Haly Abbas directs us to introduce the hand well lubricated with oil of violets, or the like, into the uterus, and extract the placenta if it be separated; but if it still adhere it is to be moved from side to side, and not pulled straight downwards. He adds, that when not extracted, it becomes putrid. (Pract. ix, 59.)
Rhases directs us when the secundines do not come away after delivery to make the woman sneeze, and if they are still retained, to pare the nails, and having introduced the hand into the uterus to pull cautiously so as not to give pain. When they cannot be removed in this way, he recommends us to throw injections into the womb so as to promote putrefaction of the placenta. In another place he mentions, that when long retained, the placenta putrefies and comes off in pieces. (Cont. xxii.)
SECT. LXXVI.—ON BURNING THE HIPS.
As in the case of the shoulder, so also the hip-joint getting dislocated from a collection of humours requires burning. Wherefore Hippocrates says: “When dislocation at the hip-joint takes place from long-continued ischiatic disease, the leg wastes, and the patients are lame unless burnt.” Burning, therefore, is to be performed more particularly at the place where the joint is dislocated, for thus the redundant humour will be dried up, and the part being condensed by the cicatrix will no longer be able to receive the bone, wherefore the burning should be carried to a considerable depth. The moderns form three eschars by burning; one behind in the hollow of the buttocks, another a little above the knee on the outside, and a third on the outside of the ankle in the fleshy part.
Commentary. Hippocrates recommends us to burn the parts over the hip-joint with crude flax. (De Affectionibus.) The author of another of the Hippocratic treatises directs us to burn the bony parts with fungi and the flesh with a red-hot iron. (De Affect. Int.)
Aëtius, upon the authority of Archigenes, recommends burning in this case with irons, the roots of fuller’s herb and birthwort, or with goat’s dung. (xii, 3.)
Cælius Aurelianus, in cases of ischiatic disease, speaks of forming issues over the hip-joint by the actual and potential cauteries. His potential cauteries, with which he mentions that eschars were burnt, appear to have been the ashes of herbs, that is to say, impure preparations of the caustic alkali, to which quicklime was sometimes added. They must, therefore, have been nearly the same as the calx cum kali of modern use. He states, that some burned the part with the root of fuller’s herb; others with pieces of iron shaped like the letter Γ; that some raised the skin in a fold and transfixed it with heated irons; that some burned it with fungi, and others with a piece of linen cloth folded and laid on the part. (Pass. Tard. v, 1.)
But the fullest account which we have of the ancient modes of burning the hips for diseases of the joint is that which is given in the book ‘Euporistôn,’ ascribed to Dioscorides. Mention is there made of the methods of burning with goat’s dung, and with wool smeared with oil. Some, it is said, form a ball of clay, and, having laid it on the place, apply to it a burning staff as long as it can be borne. Others, having stretched the skin over the affected joint, transfix it with a heated style or writing pen. The Libyans performed the operation with shavings of the lote tree, sulphur, and elaterium. The Marmaridæ are said to have done it with green pieces of the wood of olive trees. The Parthians used a leaden tube, the extremity of which they smeared with dough, in order to prevent the oil in the inside from escaping; then hot cauteries, to the number of forty or fifty, were introduced, and the burning continued as long as it could be well endured. Care in the meantime was taken to cool the face with cold water; and it was attended to, that the tube was not over-filled with oil, lest it should run over. (Euporist. i, 242.)
Albucasis describes minutely the process of burning with red-hot irons. (Chirurg. i, 43.) Haly Abbas in like manner directs us to burn an eschar over the joint, and to keep it open for a considerable time. (Pract. ix, 81.)
Asclepiades (apud Nicetæ Collect.) mentions that he had seen two cases in which dislocation had taken place at the hip-joint without any accident. The editor of this work, Anthony Cocchi, states that he had met with only one such case in the whole course of his practice. We need scarcely remark that such cases, however, are by no means of rare occurrence.