Treatment of fractures of long bones by simple extension / by John Swinburne.

  • Swinburne, John, 1820-1889.
Date:
1861
Catalogue details

Licence: Public Domain Mark

Credit: Treatment of fractures of long bones by simple extension / by John Swinburne. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    accident furnishes the material, while the young man must have the proper knowledge to profit by it; for it is purely accident, and not intention, that gives the surgeon employment, thereby giving the public an opportunity to distinguish between the really scientific surgeon and the charlatan. If the surgeon has all the knowledge, and not the means, to purchase the complicated and increasing complications of surgi- cal appliances, he is like a ship without ballast, or like a carpen- ter without his tools. And here I would enquire how many young practitioners have the means to purchase mechanical appliances for the treatment of fractures indiscriminately, in order that they may be able to compete with old practitioners, or be prepared for any emergency ? It has been said that accident makes the man. Would accident make the man if lie had not the knowledge to take advantage ot circumstances ? I can conceive how accident might give us wealth ; but accident, developing wealth or social position, and accident developing one's mental and scientific resources, are two things quite separate and distinct. I would ask of what service are splints ? What office do they perform in the treatment of fractures ? Authors say they sup- port the bone while union is being effected. I would ask, how many fractures of the long bones can be placed in apposition without the use of extension, particularly in oblique fractures, or where there has been great injury to soft parts, and overlapping of the bones ? I know of few exceptions. The true use of splints should be to keep the fractured ends of the bone in apposition, by placing the muscles on the stretch, and thereby making them (the muscles) the true splints. The experiments of Reid and others show that muscles are not susceptible of being stretched beyond their normal capacity; that when so stretched, they are capable of bearing great lateral pressure without much deflection; and any attempt at undue lateral pressue results in rupture of the muscular substance. The supporting power of the muscles may be pretty well illus- trated by the following experiment: Take a strip of wood, and encircle it lengthwise with a number of cords or catgut or other strong fibre. Fasten these cords to two pieces of board, and then, by drawing these boards strongly apart, render the cords tense. The cords represent muscles; the strip of wood, bone: