treatment of fractures without splints

1
312 most probably would have succeeded with a less experienced practitioner, but my friend, on the instant that the first.motion gave in- timation of the wayward design, instinc- tively hooked his finger. The soldier strug- gled. The doctor hooked tighter and held faster. The soldier redoubled his exer- tions, The doctor crouched and grasped the table. The soldier redoubled his efforts. A scene presented itself which eiefies de- scription. I know not whether the olient state of the finger, or a sudden relaxa- tion of the sphincter, caused the result, hut the soldier, by a cunning screw and a final jerlr, slid from the doctor’s crooked but slippery finger, with a rapid concussion of air from the cavity, which astonished the by-standers, and excited still farther the ire of the bailled surgeon, who, I regret to say, Messed him once or twice with unbecoming vigour, and administered, as he staggered on’, such an inhuman "rise" behind, that the poor sufferer came to the floor, lengthwise, amid the half-disappointed, half-compunc- tuous feelings of spectators and surgeon, who was almost inconsolable at the frus- tration of an operation by the terror and in- decision of the patient.—Medical Pencil- lings. TREATMENT OF FRACTURES WITHOUT SPLINTS. To the Editor of THE LANCET. SIR: In your valuable Journal, dated May 14th, 1 observe "A Case of Double Fracture of the Thigh successfully treated in less than four weeks, without the Use of Splints," by Dr. James Inglis. The com- munication commences with a smartish tirade against the profession generally, h8- cause it has not permitted a revolution in the treatment of broken bones to occur within the short period of six months. The writer’s disappointment need not be so acute as he says it is. There is no doubt that if the system proposed by Mr. Radley be judi- cious, it wilt prevail, in spite of prejudice, either professional or otherwise. But m) imsiuess is not with Mr. Radley, but Dr Inglis. It seems tolne (and 1 have had some experience in fractures) that his case, like many cases in surgery now-a-days, is a little too striking, to produce the beneiit he de- sires. In a boy, niue years old, there were two fractures of the thigh, one below the great trochanter, where several sylirrters oj’, bone co2ald be distinctly felt; the other at the lower third of the bone. The accident oc- curred 0:1 the 1st of March. In nine dnyh the lower fractuie was united, but at the upper fracture the " splinters were felt rub- bing against each other with thc usuzl grato ing noise ;" i. e. no restorative action had commenced, and yet on the twelfth day, we are informed that both fractures were united. This strikes me as a little unusual, at least it is so in Dublin. I am, Sir, Your obedient servant, M.R.C.S.I. Dublin, May 22,1836. We cannot understand whether our correspondent means to imply his belief that the case was not one of double frac- ture, or to express a doubt that. the dates were erroneously quoted. However, even presuming that the former is intended, in. correct as must be the assumption, it is very certain that the case would, but for the pro. mulgation of Mr. Radiey’s plan, have been treated, with splints and tight bandages, in consequence of the evidences of fracture which, in the opinion of Dr. Inglis, were manifest, and in that case no sensible man can entertain a doubt of the mischievous effects of their application to a limb so deeply injured. We print the letter, how- ever, to obtain the attention of Dr. Inglis to the doubt which the hingularly rapid denoue- ment is calculated to create. NEW POOR-LAW ACT.—MEDICAL ASSISTANTS. To tile Editor of THE LANCET. SiR : Allow mc to call your attention to a new device of the proprietors of the Apo. thecaries’ Hall, by which they seek to levy new contributions on the medical profession, now that they find their career drawing to a close. They have been endeavouring to persuade country practitioneis, that under the provisions of the New Poor-Law Act, a medical man contracting for parishes can- not any longer employ any assistant, unless such assistant be a member of the Ariotlic- caries’ Company, whereas the Act merely provides that the medical men corit7,acti)tg for parishes shall be legally-licensed practi- tioners ; as the legislature could never con- template on compelling medical men to provide for parish patients ai assistant who is otherwise qualified than the one em- ployed in attending upon his own private patients, and the Apothecaries’ Act does not require that assistants should be mem- bers of the Apothecaries’ Company. Will you have the kindness to look into the Act and f’avour the profession with your opinion on the subject. The interrerenceof the company is calculated to occasion mucn inconvenience to country practitioner-, and

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Page 1: TREATMENT OF FRACTURES WITHOUT SPLINTS

312

most probably would have succeeded with aless experienced practitioner, but my friend,on the instant that the first.motion gave in-timation of the wayward design, instinc-tively hooked his finger. The soldier strug-gled. The doctor hooked tighter and heldfaster. The soldier redoubled his exer-

tions, The doctor crouched and graspedthe table. The soldier redoubled his efforts.A scene presented itself which eiefies de-

scription. I know not whether the olientstate of the finger, or a sudden relaxa-tion of the sphincter, caused the result,hut the soldier, by a cunning screw and afinal jerlr, slid from the doctor’s crookedbut slippery finger, with a rapid concussionof air from the cavity, which astonished theby-standers, and excited still farther the ireof the bailled surgeon, who, I regret to say,Messed him once or twice with unbecomingvigour, and administered, as he staggeredon’, such an inhuman "rise" behind, that thepoor sufferer came to the floor, lengthwise,amid the half-disappointed, half-compunc-tuous feelings of spectators and surgeon,who was almost inconsolable at the frus-tration of an operation by the terror and in-decision of the patient.—Medical Pencil-lings.

TREATMENT OF FRACTURES

WITHOUT SPLINTS.

To the Editor of THE LANCET.

SIR: In your valuable Journal, dated

May 14th, 1 observe "A Case of DoubleFracture of the Thigh successfully treated inless than four weeks, without the Use ofSplints," by Dr. James Inglis. The com-munication commences with a smartishtirade against the profession generally, h8-cause it has not permitted a revolution inthe treatment of broken bones to occur

within the short period of six months. Thewriter’s disappointment need not be so acuteas he says it is. There is no doubt that ifthe system proposed by Mr. Radley be judi-cious, it wilt prevail, in spite of prejudice,either professional or otherwise. But m)imsiuess is not with Mr. Radley, but DrInglis. It seems tolne (and 1 have had someexperience in fractures) that his case, likemany cases in surgery now-a-days, is a littletoo striking, to produce the beneiit he de-sires. In a boy, niue years old, there weretwo fractures of the thigh, one below the

great trochanter, where several sylirrters oj’,bone co2ald be distinctly felt; the other at thelower third of the bone. The accident oc-curred 0:1 the 1st of March. In nine dnyhthe lower fractuie was united, but at the

upper fracture the " splinters were felt rub-

bing against each other with thc usuzl grato

ing noise ;" i. e. no restorative action hadcommenced, and yet on the twelfth day, weare informed that both fractures were

united. This strikes me as a little unusual,at least it is so in Dublin. I am, Sir,

Your obedient servant,M.R.C.S.I.

Dublin, May 22,1836.

We cannot understand whether our

correspondent means to imply his beliefthat the case was not one of double frac-

ture, or to express a doubt that. the dateswere erroneously quoted. However, even

presuming that the former is intended, in.correct as must be the assumption, it is verycertain that the case would, but for the pro.mulgation of Mr. Radiey’s plan, have beentreated, with splints and tight bandages, inconsequence of the evidences of fracture

which, in the opinion of Dr. Inglis, were

manifest, and in that case no sensible mancan entertain a doubt of the mischievouseffects of their application to a limb so

deeply injured. We print the letter, how-

ever, to obtain the attention of Dr. Inglis tothe doubt which the hingularly rapid denoue-ment is calculated to create.

NEW POOR-LAW ACT.—MEDICALASSISTANTS.

To tile Editor of THE LANCET.SiR : Allow mc to call your attention to

a new device of the proprietors of the Apo.thecaries’ Hall, by which they seek to levynew contributions on the medical profession,now that they find their career drawing to aclose. They have been endeavouring to

persuade country practitioneis, that underthe provisions of the New Poor-Law Act, amedical man contracting for parishes can-not any longer employ any assistant, unlesssuch assistant be a member of the Ariotlic-caries’ Company, whereas the Act merelyprovides that the medical men corit7,acti)tgfor parishes shall be legally-licensed practi-tioners ; as the legislature could never con-template on compelling medical men to

provide for parish patients ai assistantwho is otherwise qualified than the one em-ployed in attending upon his own privatepatients, and the Apothecaries’ Act doesnot require that assistants should be mem-bers of the Apothecaries’ Company.

Will you have the kindness to look intothe Act and f’avour the profession with youropinion on the subject. The interrerenceofthe company is calculated to occasion mucninconvenience to country practitioner-, and