Over this again put a compress, and then put on the splints, (previously bolstered with some tow) which secure with tape, as before observed with the fracture of the arm.
The many-tailed bandage is however superior to the roller, in the fracture of the Leg. The method of laying it on is this: the patient laying upon his back, with his thigh lifted upwards by the assistant, put the bandage under the calf of the leg; then begin from the ancle upwards, folding over alternately the tails of the bandage, so that they secure each other. When this is compleated, put over the whole a Compress, as before directed, as also the Splints; or in the room of common splints, put on the new invented splints of Mr. Sharp; of which a ship should have three or four pair of different sizes, both for the right and left leg.
When this is performed, the patient should be put to rest as soon as possible; and he will lay easiest upon the side where the fracture is, with his thigh and leg bent forwards. This position suits not only best on board a ship where the motion is continually apt to disturb the sick part, but is also most natural both for ease, and for healing; as the muscles are all at rest, and adds firmness and ease to the body.
Compound Fractures.
When a fracture is attended with a wound, it is needless to observe, that the case is of a more dangerous nature. If the contusion has been so great, as to splinter the bones, such splints as are loose, and seem to prick through the flesh, should by all means be removed. Violence must however be avoided; for by a little patience, nature will of her own accord separate and discharge them.
Gentleness should ever be observed in surgery, though not a timid weakness, by being defective in dressing properly. The reduction of the fracture should be conducted the same as before, with this difference, that always a many-tailed bandage should be chosen, so that it may be opened when requisite.
The dressing of the wound should be the simplest possible; for the nature of bone is so delicate, that it will neither bear to be much exposed to the air, nor suffer any greasy salve or ointment to come near it; both are liable to corrode it, and bring on a carious, which is of a most dangerous tendency. Dry lint therefore is the best, particularly near the fractured bone.
In short, it is to be treated cautiously, like an ulcer, and the greatest care to be taken, that the arm, leg, or whatever fractured part it is, be kept steady, and no oftener dressed than what is absolutely necessary.
Conclusive Observations on Fractures.
In the obscure times of surgery, various medicines were applied to broken bones, with a notion to unite them the sooner. This, however, is entirely exploded from modern practice.