But there are some peculiarities to be observed relating to the ribs; because they are near the viscera, and that part is exposed to great dangers. A rib then is sometimes fissured in such a manner, that not the exterior surface of the bone, but the interior part of it, which is thin, is hurt; sometimes it is broke entirely through. If the whole is not fractured, there rarely follows either a spitting of blood, or a febricula, or any suppuration; and the pain is not great; however the place is slightly pained upon being touched. But this case requires no more than to do what is above directed; and in binding it up to begin at the middle of the roller (a double-headed roller) lest it draw the skin to either side. After the twenty-first day, when the bone ought to be united, we must endeavour, by a more plentiful diet, to render the body as plump as possible, that it may cover the bone the better; which being yet tender is in that part exposed to injuries under a thin skin. And through the whole time of the cure, vociferation must be avoided, and even speaking, hurrying, anger, all violence of motion, smoke, dust, and whatever excites either coughing or sneezing; and it is not even proper to hold in the breath much.

But if a rib be entirely broke through, the case is more troublesome: for both violent inflammations, and a fever and suppuration, and often a danger of death ensue; and a spitting of blood. Therefore, if the strength admits, blood must be taken from the arm of the same side with the rib; if it does not allow this, a clyster must be given, but without any thing acrid; and the patient must fast a considerable time. He must not eat bread before the seventh day, but live upon gruel alone; and upon the part must be applied cerate made of lycium, with an addition of boiled resin; or the malagma of Polyarchus; or cloths squeezed out of wine, rose oil, and common oil; and over these soft sordid wool, and two double-headed rollers, but not tight. What I mentioned before as hurtful, are in this case to be avoided with greater caution; so that even the breath must not be too often fetched. But if a cough be troublesome, a potion must be taken for it, either of germander, or rue, or the herb staechas, or of cummin and pepper. When there are severe pains, it is proper to lay on a cataplasm either of darnel or barley, with an addition of a third part of mellow figs. And this must lie on in the day time; but in the night, either cerate, or a malagma, or cloths; because the cataplasm may drop off. Therefore it must be opened every day, till such time as we may be content with the cerate or malagma. And for ten days the body must be reduced by fasting; from the eleventh we must begin to nourish it; and therefore the bandage about it must be more lax than at first; and generally this method is continued to the fortieth day.

In the course of which, if there be any fear of a suppuration, the malagma will be more effectual to discuss it than cerate. If, notwithstanding, the suppuration take place, and cannot be discussed by the medicines prescribed before, no time must be lost, lest the bone below be affected; but in the part where it shall swell most, a hot iron must be introduced, till it reach the pus, which must be evacuated. If a tumour does not appear any where, we may discover where the pus is principally lodged in this manner. We must rub all the part with Cimolian chalk, and suffer it to dry; and wherever the moisture shall penetrate deepest, there the pus is nearest to the skin; and here the actual cautery is to be used. If there shall be a pretty large abscess, it will require two or three perforations; and lint to be put into them, or some part of a penecillum; which may be tied by a thread at the top, that it may be easily drawn out. What remains to be done is the same as in other burns. When the ulcer shall be clean, the body must be nourished, lest a consumption follow, which would be fatal. Sometimes too, when the bone is more slightly affected, and neglected at first, not pus, but a certain humour like mucus is collected within, and the skin over it grows soft; in which case, we must use the cautery in the same manner.

There is also something peculiar to be noted in the spine: for if any part has separated from a vertebra, or is any way broken(16), the part becomes hollow; prickings are felt there, because these fragments must necessarily be jagged: whence it happens, that the patient now and then leans forward. These are indications of the case; and the same medicines are necessary, which have been mentioned in the first part of this chapter.