Broken bones- Roman doctors

[Caballo]

Could someone help me with Roman techniques for mending fractured bones? After our sone broke his leg badly (tibia and fibia) my wife asked - and I didn't know the answer (happens a lot....). I've read about bone forceps as well- but am at a loss to explain how they are used.

Also, I assume that opiates were used for pain prevention?

[M. Caecilius]

Sorry to hear about your son. I wish him speedy recovery!

Variant 1: Cato the Elder, de Agricultura,160 (although he begins by talking about dislocations, he also mentions fractures as an aside. Any kind of dislocation may be cured by the following charm: Take a green reed four or five feet long and split it down the middle, and let two men hold it to your hips. Begin to chant: "motas uaeta daries dardares astataries dissunapiter" and continue until they meet. Brandish a knife over them, and when the reeds meet so that one touches the other, grasp with the hand and cut right and left. If the pieces are applied to the dislocation or the fracture, it will heal. And none the less chant every day, and, in the case of a dislocation, in this manner, if you wish: "huat haut haut istasis tarsis ardannabou dannaustra."

Variant 2: Celsus, de Medicina 7.ss. "As I am going to pass on from the above to the lower jaw I think I ought to point out certain matters pertaining to fractures so as not to have to say the same things too often. Any bone, then, may be split, either in a straight line as a log of wood is cleft lengthwise, or across, sometimes obliquely; and in the latter case, the fractured ends are sometimes blunted, sometimes pointed. The last is the worst because two ends are not brought together easily when they have nothing blunt to rest against, and they lacerate the flesh, sometimes also sinews and muscles; indeed sometimes there are several fragments. [...] What follows applies to fractures in general: fasting is a necessity at first; then from the third day a fluid diet, and when the inflammation has subsided a somewhat fuller diet to build up the strength; wine is wrong throughout; then on the third day the bandage is removed, and the part fomented with steam by means of a sponge, and the bandage reapplied as before; the same thing is to be done again on the fifth day and so on until the inflammation has ceased, which is generally by the ninth or the seventh day. The inflammation gone, the bones must be examined again, and if the fractured ends are not in place, they are reset; after which the bandaging should not be dispensed with until two-thirds of the time has elapsed which such bones take to unite. Bones generally reunite as follows: between the fourteenth and twenty-first days the lower jaw, cheek-bones, clavicle, sternum, blade-bones, ribs, spine, hip-bone, astragalus, heel-bone, and the bones of the hands and feet; between the twentieth and thirtieth days the bones of the leg and forearm; between the twenty-seventh and fortieth days the upper arm and thigh. But in the case of the lower jaw, there is this addition, that fluid food has to be taken for a longer period. [...] In the case of the leg it is equally important that one bone at least should be sound. One thing is common to fractures of leg and thigh, that after being bandaged the limb is laid in a gutter-splint. This splint should have two holes near the lower end, by which any fluid that has formed may run off; and there should be a stay for the sole of the foot both to support it and stop it from slipping backwards; and at the sides are slots so that when straps are passed through these, a kind of stay holds the leg and thigh as they have been set. If the leg is fractured, the splint should start from the sole; if the thigh, from about the ham up to the hip; if the fracture is near the head of the thigh, the hip should be included as well. It must not be overlooked, however, that if the thigh-bone is fractured it becomes shorter, for it never returns to its former state, and that afterwards the patient treads on the tips of the toes of that leg; but the disablement is much uglier when neglect is added to misfortune. [...] While these instructions are for individual bones, the following are general for all. For the first days fasting; next a more liberal diet as soon as the callus should be forming; abstinence from wine for a long time; free fomentation with hot water while there is inflammation; more sparing when it has subsided, then long continued but gentle inunction with liquid cerate, for the extremities of the fractured limb. And the limb should not be exercised too soon but brought back to its former use gradually. [...]" Read more about this here

You'll find a number of medical instruments for this type of operation, including bone levers and bone plyers, which both would require the use of a scalpel first.

Opiates existed. Pliny (NH 20.76) mentions the milk of poppies as well as lozenges made from poppy seeds and milk as soporifics, though not as pain killers; 20.81 mentions, with regards to wild purslain, that "in conjunction with oil, it is applied, with polenta, to assuage the pain of wounds", further (25.90) "Psyllion, cynoïdes, crystallion, sicelicon, or cynomyia, [...] mixed in the proportion of one acetabulum to one sextarius of water, it is left to coagulate and thicken; after which it is beaten up, and the thick solution is used as a liniment for all kinds of pains, abscesses, and inflammations.", (25.94) "[Mandragora] is given, too, for injuries inflicted by serpents, and before incisions or punctures are made in the body, in order to ensure insensibility to the pain", likewise, Pliny suggests hemlock (25.95).

Disclaimer: Don't do anything of this at home! Not that I think you would ever get that radical in reenactment! I guess Cato's method can't do any harm (unless this is the only method you attempt!), though it can't do much to help , either, but Celsus' should be used only by trained people and some of Pliny's remedies are potentially lethal. He himself mentions a suicide by opium, Psyllion can cause allergies, mandrake is a nightshade and may induce hallucinations and coma, and hemlock is primarily a lethal poison (famous victim: Socrates).

Again I wish your son a speedy and painless recovery.

[M. Caecilius]

Also, if you like to spend some time reading : http://classics.mit.edu/Hippocrates/fractur.html

[Robert Vermaat]

Ouch. Speedy recovery!