and the joint is to be kept
thus refrigerated until it even becomes numb (_stupefactionem_); after
which stupes of salt water and urine are to be applied, followed by a
plaster of galbanum, opoponax, the apostolicon, etc.

Fractures of the femur are to be treated like those of the humerus,
except that the ends of the fractured bone are to be separated by
the space of an inch, and a bandage six fingers in width carefully
applied. Such fractures within three inches of the hip or knee-joint
are regarded as specially dangerous.

Dislocations of the ankle, after reduction of proper manipulation,
should be bound with suitable splints. If of a less severe character,
the dislocation may be dressed with stupes of canabina (Indian hemp),
urine and salt water, which greatly mitigate the pain and swelling.
Afterwards the joint should be strapped for four or five inches above
the ankle with plaster, _ut prohibeatur fluxus_.

It should be said that the brevity of this chapter of Gilbert is
modeled after the manner of Roger of Parma, who refers the treatment
of injuries of the lower extremities very largely to that of similar
injuries of the upper, merely adding thereto such explanations as may
be demanded by the differences of location and function of the members
involved. Thus in his discussion of dislocation of the femur Roger
says:

_Si crus a coxa sit disjunctum, eadem sit cura quam et in disjuncturam
brachii et cubiti diximus, etc._

The general subject of fistulae is treated at considerable length on
folio 205b, and fistula lachrymalis and fistulae of the jaw receive
special attention in their appropriate places. As a rule, the fistula
is dilated by a tent of alder-pith, mandragora, briony or gentian,
the lining membrane destroyed by an ointment of quick-lime or even the
actual cautery, and the wound then dressed with egg-albumen followed
by the _unguentum viride_. Necrosed bone is to be removed, if
necessary, by deep incisions, and decayed teeth are to be extracted.

The elongated uvula is to be snipped off, and abscesses of the tonsils
opened _tout comme chez nous_.

An elaborate discussion of the subject of hernia is given under the
title "_De relaxatione siphac et ruptura_" (f. 280c)--siphac being
the Arabian name for the peritoneum. Gilbert tells us the siphac is
sometimes relaxed, sometimes ruptured (_crepatur_?) and sometimes
inflated. He had seen a large rupture (_crepatura_) in which it was
impossible to rest