第 7 节
作者:没事找事      更新:2021-10-16 18:43      字数:9322
  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。
  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
  touch as little as possible; for it is a good sometimes to apply
  nothing at all; both to the ear and to many other cases。 Attention
  must be paid to the patient's position during sleep。 And the body must
  be reduced; more especially if there be danger lest the ear suppurate;
  it will also be better to open the bowels; and if the patient can be
  readily made to vomit; this may be accomplished by means of the
  syrmaism。 If the part come to suppuration; it should not be hastily
  opened; for often when matter appears to be formed it is absorbed
  again; even when no cataplasm is applied。 But if forced to open it;
  the part will get soonest well if transfixed with a cautery; and yet
  it should be well understood that the ear gets maimed; and is less
  than the other if burned through。 If not burned through; an
  incision; and not a very small one; should be made on the upper
  side; for the pus is found to be surrounded with a thicker covering
  than one would have supposed; and it may be said; in general; that all
  parts of a mucous nature and which form mucus; as being all viscid;
  when touched; slip from below the fingers to either side; and on
  that account the physician; in such cases; finds that he has to pass
  his instrument through a thicker substance than he supposed; and in
  certain ganglionic cases; when the skin is flabby and mucous; many
  physicians open them; expecting to find a collection in them; here the
  physician forms a wrong judgment; but by such a procedure no great
  harm results to the patient from having had the part opened。 But
  with regard to watery parts; and such as are filled with mucus; and
  which are situated in regions where every one of the parts; if opened;
  will occasion death or some other injury; these will be treated of
  in another work。 When; therefore; incision is made in the ear; all
  sorts of cataplasms and pledges should be avoided; and it is to be
  treated either with applications for recent wounds; or anything else
  which is neither heavy nor will occasion pain; for if the cartilage be
  laid bare and abscesses form; the case will be troublesome; this
  happens from such modes of treatment。 In all aggravated cases; the
  most effectual remedy is the transfixing of the part with a hot iron。
  41。 The vertebrae of the spine when contracted into a hump behind
  from disease; for the most part cannot be remedied; more especially
  when the gibbosity is above the attachment of the diaphragm to the
  spine。 Certain of those below the diaphragm are carried off by varices
  in the legs; more especially by such as occur in the vein at the
  ham; and in those cases where the gibbosities are removed; the varices
  take place also in the groin; and some have been carried off by a
  dysentery when it becomes chronic。 And when the gibbosity occurs in
  youth before the b