148 APPENDIX. [No. III. 



to its previous form, sliOTying considerable elasticity. It is neither liable 

 to be torn nor broken ; and, lastly, it possesses the advantage of light- 

 ness combined with durability. Whilst in search of a moulding sub- 

 stance, I thought it advisable to try various compositions in order that 

 the best might be selected, but none appeared so excellent as that last 

 described. 



[Several paragraphs here follow of other ways for making these 

 tablets, which I omit here.] 



Of all these preparations, and many others that were tried, few were 

 applicable, and none iu all respects equal to the composition of gum 

 and whiting, both of which substances are always easily obtained, and 

 have the additional advantage of cheapness. The solution of gum which 

 was found most adapted contained 10 or 12 oimces of gum to the pint 

 of water. As far as regards the nature and texture of the cloth it is 

 to be remarked that linen is stronger than cotton, and less liable to be 

 torn, and therefore to be preferred. Of the various kinds of linen, 

 none moulds so perfectly as moderately coarse old sheeting ; for when the 

 tablets were made of finer Irish, they were inferior iu this respect. The 

 application of these tablets is rather extensive ; they may be used with 

 great advantage for all fractures of the metacarpal bones, also for those of 

 the forearm, or even for the humerus. When the humerus is fractured, the 

 method which has been adopted is to cut a piece of paper somewhat into 

 the shape of the required spliut. It should cover a portion of the pectorahs 

 major, and extend as high as the bend of the neck, and include the whole 

 of the scapula. Fi'om this broad plate a piece descends to the bend of 

 the elbow, and should be sufficiently -wide to cover about two-thirds of 

 the outer part of the arm. The paper is then placed on one of the 

 prepared tablets, which is cut to a similar shape. The piece thus prepared 

 is moistened until it becomes perfectly soft, and it is then moulded on the 

 arm and neck. From the general shape of these parts, there wiU be found 

 a superfluity of substance about the deltoid, which must be piached up 

 and turned down so as to form a fold over the other part. The spUnt 

 then may be ia a degree dried, and its inner surface lined vdth lint. The 

 whole is to be enveloped in a starched roUer.* 



This mode of proceeding may appear tedious, but it is a source of 

 much comfort to the patient; for whilst the upper ai-m is enveloped in this 

 hard case, so that it is quite immovable, the forearm and hand may be let 

 loose, and the patient may in some degree enjoy the use of them. The 

 benefit of this mode of treating fractures is not confined to the patient 

 only ; it lessens also the labour of the surgeon : for when the injured limb 

 is once put up in this manner, it requires no further attention for days, 

 vyeeks, or even till the cure is accomplished. Its application to chronic 

 diseases of the joints will be found particularly useful. In these cases two 

 lateral spUnts are to be formed, and enveloped in a starch roller. It is 

 hardly necessary to add that in fractures of the lower jaw it must prove a 

 valuable auxiliary. Great, however, as these advantages may be, perhaps 

 they are trifling in comparison with the importance of its application to 

 simple fractures of the leg. The mode of treating these fractui-es at 



* The roller is merely soaked in boiled starch and wound up in the usual 

 manner before it is applied. 



