means be perswaded to undertake the Cure but rather perswaded the sick person that he should put himself into no mans hands in hope of Cure for that it seemed unto me altogether impossible But Johannes Philippus Ingrassias in his first Tract of Tumors and Chap. 1. relateth that he saw at Panormus a certain Noble Virgin a Girl that was afflicted with very many of these crooked excrescencies that were withal sharpened in the top of them like unto Calves Horns almost in al the Limbs and especially in the Joynts of the Hands the Arms and the Knees as also in the Head and the Forehead But yet notwithstanding saith he those Tumors were not bred in the Skin but upon it and that indeed in a certain new order of generation For like as the generation of the stone happeneth in the bladder to wit that one Tunicle as it were coming upon another it encreaseth unto a greatness so in like manner we beheld in them very many as it were boney crusts sticking the one to the other just in such a fashion also as if we should put the half rinds of Filberds one upon another the less still upon the greater that so they may be joyned together in an acute and sharp form and the shape of a Pyramid But these when they were touched about the basis and bottom of them were extreamly painful and they stuck so fast in and were of such an extraordinary hardness that no Physitian being able by any kind of Remedies whatsoever to yield the Patient any help or relief her kinred at the length after that the Disease and the growth of these Cornua had for many yeers continued came unto me For they were continually augmented both in their bigness and divers other new ones budding forth in their number also whom by the gracious assistance of Almighty God we recovered unto her former health and soundness and also unto her former beauty and comely feature Who notwithstanding was become so deformed and mis shapen that she was now become more like an ugly Monster and frightful Devil than to any Woman kind insomuch that her Parents much rather desired her death than her life Julius Caesar Scaliger in his 199. Exercitat Sect. 5. writeth That for the growing of these Cornua upon men and women making them like unto Monsters rather than unto what indeed they are although he was told thereof by Prince Aboalis and by that person of note Abumeron yet notwithstanding their great Authority and credit he could not beleeve a thing so strange until he himself saw one of them on the back of a certain Rower that had been for a long time in the Triremis a long Boat with three Oars so called of the Ligurians Alexander Benedictus in the first Book of his Anatomy and 14. Chap. telleth us that in Crete he saw a black horn most like unto the head of a wild G●ar growing forth in a mans Knee that was wounded by an Arrow and that the matter that ought to have been converted into the substance of a bone was easily by the blowing in of the Air turned into an horney Nature and soon got unto it self an hardness after the manner of Gums And Fallopius in his Book of the similar parts Chap. 7. writeth That somtimes likewise in whol bones as wel as in fractures there may be somthing bred like unto a horn and that this same horn may grow forth without the flesh and the skin and that he himself saw this at Padua in the thigh of a certain noble man out of whose thigh there grew forth as it were a little long stake or post Zacutus in his second Book of the Administration of Practical Physick Zacutus his observation touching Cornu bred in the heel Observ 188. relateth that a certain poor man naturally melancholick long complained of a pain he had in the heel of his right foot and that he there felt a certain hardness that afterward grew forth into a Tumor of the bigness of a smal Chesnut hard rough and leaden colored which in eight months time so encreased that it was become an hand breadth long and resembled a true horn Which after it had been cut off by the advice of Physitians no symptoms following thereupon and the body purged twice every yeer he lived for two yeers in sound and perfect health But after this he suddenly grew sensible of extream and intollerable pain in the very same place and in six months the Cornu grew forth again hard and encompassed about with most sharp pricks and was in length at least one hand breadth and an half The which being again cut in the very bottom thereof there was left a little hollow place out of which there flowed forth great store of a black stinking humor of so corroding a nature that it soon eat through the flesh neer unto it We then indeed purged his body with Medicaments that were fit and proper for the evacuation of the melancholy humor and there were likewise Sudorificks of the China Root administred but al to no purpose And therefore to intercept the flux there were several Issues made one in the Leg that was sound four fingers below the Knee in the external part another in the Leg affected eight fingers above the Knee or else in the Thigh in the inside thereof He was every month purged and so by this means the Cornu was hindered from growing again any more and the

the sharp points of the broken bones that prick as if they were Thorns or Goads Prognosticks 1. The process of the Vertebrae is easily of it self consolidated unless some other evil happen to follow in regard that the bones are Spungy and thin 2. Otherwise this Fracture is for the most part Mortal by reason of the hurting of the spinal Marrow and the Membranes and the Nerves and especially if the Fracture happen neer about the Vertebrae of the Neck 3. And if there happen a Fracture in the Vertebrae of the Neck there followeth a Palsey of the Arms and Hands but if the Fracture chance in the inferior part then there followeth a Palsey of the Thighs Legs and Feet and this is deadly but if the motion and sense be not altogether abolished there is yet some smal Hopes left of recovery 4. If in the Fracture of the Vertebrae there shall appear any voluntary Egestion of the Excrements and that there happen a suppression of the Urine it is a very desperate and deadly Sign The Cure Although there be here but little ground for Hope yet nevertheless that the sick person may not be wholly left in a helpless condition the broken Apophyses of the Back-bone are again to be put back into their own places if they be not altogether broken off and Medicaments are to be imposed that may moderate the pain prevent an Inflammation and further the Conglutination of the bones and such medicaments as these have already been very frequently mentioned But if the process be wholly broken off from the Periostium the Skin is then by an incision to be opened and the piece of bone to be drawn forth and the Wound afterward in a due and convenient manner to be healed And this is likewise to be done if the fragments or broken pieces of the other Vertebrae press together and prick the spinal Marrow and the Nerves thereof for otherwise the life may be much endangered Unto the Fractures of the Spina there belongeth also the Fracture of the Os Sacrum The Fractu●e of the holy bone and the Crupper and the Crupper-bone which if they shal be so broken and bruised that thereupon the Spinal Marrow be hurt the Malady then is very dangerous if not altogether deadly But if there be any the least hope left the Finger being put up into the Arse even unto the broken place the bone that is broken is to be driven forth but outwardly by the other Hand or else by the help of some assistant the bones are to be made equal and even and so to be put back into their own places again and afterwards Medicaments convenient for the Fracture are to be applied and laid on Chap. 19. Of the Fracture of the Bones of the Hand THe Bones of the Hand which are divided into the bones of the Wrist upper part of the Hand and the Fingers are likewise somtimes broken Signs Diagnostick The Fracture in these bones is easily known both by the sight and touch in regard that these bones when they are broken do for the most part decline either unto the exteriour or the interior parts Prognostick These Bones without any great ado and indeed within twenty daies do perfectly grow together again and so are healed The Cure Let the sick person stretch forth the Hand that is hurt upon an even and smooth Table and then let the Chirurgeons assistant stretch forth the broken bones but let the Chirurgeon himself restore with his Hand the bones into their places again When the bones are well set together then some Medicament such as is wont to be administred in Fractures is to be imposed and then afterward the part is to be wrapt about with a Swathe And indeed if the Fingers chance to be broken they are to be tied fast unto those sound Fingers that are next that so by them as it were by Splinters fastened on they may be kept unmoved in their places And then at length the hollow of the Hand is to be filled up with a bottom or ball of Linen rowled up together For so by this means the bones when they are set are the more easily kept in their places and the Fingers preserved in a middle Figure But if either in the extending or contracting the Fingers there be any Callus generated the Office of the Hand in laying hold on any thing is much hurt And let the Hand also with the Arm hung in a fit Scarf or Swathe from the Neck be kept in rest and quietness Chap. 20. Of the Fracture of the Hip-bone THe Hip bone consisteth of three bones of which the First is the Ilium the Second the Ischion bone and the Third the share bone which in Infants may even be separated but yet nevertheless in persons of ripe Age they grow so fast together that they can very hardly be parted assunder But now these bones may be broken like as those of the Shoulder-blade either in their Extremityes or long waies or in the middle Signs Diagnostick This Fracture is easily known by the pain which is more especially exasperated by the touch and compression by the Cavity and unevenness and also by the pricking and benummedness in the Leg of the same side Prognostick These Bones are consolidated in the space of twenty four daies The Cure The broken bones are with all possible speed and diligence to be set together and to be restored into their own places and then afterward fit and proper Medicaments are to be laid on But if any fragment of the bone be broken off and by pricking excite pain and that there be any fear of an Inflammation there are some who perswade us that even at the very first dressing an incision is to be made in the Skin and the broken piece of bone forthwith taken out But whereas it is very seldom that these fragments lie hid under the Skin alone but even under the very Muscles themselves such a like Section as they advise us unto may not be instituted without much danger And he that will needs attempt it let him be very cautious lest that he hurt the Heads of the Muscles or some one of the principal Vessels or that greater Nerve which is stretched forth into the Muscles of the Thigh and Leg. Chap. 21. Of the Fracture of the Whirl-Bone in the Knee ANd somtimes likewise even the Whirl-bone it self is broken and this happeneth somtimes in the length of it in respect of the whole Thigh somtimes in a transverse and somtimes in an oblique manner and somtimes it is broken into two parts and somtimes into very many pieces and somtimes again this Fracture is with a Wound and very often without Signs Diagnostick The Fracture of this bone is easily discovered by the distance of the broken bones appearing by the touch by the Patients weakness and inability in going by the Cavity that is perceived in the place where the Fracture is both by the sight and by the touch and by the

bosom of the head of the Thigh to the end that the Thigh might by so much the easier and more readily be bowed extended moved to the sides and turned about and not easily slip forth The Causes The Causes of a perfect Luxation of the Thigh are the same as of the Luxation of the Shoulder to wit external and violent a fal a blow or some other violent and indecent extension and distorsion of the Thigh but the causes of an imperfect Luxation are the humors flowing to this joynt and by degrees thrusting it out of its seat The Differences But this joynt fals forth to four parts the former hinder but seldom whenas the brow of the Cavity in this part is higher to the outer and inward part most often whenas at that place the brow is lower and somtimes the Thigh admits of a Subluxation from an internal cause whence when Paulus Aegineta lib. 6. de remed c. 118. writes that the Articulation of the Hip doth only suffer a Luxation and not a Subluxation that is to be understood of that only which is from an external and violent cause for we see oftentimes that by a flux of humors some have the Ligaments in the Thigh relaxt and mollefied that they cannot retain the head of the Thigh-bone firmly in its Cavity whence follows a certain Subluxation Signs Diagnostick the Diagnostick signs of a thigh luxated to the fore part If the Thigh be luxated to the fore part a Tumor appears about the Groins whenas the head of the Thigh leans to the Pubes the Buttocks on the contrary by reason of the Muscles contracted with the Thigh to the Pubes seem wrinkled the Urine is supprest by reason of the compression of the bladder by the head of the Thigh the external Thigh can neither be bent nor brought to the Groin whenas the head of the Thigh is in the very bending place the man is also in pain if he be forced to bend his Knee by reason of the former Muscle which ariseth from the bone which belongeth to the Loyns for that is comprest and being retcht is lift up by the head of the Thigh and whenas it can be no further extended it resists otherwise it equals in length the whol sound Thigh to the Heel for the Thigh going forth of its Cavity comes to the fore part and a little lower by which it comes to pass that the Thigh hurt equals the length of the sound one which especially fals out so at the Heel the Toes of the Foot cannot easily be extended nor turned to the ground whence in walking the Patient is compelled to tread only on the Heel But in them who at strong age have this joynt fallen forth into this part and not restored they when the pain ceaseth and the joynt is accustomed to be contained in that place into which it is fallen can forthwith go upright without a staff and wholly upright for by reason of the inflexibility of the Groyn they use the whol Thigh more straight in going than when it was sound somtimes also they draw their foot upon the ground whenas they cannot easily bend the upper iunctures which are at the Groyn and Knee although they walk upon the whol foot but in those at whose render age this joynt fallen forth is not restored their Thigh-bone is more diminished than that of the Leg or Foot but the Thigh is little diminished only the flesh every where is abated especially at the hinder part to the hinder part If the Thigh-bone be luxated to the hinder part there are contrary signs to those mentioned to wit The Head of the Thigh being fallen to the Buttocks is discovered by a Tumor about those parts both by the sight and touch the Groyns on the contrary appear more loose the affected Thigh by reason of the compression and distension of the Muscles compassing the head of the Thigh cannot be extended and 't is rendered shorter than the sound one the heel doth not touch the ground whence the Patients can neither stand nor go but fal headlong backwards because the body slides to that part and the head of the Thigh being out of its proper place is not directly opposed to under-prop the body yet the man may bend his Thigh if he be not hindered by pain for whenas the head of the Thighs is by force with its whol neck expelled into the great Muscle of the Buttocks which extends this Articulation this Muscle admitting the head of the Thigh fallen forth is most of al tormented whenas 't is distended and prest under it and of necessity must be seized on by an Inflammation but in process of time when this Muscle is freed from an Inflammation and contracts a certain glutinous humor that part of it which toucheth the joynt grows to a Callus and the Knee is bent without any pain moreover the head of the Thigh being luxated to the hinder part the Thigh and Foot appear moderately straight and do not incline much one way nor other But when in ripe age the Thigh-bone fallen forth is not restored when the pain is ceased and the joynt accustomed to be turned in the flesh the man indeed may walk yet he is forced to bow very much towards the Groyn when he walks and that for two reasons Because the Thigh is rendered much shorter and the heel is far off from touching the ground for if he try never so much to stand on that foot leaning upon no other thing he wil every where fal backwards but if in tender age this joynt luxated after this manner be not reduced the Thigh-bone is made short and the whol Thigh is spoiled and is less increased and made slenderer being for no use To the outer If the Thigh be luxated to the outer part it is known by these signs Between the Anus and Cod there is seen a Cavity and leanness on the contrary in the buttocks a certain Tumor the Thigh by how much the head of it is fallen forth to a higher place is rendered shorter the Knee with the Leg looks inwards the Heel toucheth not the ground whence when the Patient would walk he goes only a tiptoes And if in those of ripe age this Joynt be not restored but the flesh into which the Joynt is fallen grows callous and the pain therefore ceaseth they may go without a Staff and therefore when they use their Thigh in these the flesh is less offended but they to whom in tender age this misfortune happens require a diligent care for if they be neglected the whole Thigh becomes unprofitable and is little increased the flesh also of the whole Thigh is more abated then in the sound one Lastly a Luxation of the Thigh to the inner part is known this way to the inner the Thigh is longer if it be compared with the other and that for two reasons for the head of the Thigh sticks to the bone which proceeds from the Hip upwards