An introduction to surgery

1575. Original in Latin, later translated into French and English

Paré, Ambroise

Royal Surgeon, Hôtel Dieu, Paris

Reference for date of publication of collected works: page 208 of Ambroise Paré and his times, 1510-1590, by Paget, Stephen, 1855-1926. Published 1897, Publisher New York, London, G.P. Putnam's sons

Translation into French, published 1614

The quotes below are taken from the translation into English by Thomas Johnson, published 1649 (spelling moderninsed)

Book 15: Fractures; Chapter 15: Fracture of the rump

The rump is composed of four bones, the first whereof hath a cavity, wherein it receives the lowest vertebra of the holy-bone [sacrum]; the other three are joined together by symphysis or coalition, and at the end of these hangs a certain small gristle.

The fracture of these bones shall be cured by putting your finger into the patient's fundament, and so thrusting it even to the fractured place. For, thus you may thrust the fragment forth, and fit and restore it to the rest of the bones by your other hand lying on the back. But that it may be sooner healed, it is fit for the patient to keep his bed, during all the time of the cure. But if there be a necessity to rise, he shall so sit in a perforated seat, that there may be nothing which may press the broken part, and fitting remedies for healing fractures shall be applied as occasion shall offer itself.

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Book 16: Dislocations; Chapter 19: Dislocation of the rump

The rump is oft-times after a sort dislocated inwards by a violent fall upon the buttocks, or a great blow; in this affect the patient cannot bring his heel to buttocks, neither, unless with much force, bend the knee. Going to stool is painful to him, neither can he sit unless in a hollow chair.

That this (as it were) dislocation may be restored, you must thrust your finger in by the fundament, even to the place affected, as we have said in a fracture; then must you strongly raise up the bone, and with your other hand at the same time join it rightly on the outside with the neighbouring parts. Lastly, it must be strengthened with the formerly mentioned remedies, and kept in its place. Now it will be recovered about the twentieth day after it is set. During all which time the patient must not sit, unless sitting upon a hollow seat, lest the bone, as yet scarce well recovered, should fall again out of its place.

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Book 24: Concerning the generation of man; Chapter 13: With what travail the child is brought into the world

[...] in many unto whom I have been called, being in great extremity of difficult and hard travail, I have not only heard, but also felt the bones to crackle and make a noise, when I laid my hand upon the coccyx or rump, by the violence of the distension. Also honest matrons have declared unto me that they themselves, a few days before the birth, have felt and heard the noise of those bones separating themselves one from another with great pain. Also a long time after the birth many do feel great pain and ache about the region of the coccyx and os sacrum, so that when nature is notable to repair the dissolved continuity of the bones of Ilium, they are constrained to halt all the days of their life after.

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Paré listed 173 authors he consulted in preparing his work on surgery, including Paulus Aegineta and Albucasis, who describe this method of treatment of coccyx injury.

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