Part 30
Persons who, in jumping from a height, have pitched on the heel, so
as to occasion diastasis (separation) of the bones, ecchymosis of
the veins, and contusion of the nerves,-when these symptoms are very
violent, there is danger that the parts may sphacelate, and give trouble
to the patient during the remainder of his life; for these bones are
so constructed as to slip past one another, and the nerves communicate
together. And, likewise in cases of fracture, either from an injury
in the leg or thigh, or in paralysis of the nerves connected with
these parts, or, when in any other case of confinement to bed the
heel, from neglect, becomes blackened, in all these cases serious
effects result therefrom. Sometimes, in addition to the sphacelus,
very acute fevers supervene, attended with hiccup, tumors, aberration
of intellect, and speedy death, along with lividity of the large bloodvessels,
and gangrene. The symptoms of the exacerbations are these: if the
ecchymosis, the blackened parts, and those around them, be somewhat
hard and red, and if lividity be combined with the hardness, there
is danger of mortification; but, not withstanding, if the parts are
sublivid, or even very livid and diffused, or greenish and soft, these
symptoms, in all such cases, are favorable. The treatment consists
in the administration of hellebore, if they be free from fever, but
otherwise, they are to have
oxyglyky for drink, if re-
[p. 291]quired. Bandaging,-agreeably
to the rule in other joints; but this is to be attended to also,-the
bandages should be numerous, and softer than usual; compression less;
more water than usual to be used in the allusions; to be applied especially
to the heel. The same object should be sought after in the position
as in the bandaging, namely, that the humors may not be determined
to the heel; the limb to be well laid should have the heel higher
than the knee. Splints not to be used.
