22. If the displacement be in an external direction, as most commonly occurs (7), a contrary effect must be produced, as well by the pressure made by the bandage, on the upper extremity of the displaced fragment, as by the situation of the elbow which is directed outwards by means of the thick end of the bolster being placed lowermost. The external splint will also prevent the displacement outwards, as well by opposing to the bone a mechanical resistance, as in compressing the deltoid muscle, which is the principal cause of the displacement. The derangement of the lower fragment forward and backward, will be prevented by the two splints before and behind. The displacement longitudinally, already checked by the weight of the limb, will be still further prevented, by the compression made on the muscles of the arm, which are the instruments of displacement, by the splints and the bandage. 23. To the advantage of keeping the fragments exactly in place, this apparatus unites that of not confining the patient, who is not obliged to keep his bed, and to whom a lying position is even, in general, more troublesome and injurious than an erect one. This observation applies to the treatment of fractures of the clavicle, of the scapula, and even of the fore-arm, when no accident has rendered them complicated. Desault has cured several patients, but more particularly two, who, being obliged to travel daily, did not, except on the day of the accident, deviate in any measure from their usual mode of life. An inexperienced surgeon sometimes applies the rollers too tight, in which case, a swelling of the fore-arm is the consequence. This is remedied by relaxing the bandage; but if, notwithstanding this, the swelling still continues, it will be necessary to extend the bandage from the hand to the shoulder. § VII. OF THE SUBSEQUENT TREATMENT. 24. The pain ceases as soon as the apparatus is applied, because the fragments, now brought into perfect contact, cease to irritate the surrounding parts. Nor does it return during the treatment, as they are firmly retained, and not suffered again to separate. It is rare that any serious accident follows this fracture, and, among the numerous examples met with by Desault, he has scarcely ever had one such to encounter: yet he generally paid but little attention to those internal means which are usually combined with external ones. In most cases, the patients pursued the regimen to which they had been accustomed. In cases, where a considerable swelling attacked the upper part of the joint, a circumstance which occasionally occurs in practice, one or two bleedings, a diet more or less strict, and the use of diluent drinks, constituted the internal treatment. Of this the following case, related by Brochier, furnishes a detail.