number of bandages should be increased; and the patient, if asked,
should answer, that he feels the bandages somewhat tighter than on
the former occasion, especially about the fracture, and everything
else in proportion; and with respect to the swelling, the pain, and
recovery, everything should proceed as after the former dressing.
But on the third day the outer bandaging should appear looser. Then
having removed the bandages, you should bind it up again, somewhat
tighter than before, and with all the bandages which will be required
on the occasion, and afterwards one ought to experience the same train
of symptoms as at the former periods of bandaging.
PART 6
When the third day arrives, that is to say, the seventh from the first
dressing, if properly done, the swelling in the hand should be not
very great; and the part which has been bandaged should be found more
slender and less swelled at each time, and on the seventh day the
swelling should be quite gone, and the broken bones should be more
readily moved, and admit of being easily adjusted. And if these things
be so, you should, after setting the fracture, apply the bandages
so as to suit the splints, and a little more tight than formerly,
unless there be more pain from the swelling in the hand. When you
have applied the bandages, you must adjust the splints all around
the limb, and secure them secure them with strings so loose as just
to keep them in their place, without the application of the splints
contributing at all to the compression of the arm. After this the
pain and recovery should proceed as in the preceding periods of the
bandaging. But if, on the third day, the patient say that the bandaging
is loose, you must then fasten the splints, especially at the fracture,
but also elsewhere, wherever the bandaging is rather loose than tight.
The splint should be thickest where the fracture protrudes, but it
should not be much more so than elsewhere. Particular attention should
be paid to the line of the arm corresponding to the thumb, so that
no splint be laid on it, but upon each side of it, nor in the line
of the little finger where the bone is prominent at the wrist, but
on each side of it. And if it be found necessary that splints should
be applied in these directions at the seat of the fracture, they should
be made shorter than the others, so as that they may not reach the
bones which are prominent at the wrist, for otherwise there is danger
of ulceration, and of the tendons being laid bare. The splints should
be adjusted anew every third day, in a very gentle manner, always
keeping in mind that the object of the splints is to maintain the
lower bandages in their place, and that they are not needed in order
to contribute to the compression.
PART 7
If, then, you see that the bones are properly adjusted by the first
dressings, and that there is no troublesome pruritus in the part,
nor any reason to suspect ulceration, you may allow the arm to remain
bandaged in the splints until after the lapse of more than twenty
days. The bones of the fore-arm generally get consolidated in thirty
days altogether; but there is nothing precise in this matter, for
one constitution differs from another, and one period of life from
another. When you remove the bandages, you must pour hot water on
the arm and bind it up again, but somewhat slacker, and with fewer
bandages than formerly: and again on the third day you undo the bandages,
and bind it still more loosely, and with still fewer bandages. And
if, while the arm is bound up in the splints, you should at any time
suspect that the bones do not lie properly, or if anything about the
bandages annoys the patient, you should loose them at the middle of
the time, or a little earlier, and apply them again. A diet slightly
restricted will be sufficient in those cases in which there was no
external wound at first, or when the bone does not protrude; but one