A practical treatise on fractures and dislocations / by Frank Hastings Hamilton.
- Frank Hastings Hamilton
- Date:
- 1863
Licence: Public Domain Mark
Credit: A practical treatise on fractures and dislocations / by Frank Hastings Hamilton. Source: Wellcome Collection.
Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)
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![moderate compression, and rest. If it does not, tlie claances are tliat tlie case will call for amputation. The rule generally laid down by surgeons that we should at once close the wound in compound fractures, with sutures and adhesive straps if necessary, or with bandages, is far too absolute. This prac- tice will do when there is no great contusion or extravasation of blood, but if blood is flowing it is much better to leave the wound open so as to permit it to escape freely; and if the severity of the injury war- rants the supposition that much inflammation is to ensue, the danger of gangrene is greatly lessened by thus allowing the opening to remain as a channel of exit for the inflammatory effusions. Many years since Dr. J. Ehea Barton introduced into the Pennsyl- vania Hospital what has since been called the bran dressing for the treatment of compound fractures of the leg; the limb being made to repose in a box filled with this material.^ I have used it very fre- quently, and can speak of it as possessing many qualities of excellence, especially as a summer dressing. The particular mode of using this apparatus I shall describe more minutely when treating of fractures of the leg. The treatment of inflammatory symptoms, and of the later accidents, such as suppuration, oedema, gangrene, tetanus, &c., must be left mainly to the good judgment of the surgeon. Gentle manipulation, uniform support, rest and sometimes cooling lotions constitute the most impor- tant means by which inflammation is to be controlled. Bleeding is rarely necessary, and in a' large majority of cases it might prove injurious by lowering too much the vital forces, which need to be husbanded in view of the requirements of the process of repair and of the long and exhausting confinement. Cathartics should also be administered cautiously for the same reason, and because they are liable, especially in fractures of the lower extremities, to occasion a serious disturbance of the limb. CHAPTER VI. DELAYED UNION AND NON-UNION OF BROKEN B0NES.2 Most surgical writers concur in the statement that non-union of broken bones is an uncommon event. Walker, of Oxford, affirms that of not less than one thousand fractures which have come under • Paper on Bran Dressings, by Reynell Coates, of Philadelphia. Amer. Journ. Med. Soi., April, 1842, p. 515; from the Med. Examiner, Nos. 9 and 11, vol. i., New Series. 2 I shall, in this chapter, avail myself freely of the labors of George W. Norris, of Philadelphia, whose paper, entitled On the Occurrence of Non-union after Fractures, its Causes and Treatment, published in the American Journal of u]f('dicnl Sciences for Jan. 1842, constitutes the most complete and reliable monograph upon this subject contained in any language.](https://iiif.wellcomecollection.org/image/b21125892_0060.jp2/full/800%2C/0/default.jpg)
