Simple fracture of the humerus, Gilbert tells us, is to be reduced
(_ad proprium locum reducator_) at once by grasping the arm above and
below the seat of fracture and exercising gentle and gradual extension
and compression. Then four pieces of lint wet in egg-albumen are
to be placed around the arm on all sides, a bandage, four fingers
wide, also moistened in albumen is to be snugly applied, another dry
bandage placed above this, and finally splints fastened in position
by cords. This dressing is to remain undisturbed for three days, and
then renewed every third day for nine days. After the ninth day a
_strictura_ (cast, apparatus immobile?) is to be prepared and firmly
applied with splints and a bandage, and the patient is to be cautioned
not to bear any weight upon the injured arm (_ne infirmus se super
illud appodiet_?). The fracture is then left until it is believed that
consolidation has occurred. If, however, it is found that swelling
is occasioned by the cast (_ex strictorio_?), the latter should be
removed, and the arm well bathed in warm water containing mallowae and
other emollients and thoroughly cleansed. If the bone seems to be well
consolidated, it should be rubbed with an ointment of _dialthea_ or
the _unguentum marciation_, after which the splints and bandage are
to be reapplied. If, however, it is found that the bone is not well
consolidated, the cast should be replaced in the original manner,
until consolidation is accomplished. If erysipelas results from
the dressings, it is to be treated in the ordinary manner. During
the entire treatment potions of nasturtium seeds, _pes columbini_
(crowfoot) and other "consolidatives" are to be administered
diligently. If the fracture is compound, any loose fragments of
bone are to be removed, the fracture reduced as before, and similar
dressings applied, perforated, however, over the wound in the soft
parts.
In fracture of the ribs (_flexura costi_) Gilbert recommends a
somewhat novel plan for the replacement of the displaced bone. Having
put the patient in a bath, the physician rubs his hands well with
honey, turpentine, pitch or bird-lime (_visco_), applies his sticky
palms over the displaced ribs, and gradually raises them to their
normal position. He also says (f. 183a), the application of a dry cup
(_cuffa vero cum igne_?) over the displaced rib is a convenient method
for raising it into position.
Of fractures of the forearm Gilbert simply says that they are to be
recognized by the touch and a comparison of the injured with the sound
arm. They should be diligently fomented, extension made if necessary,
and then treated like other fractures.
Public-domain text, read in full here on John Shaqi.
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