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should be well carded and not rough； for in small quantity and of a
bad quality it has little power。 But those who approve of binding up
the limb with wool for a day or two； and on the third and fourth apply
bandages； and make the greatest compression and extension at that
period； such persons show themselves to be ignorant of the most
important principles of medicine； for； in a word； at no time is it
so little proper to disturb all kinds of wounds as on the third and
fourth day； and all sort of probing should be avoided on these days in
whatever other injuries are attended with irritation。 For；
generally； the third and fourth day in most cases of wounds； are those
which give rise to exacerbations； whether the tendency be to
inflammation； to a foul condition of the sore； or to fevers。 And if
any piece of information be particularly valuable this is； to which of
the most important cases in medicine does it not apply？ and that not
only in wounds but in many other diseases； unless one should call
all other diseases wounds。 And this doctrine is not devoid of a
certain degree of plausibility； for they are allied to one another
in many respects。 But those who maintain that wool should be used
until after the first seven days； and then that the parts should be
extended and adjusted； and secured with bandages； would appear not
to be equally devoid of proper judgment； for the proper judgment；
for the most dangerous season for inflammation is then past； and the
bones being loose can be easily set after the lapse of these days。 But
still this mode of treatment is far inferior to that with bandages
from the commencement； for； the latter method exhibits the patient
on the seventh day free from inflammation； and ready for complete
bandaging with splints； while the former method is far behind in
this respect； and is attended with many other bad effects which it
would be tedious to describe。
31a。 In those cases of fracture in which the bones protrude and
cannot be restored to their place； the following mode of reduction may
be practiced：… Some small pieces of iron are to be prepared like the
levers which the cutters of stone make use of； one being rather
broader and another narrower； and there should be three of them at
least； and still more； so that you may use those that suit best； and
then； along with extension； we must use these as levers； applying
the under surface of the piece of iron to the under fragment of the
bone； and the upper surface to the upper bone； and； in a word； we must
operate powerfully with the lever as we would do upon a stone or a
piece of wood。 The pieces of iron should be as strong as possible；
so that they may not bend。 This is a powerful assistance； provided the
pieces of iron be suitable； and one use them properly as levers。 Of
all the mechanical instruments used by men； the most powerful are
these three； the axis in peritrochio； the lever； and the wedge。
Without these； one or all； men could not perform any of their works
which require great force。 Wherefore； reduction with the lever is
not to be despised； for the bones will be reduced in this way； or
not at all。 But if the upper fragment which rides over the other
does not furnish a suitable point of support a suitable point of
support for the lever； but the protruding part is sharp； you must
scoop out of the bone what will furnish a proper place for the lever
to rest on。 The lever； along with extension； may be had recourse to on
the day of the accident； or the accident； or next day； but by no means
on the third； the fourth； and the fifth。 For if the limb is
disturbed on these days； and yet the fractured bones not reduced；
inflammation will be excited； and this no less if they are reduced；
for convulsions are more apt to occur if reduction take place； than if
the attempt should fail。 These facts should be well known； for if
convulsions should come on when reduction is effected； there effected；
there is little hope of recovery； but it is of use to displace the
bones again if this can be done with out trouble。 For it is not at the
time when the parts are in a particularly relaxed condition that
convulsions and tetanus are apt to supervene； but when they are more
than usually tense。 In the case we are now treating of； we should
not disturb the limb on the aforesaid days； but strive to keep the
wound as free from inflammation as possible； and especially
encourage suppuration in it。 But when seven days have elapsed； or
rather more； if there be no fever； and if the wound be not inflamed；
then there will be less to prevent an attempt at reduction； if you
hope to succeed； but otherwise you need not take and give trouble in
vain。
32。 When you have reduced the bones to their place； the modes of
treatment； whether you expect the bones to exfoliate or not； have been
already described。 All those cases in which an exfoliation of bone
is expected； should be treated by the method of bandaging with cloths；
beginning for the most part at the middle of the bandage； as is done
with the double…headed bandage； but particular attention should be
paid to the shape of the wound； so that its lips may gape or be
distorted as little as possible under the bandage。 Sometimes the turns
of the bandage have to be made to the right； and sometimes to the
left； and sometimes a double…headed bandage is to be used。
33。 It should be known that bones； which it has been found
impossible to reduce； as well as those which are wholly denuded of
flesh； will become detached。 In some cases the upper part of the
bone is laid bare； and in others the flesh dies all around； and；
from a sore of long standing； certain of the bones become carious； and
some not； some more； and some less； and in some the small； and in
others the large bones。 From what has been said it will be seen；
that it is impossible to tell in one word when the bones will
separate。 Some come away more quickly； owing to their smallness； and
some from being merely fixed at the point； and some； from pieces not
separating； but merely exfoliating； become dried up and putrid； and
besides； different modes of treatment have different effects。 For
the most part； the bones separate most quickly in those cases in which
suppuration takes place most quickly； and when new flesh is most
quickly formed； and is particularly sound； for the flesh which grows
up below in the wound generally elevates the pieces of bone。 It will
be well if the whole circle of the bone separate in forty days； for in
some cases it is protracted to sixty days； and in some to more； for
the more porous pieces of bone separate more quickly； but the more
solid come away more slowly； but the other smaller splinters in much
less time； and others otherwise。 A portion of bone which protrudes
should be sawn off for the following reasons： if it cannot be reduced；
and if it appears sons： that only a small piece is required in order
that it may get back into its place； and if it be such that it can
be taken out； and if it occasions inconvenience and irritates any part
of the flesh； and prevents the limb from being properly laid； and
if； moreover； it be denuded of flesh； such a piece of bone sh