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Show 122 GENERAL TREATMENT or sucrose. GbXERAL TREATMENT OF FRAC'I'URE. s.. "..‘,.,x_.,'. -. --_v,.. _, ;. .- rutv'r: a, . and the extremities of the broken bone are rounded ofi‘, so that an artificial joint is formed. It is surely no erroneous W'IIEN A JOINT HAS BEEN FORMED IN COXSEQUENCE (ll' Tll'kl stroy the disposition in the action to unite the bones by bone ; and that in a lesser degree it retards the cure, and makes the confinement longer, increasing the chances of failure. On the MISMANACEMENT OF FRAC'I‘URE. ing absolute rest to the limb. But we must not be so blinded as to carry the argument too has ever been done with success, but I know that it has been tractcd, we place it again in its proper position, and endeavour more perfectly to secure it, because by this twisting or extension we do not, as by a perpetual teasing interference with the process going forward, destroy the usual disposition. Here the new adhesions may be broken, and they will readily unite done with continued pain, during the operation, almost to death, and with no good effect. The thigh has been cut so that the bone has been exposed, but lying deep in the flesh ; the disentanglement of the end of the bone has been found most difficult, painful, and tedious; the saw moving in these deep parts requires a large wound and moves with difficulty, and in one case, long before one extremity of the bone was cut 011‘, the patient was pale and feeble, and incessantly vomiting from pain and irritation. I believe hours have been spent in the attempt, and what has been the result? an extensive open wound, the ends of the bone consequently exposed, and these ends injured by the working of the saw. A disposition in short is left upon the part the very reverse of the quiet ossific action. There follows inflammation and suppuration, (ever at variance, with healthy ossification), the inflannnation has subsided, and when the parts may be ex- again, and the cure go on. To say, however, that because we can thus interfere with a t broken limb, without essentially interrupting the cure, it is time enough to set the limb in its position after four weeks have elapsed, were to carry the doctrine to a dangerous as well as a ridiculous excess; for at such a distance of time l. i from the accident, the connexions must be strong, and the violence necessary to replace the limb in its natural situation proportionally great. It is but at best bringing matters to their original state, and of course the previous time is lost ; the We can as» j I cribe such extravagant practice as this, only on the one hand to ingenious argument pushed rather too far for common readers, and on the other to stupidity in taking the illustration of a doctrine for the enunciation of a principle. A frac« tured bone will feel quite loose towards the end of the third week, and in three or four days more it will be firm. This, I suppose, is the origin of the opinion, but the fact is insutli» Cient to establish the rule of practice. Y -W"' a} 0'1-1"‘->f.~w _.. rw-o‘ A confinement being in this way much increased. , WHEN, in consequence of using the limb too freely a joint has been formed, instead of the bone uniting, it has been proposed, to cut down through the flesh, and to cut oil" the callous extremities of the bones. I do not recollect that this If, on examining a limb, we find that it is distorted or re» far. i- OF THE MEANS PROPOSED FOR EXCITING THE OSSIFIC ACTIOT" conclusion to draw, that motion, to a certain extent, will de- other hand, no argument will ever be discovered against giv- _ shrew" mum '4 12;} pected to granulate and take the disposition to unite by bone --that disposition has been already destroyed by the violence of the inflammation, the time for their union is past, and the bones remain loose as before. In one case I thought myself, by observations made on animals, authorized to propose that a long and sharp instrument should be pushed obliquely down upon the bone, so as to work upon and penetrate the extremities of the bones. By this means I imagined the wound made by the transit of the instrument would immediately heal, and yet the extremifies of the bone be so excited as to resemble the state of |