25bc-50Celsus

Fragment from the treatise Celsus AC On Medicine (De Medicina, ca. 25-30). The author recommends specific treatment for the traumatic pathology of ligamentum capitis femoris (LCF). See our commentary at the link: 25bc-50Celsus [Rus], and 2020ArkhipovSV_ProlyginaIV.

Quote.

[Lat]

Liber octavus. Cp. XX. De Femore luxato.

Magnum autem femori periculum est, ne vel difficulter reponatur, vel repositum rursus excidat. Quidam semper iterum excidere contendunt: sed Hippocrates, et Diocles, et Philotimus, et Nileus, et Heraclides Tarentinus, clari admodum auctores, ex toto se restituisse memoriae prodiderunt. Neque tot genera machinamentorum quoque, ad extendendum in hoc casu femur, Hippocrates, Andreas, Nileus, Nymphodorus, Protarchus, Heraclides, faber quoque quidam reperissent, si id frustra esset. Sed ut haec falsa opinio est; sic illud verum est: cum ibi valentissimi nervi musculique sint, si suum robur habent, vix admittere; si non habent, postea non continere.

Tentandum igitur est, et, si tenerius membrum est, satis est habenam alteram ab inguine, aiteram a genu intendi: si validius, melius adducent, qui easdem habenas ad valida bacula deligarint; cumque eorum fustium imas partes oppositae morae objecerint, superiores ad se utraque manu traxernt. Etiamnum valentius intenditur membrum super scamnum, cui ab utraque parte axes sunt, ad quos habenae illae deligantur: qui, ut in torcularibus, conversi, rumpere quoque, si quis perseveraverit, non solum extendere, nervos et musculos possunt.

Collocandus autem homo super id scamnum est, aut pronus, aut supinus, aut in latus, sic, ut semper ea pars superior sit, in quam os prolapsum est; ea etiam inferior, a qua recessit. Nervis extentis, si in priorem partem os venit, rotundum aliquid super inguen ponendum; subitoque super id genu adducendum est eodem modo, eademque de causa, qua idem in brachio fit; protinusque, si complicari femur potest, intus est.

In ceteris vero casibus, ubi ossa per vim paulum inter se recesserunt, medicus debet id, quod eminet, retro cogere; minister contra coxam propellere. Reposito osse, nihil novi aliud curatio requirit, quam ut diutius is in lecto detineatur; ne, si motum adhuc nervis laxioribus femur fuerit, rursus erumpat. (original source: 1831CelsusAC, Vol. 2, pp. 442-444) + Potest tamen conditus articulus medius aut summus canaliculo, aliquo contineri. (original source: 1713CelsusAC, p. 555)

Translation

[Eng]

Book VIII. Chap. XX. Luxation of the Femur.

But the greatest danger is, in a luxation of the femur, lest there be a difficulty in replacing it, or, when reduced, it may slip out again. Some maintain that it always does so, but Hippocrates, Diocles, Philotinus, Nileus, and Heraclides the Tarentine, all very celebrated authors, have asserted that they have effected a perfect cure. Neither would Hippocrates, Andreas, Nileus, Nymphodorus, Protarcchus, Heraclides, and also a certain mechanician, have invented so many kinds of machines for extending the femur in this case, if it had been to no purpose. But as this opinion is false, so is the other true; since the ligaments and muscles there being very powerful, scarcely admit of reduction, if they retain their natural strength: if they do not, the femur cannot be maintained in its place, after it has been veduced.

Therefore it must be tried, and if the limb be tender, it will be sufficient for one strap to be extended from the groin, and another from the knee; if the person be muscular, the extension will be made better, by attaching these Straps to strong sticks, placing the lower end of these sticks against a fulcrum, and pulling the upper ends with both hands. The extension of the limb may be still more powerfully effected by placing it on a bench, with pulleys at each end, to which these straps are made fast; these being turned in the manner of a wine-press, they will not only extend the limb, but even rupture the ligaments and muscles, should the operator persevere.

Now the patient is to be placed on this bench, either prone or supine, or upon his side, provided that the part to which the bone has been impelled be always uppermost, and that from which it has slipped, the lowermost. The ligaments being put upon the stretch, if the bone be dislocated anteriorly, some rounded body is to be placed upon the groin, and the knee is to be drawn suddenly towards the abdomen in the same way, and for the same reason, that is directed for a luxation of the arm; and if the femur can be flexed, it will be immediately reduced.

But in the other accidents, where the bones have receded a little from each other by violence, the physician ought to force that back which projects, and an assistant should impel the pelvis in a contrary direction. The bone being replaced, the subsequent treatment requires nothing additional, except that the patient be detained in bed for a longer period, lest the femur being moved whilst the ligaments are yet very relaxed, it may again slip out. (original source: 1831CelsusAC, Vol. 2, pp. 442-444) + However, the reduced joint can be fixed with a medium or deep groove. (our translation of the final sentence of the paragraph from 1713CelsusAC, p. 555)

External links

Celsus AC. De medicina libri octo. Brevioribus Rob. Constntini, IS. Casauboni Aliorum que Scholiis ac locis parallelis illustrati. Cura c Studio TH. J. ae ALMELOVEEN… Amstelædami: Apud J. Wolters, 1713. [archive.org]

Celsus AC. On medicine, in eight books, Latin and English. Translated from L. Targa's edition, the words of the text being arranged in the order of construction. To which are prefixed, a life of the author, tables of weights and measures, with explanatory notes, etc. designed to facilitate the progress of medical students. By Alex. Lee, A.M., Surg. In two volumes. London: E. Cox, MDCCCXXXI [1831]. [archive.org1 , archive.org2]

Authors & Affiliations

Aulus Cornelius Celsus (ca. 25 BC – ca. 50) was a Roman encyclopaedist. [wikipedia.org]

Aulus Cornelius Celsus
Engraving from Acta Medicorum Berolinensium, in Incrementum Artis & Scientiarum collecta & digesta. Volume IV. Berlin: Gottfried Gedicke, 1719;
original in the wikimedia.org collection (CC0 – public domain, no changed).

Keywords

ligamentum capitis femoris, ligamentum teres, ligament of head of femur, synonym, dislocation, treatment, pathology, damage, Celsus

NB! Fair practice / use: copied for the purposes of criticism, review, comment, research and private study in accordance with Copyright Laws of the US: 17 U.S.C. §107; Copyright Law of the EU: Dir. 2001/29/EC, art.5/3a,d; Copyright Law of the RU: ГК РФ ст.1274/1.1-2,7

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1996ChenHH_LeeMC

Abstract of the article Chen HH, Li AF, Li KC, Wu JJ, Chen TS, Lee MC. Adaptations of ligamentum teres in ischemic necrosis of human femoral head (1996). The authors investigate the strength of the ligamentum capitis femoris (LCF) in avascular necrosis and femoral neck fracture. The text in Russian is available at the following link: 1996ChenHH_LeeMC . Annotation Little is known about the biomechanical properties of human ligamentum teres. To more fully understand the ligamentum teres, its dimensions and mechanical properties were measured in 22 cases of acute fracture of the femoral neck and 21 cases of ischemic necrosis of the femoral head. The specimens first were preconditioned and then loaded to failure with a testing machine at a fast strain rate of 100% s(-1). The ischemic necrosis group had a significantly larger volume (3.09 +/- 1.81 ml versus 1.30 +/- 0.62 ml) and cross section area (65.3 +/- 59.1 mm2 versus 30.6 +/- 27.2 mm2) than did the acute f...

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