Part 41
In those cases where there are wounds, either at first, or from protrusion
of the bones; or afterwards, from pruritus, or
[p. 298]irritation; in the
latter case you are immediately to unloose the bandages, and having
applied pitched cerate to the wound, bandage the limb, placing the
head of the roller upon the wound, and proceeding otherwise as if
there were no wound in the case; for thus will the swelling be reduced
as much as possible, and the wound will suppurate most quickly, and
the diseased parts will separate, and when it becomes clean the wound
will most quickly heal. Splints are not to be applied to the place,
nor is it to be bound tight. Proceed thus when no large bones exfoliate,
but not in the latter case, for then there is great suppuration, and
the same treatment is not applicable, but the parts require to be
exposed to the air on account of the abscesses. In such cases where
the bones protrude, and whether reduced or not, bandaging is not befitting,
but distention is to be practiced by means of rolls of cloth, made
like those used upon shackles; one of these is to be placed at the
ankle, and the other at the knee; they are to be flattened toward
the leg, soft, strong, and having rings; and rods made of cornel,
and of a proper length and thickness are to be adjusted to them, so
as to keep the parts distended; and straps, attached to both extremities,
are to be inserted into the rings, so that the extremities being fixed
into the rolls, may effect distention. Treatment:-Pitched cerate,
in a hot state; the attitudes, position of the foot and hip; regulated
diet. The bones which have protruded through the skin are to be replaced
the same day, or next; not on the fourth or fifth, but when the swelling
has subsided. Reduction is to be performed with levers; when the bone
does not present any place upon which the lever can rest, a portion
of the part which prevents this is to be sawed off. But the denuded
parts will drop off, and the limb become shortened.
