| [p. 248]ribs. And even when no
such symptoms supervene from contusion of the skin about the ribs,
still in such cases there is, generally, more combined pain than in
fractures of the ribs, and relapses of pain in the seat of the injury
are more apt to occur. Wherefore some physicians pay much less attention
to such injuries, than where the rib is fractured, whereas, if they
were wise, they would treat such cases with far greater care than
the other; for it is proper that the diet should be restricted, that
the patients should remain at rest as much as possible, and abstain
from venery, from fat articles of food, from such as excite cough,
and from everything strong; they should be bled in the arm, speak
as little as possible, should have the contused part bound round with
folded compresses, plenty of bandages, broader than the contusion,
and which should be smeared with cerate; in applying the bandages,
broad and soft shawls should be used, and they should be put on moderately
firm, so that the patient will say that they are neither too tight
nor loose, and the bandaging should commence at the seat of the injury,
and be made more particularly tight there, and the bandaging should
be conducted as is done with a double-headed roller, so that the skin
about the ribs may not be ruffled, but may lie smooth, and the bandaging
should be renewed every day, or every alternate day. It is better
also to open the bowels with some gentle medicine, so as just to produce
an evacuation of the food, and the diet is to be restricted for ten
days, and then the body is to be recruited and filled up; while you
are upon the reducing system, the bandaging should be tighter, but
when you are making him up again, it must be looser; and, if he spit
blood from the commencement, the treatment and bandaging should be
continued for forty days; but if there be no haemoptysis, treatment
for twenty days will generally be sufficient; but the length of time
must be regulated by the magnitude of the injury. When such contusions
are neglected, if no greater mischief result there from, at all events
the bruised part has its flesh more pulpy than it had formerly. When,
therefore, any such thing is left behind, and is not properly dissipated
by the treatment, it will be worse if the mucosity be lodged near
the bone, for the flesh no longer adheres to the bone
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