[p. 218]
Part 11
It deserves to be known how a shoulder which is subject to frequent
dislocations should be treated. For many persons owing to this accident
have been obliged to abandon gymnastic exercises, though otherwise
well qualified for them; and from the same misfortune have become
inept in warlike practices, and have thus perished. And this subject
deserves to be noticed, because I have never known any physician treat
the case properly; some abandon the attempt altogether, and others
hold opinions and practice the very what is proper. For physicians
have burned the shoulders subject to dislocation, at the top of the
shoulder, at the anterior part where the head of the humerus protrudes,
and a little behind the top of the shoulder; these burnings, if the
dislocation of the arm were upward, or forward, or backward, would
have been properly performed; but now, when the dislocation is downward,
they rather promote than prevent dislocations, for they shut out the
head of the humerus from the free space above. The cautery should
be applied thus: taking hold with the hands of the skin at the armpit,
it is to be drawn into the line, in which the head of the humerus
is dislocated; and then the skin thus drawn aside is to be burnt to
the opposite side. The burnings should be performed with irons, which
are not thick nor much rounded, but of an oblong form (for thus they
pass the more readily through), and they are to be pushed forward
with the hand; the cauteries should be red-hot, that they may pass
through as quickly as possible; for such as are thick pass through
slowly, and occasion eschars of a greater breadth than convenient,
and there is danger that the cicatrices may break into one another;
which, although nothing very bad, is most unseemly, or awkward. When
you have burnt through, it will be sufficient, in most cases, to make
eschars only in the lower part; but if there is no danger of the ulcers
passing into one another, and there is a considerable piece of skin
between them, a thin spatula is to be pushed through these holes which
have been burned, while, at the same time, the skin is stretched,
for otherwise the instrument could not pass through; but when you
have passed it through you must let go the skin, and then between
the two eschars you should form another eschar with a
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