Part 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
[p. 237]
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.