and the part that inclines inward is to forced outward by pushing with
the fingers from within。 It is after having applied extension to
separate the fragments that this is to be done； for they will thus
be more easily restored to their natural position； than if one
should bring them together by using force。 This is proper to be
known as applying to all such cases。 When you have set the parts；
you must fasten the teeth on both sides to one another； as formerly
directed。 The treatment is to be accomplished with cerate； a few
compresses； and bandages。 This part； in particular； requires a short
but complex （？） bandaging； for it is nearly cylindrical； though not
exactly so； but the turn of the bandage is to be made； if the right
jaw was dislocated； to the right hand （that is said to be to the right
hand when the right hand conducts the bandaging）； but if the other jaw
be the seat of the dislocation； the bandaging is to be made in the
other direction。 And if matters be properly adjusted； and the
patient keep quiet； there will be a speedy recovery； and the teeth
will be uninjured； but if not； the recovery will be more protracted；
the teeth will be distorted； will give trouble； and become useless。
35。 Of fractures of the nose there are more than one variety； but
those who； without judgment； delight in fine bandagings； do much
mischief； most especially in injuries about the nose。 For this is
the most complex of all the forms of bandaging； having most of the
turns of the bandage called 〃ascia；〃 and rhomboidal intervals and
uncovered spaces of the skin。 As has been said； those who practice
manipulation without judgment are fond of meeting with a case of
fractured nose； that they may apply the bandage。 For a day or two；
then； the physician glories in his performance； and the patient who
has been bandaged is well pleased； but speedily the patient
complains of the incumbrance of the bandage； and the physician is
satisfied； because he has had an opportunity of showing his skill in
applying a complex bandage to the nose。 Such a bandaging does
everything the very reverse of what is proper； for； in the first
place； those who have their nose flattened by the fracture； will
clearly have the part rendered still more flat； if pressure above be
applied to it； and further； those cases in which the nose is distorted
to either side； whether at the cartilage or higher up； will
evidently derive no benefit from bandaging above it； but will rather
be injured； for it will not admit of having compresses properly
arranged on either side of the nose； and indeed； persons applying this
bandage do not seek to do this。
36。 This bandaging would appear to me to answer best when the skin
surrounding the bone is contused on its ridge near the middle； or if
the bone itself have sustained some injury； but not a great one； in
such cases； redundant callus forms in the nose； and the part becomes a
little too prominent； and yet； even in these cases； the bandaging need
not require much trouble； if； indeed； any bandage be applied at all；
for it is enough if one lay a waxed compress on the contusion； and
then apply the double…headed bandage； thus taking one turn with it。
The best application to such accidents is a small cataplasm of wheaten
flour； washed； and mixed up into a viscid mass。 If the flour be made
from good wheat； and if it be glutinous； it should be used alone for
all such cases； but if it be not very glutinous； a little of the manna
of frankincense； well pulverized； is to be moistened with water； and
the flour is to be mixed up with it； or a very little gum may be mixed
in like manner。
37。 In those cases in which the fractured portions are depressed and
flattened； if it is depressed in front at the cartilage； something may
be introduced into the nostrils to rectify the parts。 If not； all such
deformities may be restored by introducing the fingers into the
nostrils； if this can be managed； but if not； a thick spatula is to be
introduced with the fingers； not to the fore part of the nose； but
to the depressed portion； and the physician is to take hold of the
nose externally on both sides； and at the same time raise it up。 And
if the fracture be much in the fore part one may introduce into the
nostrils as already stated； either caddis scraped from a linen
towel； or something such wrapped up in a piece of cloth； or rather
stitched in Carthaginian leather； and moulded into a shape suitable to
the place into which it is to be introduced。 But if the fracture be at
a greater distance； it is not possible to introduce anything within；
for if it was irksome to bear anything of the kind in the fore part；
how is it not to be so when introduced farther in？ At first； then；
by rectifying the parts from within； and sparing no pains upon them
from without； they are to be brought to their natural position； and
set。 A fractured nose may be readily restored to shape； especially
on the day of the accident； or even a little later； but the physicians
act irresolutely； and touch it more delicately at first than they
should； for the fingers should be applied on both sides along the
natural line of the nose； and it is to be pushed downward； and thus；
with pressure from within； the displacement is to be rectified。 But
for these purposes no physician is equal to the index…fingers of the
patient himself； if he will pay attention and has resolution； for they
are the most natural means。 Either of the fingers is to be placed
firmly along the whole nose； and thus it is to be gently held； and
steadily； if possible until it become firm； but if not； he himself
is to hold it for as long a time as possible； or if he cannot； a child
or woman should do it； for the hands ought to be soft。 Thus may a
fracture of the nose； attended with depression； and not with
displacement to the side； but in a straight line； be most properly
treated。 I have never seen a case of fractured nose which could not be
rectified when attempted； before callus is formed； provided the
treatment be properly applied。 But although men would give a great
price to escape being deformed； yet at the same time they do not
know how to take care； nor have resolution； if they do not
experience pain； nor fear death； although the formation of callus in
the nose speedily place； for the most part is consolidated in ten
days； provided sphacelus do not take place。
38。 When the fractured bone is displaced laterally； the treatment is
the same； but it is obvious that the reduction is to be made； not by
applying equal force on both sides； but by pushing the displaced
portion into its natural position； and pressing on it from without；
and introducing something into the nostrils； and boldly rectifying the
fragments which incline inward； until the whole be properly
adjusted； well knowing that if you do not restore the parts at once；
it is impossible but that the nose must be distorted。 But when you
restore the parts to their natural position； either the patient
himself； or some other person； is to apply one finger or more to the
part which protrudes； and keep it in position until the fracture be
consolidated； but the little finger is； from time to time； to be
pushed into the nostril； to rectify the parts which incline inward。
When any inflammation supervenes； dough must be used； but attention
must still be equally paid to the application of the fingers； although
the dough be on the part。 But if the fracture be in the cartilage；
with lateral displacement； the end of the nose must necessarily be
distorted。 In such cases some of the aforementioned means of
reduction； or whatever suits； is to be introduced into the nostril；
but there are many convenient things to be found which have no
smell； and are appropriate in other respects； thus； on one occasion； I
introduced a slice of sheep's lung； as it happened to be at hand；
for sponges； if introduced； imbibe humidities。 Then the outer skin
of Carthaginian leather it to be taken； and a piece of the size of the
thumb； or what will answer； is to be cut off and glued to the
outside of the nostril which is turned aside； and then this piece of
thong is to be stretched to the proper degree； or rather a little more
than what will be sufficient to make the nose straight and regular。
Then （for the thong must be long） it is to be brought below the ear
and round the head； and the end of the thong may either be glued to
the forehead； or a still longer one may be carried all round the head；
and secured。 This is a natural mode of setting the nose； is of easy
application； and is calculated to enable the counter…extension on
the nose to be made greater or less； as you may incline。 In a case
where the fractured nose is turned to the side； the treatment is to be
conducted otherwise； as already described； and in most of them the
thong ought to be glued to the end of the nose； in order to make
extension in the opposite direction。
39。 When the fracture is complicated with a wound； one need not be
troubled on that account； but pitch…cerate or any of the
applications for fresh wounds is to be applied to the sores； for； in
general； they admit of easy cure； even when there is reason to
apprehend that pieces of bone will come out。 The parts； at first；
are to be adjusted fearlessly； taking care that nothing is omitted；
and； subsequently； they are also to be adjusted with the fingers； more
softly； indeed； but still it must be done； and of all parts of the
body the nose is modeled with the greatest ease。 And there is
nothing to prevent us from having recourse to the practice of gluing
on the thongs； and drawing the nose to the opposite side； even if
there be a wound or the parts be inflamed； for these thongs give no
pain。
40。 In fractures of the ear all sorts of bandages do harm。 For one
would not think of applying it quite loose； and if applied more
tightly； it only does the more harm； for even the sound ear； when
confined with a bandage； becomes painful； throbs； and gets into a
febrile state。 With regard to cataplasms； the heaviest； on the
whole； are the worst； but almost all kinds are bad； form abscesses；
occasion an increase of humors； and afterward troublesome
suppurations； and a