A Treatise on Fractures, Luxations, and Other Affections of the BonesDesault, P.-J. (Pierre-Joseph)
Science
A Treatise on Fractures, Luxations, and Other Affections of the Bones
Desault, P.-J. (Pierre-Joseph)
Dislocations; Fractures; Surgery
9. Whence arose then the exaggerated fears of the ancients respecting
injuries of this kind? Doubtless from an opinion which was then
entertained, that tendons and nerves were of the same nature. Hence the
severe pains, the convulsions, and even death itself, which, according
to them, frequently happened, and was always to be apprehended, as
the consequence of injuries done to these organs. Lamotte, among the
moderns, still entertained these prejudices, when, in speaking of
affections of the tendo Achillis, he said, “So dangerous are they in
their consequences, that they can seldom be brought to a favourable
termination.”
10. Doubtless the unskilful treatment, employed by the ancients, in
cases of this kind, the use of the bloody suture without proper means
to retain the parts in a suitable situation, the abuse of irritating
remedies applied externally, the imprudent administration of oily
substances, and, still more, the motions of the patient, contributed
not a little to the production of those accidents, which no longer
occur in the practice of the moderns, since the nature and treatment
of the disease is better understood. It has been proved, by late
observations, that the division of the tendo Achillis is apt to
produce some diminution in the size of the affected leg. But this
soon disappears, nor does it, indeed, even occur, if, by a proper
application of the bandage, a speedy union of the divided part be
obtained. The patients of Desault never experienced it.
§ IV.
OF THE INDICATIONS OF CURE.
11. That I may present, in order, what I have to offer on the treatment
of the division of the tendo Achillis, 1st, I will lay down, with
precision, the indications of cure that arise out of this division:
2dly, with these indications I will compare the means used by different
authors, by which the insufficiency of almost all of them will be
demonstrated: 3dly, by showing the relation or correspondence that
subsists between these indications, and the apparatus employed by
Desault, I will prove that it fulfils them sufficiently, and is,
therefore, to be preferred to every other.
12. To bring the edges of the division into contact, and to retain them
so, are here, as in other simple wounds, the two general principles of
treatment. The first of the principles presents an easy indication; it
is only to extend the foot forcibly on the leg. The indications that
arise out of the other, are more difficult to be fulfilled.
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