SPECIAL FRACTURES.
Fracture of the Skull is caused by blows or falls. The external signs are not always present. In fracture of the base there may be hæmorrhage from ear, mouth, or nose; red patches of blood under conjuctivæ of eyes; and oozing of watery fluid from the ears. Accompanying these there may be symptoms of concussion, or symptoms of compression.
Treatment. Place the patient in a dark and quiet room on his back, with head slightly raised. Apply cold to head as soon as reaction sets in and patient gets hot and feverish, and send for a surgeon.
Fracture of Lower Jaw (Fig. 23, plate V.), is caused by direct blows; falls on chin. The symptoms are irregularity in the line of the teeth and the outline of the lower margin of bone; inability to move jaw. The treatment is simple. First fix lower jaw to upper jaw by a bandage, until the Bone-setter or surgeon connects the fractured parts.
Fracture of Collar-Bone is caused by blows on shoulder; falls on elbow or hand. It is a frequent accident, and when it occurs the shoulder sometimes drops; finger along the arm is helpless, and there is an irregularity on drawing surface of bone; a pad should be placed in arm-pit, bind the arm to side just above elbow, and sling forearm, as when a “shoulder is out.”
Fractures of Ribs are variously caused by blows, falls, weight passing over chest or back; there is pain and difficulty in breathing, and the usual signs of fracture. All that can be done at first is to apply a broad roller bandage firmly round chest, so as to prevent all movement; or strap the injured side with adhesive plaster.
Fracture of the Humerus (Fig. 21). It is caused by direct falls on elbow (fig. 26). The symptoms are mobility at seat of fracture, crepitus, or crackling, shortening, usually present when fracture is oblique, as in fig. 25. Apply first a roller bandage from hand to elbow, abduct arm and apply three or four splints from shoulder to elbow. Support arm in a sling. If there is looseness about the part apply a splint; if the flesh is broken stop the bleeding as directed elsewhere; if, however (as is often the case in a fracture of the forearm), there is no particular looseness of the bones, the case may be treated as dislocations and injuries to muscles, ligaments, &c. (see page 36.)
Fracture of the Forearm is variously caused by direct violent blows, falls, &c. The symptoms are crepitus, mobility, alteration in shape of arm (fig. 27), and in treating it, semiflex forearm with thumb pointing outwards. Apply two splints, one in front from bend of elbow to the tips of the fingers, and one behind from elbow to knuckles. The splints should be well padded. Place arm in sling.
Fractures about Wrist and Hand are caused by blows or other injuries. There is pain, swelling, irregularity in the outline of the bones and crepitus. The limb must be bandaged to a flat board or splint, and supported by sling.
Fractures of Femur or Thigh-bone (fig. 24) are caused by blows or falls, and pain and loss of power is instantly felt with crepitus, shortening, or the broken ends may be felt and the foot turned out.
Fractures (both of the leg or thigh).—First straighten the limb if bent, then tie a handkerchief round the fractured part, after which place a splint made of a broad lath, or something like it, from one joint to the other—say from the knee to the hip, if it is a broken thigh—and then tie handkerchiefs above and below the fracture, near the ends of the splint, tie the limbs together at the ankles, knees, and elsewhere, so that one supports the other. The object is to prevent motion of the fracture while the injured person is being moved, either to home or hospital. In doing this care should be taken to avoid jolting or shaking, as far as possible.
Fracture of Patella or Knee-Cap (fig. 33) may be caused by blows, or excessive muscular action, and the person is made to stand upon leg first. Fragments can also be felt. Raise limb to a position at right angles to body, and apply a figure-of-eight bandage around the knee, including the fragments.
Fractures of Bones of the Leg (fig. 28), are frequent from blows, falls, crushing weight, such as wheels passing over the limb. There is pain and loss of power; alteration in shape; crepitus, and the broken ends may be felt. Apply two splints, one inside and one outside the limb, as directed above, and elevate limb.
Fractures about Foot and Ankle. These are various results of blows or other injuries—(see figs. 30, 31, 36, and 37)—pain, swelling; alteration in outline of bones; crepitus. Treatment.—Elevate foot; apply cold water.
It must be remembered that the treatment for fractures here given is only temporary, to enable the patient to be moved without further injury, which might result in the loss of the limb or even life, till advice can be had.
When the fractured bone protrudes through the flesh, and there is much bleeding, first straighten the limb and close the wound, and tie a handkerchief tightly round over the wound, until a pad can be made, then as quickly as possible make a pad by folding old rags or cloth, or anything of the kind to be got closely together, of some thickness, and broad enough to cover the wound well, then remove the handkerchief already tied on, and place the pad over the wound and tie it lightly, so that the pad presses hard upon the wound and stops the bleeding; the bandage or handkerchief cannot well be too tight. Many a life might be saved, which is now lost if this or a similar method were adopted promptly. The materials are almost always at hand, and the application of them easy and simple. Immediately after the bleeding is stopped remove the sufferer, and call in professional advice without delay.
The stoppage of bleeding from arteries is taught practically in the ambulance classes, and though it forms no part of the Bone-setter’s art, yet many a life may be, and has been saved by this little knowledge, so I subjoin the directions given in the hand-book of the order of St. John, by the lamented Surgeon-Major Sheppard, whose humanity cost him his life after the battle of Isandula.
“The following situation of the main arteries in the different regions of the body, and their treatment when wounded.”
In the Region of the Head there is the Temporal Artery in front of ear, one P. Auricular at the back of ear at the Occipital, back of head. Compress over the wound, and bandage.
In the Neck the Carotid Arteries ascend in a line from inner ends of collar-bones to angles of jaw. Digital compression in line of vessels above and below the wound, or directly into wound on the mouths of the bleeding vessels.
In the Armpit, the Auxiliary Artery lies across hollow space of armpit. Compress subclavian artery behind middle of collar-bone, or digital pressure into the wound.
In the Upper Arm, the Brachial Artery lies on inner side of arm, in a line with seam on coat sleeve—from inner fold of armpit to middle of bend of elbow. Compress artery by a tourniquet above wound.
In the Fore-Arm the Radial and Ulnar Arteries begin below the middle of bend of elbow, and descend one on each side of the front of the arm to the wrist. Compress Brachial artery in the upper arm by a tourniquet, or place a pad in hollow of elbow and bend fore-arm against arm.
In the Palm of the Hand, the Radial and Ulnar Arteries give a number of branches, which spread out and supply the palm. Apply two small firm pads to arteries at wrist, or forcibly close and fix hand over a piece of stick or hard substance, and bandage.
In the Thigh, the Femoral Artery, from middle of fold of groin runs down the inside of thigh in its upper two-thirds. Pressure at middle of fold of groin, with fingers or by tourniquet above wound.
In the Ham, the Popliteal Artery lies along the middle of ham. Compress popliteal artery above wound, or compress femoral artery in front of thigh by tourniquet.
In the Back of the Leg are the Post, Tibial and Peroneal Arteries descend the back and outside of leg from below ham, passing behind ankle-bones. Compress at ham or in front of thigh or double leg on thigh with a pad in the ham.
In Front of the Leg and Instep the Anter. Tibial Artery descends along middle of front of leg and instep. Compress artery above wound.
In the Sole of the Foot the Post. Tibial and Peroneal Arteries descend behind ankle-bones; the former supplies branches, which spread out on sole of foot. Compress by a pad behind inner ankle-bone; if this fails, place pads behind outer ankle-bone and on middle of front of the ankle.
In dislocations generally, and displacement of cartilage, tendons &c., and also sprains and bruises, flannels soaked in warm water may be applied frequently, or warm bran poultices. This kind of treatment will almost always be suitable in the first instance. After some time has elapsed, when a little inflammation sets in, which mostly occurs some hours after the injury has been sustained, apply cloths soaked in cold water or cooling lotion, and repeat them as often as they get dry; if they are pleasant when applied, that will be an indication that they are suitable.
Displacement of cartilage, tendons, and similar injuries as Mr. Jackson points out are of frequent occurrence, and require very close attention and considerable experience to understand them. Theory is quite insufficient of itself to enable an operator to ascertain the nature of, and rectify the displacement. Such cases may be remedied by a simple manipulation, but it must be a carefully studied one, and acquired by constant practice.
Another form of accident is that of ruptured muscles which frequently come under the Bone-setter’s care; an illustration of a ruptured biceps is given in fig. 35 and fig. 38, shows the rectus femioris rupture.
These useful hints can hardly be called superfluous in a manual on the art of the Bone-setter, which is admittedly “a neglected corner of the domain of surgery.”
CHAPTER IX.
THE TESTIMONY OF MY PATIENTS.
——“If our virtues
Did not go forth of us, ’twere all alike as if we had them not.”—Shakespeare.
In the foregoing pages I have quoted the testimony of many persons of eminence who have been relieved of their ailments and cured by the art of the Bone-setter, when regular surgeons have failed to accomplish that desirable result. One, at least, of the cases thus published was contributed by one of my own patients without my knowledge. I have thought it my duty in vindicating my special art to give prominence to the opinion of others. I have shown how the sneers of the faculty have been turned to doubts, and under many who went forth to scoff at the despised “Bone-setter” remained to pray. Our so-called secrets have been appropriated and published, but our skill and reputation remain. In justice to myself I have added the testimony of a few of the many hundred patients who have sought and found relief at my hands. These testimonies are very gratifying to me as they include the Lord-Lieutenant of Warwickshire, and many clergymen and gentlemen of reputation and position, as well as a few of the general patients who from day to day and from week to week seek relief at my hands.
Stoneleigh Abbey, Kenilworth,
April 22nd, 1881.Lord Leigh has much pleasure in stating that Mr. Matthews Bennett is a very skilful operator, and has attended him and several of his neighbours and servants on various occasions with very great success.
Spottiswood,xxxxxxxx
July 10th, 1882xx.Lady John Scott begs to say that she has known several cases which were in the hands of Mr. Matthews Bennett, and she has always heard his treatment spoken of with the greatest praise, and in many instances which has come under her observation he was invariably successful. She has more than once sent for him in preference to any one else, for people in whom she was interested.
Willoughby House, Leamington,
February 14th, 1883xx.Miss Holy has taken every opportunity of mentioning Mr. Matthews Bennett’s skill in his profession.
Of his successful treatment of her sprains, she can speak with confidence—not only from her own experience, but from personal knowledge of other cases.
Rugby,xxxxxxxx
March 17th, 1882.xxI have much pleasure in stating that Mr. G. Matthews Bennett attended me for a broken foot, and that his treatment was so successful, that for the last eight years I have been able to walk with much ease and comfort.
R. DIXON, D.D.,xxxxxxxxxx
Hon. Canon of Worcester, and Vicar of
St. Matthews, Rugby.xx
12, Calthorpe Road, Banbury,
January 9th, 1882xx.The Rev. C. F. Nightingale has known Mr. Matthews Bennett for several years, and can testify with pleasure to the great skill with which Mr. Bennett has treated him, as also friends of his.
Donington Rectory, Wolverhampton,
December 11th, 1883.xxI have great pleasure in bearing testimony to the proper attention and remarkable skill shown by Mr. G. Matthews Bennett, of Leamington, in every case which has come under my cognizance.
In two cases especially he has been enabled to restore the use of limbs, which had become useless partly from accident and partly from the insufficient or defective treatment which they had before received.
H. G. de BUNSEN, M.A.,xxxxxxxxxxxx
Rector of Donington, Rural Dean
of Shifnal.xxxxxxThe Rev. H. G. de Bunsen also writing under date December 1st, 1882, gives particulars of one of the cases he mentions:—
“My dear Sir,—It was only yesterday that I could catch the wife of Richard Wood, of Albrighton, to give me particulars of his accident, of his lameness, and your care. He is about 50 years old. It was in April, 1880, that he “sprained” (or I believe rather dislocated somehow) his foot by its turning on one side when he trod on and slipped from a brick. He had his club doctor, who treated it and called it a sprain, sent lotion, &c. But for 17 weeks he could not tread on it, and was in pain all the time. Then me hearing of it sent him to you in August. He was driven to the station at Albrighton, and from Snow Hill to Bullivant’s Hotel, where you saw him, moved his foot up and down, then gave a strong jerk up, it snacked, and you bandaged it, and he walked up and down the room for the first time after the accident! He came again to you a fortnight after driving to the Albrighton Station, and from Snow Hill to your Hotel. But he walked back to the station by your permission; his wife accompanied him both times. He came once more to show you his foot a fortnight after that, but his wife did not think it necessary to accompany him, and he walked both ways without feeling any the worse.
It was not till April, 1881, that he went regularly to work again, and he has continued at it without intermission.”
Whilton Rectory, Daventry,xxxxxx
April 28th, 1881xx.Dear Sir,—I have pleasure in stating that you successfully replaced a dislocation of my knee-joint some years since, and that I have every confidence in your skill as a Bone-setter. I shall be glad to learn that your practice is extending and with every good wish.
I am, yours faithfully,xxxxxx
R. SKIPWORTH.xx
Kilby House, Leamingtonxxxxxx,
December 6th, 1883xx.Dear Sir,—I have much pleasure in bearing testimony to the skilful manner you treated me for a contracted shoulder some years since, having now free use of the shoulder, and suffering no ill effects from the injury.
Yours truly,xxxxxxxxxxxx
J. GLOVER, J.P.xx
Cliff Hill, Warwick,xxxx
April 27th, 1881.xxxxDear Sir,—I have great pleasure in saying that I am indebted to your skill in curing my knee after twelve months’ treatment of surgeons, except a twinge now and then I believe the joint is perfectly sound.
Yours,xxxxxxxxxxxx
JAMES PLUCKNETT.xx
51, St. John Street, Coventry,
December 31st, 1880xx.Sir,—It is with a spirit of deep thankfulness that I write to tell you that I have now been able to resume my duties to-day.
On February 19, while in performance of duty I was knocked down and severely injured by an infuriated cow. For these injuries I was treated first at the Coventry Hospital, and afterwards at the General Hospital, Birmingham, also by an eminent physician or surgeon, but from these institutions nor from the gentleman mentioned did I seem to derive any benefit, and it was only when examined by you (Nov. 8th) that I was aware that any bone was injured. From that time my improvement has been rapid, and to-day I am able to work again.
I need scarcely say I consider myself under a deep debt of gratitude to you, and shall at all times be anxious to serve you by any means in my power.
I am, yours obediently,xxxxxxxxxxxx
HENRY ALLEN,xxxxxx
Foreman Porter, Coventry Station.
14, Portland Road, Leamington,
November 29th, 1883.xxxxDear Sir,—I have very much pleasure in testifying to the marked ability with which you restored my arm in 1880 when suffering from a very severe sprain of the ligaments in consequence of being thrown from my trap. Medical men, whom I called in at the time, failed to discern the real diagnosis of the case.
I am, dear Sir, Yours very truly,xxxxxx
J. CROAD.xxxx
Cubbington, Leamington,
December, 1883xx.Dear Sir,—I hear you are publishing a book, and thought, perhaps, you would like my case. On April 4, 1882, I came to your house at Milverton suffering from a dislocation of the jaw which you reduced at once. I might add that a medical man had been attending me for a week previously, but could not reduce the dislocation.
Yours very gratefully,xxxxxxxx
ELLEN STANLEY.xx
44, Porlen Road, West Kensington Park, London,
February 23rd, 1882.xxDear Sir,—About nine years ago I consulted you about my knee. I had been under treatment for synovites in my right knee by two eminent surgeons for twelve weeks, and afterwards an in-patient of Leicester Infirmary. I left the latter institution on crutches and with a stiff joint. After six weeks of your treatment I had recovered full use of my leg and resumed my ordinary employment. Since then I severely injured my other knee, and your treatment of that was eminently satisfactory.
Yours faithfully,xxxxxxxxxxxx
WILLIAM KNIGHT.xx
Thomly Hall, Thame, Oxon, November 28th, 1882.xx
Dear Sir,—It is a pleasure as well as a duty to bear testimony to the great benefit I have derived from your skill in restoring my shoulder. It had been out of joint nine months, and was very badly contracted, now I can use it as well as the other.
I am, dear Sir, Yours very truly,xxxxxxxx
ELIZ. WIGGINS.xx
36, Market Place, Banbury,
November 9th, 1882.xxxxDear Sir,—I feel great pleasure in sending you my testimonial to your skill. Having been under Dr. Deyons, of Fenny Stratford, with fracture and dislocation of elbow for three months, and who left me at that time a complete cripple, I was not able to feed myself or do anything at my trade. I then had advice from two prominent medical doctors of this town, but neither would undertake the operation, and the advice received from both was go to Guy’s Hospital. I then presented myself to you, and you have succeeded far better than I anticipated, for I am now able to work at my trade and earn my living, and my arm is getting stronger every day.
I am, gratefully yours,xxxxxx
FRED. H. HARTALL.xx
Poundon, Near Bicester, Oxon,
December 1st, 1883.xxDear Sir,—About twelve months ago I was suffering from pains in my left shoulder which I thought was rheumatism. After waiting about four months I consulted my medical man, who said the collar-bone was broken. He set it and attended me about a month. Being no better I was advised to go to you. You told me it had not been broken, but that the ligaments of the shoulder were contracted, and I could not got my hand higher than my head. After your treatment and advice I am happy to say it is now well and strong, and had it not been for your skill, I feel sure I should have lost the use of it.
Yours,xxxxxxxx
SARAH DEELEY.xx
Guy’s Cliffe, Warwick, 1875.xx
Dear Sir,—I have great pleasure in stating I am quite sound again. Also allow me to state I have every confidence in your skill as a practical Bone-setter. You relieved me after suffering for two months with dislocation of my knee. I could not get my heel to the ground till one Sunday morning (which I shall never forget) when I sent for you and you put my knee in. I was able to walk at once free from pain. I had been under our local surgeon some time and received no benefit.
I am, yours respectfully,xxxxxxxx
Head Coachman to the Lady Charles Bertie Percy.
Snitterfield, Stratford-on-Avon,
January 27th, 1883.xxDear Sir,—It is with much pleasure that I write to thank you for your kindness and skilful attention to my arm. I may mention on the 10th of October, 1882, I was thrown from my bicycle near Dunchurch, and severely fractured my left elbow. I saw a surgeon at Stratford-on-Avon on the 12th and 16th of October after the accident, who said there was no fracture or dislocation. Not feeling satisfied, my employer gave me a ticket to go into the Kidderminster Hospital. The doctor there told me my elbow was ruined for life—that I should have a stiff joint; the thought of it gave me an awful turn, knowing that the means of earning my living would be very much impaired. I therefore made up my mind to go to you, and am now very thankful I did go, for after two months of your skilful treatment I can use my arm again quite freely. I find it no detriment to my work whatever, and am able to follow my occupation as well as before the accident.
With very many thanks, I remain,
Yours very gratefully,xxxxxx
JOHN NEAL.xx
Floode Row, Chilvers Coten, Nuneaton,
August 9th, 1881.xxJohn Knight wishes to say that he has every confidence in Mr. Matthews Bennett’s skill having been under his treatment several times with broken bones and dislocations, the last of which was a fracture of both thighs and a collar bone caused by a fall of earth in a coal pit belonging to Mr. Newdegate, M.P., January 2, 1875, and with God’s blessing and Mr. Bennett’s kind skill and attention he is now perfectly well.
(Signed)xxxxJOHN KNIGHT.
To G. Matthews Bennett, Esq.,
xxSpecialist, &c., Milverton, Leamington.