| [p. 224]with the shoulder and arm downward than upward.
Matters being as I have stated, they act imprudently who think to
depress the projecting end of the bone. But it is clear that the under
part ought to be brought to the upper, for the former is the movable
part, and that which has been displaced from its natural position.
It is obvious, therefore, that there is no other way of applying force
to it (for the bandages no more force it to than they force it from);
but if one will push the arm when at the sides as much as possible
upward, so that the shoulder may appear as sharp as possible, it is
clear that in this way it will be adjusted to the fragment of the
bone connected with the breast from which it was torn. If one then
will apply a bandage, secundum artem, for the purpose of promoting
a speedy cure, and will reckon everything else of no value, except
the position as described, he will form a correct opinion of the case,
and will effect a cure in the speediest and most appropriate manner.
It is of great importance, however, that the patient should lie in
a recumbent posture. Fourteen days will be sufficient if he keep quiet,
and twenty at most.
But if the clavicle be fractured in the opposite manner (which does
not readily happen), so that the fragment of bone connected with the
breast is depressed, while the piece connected with the acromion is
raised up and rides over other, this case does not require much management,
for if the shoulder and arm be let go, the fragments of the bone will
be adjusted to one another, and an ordinary bandage will suffice,
and the callus will be formed in the course of a few days.
If the fracture be not thus, but if it incline either forward or backward,
it may be restored to its natural position, by raising the shoulder
with the arm as formerly described, and brought back to its natural
place, when the cure will be speedily accomplished. Most of the varieties
of displacement may be rectified by raising the arm upward. When the
upper bone is displaced laterally or downward, it would favor the
adaptation of the parts if the patient would lie on his back, and
if some elevated substance were placed between the shoulder-blades,
so that the breast may be depressed as much as possible upon the two
sides; and if, while