Part 38
When the fractured bone is displaced laterally, the treatment is the
same, but it is obvious that the reduction is to be made, not by applying
equal force on both sides, but by pushing the displaced portion into
its natural position, and pressing on it from without, and introducing
something into the nostrils, and boldly rectifying the fragments which
incline inward, until the whole be properly adjusted, well knowing
that if you do not restore the parts at once, it is impossible but
that the nose must
[p. 235] be distorted. But when you restore the parts to
their natural position, either the patient himself, or some other
person, is to apply one finger or more to the part which protrudes,
and keep it in position until the fracture be consolidated; but the
little finger is, from time to time, to be pushed into the nostril,
to rectify the parts which incline inward. When any inflammation supervenes,
dough must be used, but attention must still be equally paid to the
application of the fingers, although the dough be on the part. But
if the fracture be in the cartilage, with lateral displacement, the
end of the nose must necessarily be distorted. In such cases some
of the aforementioned means of reduction, or whatever suits, is to
be introduced into the nostril; but there are many convenient things
to be found which have no smell, and are appropriate in other respects;
thus, on one occasion, I introduced a slice of sheep's lung, as it
happened to be at hand; for sponges, if introduced, imbibe humidities.
Then the outer skin of Carthaginian leather is to be taken, and a
piece of the size of the thumb, or what will answer, is to be cut
off and glued to the outside of the nostril which is turned aside,
and then this piece of thong is to be stretched to the proper degree,
or rather a little more than what will be sufficient to make the nose
straight and regular. Then (for the thong must be long) it is to be
brought below the ear and round the head, and the end of the thong
may either be glued to the forehead, or a still longer one may be
carried all round the head, and secured. This is a natural mode of
setting the nose, is of easy application, and is calculated to enable
the counter-extension on the nose to be made greater or less, as you
may incline. In a case where the fractured nose is turned to the side,
the treatment is to be conducted otherwise, as already described;
and in most of them the thong ought to be glued to the end of the
nose, in order to make extension in the opposite direction.
