230 HEALTH AND DISEASE 



a powerful opiate or a subcutaneous injection of morphia may in some cases 

 so far overcome the irritability of the animal as to allow of readjustment 

 of the broken parts and the application of retaining appliances. Where 

 this fails the horse should be lifted on to a proper operating - table 

 and placed under the influence of chloroform. By this means a more 

 careful examination of the divided bone may be made, and a correct idea 

 of the direction of the displacement and the extent of damage to neigh- 

 bouring structures is obtained. In this connection it may be desirable 

 to caution the operator against unnecessary manipulation, but when once 

 he has decided what is required to be done, he must not hesitate to apply 

 the necessary force to do it. How that force can best be obtained will be 

 a question for solution when all the facts of the case are known. Hands 

 and apparatus are the means to be applied, and whether one or both are 

 brought into requisition, the direction in which they will be called upon to 

 act will be the same. Ropes and pulleys are in some cases indispensable. 



In proceeding to reduce the fracture of a long bone, force will require 

 to be exercised to a greater or less extent in two directions, extension and 

 counter-extension, and for this purpose one rope will need to be applied 

 below the fracture and the other above it. On each steady and continuous 

 traction is to be made by assistants, while the operator regulates the 

 position of the limb according to his requirements, and directs the 

 broken pieces into their normal position. Those to whom traction is con- 

 fided should be reminded that sudden and spasmodic or jerky action may 

 add to the difficulties of the operator by exciting the muscles to violent 

 contraction, or lacerating their fibres and with them other correlated struc- 

 tures. The pull in both directions should be as nearly as possible equal in 

 force and steadily maintained throughout in a line with the natural axis of 

 the limb. Those parts of the limb to which the rope or webbing is applied 

 should be well padded with tow. 



Where difficulty is experienced in bringing the displaced parts into 

 their proper position, the lower segment of the limb should be moved in 

 various directions by an assistant while the operator manipulates the frac- 

 ture. Slight rotation, first in one direction, then in another, and a little 

 manoeuvring of this kind will sometimes direct the fragments into their 

 normal position. If, however, exact coaptation cannot be effected, the best 

 that can be done must suffice. 



We have already pointed out the desirability of early " setting " as 

 favourable to speedy and complete reparation. Where, however, delay has 

 been allowed to occur, some consideration must be given to the state of the 

 parts before readjustment is undertaken. Round and about the broken 

 bone the tissues will be swollen, inflamed, and "painful, and more or less 



