CHAP. XXV. OF LUXATIONS ATTENDED WITH A WOUND.
These are the methods to be taken, when the bones have been displaced without a wound; but they are often dislocated, and the part wounded at the same time; and here the danger is great, and so much the greater, as the limb is larger, and the ligaments, or muscles that hold it, stronger; and therefore, from the arm and thigh bones there is danger of death: and if the bones are reduced, there is no hope; and yet when they are not replaced, there is also some danger. In both, the event is the more to be feared, the nearer the wound is to the articulation. For Hippocrates has asserted, that no bone could in this case be safely reduced, except the fingers and toes, and the bones of the feet and hands; and that even here great caution must be used, lest it suddenly destroy the patient. Some have reduced both arms and legs; and to prevent gangrenes and convulsions (which in such cases often terminate in speedy death) they let blood from the arm. But not even a finger (where, as the malady, so also the danger is least) ought to be reduced, either while there is an inflammation, or afterwards, when the bones have continued long luxated. And farther, if after the reduction of the bone, convulsions come on, it must be immediately put out again.
Now every member that is at once wounded and dislocated, and continues unreduced, ought to lie in the posture easiest to the patient; provided it neither be moved nor hang down. In every case of this kind the cure is much promoted by long fasting; and then the use of those methods prescribed before. In fractured bones, where there is a wound, if the naked bone project, it will always prevent its healing; therefore, the prominent part must be cut away, and dry lint applied, and medicines not greasy; till the greatest degree of soundness attainable in such a case be restored; for it both leaves a weakness behind it, and the part is covered with a thin cicatrix, which must of necessity be ever after greatly exposed to injuries.