General Diseases of Bones, Joints and Muscles. 395 



Treatment should be directed to the improvement of 

 the general health by tonics, (cinchona, nux vomica, cas- 

 carilla, boneset, willow bark, myrrh, oxide of iron, phos- 

 phate of iron, etc.,) carminatives, (ginger, pimento, fennel, 

 fainugrec, cardamoms, coriander,) pepsin, sound nutritious 

 food, (given soft-boiled or steamed if necessary) pure air, 

 exercise in sunshine, grooming, etc.) No good can be ex- 

 pected of advanced cases, but only of those seen in the 

 3arly stage, with some stilBEtiess, and swelling of bone, and 

 the passage of phosphates, to excess, in the urine. 



FEACTUBES. 



These are simple when a bone is broken across ; commi- 

 nuted when broken into several pieces ; and compound when 

 the soft parts are torn so as to establish a communication 

 between the broken ends and the external air. The two 

 last are extremely dangerous, but the first is more hopeful. 

 Simple fractures, however, vary in gravity according to 

 their kind. Thus iu the very young the break is liable to 

 be imperfect, with a number of pointed processes locking 

 into each other (greenstick fracture) and as the ends are 

 easily and accurately replaced and the bones soft and 

 vascular, repair is prompt and perfect. In others the 

 break is directly and smoothly across, or with indentations 

 and processes, so that when the ends are placed in appo- 

 sition they cannot sUde past each other ; these too are 

 easily repaired. A third class are broken obliquely or mtli 

 a bevel, so that the broken surfaces slide upon each other 

 imder the contractions of the muscles, and the sharp ends 

 are continually jerked into the soft parts around. The 

 continuous movement prevents imion and the irritation oi 

 the soft parts sets up inflammation so that such fractures 

 may prove as troublesome as the compound. 



Symptoms. Disuse of the affected bone, distortion ol 

 the part, shortening, if it is the main bone of a limb, 

 trembhng of the muscles over the injury, a grating sensa- 

 tion conveyed to the hand on moving the broken bone, 



