Part 37
In those cases in which the fractured portions are depressed and flattened,
if it is depressed in front at the cartilage, something may be introduced
into the nostrils to rectify the parts. If not, all such deformities
may be restored by introducing the fingers into the nostrils, if this
can be managed, but if not, a thick spatula is to be introduced with
the fingers, not to the fore part of the nose, but to the depressed
portion, and the physician is to take hold of the nose externally
on both sides, and at the same time raise it up. And if the fracture
be much in the fore part one may introduce into the nostrils as already
stated, either caddis scraped from a linen towel, or something such
wrapped up in a piece of cloth, or rather stitched in Carthaginian
leather, and moulded into a shape suitable to the place into which
it is to be introduced. But if the fracture be at a greater distance,
it is
[p. 234] not possible to introduce anything within, for if it was irksome
to bear anything of the kind in the fore part, how is it not to be
so when introduced farther in? At first, then, by rectifying the parts
from within, and sparing no pains upon them from without, they are
to be brought to their natural position, and set. A fractured nose
may be readily restored to shape, especially on the day of the accident,
or even a little later, but the physicians act irresolutely, and touch
it more delicately at first than they should; for the fingers should
be applied on both sides along the natural line of the nose, and it
is to be pushed downward, and thus, with pressure from within, the
displacement is to be rectified. But for these purposes no physician
is equal to the index-fingers of the patient himself, if he will pay
attention and has resolution, for they are the most natural means.
Either of the fingers is to be placed firmly along the whole nose,
and thus it is to be gently held, and steadily, if possible until
it become firm, but if not, he himself is to hold it for as long a
time as possible, or if he cannot, a child or woman should do it,
for the hands ought to be soft. Thus may a fracture of the nose, attended
with depression, and not with displacement to the side, but in a straight
line, be most properly treated. I have never seen a case of fractured
nose which could not be rectified when attempted, before callus is
formed, provided the treatment be properly applied. But although men
would give a great price to escape being deformed, yet at the same
time they do not know how to take care, nor have resolution, if they
do not experience pain, nor fear death, although the formation of
callus in the nose speedily place, for the most part is consolidated
in ten days, provided sphacelus do not take place.
