316 DISEASES OF THE HOESE. 



when such an injury exists the surgeon will, of course, become vigi- 

 lant, in view of possible and probable complications of thoracic 

 trouble, and prepare himself for an encounter with a case of trau- 

 matic pleuritis or pneumonia. Fatal injuries of the heart are re- 

 corded. Subcutaneous emphysema is a common accompaniment of 

 broken ribs, and I recall the death from this cause of a patient of my 

 own which had suffered a fracture of two ribs in the region of the 

 withers, under the cartilages of the shoulder, and of which the diag- 

 nosis was only made after the fatal ending of the case. 



These hurts are not often of a very serious character, though the 

 union is never as solid and complete as in other fractures, the callus 

 being usually imperfect and of a fibrous character, with an amphiar- 

 throsis formation. Still, complications occur which may impart 

 gravity to the prognosis. 



Treatment. — Fractures with but a slight or no displacement need 

 no reduction. All that is necessary is a simple application of a blis- 

 tering nature as a preventive of inflammation or for its subjugation 

 when present, and in order to excite an exudation which will tend to 

 aid in the support and immobilization of the parts. At times, how- 

 ever, a better effect is obtained by the application of a bandage placed 

 firmly around the chest, although, while this limits the motion of the 

 ribs, it is apt to render the respiration more labored. 



If there is displacement, with much accompanying pain and evident 

 irritation of the lungs, the fracture must be reduced without delay. 

 The means of effecting this vary according to whether the displace- 

 ment is outward or inward. In the first case the bone may be 

 straightened by pressure from without, while in the second the end of 

 the bone must be raised by a lever, for the introduction of which a 

 small incision through the skin and intercostal spaces will be neces- 

 sary. When coaptation has been effected it must be retained by the 

 external application of adhesive mixture, with splints and bandages 

 around the chest. 



FEACTUEES OF THE BONES OF THE PELVIS. 



These fractures will be considered under their separate denomina- 

 tions, as those of the sacrum and the os innominatuTn, or hip, which 

 includes the subdivisions of the ilium, the pubes, and the ischium. 



The sacrum. — Fractures of this bone are rarely met with among 

 solipeds. Among -cattle, however, it is of common occurrence, being 

 attributed not only to the usual varieties of violence, as blows and 

 other external hurts, but to the act of coition and violent efforts in 

 parturition. It is generally of the transverse kind and may be recog- 

 nized by the deformity which it occasions. This is due to the drop- 

 ping of the bone, with a change in its direction and a lower attachment 

 of the tail, which also becomes more or less paralyzed. The natural 

 and spontaneous relief which usually interposes in these cases has 

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