| [p. 200] rather broader
and another narrower; and there should be three of them at least,
and still more, so that you may use those that suit best; and then,
along with extension, we must use these as levers, applying the under
surface of the piece of iron to the under fragment of the bone, and
the upper surface to the upper bone; and, in a word, we must operate
powerfully with the lever as we would do upon a stone or a piece of
wood. The pieces of iron should be as strong as possible, so that
they may not bend. This is a powerful assistance, provided the pieces
of iron be suitable, and one use them properly as levers. Of all the
mechanical instruments used by men, the most powerful are these three,
the axis in peritrochio, the lever, and the wedge. Without these,
one or all, men could not perform any of their works which require
great force. Wherefore, reduction with the lever is not to be despised,
for the bones will be reduced in this way, or not at all. But if the
upper fragment which rides over the other does not furnish a suitable
point of support a suitable point of support for the lever, but the
protruding part is sharp, you must scoop out of the bone what will
furnish a proper place for the lever to rest on. The lever, along
with extension, may be had recourse to on the day of the accident,
or next day, but by no means on the third, the fourth,
and the fifth. For if the limb is disturbed on these days, and yet
the fractured bones not reduced, inflammation will be excited, and
this no less if they are reduced; for convulsions are more apt to
occur if reduction take place, than if the attempt should fail. These
facts should be well known, for if convulsions should come on when
reduction is effected, there is little hope of recovery;
but it is of use to displace the bones again if this can be done with
out trouble. For it is not at the time when the parts are in a particularly
relaxed condition that convulsions and tetanus are apt to supervene,
but when they are more than usually tense. In the case we are now
treating of, we should not disturb the limb on the aforesaid days,
but strive to keep the wound as free from inflammation as possible,
and especially encourage suppuration in it. But when seven days have
elapsed, or rather more, if there be no fever, and if the wound be
not inflamed, then there will be less to prevent an attempt at reduction,
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