Part 36
Displacement of the spine, if inward, threatens immediate death, attended
with retention of urine and loss of sensibility. Outward, the accident
is free from most of these bad effects, much more so than where there
is merely concussion without displacement; the effects in the former
case being confined to the spot affected, whereas in the latter they
are further communicated to the whole body, and are of a mortal character.
In like manner, when the ribs are fractured, whether one or more,
provided there be no splinters, there is rarely fever, spitting of
blood, and sphacelus, and ordinary treatment without evacuation will
suffice, provided there be no fever;-bandaging, according to rule;
and the callus forms in twenty days, the bone being of a porous nature.
But in cases of contusion, tubercles form, along with cough, suppurating
sores, and sphacelus of the ribs, for nerves from all the parts run
along each rib. In many of these cases haemoptysis and empyema also
take place. The management of this case consists in careful treatment,
bandaging according to rule, diet at first restricted, but afterward
more liberal, quiet, silence, position, bowels, and venereal matters
regulated. Even when there is no spitting of blood, these contusions
are more painful than fractures, and are more subject in time to relapses;
and when any mucous collection is left in the part, it makes itself
be felt in disorders of the body. Treatment:-burning, when the bone
is
[p. 294]affected, down to the bone, but not touching the bone itself; if
in the intercostal space, the burning must not extend through it,
nor be too superficial. In sphacelus of the ribs, tents are to be
tried, all other particulars will be stated afterward: but they should
be learned by sight rather than by words, namely, food, drink, heat,
cold, attitude; medicines, dry, liquid, red, dark, white, sour, for
the ulcers, and so with regard to the diet.
