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negligent； and the physicians finding they cannot make the parts
look well； take themselves off； and are not sorry at the neglect of
the patients； and in the meantime the callus is quickly formed。 The
method of dressing which is most appropriate； is similar to that
used in ordinary cases； consisting of cerate； compresses； and
bandages； and it should be most especially known in this operation；
that most compresses should be placed on the projecting bone； and that
the greatest pressure should be made there。 There are certain
physicians who make a show of superior skill by binding a heavy
piece of lead on the part in order to depress the projecting bone； but
this mode of treatment does not apply to the clavicle； for it is
impossible to depress the projecting part to any extent worth
mentioning。 There are others who； knowing the fact that the bandages
are apt to slip off； and that they do not keep the projecting parts in
their place； apply compresses and bandages like the others； and then
having girt the patient with a girdle； where it is usually applied
with most effect； they make a heap of the compresses upon of the
compresses upon the projecting bone when they apply them； and having
fastened the head of the bandage to the girdle in front； they apply it
so as to bring the turns of it into the line of the clavicle； carrying
them to the back； and then bringing them around the girdle they
carry them to the fore part and again backward。 There are others who
do not apply the bandage round the girdle； but carry the rounds of
it by the perineum and anus； and along the spine； so as to compress
the fracture。 To an inexperienced person these methods will appear not
far from natural； but when tied； they will be found of no service； for
they do not remain firm any length of time； even if the patient keep
his bed； although in this position they answer best； and yet even when
lying in bed； should he bend his leg； or should his trunk be bent； all
the will be displaced； and； moreover； the bandaging is inconvenient；
in as much as the anus is comprehended by it； and many turns of the
bandage are crowded there in a narrow space。 And in the method with
the girdle； the girdle cannot be so firmly girt around； but that the
turns of the bandage force the girdle to ascend； and hence of
necessity all the other bandages must be slackened。 He would seem to
me to come nearest his purpose； although after all he effects but
little； who would take a few turns round the girdle； few turns round
the girdle； but would use the bandage principally to secure the former
bandaging； for in this manner the bandages would be most secure； and
would mutually assist one another。 Every thing now almost has been
said which applies to fracture of the clavicle。 But this also should
be known； that in fractures of the clavicle； it is the part attached
to the breast which is uppermost； and that the piece attached to the
acromion is the lowermost。 The cause of this is； that for the most
part the breast can neither be depressed nor raised； there being but a
slight movement of the joint at the breast； for the sternum is
connected together on both sides with the spine。 The clavicle admits
of most motion at the joint of the shoulder； and this arises from
its connection with the acromion。 And； moreover； when broken； the part
which is connected with the sternum flies upward； and is not easily
forced downward； for it is naturally light； and there is more room for
it above than below。 But the shoulder； the arm； and the parts
connected with them； are easily moved from the sides and breast；
and； on that account； they admit of being considerably elevated and
depressed。 When； therefore； the clavicle is broken； the fragment
attached to the shoulder inclines downward； for it inclines much
more readily with the shoulder and arm downward than upward。 Matters
being as I have stated； they act imprudently who think to depress
the projecting end of the bone。 But it is clear that the under part
ought to be brought to the upper； for the former is the movable
part； and that which has been displaced from its natural position。
It is obvious； therefore； that there is no other way of applying force
to it （for the bandages no more force it to than they force it
from）； but if one will push the arm when at the sides as much as
possible upward； so that the shoulder may appear as sharp as possible；
it is clear that in this way it will be adjusted to the fragment of
the bone connected with the breast from which it was torn。 If one then
will apply a bandage； secundum artem； for the purpose of promoting a
speedy cure； and will reckon everything else of no value； except the
position as described； he will form a correct opinion of the case； and
will effect a cure in the speediest and most appropriate manner。 It is
of great importance； however； that the patient should lie in a
recumbent posture。 Fourteen days will be sufficient if he keep
quiet； and twenty at most。
15。 But if the clavicle be fractured in the opposite manner （which
does not readily happen）； so that the fragment of bone connected
with the breast is depressed； while the piece connected with the
acromion is raised up and rides over other； this case does not require
much management； for if the shoulder and arm be let go； the
fragments of the bone will be adjusted to one another； and an ordinary
bandage will suffice； and the callus will be formed in the course of a
few days。
16。 If the fracture be not thus； but if it incline either forward or
backward； it may be restored to its natural position； by raising the
shoulder with the arm as formerly described； and brought back to its
natural place； when the cure will be speedily accomplished。 Most of
the varieties of displacement may be rectified by raising the arm
upward。 When the upper bone is displaced laterally or downward； it
would favor the adaptation of the parts if the patient would lie on
his back； and if some elevated substance were placed between the
shoulder…blades； so that the breast may be depressed as much as
possible upon the two sides； and if； while another person raised the
arm extended along the sides； the physician； applying the palm of
the one hand to the head of the bone； would push it away； and with the
other would adjust the broken bones； he would thus reduce the parts
most readily to their natural position。 But； as formerly stated； the
upper bone （sternal fragment？） is rarely depressed downward。 In most
cases； after the bandages have been applied； that position is
beneficial in which the elbow is fixed to the same side； and the
shoulder is kept elevated； but in certain cases； the shoulder is to be
raised； as has been directed； and the elbow is to be brought forward
to the breast； and the hand laid on the acromion of the sound side。 If
the patient has the resolution to lie in bed； something should be
placed so as to support the shoulder； and keep it as much elevated
as possible。 But if he walk about； the arm should be slung in a shawl；
which embraces the point of the elbow； and is passed round the neck。
17。 When the elbow…joint is displaced or dislocated to the side or
outward；