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.
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.
The inflammation that generally attends fractures requires however a fomentation of _Camphor Spirits_ (A), in order to disperse the obstructed humour; but if there is no inflammation, the part undoubtedly is the better without such applications; as then there will be nothing to hinder a free circulation; for which reason, fomentation should be used as sparingly as possible.
It is well known too, with what difficulty the fractured bones were set formerly, owing principally to the limb being stretched out in a position that excited all the muscles to contraction. This is also here obviated.
In reducing therefore a dislocation or fracture, the muscles should be as much at rest as possible, both in the operation, as well as during the whole time of the cure. It is for that very reason my direction in this respect differs from what has been delivered to us by authors on that subject, particularly such, as might be expected to fall into the hands of a seaman.
Another error has been practised, namely, the laying on the bandage very tight. It was supposed, that that would strengthen the limb, and make the bone smooth; but it has sometimes prevented the bones from growing together at any rate. The bandage to be sure should not be too slack, for then we might as well lay it aside entirely. A bandage certainly is necessary, but merely as a support, and it should never be tighter than what the patient can well bear.
In simple fractures, the first dressing should be so permanent, as to have no need for being removed, at least for six, seven, eight, nine days, or more; if the patient don’t feel uneasy. For my own part, having ever been successful in fractures, I have not opened the first dressing for a fortnight, and sometimes three weeks.
The laying stretched upon the back when a leg is fractured, is altogether needless, troublesome, and even a hindrance to the healing. The patient should have a good wide cot, and so that it may swing pretty easy; or else entirely confined, when the ship has much motion; and having the leg well secured with splints, he may safely lay on what side he pleases, provided he does not sit up in the bed (though he may out of it) for the first three weeks; for that strains the muscles very much.