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Show 158 macrens or THE BOXES or THE nose. 0F DISLOCA TION. cork splints may be laid along the teeth, which, while they give firmness to the bandaging, allow an interstice in front for giving food. CHAPTER VHI. FRACTURE OF THE BONES OF THE NOSE. ii i i i . . ‘ [Joy-"UN:- WW"‘~_‘<~W‘- w-‘V1‘ __ .- K" . "- Mum No doubt the ossa nasi sufl'er fracture, but they are oftener in a manner dislocated, that is to say, one of them is beat in, while the other lies over it. When they are fractured and entirely beat down, the shock sometimes reaches the septum. nasi, and it is also fractured. Nay, a worse effect may yet be a consequence of a blow on the nose. It‘has happened that the delicate cribriform plate of the ethmoid bone has been fractured and pushed up on the brain, from the shock com~ municated to it through the septum ! The arch of the nose is to be raised by a strong probe eo~ vered with lint: by putting oil on the little finger, we may push it into the nostril, so as to replace the cartilage and bone of the septum -, tubes of any kind, I believe cannot be intro duced so as to support the broken bones. When the bones are replaced they will not readily move from their place ; there are no muscles, no motion of the part to change their position, and very soon a swelling of the nose and membranes comes on which supports them sufficiently. If, in consequence of a blow on the nose, and a fracture of the ethmoid bone, there should succeed discharge of matter with symptoms of a beginning affection of the brain, then ought we to probe gently and perhaps pull upon the perpen- dicular plate of the ctlnnoid bone, that we may bring down any part of the horizontal plate which may be irritating the brain. In the mean time, by every means in our power, we ward off inflammation. Happily the case is not likely to occur: OF DISLOCATION. Lennon or DISLOCATION is the displacement of the articulating surfaces of the bones. Dislocation is the conse quence of a twist of the limb not the effect of direct injury to the joint which is deranged. Mistakes both in the diagnosis and in the efforts to reduce the bones, will arise from overlook- ing this very obvious fact. There is a division of dislocation into kinds. DISLOCATION implies that the articulating sur- faces of the bones no longer correspond in any degree, that the bone is entirely displaced -, as when the head of the humerus lies in the axilla, or the head of the femur has been forced from the acetabnlum, and lies on the back of the ilium. SUBLUXATION is the derangement of the articulating heads of the bones, while yet they are in contact and rest against each other. The entanglement of the articulating processes of the vertebrae of the loins is a subluxation : there may be a sublnxation of the knee, or more frequently of the ancle joint. Then we have the distinction of simple and compound dislocation, analogous to that of simple and compound fracture. In compound dislocation there is a wound of the integuments with dislocation of the bone; and it is dangerous, as there is united an inflamed and snppurating wound of the soft parts with the wound of a joint, which consists of parts widciy dif- fering in economy, parts slow to inflame, but of which the inflammation when excited is violent in degree. Diastasz's is a mere separation of the bones. There is yet another distinction, viz. into old and recent dislocation. This is a distinction sometimes important to the |
