Costa

Van-Homan-bruised-ribs

Proprie quaedam tamen de costa dicenda sunt; quia iuxta viscera est, gravioribusque periculis is locus expositus est. haec quoque igitur interdum sic finditur, ut ne summum quidem os sed interior pars eius, quae rara est, laedatur, interdum sic, ut eam totam is casus perruperit. si tota fracta non est, nec sanguis exspuitur nec febricula sequitur, nec quicquam suppurat, nisi admodum raro, nec dolor magnus est: tactu tamen is locus leniter indolescit. sed abunde est eadem, quae supra scripta sunt, facere, et a media fascea incipere deligare, ne in alterutram partem haec cutem inclinet. ab uno vero et vicensimo die, quo utique os esse debet glutinatum, id agendum cibis uberioribus est, ut corpus quam plenissimum fiat, quo melius os vestiat, quod illo loco tenerum adhuc iniuriae sub tenui cute expositum est. per omne autem tempus curationis vitandus clamor, strictior quoque <vox>, tumultus, ira, motus vehementior corporis, fumus, pulvis, et quicquid vel tussim vel sternumentum movet; ne spiritum quidem magnopere continere expedit. at si tota costa perfracta est, casus asperior est: nam et graves inflammationes et febris et suppuratio et saepe vitae periculum sequitur: et sanguis spuitur.
(Celsus, De Medicina 8.9.1a-b)

There is, however, something special to be said of the rib, because it is near the viscera, and that region is exposed to greater danger. A rib then is sometimes split so as not to injure the upper bone, but only the thin structure on its inner side; sometimes it is completely broken across. If the fracture is incomplete, blood is not expectorated, and fever does not follow, nor is there suppuration except very rarely, nor great pain; nevertheless there is some tenderness to touch, but it is quite enough to do what has been described above, and to begin the bandaging from the middle of the bandage that it may not displace the skin to either side. Then after twenty-one days, by which time the bone ought to have formed a firm union, a fuller diet is to be administered in order to fatten the body as much as possible, so as to cover the bone better, for the bone there whilst still tender is liable to injury owing to the thinness of the skin. But during the whole course of recovery the patient must avoid shouting or even straining the voice, noise, anger, violent bodily movements, smoke, dust, and anything that causes a cough or sneeze; it is not even advisable to hold the breath for long. But if a rib has been broken right across the case is more severe; for grave inflammations follow and fever and suppuration and often danger to life: and blood is expectorated. (tr. Walter George Spencer)

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