The apparatus used by the Greeks and Romans in the setting of fractures and the reduction of dislocations

by John Stewart Milne

Fig. 19A. Anterior and posterior views of the machine of Fabrus. (After Vidius.) Between them is an ambè which has at its axillary end a bolt to fit into the top cross-bar of the machine.

The power varies only with the ratio of the diameter of the axle to length of crank. The pulleys do not multiply power.

The Ambè. We have seen that in using the scamnum ([Fig. 19]) for the reduction of dislocation inwards of the thigh, Paulus Ægineta, (also Hippocrates, from whom Paul is copying), recommends us to fix a piece of board along the inside of the thigh and leg, to assist in levering the head of the bone into position. A board applied in this way was also used in reducing the dislocations of the shoulder, either by levering the board over the back of a chair or the lower half of a door, or by using it in conjunction with some specially constructed machine, such as that of Fabrus, with which we shall meet presently.

A board especially prepared for this purpose had a rounded enlargement on its extremity, to assist in pushing the head of the humerus outwards.

The name of this enlargement (ἄμβη) gradually became transferred to the whole instrument. The “ambè” was well known in England till well into the last century.

The time of its disappearance in England may be fixed by a passage in Adams’ edition of Hippocrates (vol. ii, p. 575) where he says: “Of late years the ambè has fallen completely into disuse, and none of the various modifications of it are to be seen except in the cabinets of the curious.” (This was in 1849.)

Scultetus shows us an ambè mounted in a specially prepared upright for use in the surgery ([Fig. 19]).

The ambè is thus described by Hippocrates:

“We must get a piece of wood five, or at least four, inches broad, two inches in thickness, or thinner, and two cubits in length, or a little less, and its extremity should be rounded, and made very narrow and very slender there, and it should have a slightly projecting edge (ἄμβη) on its round extremity—not on the part that is to meet the chest, but the head of the humerus.