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Show 115 GENERAL Thurman or rnacroen. GENERAL ram I‘MENT or FRACTURE. the bruising and laceration of the soft parts which accompany an g gatin breaking of the bone may, by producing and propa t action distinct from that which would knit the bones, preven high the Either the formation of the callus or new bone. naand inflammatory state of the general system, or an inflanu tion tending to suppuration of the part injured, will retard can the cure ; and therefore all that is necessary, all that we ness and want of exercise in a habit perhaps naturally active, accumulation in the bowels is particularly apt to happen, Which produces a feverish state. During confinement, free air and a change of the bed-chamber, if it can be accomplished, and and recreation, is very necessary, for there is a healthy ' natural action to perform. vlt' the do, is to relieve the system from its high action, to sooth TREATMENT OF A SIMPLE FRACTURE- lv local inflammation, and as it were, to procure time and opportunity for the ends of the bones to take upon them the change necessary for the formation of the callus. -m .. lit 3‘, u f. i '1. 't ‘. J. k .r. i E When, therefore, we have reduced and adapted to each l l i saw mm other, the broken bones, (the manner of doing which I an; presently to describe), we have to consider the nature and ex‘ tent of the general or local injury, and comparing it with the circumstances and constitution of the patient, to proceed accordingly. If a person in the full vigour of health be thus suddenly confined to a posture, with a rising pulse and con:idcrable pain, bleeding is indispensable. When ,there is A (I .w‘iv‘} "rev"nr,‘-'¢&<.. ' _ , much swelling in the injured limb, it should be placed ina natural and easy position, but not bandaged ; on the con trary, we bleed with leeches, and by fomentation promote the bleeding and allay the swelling. If, from the violence of the injury, and the shock, and the alarm of the patient, fever and delirium succeed, or restlessness with shaking and spasm of the limb, the fracture should be covered with compresses and soft slight bandage, and pillows rather than splints should be applied around the limb. "'e must wait for returning com~ posure, and the subsiding of the swelling, before we finally adjust the limb. In this state we must by no means give opiates with the intention of quieting the perturbations before very free evacuations have been made. if we find restlessness and irritation prolonging the pain and retarding the cure, it most probably proceeds from a neglect of the bowels. By procuring regular motions and by an attention to diet, this irritable state will subside. By stillv r by BY the same force which broke the bone, but oftene the bone the contraction of the muscles, the broken ends of ion are pushed past each other. Our first object is, by extens their in bone the of ities extrem of the limb, again to place the care that. natural relation to each other ; next we have to take made to the part of the limb which is below the fracture be not suffer lie in its natural position, that it is not twisted, and its pro from e declin ed by gravitation or any other cause, to against it, per direction. Thus, if we do not take precautions and when the fore arm is fractured, the palm will fall prone ation. gravit by lly, distort the bones : the foot will natura thigh fall outward, and lie upon its outer edge when the bone or the tibia is broken. the naWhen the limb is put into what we conceive to be sly aneou tural position, we have to observe whether it spont e. retracts, which it is apt to do if the fracture be obliqu ract. This we must endeavour to counte soap If I can procure it at the time, I use a pledget of the part plaster, which I put upon the limb, especially on r alone; oftene But chafe. to where the splints are expected or a flat« the limb and in those parts where there are hollows, ness which will not be uniformly embraced by the splints, l lay some layers of lint or old linen soaked in brandy or a solu- we tion of crude sal ammoniac in vinegar and water. When wish to give unity and firmness to these applications, we soak them in gum or in the white of an egg. When stiff unyieldof ing splints are to be used, much of the security and case the By the limb dc; ends upon laying this ground work. III N rim Messrs» |