health and disease: primary source documents 535 applied to the perinaeum, and the ends of it brought up to the head and given to an assistant to hold, and applying a ligature below the fracture, we give the ends of it to another assistant to make extension If it is fractured near the knee, we apply the ligature immediately above the fracture, and give the ends to an assistant, with which to make extension upwards; and while we put a ligature round the knee to secure it, and while the patient lies thus, with his leg extended, we arrange the fracture Pieces of bone which irritate the parts, as has been often said, are to be taken out from above; and the rest of the treatment we have already described in the section on the arm The thigh gets consolidated within fifty days The manner of arranging it afterwards will be described after delivering the treatment of the whole leg The under part of the nose being cartilaginous does not admit of fracture, but it is liable to be crushed, flattened, and distorted; but the upper part being of a bony substance is sometimes fractured. . When, therefore, the nose is fractured in its under parts, having introduced the index or little finger into the nostril, push the parts outwards to their proper position When the fracture is of the inner parts this is to be done with the head of a probe immediately, during the course of the first day, or not long afterwards, because the bones of the nose get consolidated about the tenth day But they are to be put into the proper position with the index-finger and thumb externally In order to prevent the bones from The Islamic World changing their position, two wedge-like tents, formed of a twisted rag, are to be applied, one to each nostril, even if but one part of the nose be deranged, and these are to be allowed to remain until the bone or cartilage gets consolidated If the nose become inflamed we may use some antiinflammatory application to it, such as that from juices [diachylon], the one from vinegar and oil, and such like; or a cataplasm of fine wheaten flour boiled with manna or gum may be applied, both for the sake of the inflammation and in order to keep the nose in position When the nose is distorted to either side, Hippocrates directs us, after it has been restored to its proper position, to take a piece of leather of a finger’s breadth, and having spread one of its ends with taurocolla or gum, to fasten one extremity of it on that side of the nose to which it inclines, and after it dries to bring the thong by the opposite ear to the occiput and forehead, and to fix the other end of the thong firmly there, so that the nose being drawn sideways may take the proper position in the middle This practice, however, is not much approved of by the moderns If the bones of the nose are broken into small pieces we must make an incision or enlarge the wound, and having removed the small bones with a hair forceps, unite the divided parts with sutures, and use the applications for recent wounds and those of an agglutinative nature From: The Seven Books of Paulus Aegineta, trans and ed Francis Adams (London: Sydenham Society, 1844) • Ibn Sina (Avicenna): Excerpt from “On Medicine” (ca 1020) • Medicine considers the human body as to the means by which it is cured and by which it is driven away from health The knowledge of anything, since all things have causes, is not acquired or complete unless it is known by its causes Therefore in medicine we ought to know the causes of sickness and health And because health and sickness and their causes are sometimes manifest, and sometimes hidden and not to be comprehended except by the study of symptoms, we must also study the symptoms of health and disease Now it is established in the sciences that no knowledge is acquired save through the study of its causes and beginnings, if it has had causes and beginnings; nor completed except by knowledge of its accidents and accompanying essentials Of these causes there are four kinds: material, efficient, formal, and final (continued)