Fractures and Sprains from a late nineteenth century perspective

Fractures are known by the sudden and severe pain, by the misshapen appearance of the limb, sometimes by its being shortened, by the patient being unable to move it without excruciating pain, but most certainly, by grasping the limb above and below the spot where the fracture is supposed to exist, and twisting it different ways, when a grating will be felt, occasioned by the broken ends of the bone rubbing against each other. If the swelling, however, is very great, this experiment should not be made until it is reduced.

Dislocations, or bones being out of joint, are known by the deformity of the joint when compared with its fellow, by the pain and inability to move the limb, by its being longer or shorter than usual, and by the impossibility of moving it in particular directions.

_Of Sprains._

Plunge the part sprained into very cold water, and hold it there as long at a time as you can bear it--for several hours--then rub it well with camphorated spirits. If the accident has happened to a joint, as in the ankle, and it remains weak, pour cold water on it from the spout of a teakettle, held at a distance, several times in the day.

_Of Contusions._

If slight, bathe the part frequently with cold vinegar and water for a few hours, and then rub it well with brandy, or spirits of any kind. Should it be very great, or so as to affect the whole body, which may be known by a general soreness, bleed and purge the patient, and confine him to a diet of rice-water, lemonade, panada, etc. If fever comes on, repeat the purging, etc. In all cases of this nature, be sure the water is regularly evacuated, for it sometimes happens that in consequence of the nerves of the bladder being palsied by the blow, the patient feels no desire to pass it, though the bladder be full. If a suppression ensues, pass a catheter, if possible, or procure assistance for that purpose. The most serious effects, however, resulting from contusion, are when the blow is applied to the head, producing either concussion or compression of the brain.

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