第 7 节
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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