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On The Articulations   


patient's skin, for in this way it will be more tenacious; then we
must stretch this thong, but still more so the one at the chin, in
order to prevent the fragments of the jaw from riding over each other,
and the thongs are to be fastened at the vertex, and then a bandage is
to be bound round the forehead, and a proper apparatus is to be put
over all, to prevent the bandages from being displaced. The patient
should lie upon the sound side of the jaw, not resting upon the jaw,
but upon the head. He is to be kept on a spare diet for ten days,
and then nourished without delay. If there be no inflammation during
the first days, the jaw is consolidated in twenty days; for callus
quickly forms in this, as in all the other porous bones, provided
there be no sphacelus (exfoliation?). But much remains to be said on
the sphacelus of bones in another place. This method of distention
with glued substances is mild, of easy application, and is useful
for many dislocations in many parts of the body. Those physicians
who have not judgment combined with their dexterity, expose themselves
in fractures of the jaws, as in other cases, for they apply a
variety of bandages to a fractured jaw-bone, sometimes properly, and
sometimes improperly. For all such bandaging of a fractured jawbone
has a tendency rather to derange the bones connected with the
fracture, than to bring them into their natural position.

34. But if the lower jaw be disjointed at its symphysis in the
chin (there is but one symphysis in the lower jaw, but there are
several in the upper; but I am unwilling to digress from the
subject, as these matters will have to be touched upon in other
kinds of disease)-if, then, the symphysis be separated at the chin, it
is the work which anybody can perform, to rectify it; for the part
which protrudes is to be pushed inward by pressure with the fingers,
and the part that inclines inward is to forced outward by pushing with
the fingers from within. It is after having applied extension to
separate the fragments that this is to be done, for they will thus
be more easily restored to their natural position, than if one
should bring them together by using force. This is proper to be
known as applying to all such cases. When you have set the parts,
you must fasten the teeth on both sides to one another, as formerly
directed. The treatment is to be accomplished with cerate, a few
compresses, and bandages. This part, in particular, requires a short
but complex (?) bandaging, for it is nearly cylindrical, though not
exactly so; but the turn of the bandage is to be made, if the right
jaw was dislocated, to the right hand (that is said to be to the right
hand when the right hand conducts the bandaging); but if the other jaw
be the seat of the dislocation, the bandaging is to be made in the
other direction. And if matters be properly adjusted, and the
patient keep quiet, there will be a speedy recovery, and the teeth
will be uninjured; but if not, the recovery will be more protracted,
the teeth will be distorted, will give trouble, and become useless.

35. Of fractures of the nose there are more than one variety, but
those who, without judgment, delight in fine bandagings, do much
mischief, most especially in injuries about the nose. For this is
the most complex of all the forms of bandaging, having most of the
turns of the bandage called "ascia," and rhomboidal intervals and
uncovered spaces of the skin. As has been said, those who practice
manipulation without judgment are fond of meeting with a case of
fractured nose, that they may apply the bandage. For a day or two,
then, the physician glories in his performance, and the patient who
has been bandaged is well pleased, but speedily the patient
complains of the incumbrance of the bandage, and the physician is
satisfied, because he has had an opportunity of showing his skill in
applying a complex bandage to the nose. Such a bandaging does
everything the very reverse of what is proper; for, in the first
place, those who have their nose flattened by the fracture, will
clearly have the part rendered still more flat, if pressure above be

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