Of Medicine, in Eight Books

As I am to proceed from these parts to the lower jaw, I think it proper to insert some observations relating to all the bones in general, to prevent a frequent repetition of them. Every bone then is sometimes split longitudinally, like wood, sometimes is fractured transversely, sometimes obliquely; and in this last species the ends are sometimes blunt, sometimes acute, which last is of the worst kind; because they are not easily united, where they do not rest upon something obtuse, then they also wound the flesh, and sometimes a nerve or a muscle: moreover, one fragment sometimes happens to be divided into several. In fractures of the other bones, one end often recedes entirely from the other; but the broken ends of a jaw-bone remain always in contact in some one part.

Therefore, first the bones are to be forced into their place, by two fingers pressing on each side, both within the mouth and upon the chin; then if the fracture of the jaw-bone be transverse, (in which case one tooth generally stands out beyond that next to it) when it is reduced, the two contiguous teeth, or if they are loose, those next to them, must be tied together by a horse-hair. In a different kind of fracture this is needless. All the other steps are the same as in the above-described fractures; for a double linen cloth dipped in wine and oil must be laid upon it, and with that fine flour, and the soot of frankincense; then a roller or soft strap, with a longitudinal opening in the middle, that it may take in the chin both above and below; and lastly, the ends of it must be brought over the head and tied there.

With regard to the bones in general, it may further be remarked once for all, that fasting at first is necessary; then from the third day moist food; when the inflammation is removed a little fuller diet and such as promotes the growth of flesh; wine is hurtful through the whole time. On the third day, they ought to be opened, and fomented with the vapour of hot water by a spunge, and the same dressings, as at first, are to be put on; this to be repeated on the fifth day, and so on, till the inflammation is gone, which ceases, either on the ninth day, or generally on the seventh: when that is removed, the bones must be examined again, that if any fragment is not in its place, it may be reduced, and the bandage must not be taken away, till two thirds of the time have elapsed, in which the several bones unite.

Now, generally between the fourteenth and twenty-first day, the following bones heal: the lower jaw, cheek-bone, clavicle, breast-bone, scapula, ribs, the spine at the hips, the ancle-bone, heel, hand, and foot; between the twentieth and thirtieth, the bones of the leg and fore arm; between the twenty-seventh and fortieth, the arm and thigh bones.

But concerning the lower jaw-bone I must add, that the case requires the long use of a liquid diet. Also far a considerable time pancakes and such like must be continued, and nothing be chewed, till the callus has perfectly restored the strength of the bone: and for some days, at first, the patient must not speak at all.