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Show 1 _, ._...'..==, 53 ,,..,,. -..‘..-£A‘-W-‘-<; .. .-m.,. llS taat tNUtA t t t tr . m3.‘~7.-‘.5":7"" "Wt-1' .:,:-_...,. r. . 0 onxnnsL TREATMENT or ammonia. (Juneau, measures"): or renown k 119 broken portion of the bone into the flesh-If we were to putt sition of the bone is our least care. this leg in the direction A, then B, would be forced against C, and the sharp point C, forced into the flesh, and the a good constitution must rise to a great height; in a bad constitution the natural high action, (a necessary consequence of a previous healthy state of the body in these circumstances), may be converted into bad inflammation, and have a wounded integuments would be girt round the ends of the bones. We must therefore extend the lower part of the leg in the axis of the lower end of the bone, in the direction B, D, until the two ends of the bone are no longer thus tendency to gangreneas. The inflammation in We have to study the previous state, and watch the present symptoms; relieve the high activity by bleeding and every relaxing means, lower the irri« locked into each other; then raising the foot into the position A, the parts are adapted to each other. If there project through the skin a long splinter of the bone, which we foresee cannot well be retracted, or perhaps without injury to the surrounding soft parts, then it had. better be taken 011‘ with the saw-To saw or break oil the projecting point is better than to cut up the integuments. When the bones are replaced, our next object ought to be so to adapt and bring together the integuments, that they may unite by the first intention. They ought to be brought together by a slip of plaster, if they admit of it, and over this a piece of dry lint should be laid on lightly, so as to absorb the first exudation; this may be covered by a piece may be removed, or the constitutional powers have been al lowed to go too low. By probing gently, perhaps, a loose piece of bone may be removed, with an immediate change in the complexion of the wound; or on examination of the parts we may discover a lodgment or sinus, which were bet: of cerate; but nothing oily should touch the wound, where ter opened. we hope for the scabbing and healing of the broken skin. In other respects the limb is to be managed as a simple When the pulse indicates rather the quickness and irrita bility of langour or exhaustion, than of inflammatory fever, by changing the plan of diet, and general remedies, and fracture, only that in the bandaging we should not use a tation, or correct the habit ; and as to the limb, to lay it ea= sy is our only aim, until the high tumefaction and pain shall have subsided ; then suppuration will also have taken place. Good suppuration ensures the subsiding of the inflammaBut tory tumour, and of the high tension and irritability. if after a time, the discharge continues and becomes profuse, there is either a cause of irritation in the wound which roller, but the eighteen tailed bandag ; and in applying it by leaving such tails, as cover the wound, hanging out un- tied, till the rest are bound up, they can at any time be unpinned and taken oil", to expose the wound for the convenience of dressing, without moving the rest'of [he bandage, ens to reduce the ,patient to a still greater degree of weak or disturbing the limb. ness ; then bark and wine, mild nourishing diet, and free air, But a compound fracture in the common application of by supporting the system, we may restore due energy to the bodily powers. When the languor increases, the appetite fails the per~ spiration is copious and easily excited, and a purging threat- with fracture of the bone; not the ell‘ect for example of a shock in falling, which breaks the bone and pushes it through if possible, are our resources. After this, the patient still sinking, and the integuments losing their tumefaction, and becoming loose and flabby ; and from the unfavourable state of the bowels, the food having ceased tobe nutritious while the skin; but of the injury received by a waggon w heel going over the limb, bruising and cutting and laying open " In practice it is of the utmost consequence to ascertain the state of the. MR parts-a fracture with contusion, though we must call it a simple Frac- the shattered bone. i‘f'I‘, is often Worse than a compound fracture the term, may be a bruised and lacerated limb, complicated Hero, of course, the reduction and po- ‘1 l m. IUNI . more "‘" |