1. Immobilization in those cases especially demanding it, from the character of the fracture, until formation assures solid and firm union. 2. Manipulation and massage and movements of parts at an early period, compatible with the above, to render soft tissues pliable, to remove stiffness and adhesions, to restore a normal circulation, and to exercise and function the parts. 3. In cases of laceration of soft tissues, abrasions, etc., great care should be taken so as not to infect the parts. 4. Great care should be taken where fracture is compound, and where fragments exist. 5. In all cases, both acute and chronic, critically examine for slight anatomical deviations locally and remotely. In dislocations the fundamentals of the above are applicable. Do not let chronic stiffness, or rigidity, adhesions, or synovitis supervene if possible to prevent. An important consideration in all cases of sprains, fractures, and dislocations that become chronic is the probable effect upon dependent tissues by way of nerve impairment and vascular obstruction; for examples, the sprained back may readily impair organic life, the fractured elbow prevent use of the arm, the injured leg predispose to flat foot. (See J. B. Littlejohn—Osteopathic Surgery, including Treatment of Fractures, Journal of the American Osteopathic Association, Nov., 1905.) FOOTNOTES: [41] See also Jones’ latest work, Injuries to Joints. [42] See also Wharton Hood, Sprains and Fractures. POSTURAL DEFECTS A postural defect is any abnormal position, congenital or acquired, of the body, assumed in sitting, standing or walking. This leads to a symmetrical development, causes structural changes, and as a sequel, disturbance of function and organic life results. Defects in posture are of very common occurrence. A perfect posture, in fact, is somewhat rare. Considerable is being accomplished, especially of late years, by the laity through various physical methods and exercises to correct the many defects of position in sitting, standing and walking. The originators of the many so-termed systems of exercises have gone so far as to even advertise to cure various diseases of the body as well as attempting to improve the normal tissues and structure. Exercises, undoubtedly, have their place, particularly in the life of those of sedentary habits. Most of us do not exercise enough, neither do we as a rule get enough fresh air and pure water. But there are many defects of the anatomical that mere gymnastics can not adjust. And there are still other defects that gymnastics may decidedly aggravate. In these cases the mechanism of the body has become so deranged and disturbed that nothing short of actual readjustment can be effective.