BOTANIC PHYSICIAN. 
so 
2 ——— the knee $e beneath the aineley to prevent motion i | ‘ 
both those joints. rhe ae 
eve 
$ OF THE BONES OF THE FOOT AND TOES, 
tot > managed. nearly in the same manner with similar inju- 
of the hands and fingers ; it is therefore unnecessary to patti- 
x 2 ri eularize. ee Z 
COMPOUND FRACTURES. 
_ A compound fracture is when the skin is broken, either by splin- 
ters of bone protruding through the flesh, which often happens when 
the leg is broken by jumping, or by leaping from a carriage under 
ll speed ; or by an external bruise. 
e admission of air, undoubtedly, to the wounded flesh, is the 
compound fractures are so__ much more hazardous than 
he worst variety of simple fracture will continue to do 
eg -anthe skin remains entire; but if, by any accident, 
1€ point of the bone is pushed through the flesh, from that moment 
the pain becomes severe ; inflammation and fever take place; the 
Le 
limb is apt to be attacked with severe spasmodic twitchings; and to 
these gangrene or extensive suppurations. frequently succeed, if not 
prevented. a 
-dn the treatment ofa compound fracture our first object is to stop 
the effusion of blood, with the tourniquet, if considerable; and then ~ 
to consider whether we should attempt to save the limb, or amputate 
it. And it should be a very severe and hopeless case, to render am- 
putation necessary, in my opinion. It has been the common custom 
_ Nit surgeons, of late years, to take off the limb without much hesi- 
_ tation whenever a fracture of this kind is severe, Or presents an un- 
toward aspect ; and I have no doubt that this operation is often per-. 
_ formed, unnecessarily, under the idea that it presents a greater ex 
_ hibition of surgical skill and manly daring, than patiently to assist 
Nature in restoring the limb to soundness, and the use of the patient. : 
Such are weak and silly notions however, and but poorly compen- — 
” sate for the loss of a limb for life. . ae ee 
It is my firm belief, and 1 judge from experience, that there seldom, _ 
_ occurs a case of compound fracture so bad, that might not, with pro-_ 
_ per means, and proper care and attention, be made whole, and the 
‘limb restored to usefulness. The danger of mortification appears to — 
be the most urgent motive for amputation ; but I never experienced 
any difficulty from this when the proper antiseptic applications were 
made use of, as charcoal and yeast, and the like, or in the werst 
stages, of fish-worms; and also by keeping the air excluded from 
the wound. Hemorrhage is another difficulty that often occurs in | 
_ these fractures: this must be stopped, by compression, with the tour- 
niquet, if necessary, or by a ligature upon the artery. _ | 
In the treatment of compound fractures, our object is the same 
as in the management of those of the most simple nature ; namely, 
_ to replace the bones that may be deranged, and to retain them un- 
. il they are united. 7 Se ee ee 
In the first place, all extraneous bodies should be remoyed, as well 
