On Fractures   

and are new healed, they endeavor to bind up the limb with plenty
of bandages, and keep it straight with treatment does some good, and
never much harm. The bones, however, can never be equally well restored
to their place, but the part is a little more swelled than it should
be; and the limb will be somewhat shortened, provided both bones either
of the leg or fore-arm have been fractured.


PART 25
There are others who treat such cases at first with bandages, applying
them on both sides of the seat of the injury, but omit them there,
and leave the wound uncovered, and afterward they apply to the wound
some cleansing medicine, and complete the dressing with compresses
dipped in wine and greasy wool. This plan of treatment is bad, and
it is clear that those who adopt this mode of practice are guilty
of great mistakes in other cases of fracture as well as these. For
it is a most important consideration to know in what manner the head
of the bandage should be placed and at what part the greatest pressure
should be, and what benefits would result from applying the end of
the bandage and the pressure at the proper place, and what mischiefs
would result from applying the head of the bandage and the pressure
otherwise than at the proper place. Wherefore it has been stated in
the preceding part of the work what are the results of either; and
the practice of medicine bears witness to the truth of it, for in
a person thus bandaged, a swelling must necessarily arise on the wound.
For, if even a sound piece of skin were bandaged on either side, and
a part were left in the middle, the part thus left unbandaged would
become most swelled, and would assume a bad color; how then could
it be that a wound would not suffer in like manner? The wound then
must necessarily become discolored and its lips everted, the discharge
will be ichorous and without pus, and the bones, which should not
have got into a state of necrosis, exfoliate; and the wound gets into
a throbbing and inflamed condition. And they are obliged to apply
a cataplasm on account of the swelling, but this is an unsuitable
application to parts which are bandaged on both sides, for a useless
load is added to the throbbing which formerly existed in it. At last
they loose the bandages when matters get very serious, and conduct
the rest of the treatment without bandaging; and notwithstanding,
if they meet with another case of the same description, they treat
it in the same manner, for they do not think that the application
of the bandages on both sides, and the exposure of the wound are the
cause of what happened, but some other untoward circumstance. Wherefore
I would not have written so much on this subject, if I had not well
known that this mode of bandaging is unsuitable, and yet that many
conduct the treatment in this way, whose mistake it is of vital importance
to correct, while what is here said is a proof, that what was formerly
written as to the circumstances under which bandages should be tightly
applied to fractures or otherwise has been correctly written.


PART 26
As a general rule it may be said, that in those cases in which a separation
of bone is not expected, the same treatment should be applied as when
the fractures are not complicated with an external wound; for the
extension, adjustment of the bones, and the bandaging, are to be conducted
in the same manner. To the wound itself a cerate mixed with pitch
is to be applied, a thin folded compress is to be bound upon it, and
the parts around are to be anointed with white cerate. The cloths
for bandages and the other things should be torn broader than in cases
in which there is no wound, and the first turn of the bandage should
be a good deal broader than the wound. For a narrower bandage than
the wound binds the wound like a girdle, which is not proper, or the
first turn should comprehend the whole wound, and the bandaging should
extend beyond it on both sides. The bandage then should be put on