Detailed explanation of the ligation method

The bandage should start from the broken place, and from there go to where the fracture becomes larger, and there the bandage is tightened the tightest. The stronger the fracture, the stronger the bandage should be, and in general they bandage the fracture site and the place from which the matter should be driven away, keeping it in a certain position. This prevents swelling and even sometimes dissipates the tumor, and preventing swelling also prevents the bone from rotting. However, this does not help against the formation of ichor in the bone itself, right down to the brain, which destroys the brain and bone. The bone then has to be broken and separated again to remove the ichor and open the way for the pus to escape. Most of all, one should protect against the penetration of this kind of matter from places located above the fracture, although the underlying organ also sometimes drives its excesses into the upper organ if it is weak.

Bandages and splints should not be tightened to such an extent that it impedes the access of nutrients and blood, as this interferes with healing. Hippocrates, wanting to prevent swelling, added distracting ointments with unripe olive oil and wax to the bandages. Often, in order to delay swelling, it is necessary to actually cool the bandages with air or water, and sometimes it is necessary to soothe the swelling, for example, with chamomile oil or astringent wine, it dispels the swelling and strengthens the organ; do not apply wax ointment to the place where there is an ulcer. Sometimes medications with strengthening and dissolving properties are also required, for example, olive oil with mastic and ushshak.

Generally speaking, the dressing used for a fresh, non-swollen fracture should be linen, cooled, distracting, it is often enough to apply a mud cake with water and vinegar, and sometimes they use wax ointment and similar means from those mentioned by us. If a dressing is done after the appearance of a tumor, then it is best that it be made of wool dipped in oil, which resolves and softens the tumor. In all circumstances, the bandage on which the wax ointment is applied is a lower bandage, and this protects against increased pain, especially if the doctor does not hold the bandage constantly and helps when pain appears by unraveling and reapplying the bandage. It is especially not suitable to apply wax ointment if there is an ulcer; sometimes this causes rotting of the organ; instead of wax ointment, black wine is applied. Most heterogeneous fractures are accompanied by ulcers, and therefore wax ointment should be kept away from them and limited to astringent wine, which is moistened with a long bandage. We devote a separate paragraph to ointments for fractures.

When you start the bandage from the proper place, move it in turns, increasing them as the size of the fracture increases and decreasing them accordingly as it decreases or depending on the tumor, if it is visible, then return the bandage to the same place and continue bandaging until the healthy area.

This is what the first bandage should be. Then they told me to bring a second bandage and wrap it around the fracture site two or three times, and then lower it down, little by little loosening the bandage. After this, order to bring a third bandage and do the same upward, so that both bandages help each other drive away excess from the organ, straighten it and generally achieve the goal pursued by applying such bandages. Do not go overboard, spreading the bandage in both directions - then the vessels will be clogged, and it will not take in nutrients; often this even leads to chronic relaxation of the organ.

Sometimes doctors do it wrong and start with an ascending bandage, followed by a descending bandage, and then a bandage starting from the lower end of the descending bandage and going to the top of the ascending bandage; it kind of guards both bandages, and it is pulled tightest near the fracture. The goal with one bandage is the opposite of the goal with another bandage, with the help of which they want to attract strengthening matter to the organ; it is pulled under the organ, away from it, and gradually loosened, rising towards it, and this is a bandage opposite to the first.

These are the bandages found under the splints, but there are also bandages on top of the splints. As for the upper bandage, it should be such that the broken organ turns into one piece, devoid of movement, and distortion should not be allowed.

If the transverse fracture is complete, then the bandage should cover and tighten everywhere equally, but if most of the fracture is directed in one direction - and this is one of the types of fracture of false ribs - then the support of the bandage should be in the side where the fracture is stronger. In case of a fracture, you should not change the shape of the bandage; using one shape after another, this spoils the shape of the bone, which is straightened during restoration, and causes pain due to the curvature that sometimes occurs for this reason. The worst of the bandages is the one that causes spasms; if it is tightened, it causes pain, and if it is loosened, it produces curvature.

Hippocrates considers it right to untie the bandage one day, and the next - no, it’s better, because then the patient will not be burdened by the bandage, fiddle with it and scratch the diseased organ, which inevitably reaches liquid, irritating moisture, sometimes turning into ichor. It is best to check whether the bandage is good and whether the mentioned conditions persist after the tenth day and around the twentieth this is the time when a filling callus begins to form. Then, when the bone sticks to the bone, do not tighten the bandage tightly and tie it away from the fracture so that the bandage does not put pressure and does not prevent the callus from forming or reaching a sufficient size - sometimes only a thin and weak callus grows. But, of course, if a callus has already formed and grows to unnecessary sizes and becomes excessive, then one of the most powerful obstacles to this is tight contraction, as well as the use of retaining astringent drugs; they retain nutrients and tighten the callus so that it does not reach it either nutrition. However, you should also not release the patient from the bandage at the wrong time and give him rest.