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On The Articulations   

applied to it; and further, those cases in which the nose is distorted
to either side, whether at the cartilage or higher up, will
evidently derive no benefit from bandaging above it, but will rather
be injured; for it will not admit of having compresses properly
arranged on either side of the nose, and indeed, persons applying this
bandage do not seek to do this.

36. This bandaging would appear to me to answer best when the skin
surrounding the bone is contused on its ridge near the middle, or if
the bone itself have sustained some injury, but not a great one, in
such cases, redundant callus forms in the nose, and the part becomes a
little too prominent; and yet, even in these cases, the bandaging need
not require much trouble, if, indeed, any bandage be applied at all;
for it is enough if one lay a waxed compress on the contusion, and
then apply the double-headed bandage, thus taking one turn with it.
The best application to such accidents is a small cataplasm of wheaten
flour, washed, and mixed up into a viscid mass. If the flour be made
from good wheat, and if it be glutinous, it should be used alone for
all such cases, but if it be not very glutinous, a little of the manna
of frankincense, well pulverized, is to be moistened with water, and
the flour is to be mixed up with it, or a very little gum may be mixed
in like manner.

37. In those cases in which the fractured portions are depressed and
flattened, if it is depressed in front at the cartilage, something may
be introduced into the nostrils to rectify the parts. If not, all such
deformities may be restored by introducing the fingers into the
nostrils, if this can be managed, but if not, a thick spatula is to be
introduced with the fingers, not to the fore part of the nose, but
to the depressed portion, and the physician is to take hold of the
nose externally on both sides, and at the same time raise it up. And
if the fracture be much in the fore part one may introduce into the
nostrils as already stated, either caddis scraped from a linen
towel, or something such wrapped up in a piece of cloth, or rather
stitched in Carthaginian leather, and moulded into a shape suitable to
the place into which it is to be introduced. But if the fracture be at
a greater distance, it is not possible to introduce anything within,
for if it was irksome to bear anything of the kind in the fore part,
how is it not to be so when introduced farther in? At first, then,
by rectifying the parts from within, and sparing no pains upon them
from without, they are to be brought to their natural position, and
set. A fractured nose may be readily restored to shape, especially
on the day of the accident, or even a little later, but the physicians
act irresolutely, and touch it more delicately at first than they
should; for the fingers should be applied on both sides along the
natural line of the nose, and it is to be pushed downward, and thus,
with pressure from within, the displacement is to be rectified. But
for these purposes no physician is equal to the index-fingers of the
patient himself, if he will pay attention and has resolution, for they
are the most natural means. Either of the fingers is to be placed
firmly along the whole nose, and thus it is to be gently held, and
steadily, if possible until it become firm, but if not, he himself
is to hold it for as long a time as possible, or if he cannot, a child
or woman should do it, for the hands ought to be soft. Thus may a
fracture of the nose, attended with depression, and not with
displacement to the side, but in a straight line, be most properly
treated. I have never seen a case of fractured nose which could not be
rectified when attempted, before callus is formed, provided the
treatment be properly applied. But although men would give a great
price to escape being deformed, yet at the same time they do not
know how to take care, nor have resolution, if they do not
experience pain, nor fear death, although the formation of callus in
the nose speedily place, for the most part is consolidated in ten
days, provided sphacelus do not take place.

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