Ars chirurgica a compendium of the theory and practice of chirurgery in seven books ... shewing the names, causes, signs, differences, prognosticks, and various intentions of curing all kinds of chirurgick diseases ... : to which is added Pharmacopoeia chirurgica, or, The medical store, Latin and English ... / by William Salmon ...

CHAP. XVI. Of a FRACTƲRE of the NOSE-BONE.

I. IT is called in Greek, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. in Latin, Fractu∣ra Ossis Nasi; and in English, A Fracture of the Bone of the Nose.

II. Hippocrates, de Articulis, Text. 30, &c. shews, that the Bone of the Nose may be broken many ways; for a part of it may either be broken off, or the ridge of it may be broken down, &c. wherein a Wound general∣ly happens unto the Fracture.

III. The Prognosticks. A Fracture of this Part is the easiest set of all; if it is not presently set right and straight, it cannot be set straight at all, but it will always stand awry.

IV. In this Bone a Callus also is soon bred, and confirmed; and it is healed in ten or twelve days time, unless the Bone is corrupted: Yet some say it is not done in less than 18 or 20 days; but this is according to the various habits of Body.

V. The Cure. If the Bone is equally crusht down unto the lower part, and made as it were flat; then something is to be put in∣to the Nostrils that may raise it up again, which may be done with some searching Instrument, or a Spatha; or else it may be lifted up with the Finger, by putting it up into the Nostrils, outwardly also nipping it up on both sides, that so it may be restored to its natural situation and place.

VI. Or wrapping up a little Stick in Cotton, you may put it into the Nostrils as gently as may be; and therewith raise up the Bone, laying the Thumb and Finger of your left Hand on both sides the Nose, to direct, reinstate, and retain the Bones in their proper piaces.

VII. If the Nose is broken only on one side, it is gently to be set right and strait from that way to which it declines; either by thrusting in the Finger, or by the help of some fit Instrument as aforesaid, directing it also straight out∣wardly.

VIII. And that the Bones thus set may be kept in their proper places, Plugs made of Linnen-rags are to be put up the Nostrils; or else Pipes of Lead, anointed with Oil of Turpentine mixed with Spirit of Wine, which may both support the Bones, and facilitate Respiration.

IX. Some put up Sponges, but they are pernicious, for thro' the moisture of the Nostrils they will swell much, whereby becoming very thick, and much dilated, they are apt to distend the Part, and to move the Bones out of their places, after they have been well set.

X. The leaden Pipes which are

put up, ought to have leaden Ears or Handles, by which they may be fastned to the Cap, or Head; and if you please, to make them the more healing, they may be co∣vered with some Empastick Medicament, as Manna Thuris, (which is a pure white sort of Frankincense, exsudating of its own accord thro' the Bark of the Tree, and which in the West-Indies I have often gather∣ed with my own Hands) made up with Mastich, Gum Traga∣canth, and Oil of Roses, into a Body.

XI. If there is no Wound in the Nose, there will be little need of Bandage; but if a Wound is present, you are to apply pro∣per Topicks, and to lay upon each side the Nose a kind of tri∣angular Bolster, covered with a small piece of Pasteboard of the same figure.

XII. This Dressing may be kept on with a kind of Bandage, which has four ends or straps, being a piece of Linnen-cloth about two Inches broad, and two Feet long; it is slit at both ends, and all along, leaving it only in the middle whole, for about three Inches in length.

XIII. This whole part is to be laid upon the Eracture, causing the upper straps to go round the Nape of the Neck, which are to be brought back again forwards: The lower straps are also to be carried backwards to the Neck, crossing above the Neck upwards, and afterwards to be brought a∣gain forwards.

XIV. If the Nose, near to the Gristle, is turned away, a glutina∣tive Emplaster with a little Loop is to be applied to the reclining side of the Nose; which being dried firmly on, is afterwards to be straitned as much as is conveni∣ent, that so the Note may be set straight again.

XV. Paraeus uses this: Take fine Bole, Frankincense, Mastich, Dragons-blood, A. ℥i. Pine Rosin, Roch Allum, A. ℥ss. all being in fine pouder, mix them with whites of Eggs well beaten q.s. and make a sticking Emplaster.

XVI. Or this Emplaster may be put upon a very broad Tape, or a Linnen Rowler, which may be so long, that being drawn below the Ear, and so wound about the Head, it may be agglutinated upon the Forehead: After 14 days it may be removed, and a Cerate laid on, to consummate the Cure, and to confirm and strengthen the Bones.

XVII. If the Bone is shatter∣ed into small pieces, they are, as much as may be, to be put all in their places again with fit Instru∣ments; nor must you easily ad∣mit the taking of any forth, if it is possible that they may be agglutinated, lest it cause de∣formity.

XVIII. Now as some Authors approve of this Bandage, or Bind∣ing up of these Fractures, so others wholly disapprove of them, saying, it is more safe wholly to omit them; for that they either per∣form nothing at all if they be loose, or else draw the Nose a∣wry, or make it flat, if drawn but indifferently close or hard; and that the broken Bones of the Nose may very easily be

kept fast in their planes by pro∣per Plasters, without any bind∣ing at all.

XIX. And truly in this Case only is this Bandage convenient, where in the ridge of the Nose, the Flesh is bruised with, and the bro∣ken Bones stick forth; so that the Bandage pressing them together, may make them to acquire their own natural form.

XX. And yet in this very case, Bandage is not altogether necessary or profitable, for that a proper Ce∣rate or Emplastey may sufficiently do the Work without it; But we thought good in the aforegoing Sections, so deliver the Method or Way of doing it, that this our Work might not be thought defective in that particular.