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On The Articulations   



38. When the fractured bone is displaced laterally, the treatment is
the same, but it is obvious that the reduction is to be made, not by
applying equal force on both sides, but by pushing the displaced
portion into its natural position, and pressing on it from without,
and introducing something into the nostrils, and boldly rectifying the
fragments which incline inward, until the whole be properly
adjusted, well knowing that if you do not restore the parts at once,
it is impossible but that the nose must be distorted. But when you
restore the parts to their natural position, either the patient
himself, or some other person, is to apply one finger or more to the
part which protrudes, and keep it in position until the fracture be
consolidated; but the little finger is, from time to time, to be
pushed into the nostril, to rectify the parts which incline inward.
When any inflammation supervenes, dough must be used, but attention
must still be equally paid to the application of the fingers, although
the dough be on the part. But if the fracture be in the cartilage,
with lateral displacement, the end of the nose must necessarily be
distorted. In such cases some of the aforementioned means of
reduction, or whatever suits, is to be introduced into the nostril;
but there are many convenient things to be found which have no
smell, and are appropriate in other respects; thus, on one occasion, I
introduced a slice of sheep's lung, as it happened to be at hand;
for sponges, if introduced, imbibe humidities. Then the outer skin
of Carthaginian leather it to be taken, and a piece of the size of the
thumb, or what will answer, is to be cut off and glued to the
outside of the nostril which is turned aside, and then this piece of
thong is to be stretched to the proper degree, or rather a little more
than what will be sufficient to make the nose straight and regular.
Then (for the thong must be long) it is to be brought below the ear
and round the head, and the end of the thong may either be glued to
the forehead, or a still longer one may be carried all round the head,
and secured. This is a natural mode of setting the nose, is of easy
application, and is calculated to enable the counter-extension on
the nose to be made greater or less, as you may incline. In a case
where the fractured nose is turned to the side, the treatment is to be
conducted otherwise, as already described; and in most of them the
thong ought to be glued to the end of the nose, in order to make
extension in the opposite direction.

39. When the fracture is complicated with a wound, one need not be
troubled on that account, but pitch-cerate or any of the
applications for fresh wounds is to be applied to the sores; for, in
general, they admit of easy cure, even when there is reason to
apprehend that pieces of bone will come out. The parts, at first,
are to be adjusted fearlessly, taking care that nothing is omitted,
and, subsequently, they are also to be adjusted with the fingers; more
softly, indeed, but still it must be done; and of all parts of the
body the nose is modeled with the greatest ease. And there is
nothing to prevent us from having recourse to the practice of gluing
on the thongs, and drawing the nose to the opposite side, even if
there be a wound or the parts be inflamed, for these thongs give no
pain.

40. In fractures of the ear all sorts of bandages do harm. For one
would not think of applying it quite loose, and if applied more
tightly, it only does the more harm, for even the sound ear, when
confined with a bandage, becomes painful, throbs, and gets into a
febrile state. With regard to cataplasms, the heaviest, on the
whole, are the worst; but almost all kinds are bad, form abscesses,
occasion an increase of humors, and afterward troublesome
suppurations; and a fractured ear stands in less need of such
applications than any other part; the most ready, if required, is
the paste of meal, but neither should it have weight. It should

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