ON INJURIES OF THE HEAD - Περὶ τῶν ἐν κεφαλῇ τρωμάτων

1. Τῶν ἀνθρώπων αἱ κεφαλαὶ οὐδὲν ὁμοίως σφίσιν αὐταῖς, οὐδὲ αἱ ῥαφαὶ τῆς κεφαλῆς πάντων κατὰ ταὐτὰ πεφύκασιν. Ἀλλ’ ὅστις μὲν ἔχει ἐκ τοῦ ἔμπροσθεν τῆς κεφαλῆς προβολὴν ἡ δὲ προβολή ἐστι τὸ τοῦ ὀστέου ἐξέχον στρογγύλον παρὰ τὸ ἄλλὀ, τουτέου εἰσὶν αἱ ῥαφαὶ πεφυκυῖαι ἐν τῇ κεφαλῇ, ὡς γράμμα τὸ ταῦ, Τ, γράφεται τὴν μὲν γὰρ βραχυτέρην γραμμὴν ἔχει πρὸ τῆς προβολῆς ἐπικαρσίην πεφυκυῖαν τὴν δ’ ἑτέρην γραμμὴν ἔχει διὰ μέσης τῆς κεφαλῆς κατὰ μῆκος πεφυκυῖαν ἐς τὸν τράχηλον αἰεί. Ὅστις δ’ ὄπισθεν τῆς κεφαλῆς τὴν προβολὴν ἔχει, αἱ ῥαφαὶ τουτέῳ πεφύκασι τἀναντία ἢ τῷ προτέρῳ ἡ μὲν γὰρ βραχυτέρη γραμμὴ πρὸ τῆς προβολῆς πέφυκεν ἐπικαρσίη ἡ δὲ μακροτέρη διὰ μέσης τῇς κεφαλῆς πέφυκε κατὰ μῆκος ἐς τὸ μέτωπον αἰεί. Ὅστις δὲ ἀμφοτέρωθεν τῆς κεφαλῆς προβολὴν ἔχει, ἐκ τε τοῦ ἔμπροσθεν καὶ

ἐκ τοῦ ὄπισθεν, τουτέῳ αἱ ῥαφαί εἰσιν ὁμοίως πεφυκυῖαι ὡς γράμμα τὸ ἦτα, ̣, γράφεται πεφύκασι δὲ τῶν γραμμέων αἱ μὲν μακραὶ, πρὸ τῆς προβολῆς ἑκατέρης ἐπικάρσιαι πεφυκυῖαι ἡ δὲ βραχείη διὰ μέσης τῆς κεφαλῆς κατὰ μῆκος πρὸς ἑκατέρην τελευτῶσα τὴν μακρὴν γραμμήν. Ὅστις δὲ μηδ’ ἑτέρωθι μηδεμίαν προβολὴν ἔχει, οὗτος ἔχει τὰς ῥαφὰς τῆς κεφαλῆς, ὡς γράμμα τὸ χῖ, Χ, γράφεται πεφύκασι δὲ αἱ γραμμαὶ, ἡ μὲν ἑτέρη ἐπικαρσίη πρὸς τὸν κρόταφον ἀφίκουσα ἡ δὲ ἑτέρη, κατὰ μῆκος διὰ μέσης τῆς κεφαλῆς. Δίπλοον δ’ ἐστὶ τὸ ὀστέον κατὰ μέσην τὴν κεφαλήν σκληρότατον δὲ καὶ πυκνότατον αὐτέου πέφυκεν τό τε ἀνώτατον, ᾗ ἡ ὁμοχροίη τοῦ ὀστέου ἡ ὑπὸ τῇ σαρκὶ,

καὶ τὸ κατώτατον τὸ πρὸς τῇ μήνιγγι, ᾗ ἡ ὁμοχροίη τοῦ ὀστέου ἡ κάτω ἀποχωρέον δὲ ἀπὸ τοῦ ἀνωτάτου ὀστέου καὶ τοῦ κατωτάτου, ἀπὸ τῶν σκληροτάτων καὶ πυκνοτάτων ἐπὶ τὸ μαλθακώτερον καὶ ἧσσον πυκνὸν καὶ ἐπικοιλότερον ἐς τὴν διπλόην αἰεί. Ἡ δὲ διπλόη κοιλότατον καὶ μαλθακώτατον καὶ

μάλιστα σηραγγῶδές ἐστιν. Ἔστι δὲ καὶ πᾶν τὸ ὀστέον τῆς κεφαλῆς, πλὴν κάρτα ὀλίγου τοῦ τε ἀνωτάτου καὶ τοῦ κατωτάτου, σπόγγῳ ὅμοιον καὶ ἔχει τὸ ὀστέον ἐν ἑωυτῷ ὁκοῖα σαρκία πολλὰ καὶ ὑγρὰ, καὶ εἴ τις αὐτὰ διατρίβοι τοῖσι δακτύλοισιν, αἷμα ἂν διαγίγνοιτο ἐξ αὐτέων. Ἔνι δ’ ἐν τῷ ὀστέῳ καὶ φλέβια λεπτότερα καὶ κοιλότερα, αἵματος πλέα. Σκληρότητος μὲν οὖν καὶ μαλθακότητος καὶ κοιλότητος ὧδε ἔχει.

1. MEN’S heads are by no means all like to one another, nor are the sutures of the head of all men constructed in the same form. Thus, whoever has a prominence in the anterior part of the head (by prominence is meant the round protuberant part of the bone which projects beyond the rest of it), in him the sutures of the head take the form of the Greek letter tau , T; for the head has the shorter line running transverse before the prominence, while the other line runs through the middle of the head, all the way to the neck. But whoever has the prominence in the back part of the head, in him the sutures are constructed in quite the opposite form to the former; for in this case the shorter line runs in front of the prominence, while the longer runs through the middle all along to the forehead. But whoever has a prominence of the head both before and behind, in him the sutures resemble the Greek letter eta E; for the long lines of the letter run transverse before each prominence while the short one runs through the middle and terminates in the long lines. But whoever has no prominence on either part he has the sutures of the head resembling the Greek letter chi; for the one line comes transverse to the temple while the other passes along the middle of the head. The bone at the middle of the head is double, the hardest and most compact part being the upper portion, where it is connected with the skin, and the lowest, where it is connected with the meninx (dura mater); and from the uppermost and lowermost parts the bone gradually becomes softer and less compact, till you come to the diploe . The diploe is the most porous, the softest, and most cavernous part. But the whole bone of the head, with the, exception of a small portion of the uppermost and lowermost portions of it, is like a sponge; and the bone has in it many juicy substances, like caruncles; and if one will rub them with the fingers, some blood will issue from them. There are also in the bone certain very slender and hollow vessels full of blood. So it is with regard to hardness, softness, and porosity.

2. Παχύτητι δὲ καὶ λεπτότητι, ξυμπάσης τῆς κεφαλῆς τὸ ὀστέον λεπτότατόν ἐστιν καὶ ἀσθενέστατον τὸ κατὰ βρέγμα, καὶ σάρκα ὀλιγίστην καὶ λεπτοτάτην ἔχει ἐφ’ ἑωυτέῳ ταύτῃ τῆς κεφαλῆς τὸ ὀστέον, καὶ ὁ ἐγκέφαλος κατὰ τοῦτο τῆς κεφαλῆς πλεῖστος ὕπεστιν. Καὶ δὴ, ὅτι οὕτω ταῦτα ἔχει, τῶν τε τρωσίων

καὶ τῶν βελέων ἴσων τε ἐόντων κατὰ μεγέθος, καὶ ἐλασσόνων, καὶ ὁμοίως τε τρωθεὶς καὶ ἧσσον, τὸ ὀστέον ταύτῃ τῆς κεφαλῆς φλᾶταί τε μᾶλλον καὶ ῥήγνυται, καὶ ἔσω ἐσφλᾶται, καὶ θανασιμώτερά ἐστι καὶ χαλεπώτερα ἰητρεύεσθαί τε καὶ ἐκφυγγάνειν τὸν θάνατον ταύτῃ ἤπου ἄλλοθι τῆς κεφαλῆς ἐξίσων τε ἐόντων τῶν τρωμάτων καὶ ἡσσόνων, καὶ ὁμοίως τε τρωθεὶς καὶ ἧσσον, ἀποθνήσκει ὁ ἄνθρωπος, ὅταν καὶ ἄλλως μέλλῃ ἀποθανεῖσθαι ἐκ τοῦ τρώματος, ἐν ἐλάσσονι χρόνῳ ὁ ταύτῃ ἔχων τὸ τρῶμα τῆς κεφαλῆς, ἤπου ἄλλοθι. Ὁ γὰρ ἐγκέφαλος τάχιστά τε καὶ μάλιστα κατὰ τὸ βρέγμα αἰσθάνεται τῶν κακῶν τῶν γιγνομένων ἔν τε τῇ σαρκὶ καὶ τῷ ὀστέῳ ὑπὸ λεπτοτάτῳ γὰρ ὀστέῳ ἐστὶ ταύτῃ ὁ ἐγκέφαλος καὶ ὀλιγίστῃ σαρκὶ, καὶ ὁ πλεῖστος ἐγκέφαλος ὑπὸ τῷ βρέγματι κεῖται. Τῶν δὲ ἄλλων τὸ κατὰ τοὺς κροτάφους ἀσθενέστατόν ἐστιν ξυμβολή τε γὰρ τῆς κάτω γνάθου πρὸς τὸ κρανίον, καὶ κίνησις ἔνεστιν ἐν τῷ κροτάφῳ ἄνω καὶ κάτω ὥσπερ ἄρθρου καὶ ἡ ἀκοὴ πλησίον γίγνεται αὐτέου, καὶ φλὲψ διὰ τοῦ κροτάφου τέταται κοίλη τε καὶ ἰσχυρή. Ἰσχυρότερον δ’ ἐστὶ τῆς κεφαλῆς τὸ ὀστέον ἅπαν τὸ ὄπισθεν τῆς κορυφῆς καὶ τῶν

οὐάτων, ἢ ἅπαν τὸ πρόσθεν, καὶ σάρκα πλέονα καὶ βαθυτέρην ἐφ’ ἑωυτέῳ ἔχει τοῦτο τὸ ὀστέον. Καὶ δὴ, τουτέων οὕτως ἐχόντων ὑπὸ τῶν τε τρωσίων καὶ τῶν βελέων ἴσων ἐόντων καὶ ὁμοίων, καὶ μεζόνων, καὶ ὁμοίως τιτρωσκόμενος καὶ μᾶλλον, ταύτῃ τῆς κεφαλῆς τὸ ὀστέον ἧσσον ῥήγνυται καὶ φλᾶται ἔσω κἢν μέλλῃ ὥνθρωπος ἀποθνήσκειν καὶ ἄλλως ἐκ τοῦ τρώματος, ἐν τῷ ὄπισθεν τῆς κεφαλῆς ἔχων τὸ τρῶμα, ἐν πλέονι χρόνῳ ἀποθανεῖται ἐν πλέονι γὰρ χρόνῳ τὸ ὀστέον ἐμπυΐσκεταί τε καὶ διαπυΐσκεται κάτω ἐπὶ τὸν ἐγκέφαλον διὰ τὴν παχύτητα τοῦ ὀστέου, καὶ ἐλάσσων ταύτῃ τῆς κεφαλῆς ὁ ἐγκέφαλος ὕπεστι, καὶ πλέονες ἐκφυγγάνουσι τὸν θάνατον τῶν ὄπισθεν τιτρωσκομένων τῆς κεφαλῆς ὡς ἐπιτοπολὺ, ἢ τῶν ἔμπροσθεν. Καὶ ἐν χειμῶνι πλέονα χρόνον ζῇ ὥνθρωπος ἢ ἐν θέρει, ὅστις καὶ ἄλλως μέλλει ἀποθανεῖσθαι ἐκ τοῦ τρώματος, ὁκουοῦν τῆς κεφαλῆς ἔχων τὸ τρῶμα.

2. In respect to thickness and thinness; the thinnest and weakest part of the whole head is the part about the bregma; and the bone there has the smallest and thinnest covering of flesh upon it, and the largest proportion of brain is situated in that region of the head. And hence it happens that from similar or even smaller wounds and instruments, when a person is wounded to the same or a less degree, the bone of the head there is more contused, fractured, and depressed; and that injuries there are more deadly and more difficult to cure; and it is more difficult to save one’s life in injuries there than in any other part of the head; that from having sustained a similar or even a less wound a man will die, and that, too, in a shorter space of time than from a wound in any other part of the head. For the brain about the bregma feels more quickly and strongly any mischief that may occur to the flesh or the bone; for the brain about the bregma is in largest quantity, and is covered by the thinnest bone and the least flesh. Of the other portions, the weakest is that about the temples; for it is the conjunction of the lower jaw with the cranium, and there is motion there up and down as at a joint; and the organ of hearing is near it; and further, a hollow and important vein runs along the temple. But the whole bone of the head behind the vertex and the ear is stronger than the whole anterior part, and the bone itself has a larger and deeper covering of flesh upon it. And hence it follows, that when exposed to the same or even greater injuries from instruments of the same or greater size, the bone is less liable to be fractured and depressed than elsewhere; and that in a fatal accident the patient will live longer when the wound is in the posterior part of the head than when elsewhere; and that pus takes longer time to form and penetrate through the bone to the brain, owing to the thickness of the bone; and moreover, as there is less brain in that part of the head, more persons who are wounded in the back part of the head escape than of those who wounded in the anterior part. And in fatal cases, a man will survive longer in winter than in summer, whatever be the part of the head in which the wound is situated.

3. Αἱ δὲ ἕδραι τῶν βελέων τῶν ὀξέων καὶ κουφοτέρων, αὐταὶ

ἐπὶ σφῶν αὐτέων γινόμεναι ἐν τῷ ὀστέῳ, ἄνευ ῥωγμῆς τε καὶ φλάσιος, ἢ ἔσω ἐσφλάσιος αὗται δὲ γίνονται ὁμοίως ἔν τε τῷ ἔμπροσθεν τῆς κεφαλῆς, καὶ ἐν τῷ ὄπισθεν, ἐκ τουτέων ὁ θάνατος οὐ γίνεται κατά γε δίκην, οὐδ’ ἢν γένηται. Ῥαφὴ δὲ ἐν ἕλκει φανεῖσα, ὀστέου ψιλωθέντος, πανταχοῦ τῆς κεφαλῆς τοῦ ἕλκεος γενομένου, ἀσθενέστατον γίγνεται τῇ τρώσει καὶ τῷ βέλει ἀντέχειν, εἰ τύχοι τὸ βέλος ἐς αὐτὴν τὴν ῥαφὴν στηριχθέν πάντων δὲ μάλιστα ἐν τῷ βρέγματι γενόμενον κατὰ τὸ ἀσθενέστατον τῆς κεφαλῆς, καὶ αἱ ῥαφαὶ εἰ τύχοιεν ἐοῦσαι περὶ τὸ ἕλκος, καὶ τὸ βέλος αὐτέων τύχοι τῶν ῥαφῶν.

3. As to the haedrae (dints or marks?) of sharp and light weapons, when they take place in the bone without fissure, contusion, or depression inwards (and these take place equally in the anterior and posterior part of the head), death, when it does occur, does not properly result from them. A suture appearing in a wound, when the bone is laid bare, on whatever part of the head the wound may have been inflicted, is the weakest point of the head to resist a blow or a weapon, when the weapon happens to be impinged into the suture itself; but more especially when this occurs in the bregma at the weakest part of the head, and the sutures happen to be situated near the wound, and the weapon has hit the sutures themselves.

4. Τιτρώσκεται δὲ ὀστέον τὸ ἐν τῇ κεφαλῇ τοσούσδε τρόπους τῶν δὲ τρόπων ἑκάστου πλέονες ἰδέαι γίγνονται τοῦ κατήγματος

ἐν τῇ τρώσει. Ὀστέον ῥήγνυται τιτρωσκόμενον, καὶ τῷ περιέχοντι ὀστέῳ τὴν ῥωγμὴν, ἀνάγκη φλάσιν προσγίγνεσθαι, ἤνπερ ῥαγῇ τῶν γὰρ βελέων ὅ τι περ ῥήγνυσι τὸ ὀστέον, τὸ αὐτὸ τοῦτο καὶ φλᾷ τὸ ὀστέον ἢ μᾶλλον, ἢ ἧσσον, αὐτό τε ἐν ᾧπερ καὶ ῥήγνυσι τὴν ῥωγμὴν, καὶ τὰ περιέχοντα ὀστέα τὴν ῥώγμήν εἷς οὗτος τρόπος. Ἰδέαι δὲ ῥωγμέων παντοῖαι γίγνονται καὶ γὰρ λεπτότεραί τε καὶ λεπταὶ πάνυ, ὥστε οὐ καταφανέες γίγνονται ἔστιν αἳ τῶν ῥωγμέων, οὔτε αὐτίκα μετὰ τὴν τρῶσιν, οὔτ’ ἐν τῇσιν ἡμέρῃσιν, ἐν ᾗσιν ἂν καὶ πλέον ὄφελος γένοιτο ἐκ

τούτου τῷ ἀνθρώπῳ αἱ δ’ αὖ παχύτεραί τε καὶ εὐρύτεραι ῥήγνυνται τῶν ῥωγμέων ἔνιαι δὲ καὶ πάνυ εὐρέαι. Ἔστι δὲ αὐτέων καὶ αἳ μὲν ἐπὶ μακρότερον ῥήγνυνται, αἳ δὲ ἐπὶ βραχύτερον. Καὶ αἱ μὲν ἰθύτεραί τε καὶ ἰθεῖαι πάνυ, αἱ δὲ καμπυλώτεραί τε καὶ καμπύλαι καὶ βαθύτεραί τε ἐς τὸ κάτω καὶ διὰ παντὸς τοῦ ὀστέου, καὶ ἧσσον βαθεῖαι ἐς τὸ κάτω, καὶ οὐ διὰ παντὸς τοῦ ὀστέου.

4. The bone in the head is liable to be wounded in the following modes, and there are many varieties in each of these modes of fracture: When a wounded bone breaks, in the bone comprehending the fissure, contusion necessarily takes place where the bone is broken; for an instrument that breaks the bone occasions a contusion thereof more or less, both at the fracture and in the parts of the bone surrounding the fracture. This is the first mode. But there are all possible varieties of fissures; for some of them are fine, and so very fine that they cannot be discovered, either immediately after the injury, or during the period in which it would be of use to the patient if this could be ascertained. And some of these fissures are thicker and wider, certain of them being very wide. And some of them extend to a greater, and some to a smaller, distance. And some are more straight, nay, completely straight; and some are more curved, and that in a remarkable degree. And some are deep, so as to extend downwards and through the whole bone; and some are less so, and do not penetrate through the whole bone.

5. Φλασθείη δ’ ἂν τὸ ὀστέον μένον ἐν τῇ ἑωυτοῦ φύσει, καὶ ῥωγμὴ τῇ φλάσει οὐκ ἂν προσγένοιτο ἐν τῷ ὀστέῳ οὐδεμία δεύτερος οὗτος τρόπος. Ἰδέαι δὲ τῆς φλάσιος πλείους γίγνονται καὶ γὰρ μᾶλλόν τε καὶ ἧσσον φλᾶται, καὶ ἐς βαθύτερόν τε καὶ διὰ παντὸς τοῦ ὀστέου, καὶ ἧσσον ἐς βαθὺ, καὶ οὐ διὰ παντὸς τοῦ ὀστέου, καὶ ἐπὶ πλέον τε καὶ ἔλασσον μήκεός τε καὶ πλατύτητος. Ἀλλ’ οὐ τουτέων τῶν ἰδεῶν οὐδεμίαν ἐστὶν ἰδόντα τοῖσιν ὀφθαλμοῖσι γνῶναι, ὁκοίη τίς ἐστι τὴν ἰδέην, καὶ ὁκόση

τις τὸ μέγεθος οὐδὲ γὰρ εἰ πέφλασται, ἢ μὴ πέφλασται, ἐόντων πεφλασμένων καὶ τοῦ κακοῦ γεγενημένου, γίγνεται τοῖσιν ὀφθαλμοῖσι καταφανὲς ἰδεῖν αὐτίκα μετὰ τὴν τρῶσιν, ὥσπερ οὐδὲ τῶν ῥωγμέων ἔνιαι ἑκὰς ἐοῦσαι.

5. But a bone may be contused, and yet remain in its natural condition without any fracture in it; this is the second mode. And there are many varieties of contusion; for they occur to a greater or less degree, and to a greater depth, so as sometimes to extend through the whole bone; or to a less depth, so as not to extend through the whole bone; and to a greater and smaller length and breadth. But it is not possible to recognize any of these varieties by the sight, so as to determine their form and extent; neither, indeed, is it visible to the eyes when any mischief of this kind takes place, and immediately after the injury, whether or not the bone has been actually bruised, as is likewise the case with certain fractures at a distance from the seat of injury.

6. Καὶ ἐρρωγότος τοῦ ὀστέου, ἐσφλᾶται τὸ ὀστέον ἐκ τῆς

φύσιος τῆς ἑωυτοῦ ἔσω σὺν ῥωγμῇσιν ἄλλως γὰρ οὐκ ἂν ἐσφλασθείη τὸ γὰρ ἐσφλώμενον, ἀπορρηγνύμενόν τε καὶ καταγνύμενον, ἐσφλᾶται ἔσω ἀπὸ τοῦ ἄλλου ὀστέου μένοντος ἐν τῇ φύσει τῇ ἑωυτοῦ καὶ δὴ οὕτω ῥωγμὴ ἂν προσείη τῇ ἐσφλάσει τρίτος οὗτος τρόπος. Ἐσφλᾶται δὲ τὸ ὀστέον πολλὰς ἰδέας καὶ γὰρ ἐπὶ πλέον τοῦ ὀστέου καὶ ἐπ’ ἔλασσον, καὶ μᾶλλόν τε καὶ ἐς βαθύτερον κάτω, καὶ ἧσσόν τε καὶ ἐπιπολαιότερον.

6. And the bone being fractured, is sometimes depressed inwards from its natural level along with the fractures, otherwise there would be no depression; for the depressed portion being fractured and broken off, is pushed inwards, while the rest of the bone remains in its natural position; and in this manner a fracture is combined with the depression. This is the third mode. There are many varieties of depression, for it may comprehend a greater and a small extent of bone, and may either be to a greater depth, or less so, and more superficial.

7. Καὶ ἕδρης γενομένης ἐν τῷ ὀστέῳ βέλεος, προσγένοιτο ἂν ῥωγμὴ τῇ ἑδραίῃ φλάσιν προσγενέσθαι ἀναγκαῖόν ἐστιν, ἢ

μᾶλλον, ἢ ἧσσον, ἤνπερ καὶ ῥωγμὴ προσγένηται, ἐνθάπερ ἡ ἕδρη ἐγένετο καὶ ἡ ῥωγμὴ, καὶ ἐν τῷ ὀστέῳ τῷ περιέχοντι τήν τε ἕδρην καὶ τὴν ῥωγμήν τέταρτος οὗτος τρόπος. Καὶ ἕδρη μὲν ἂν γένοιτο, φλάσιν ἔχουσα τοῦ ὀστέου περὶ αὐτὴν, ῥωγμὴ δὲ οὐκ ἂν προσγένοιτο

τῇ ἕδρῃ καὶ τῇ φλάσει ὑπὸ τοῦ βέλεος. Καὶ ἕδρη δὲ τοῦ βέλεος γίγνεται ἐν τῷ ὀστέῳ ἕδρη δὲ καλέεται, ὅταν, μένον τὸ ὀστέον ἐν τῇ ἑωυτοῦ φύσει, τὸ βέλος στηρίξαν ἐς τὸ ὀστέον δῆλον ποιήσῃ ὅκου ἐστήριξεν. Ἐν δὲ τῷ τρόπῳ ἑκάστῳ πλέονες ἰδέαι γίγνονται καὶ περὶ μὲν φλάσιός τε καὶ ῥωγμῆς, ἢν ἄμφω ταῦτα προσγένηται τῇ ἕδρῃ, καὶ ἢν φλάσις μούνη γένηται, ἤδη πέφρασται, ὅτι πολλαὶ ἰδέαι γίνονται καὶ τῆς φλάσιος καὶ τῆς ῥωγμῆς. Ἡ δὲ ἕδρη αὐτὴ ἐφ’ ἑωυτῆς γίνεται, μακροτέρη καὶ βραχυτέρη ἐοῦσα, καὶ καμπυλωτέρη, καὶ ἰθυτέρη, καὶ κυκλοτερής καὶ πολλαὶ ἄλλαι ἰδέαι τοῦ τοιουτέου τρόπου, ὁκοῖον ἄν τι καὶ τὸ σχῆμα τοῦ βέλεος ᾖ αὐταὶ δὲ καὶ βαθύτεραι τὸ κάτω καὶ μᾶλλον καὶ ἧσσον, καὶ στενότεραι, καὶ εὐρύτεραι, καὶ πάνυ εὐρέαι. διακέκοπται διακοπὴ δ’, ὁκοσητισοῦν γιγνομένη μήκεός τε καὶ εὐρύτητος ἐν τῷ ὀστέῳ, ἕδρη ἐστὶν, ἢν τὰ ἄλλα

ὀστέα τὰ περιέχοντα τὴν διακοπὴν μένῃ ἐν τῇ φύσει τῇ ἑωυτέων, καὶ μὴ ξυνεσφλᾶται τῇ διακοπῇ ἔσω ἐκ τῆς φύσιος τῆς ἑωυτέων οὕτω δ’ ἔσφλασις ἂν εἴη, καὶ οὐκ ἔτι ἕδρη.

7. When a hedra , or dint of a weapon, takes place in a bone, there may be a fracture combined with it; and provided there be a fracture, contusion must necessarily be joined, to a greater or less extent, in the seat of the dint and fracture, and in the bone which comprehends them. This is the fourth mode. And there may be a hedra , or indentation of the bone, along with contusion of the surrounding bone, but without any fracture either in the hedra or in the contusion inflicted by the weapon. But the indentation of a weapon takes place in a bone, and is called hedra , when the bone remaining in its natural state, the weapon which struck against the bone leaves its impression on the part which it struck. In each of these modes there are many varieties, with regard to the contusion and fracture, if both these be combined with the hedra , or if contusion alone, as it has been already stated that there are many varieties of contusion and fracture. And the hedra , or dint, of itself may be longer and shorter, crooked, straight, and circular; and there are many varieties of this mode, according to the shape of the weapon; and they may be more or less deep, and narrower or broader, and extremely broad. When a part is cleft, the cleft or notch which occurs in the bone, to whatever length or breadth, is a hedra , if the other bones comprehending the cleft remain in their natural position, and be not driven inwards; for in this case it would be a depression, and no longer a hedra .

8. Ὀστέον τιτρώσκεται ἄλλῃ τῆς κεφαλῆς, ἢ ᾗ τὸ ἕλκος ἔχει ὥνθρωπος, καὶ τὸ ὀστέον ἐψιλώθη τῆς σαρκός πέμπτος οὗτος τρόπος. Καὶ ταύτην τὴν ξυμφορὴν, ὅταν γένηται, οὐκ ἂν ἔχοις ὠφελῆσαι οὐδέν. Οὐδὲ γὰρ, εἰ πέπονθε τὸ κακὸν τοῦτο, οὐκ ἔστιν ὅκως χρὴ αὐτὸν ἐξελέγξαντα εἰδέναι εἰ πέπονθε τὸ κακὸν τοῦτο ὥνθρωπος, οὐδ’ ὅκοι τῆς κεφαλῆς.

8. A bone may be injured in a different part of the head from that on which the person has received the wound, and the bone has been laid bare. This is the fifth mode. And for this misfortune, when it occurs, there is no remedy; for when this mischief takes place, there is no means of ascertaining by any examination whether or not it has occurred, or on what part of the head.

9. Τούτων τῶν τρόπων τῆς κατήξιος ἐς πρίσιν ἀφήκει, ἥ τε φλάσις ἡ ἀφανὴς ἰδεῖν, καὶ ἤν πως τύχῃ φανερὴ γενομένη, καὶ ἡ ῥωγμὴ ἡ ἀφανὴς ἰδεῖν, καὶ ἢν φανερὴ ᾖ. Καὶ ἢν, ἕδρης γενομένης τοῦ βέλεος ἐν τῷ ὀστέῳ, προσγένηται ῥωγμὴ καὶ φλάσις τῇ ἕδρῃ, καὶ ἢν φλάσις μοῦνον προσγένηται ἄνευ ῥωγμῆς τῇ ἕδρῃ, καὶ αὕτη ἐς πρίσιν ἀφήκει. Τὸ δ’ ἔσω ἐσφλώμενον ὀστέον ἐκ τῆς φύσιος τῆς ἑωυτοῦ, ὀλίγα τῶν πολλῶν πρίσιος προσδεῖται

καὶ τὰ μάλιστα ἐσφλασθέντα καὶ μάλιστα καταρραγέντα, ταῦτα πρίσιος ἥκιστα κέχρηται οὐδὲ ἕδρη αὐτὴ ἐφ’ ἑωυτῆς γενομένη ἄτερ ῥωγμῆς καὶ φλάσιος, οὐδὲ αὐτὴ πρίσιος δεῖται οὐδ’ ἡ διακοπὴ, ἢν μεγάλη καὶ εὐρέη, οὐδ’ αὐτή διακοπὴ γὰρ καὶ ἕδρη τωὐτόν ἐστιν.

9. Of these modes of fracture, the following require trepanning: the contusion, whether the bone be laid bare or not; and the fissure, whether apparent or not. And if, when an indentation ( hedra ) by a weapon takes place in a bone it be attended with fracture and contusion, and even if contusion alone, without fracture, be combined with the indentation, it requires trepanning. A bone depressed from position rarely requires trepanning; and those which are most pressed and broken require trepanning the least; neither does an indentation ( hedra ） without fracture and contusion require trepanning; nor does a notch, provided it is large and wide; for a notch and a hedra are the same.

10. Πρῶτον δὲ χρὴ τὸν τρωματίην σποπεῖσθαι, ὅπη ἔχει τὸ τρῶμα τῆς κεφαλῆς, ἐἴτ’ ἐν τοῖσιν ἰσχυροτέροισιν, εἴτ’ ἐν τοῖσιν ἀσθενεστέροισι, καὶ τὰς τρίχας καταμανθάνειν τὰς περὶ τὸ ἕλκος, εἰ διακεκόφαται ὑπὸ τοῦ βέλεος, καὶ εἰ ἔσω ἤϊσαν ἐς τὸ τρῶμα καὶ ἢν τοῦτο ᾖ, φάναι κινδυνεύειν τὸ ὀστέον ψιλὸν εἶναι τῆς σαρκὸς, καὶ ἔχειν τι σίνος τὸ ὀστέον ὑπὸ τοῦ βέλεος. Ταῦτα μὲν οὖν χρὴ ἀπόπροσθεν σκεψάμενον λέξαι, μὴ ἁπτόμενον τοῦ ἀνθρώπου ἁπτόμενον δ’ ἤδη πειρᾶσθαι εἰδέναι σάφα, εἴ ἐστι ψιλὸν τὸ ὀστέον τῆς σαρκὸς, ἢ οὔ καὶ ἢν μὲν καταφανὲς ᾖ τοῖσιν ὀφθαλμοῖσι τὸ ὀστέον ψιλόν εἰ δὲ μὴ, τῇ μήλῃ σκέπτεσθαι. Καὶ ἢν μὲν εὕρῃς

ψιλὸν ἐὸν τὸ ὀστέον τῆς σαρκὸς, καὶ μὴ ὑγιὲς ἀπὸ τοῦ τρώματος, χρὴ τοῦ ἐν τῷ ὀστέῳ ἐόντος τὴν διάγνωσιν πρῶτα ποιέεσθαι, ὁρέοντα ὅσον τέ ἐστι τὸ κακὸν, καὶ τίνος δεῖται ἔργου. Χρὴ δὲ καὶ ἐρωτᾷν τὸν τετρωμένον, ὅκως ἔπαθε καὶ τίνα τρόπον. Ἢν δὲ μὴ καταφανὲς ᾖ τὸ ὀστέον, εἰ ἔχει τι κακὸν ἢ μὴ ἔχει, πολλῷ ἔτι χρὴ μᾶλλον τὴν ἐρώτησιν ποιέεσθαι, ψιλοῦ ἐόντος τοῦ ὀστέου, τὸ τρῶμα ὅκως ἐγένετο, καὶ ὅντινα τρόπον τὰς γὰρ φλάσιας καὶ τὰς ῥωγμὰς τὰς οὐ φαινομένας ἐν τῷ ὀστέῳ, ἐνεούσας δὲ, ἐκ τῆς ὑποκρίσιος τοῦ τετρωμένου πρῶτον διαγινώσκειν πειρῆσθαι, εἴ τι πέπονθε τουτέων τὸ ὀστέον ἢ οὐ πέπονθεν, ἔπειτα δὲ καὶ λόγῳ καὶ ἔργῳ ἐξελέγχειν πλὴν μηλώσιος. Μήλωσις γὰρ οὐκ ἐξελέγχει, εἰ πέπονθέ τι τουτέων τῶν κακῶν τὸ ὀστέον, καὶ εἴ τι ἔχει ἐν ἑωυτέῳ, ἢ οὐ πέπονθεν ἀλλ’ ἕδρην τε τοῦ βέλεος ἐξελέγχει μήλωσις, καὶ ἢν ἐμφλασθῇ τὸ ὀστέον ἔσω ἐκ τῆς φύσιος τῆς ἑωυτέου, καὶ ἢν ἰσχυρῶς ῥαγῇ τὸ ὀστέον, ἅπερ καὶ τοῖσιν ὀφθαλμοῖσι καταφανέα ἐστὶν ὁρῶντα γιγνώσκειν.

10. In the first place, one must examine the wounded person, in what part of the head the wound is situated, whether in the stronger or weaker parts; and ascertain respecting the hairs about the wound, whether they have been cut off by the instrument, and have gone into the wound; and if so, one should declare that the bone runs the risk of being denuded of flesh, and of having sustained some injury from the weapon. These things one should say from a distant inspection, and before laying a hand on the man; but on a close examination one should endeavor to ascertain clearly whether the bone be denuded of flesh or not; and if the denuded bone be visible to the eyes, this will be enough; but otherwise an examination must be made with the sound. And if you find the bone denuded of the flesh, and not safe from the wound, you must first ascertain the state of the bone, and the extent of the mischief, and of what assistance it stands in need. One should also inquire of the wounded person how and in what way he sustained the injury; and if it be not apparent whether the bone has sustained an injury or not, it will be still more necessary, provided the bone be denuded, to make inquiry how the wound occurred, and in what manner; for when contusions and fractures existin the bone, but are not apparent, we must ascertain, in the first place from the patient’s answers, whether or not the bone has sustained any such injuries, and then find out the nature of the case by word and deed, with the exception of sounding. For sounding does not discover to us whether the bone has sustained any of these injuries or not; but sounding discovers to us an indentation inflicted by a weapon, and whether a bone be depressed from its natural position, and whether the bone be strongly fractured; all which may also be ascertained visibly with the eyes.

11. Ῥήγνυται δὲ τὸ ὀστέον τάς τε ἀφανέας ῥωγμὰς καὶ τὰς φανερὰς, καὶ φλᾶται τὰς ἀφανέας φλάσιας, καὶ ἐσφλᾶται ἔσω ἐκ τῆς φύσιος τῆς ἑωυτέου, μάλιστα ὅταν ἕτερος ὑφ’ ἑτέρου τιτρωσκόμενος

ἐπίτηδες τρωθῇ, ἢ ὁκόταν, ἐπίτηδες τρῶσαι βουλόμενος ἢ ἀέκων, ἐξ ὑψηλοτέρου γίγνηται ἡ βολὴ ἢ ἡ πληγὴ, ὁκοτέρη ἂν ᾖ μᾶλλον, ἢ ὅταν ἐξ ἰσοπέδου τοῦ χωρίου, καὶ ἢν περικρατέῃ τῇ χειρὶ τὸ βέλος, ἤν τε βάλλῃ, ἤν τε τύπτῃ, καὶ ἰσχυρότερος ἐὼν ἀσθενέστερον τιτρώσκῃ. Ὅσοι δὲ πίπτοντες τιτρώσκονται πρός τε τὸ ὀστέον καὶ αὐτὸ τὸ ὀστέον, ὁ ἀπὸ ὑψηλοτάτου πίπτων καὶ ἐπὶ σκληρότατον καὶ ἀμβλύτατον, τουτέῳ κίνδυνος τὸ

ὀστέον ῥαγῆναι καὶ φλασθῆναι, καὶ ἔσω ἑσφλασθῆναι ἐκ τῆς φύσιος τῆς ἑωυτέου τῷ δ’ ἐξ ἰσοπέδου μᾶλλον χωρίου πίπτοντι καὶ ἐπὶ μαλθακώτερον, ἧσσον ταῦτα πάσχει τὸ ὀστέον, ἢ οὐκ ἂν πάθοι. Ὅσα δὲ ἐσπίπτοντα ἐς τὴν κεφαλὴν βέλεα τιτρώσκει πρὸς τὸ ὀστέον καὶ αὐτὸ τὸ ὀστέον, τὸ ἀπὸ ὑψηλοτάτου ἐμπεσὸν καὶ ἥκιστα ἐξ ἰσοπέδου, καὶ σκληρότατόν τε ἅμα καὶ ἀμβλύτατον καὶ βαρύτατον, καὶ ἥκιστα κοῦφον καὶ ἥκιστα ὀξὺ καὶ μαλθακὸν, τοῦτο ἂν ῥήξειε τὸ ὀστέον καὶ φλάσειεν. Καὶ μάλιστά γε ταῦτα πάσχειν τὸ ὀστέον κίνδυνος, ὅταν ταῦτά τε γίνηται, καὶ ἐς ἰθὺ τρωθῇ, καὶ κατ’ ἀντίον γένηται τὸ ὀστέον τοῦ βέλεος, ἤν τε πληγῇ ἐκ χειρὸς, ἤν τε βληθῇ, ἤν τέ τι ἐμπέσῃ αὐτέῳ, καὶ ἢν αὐτὸς καταπεσὼν τρωθῇ, καὶ ὁκωσοῦν τρωθεὶς κατ’ ἀντίον γενομένου τοῦ ὀστέου τῷ βέλει. Τὰ δ’ ἐς πλάγιον τοῦ ὀστέου παρασύραντα βέλεα ἧσσον καὶ ῥήγνυσι τὸ ὀστέον, καὶ φλᾷ, καὶ ἔσω ἐσφλᾷ, κἢν ψιλωθῇ τὸ ὀστέον τῆς σαρκός ἔνια γὰρ τῶν τρωμάτων τῶν οὕτω τρωθέντων οὐδὲ ψιλοῦται τὸ ὀστέον τῆς σαρκός. Τῶν δὲ βελέων ῥήγνυσι μάλιστα τὸ ὀστέον τάς τε φανερὰς ῥωγμὰς καὶ

τὰς ἀφανέας, καὶ φλᾶται καὶ ἐσφλᾷ ἔσω ἐκ τῆς φύσιος τῆς ἑωυτέου τὸ ὀστέον, τὰ στρογγύλα τε καὶ περιφερέα, καὶ ἀρτίστομα, ἀμβλέα τε ἐόντα καὶ βαρέα καὶ σκληρά καὶ τὴν σάρκα ταῦτα φλᾶται, καὶ πέπειρον ποιέει, καὶ κόπτει καὶ τὰ ἕλκεα γίνεται ὑπὸ τῶν τοιουτέων βελέων, ἔς τε πλάγιον καὶ ἐν κύκλῳ, ὑπόκοιλα, καὶ διάπυά τε μᾶλλον γίγνεται, καὶ ὑγρά ἐστι, καὶ ἐπὶ πλέονα χρόνον καθαίρεται ἀνάγκη γὰρ τὰς σάρκας τὰς φλασθείσας καὶ κοπείσας πῦον γενομένας ἐκτακῆναι. Τὰ δὲ βέλεα τὰ προμήκεα, ἐπιπολὺ λεπτὰ ἐόντα καὶ ὀξέα καὶ κοῦφα, τήν τε σάρκα διατάμνει μᾶλλον ἢ φλᾷ, καὶ τὸ ὀστέον ὡσαύτως καὶ ἕδρην μὲν ἐμποιέει αὐτὸ καὶ διακόψαν διακοπὴ γὰρ καὶ ἕδρη τωὐτόν ἐστἰ, φλᾷ δὲ οὐ μάλα τὸ ὀστέον τὰ τοιαῦτα βέλεα, οὐδὲ ῥήγνυσιν, οὐδ’ ἐκ τῆς φύσιος ἔσω ἐσφλᾷ. Ἀλλὰ χρὴ πρὸς τῇ ὄψει τῇ ἑωυτέου, ὅ τι ἄν σοι φαίνηται ἐν τῷ ὀστέῳ, καὶ ἐρώτησιν ποιέεσθαι πάντων τουτέων τοῦ γὰρ μᾶλλόν τε καὶ ἧσσον τρωθέντος ταῦτ’ ἐστὶ σημήϊἀ, καὶ ἢν ὁ τρωθεὶς καρωθῇ, καὶ σκότος περιχυθῇ, καὶ δῖνος ἔχῃ, καὶ πέσῃ.

11. And a bone sustains fractures, either so fine as to escape the sight, or such as are apparent, and contusions which are not apparent, and depression from its natural position, especially when one person is intentionally wounded by another, or when, whether intentionally or not, a blow or stroke is received from an elevated place, and if the instrument in the hand, whether used in throwing or striking, be of a powerful nature, and if a stronger person wound a weaker. Of those who are wounded in the parts about the bone, or in the bone itself, by a fall, he who falls from a very high place upon a very hard and blunt object is in most danger of sustaining a fracture and contusion of the bone, and of having it depressed from its natural position; whereas he that falls upon more level ground, and upon a softer object, is likely to suffer less injury in the bone, or it may not be injured at all. Of those instruments which, falling upon the head, wound the parts about the bone, or the bone itself, that which falls from a very high place, and the least on a level with the person struck, and which is at the same time very hard, very blunt, and very heavy, and which is the least light, sharp, and soft, such an instrument would occasion a fracture and contusion of the bone. And there is most danger that the bone may sustain these injuries, under such circumstances, when the wound is direct and perpendicular to the bone, whether struck from the hand or from a throw, or when any object falls upon the person, or when he is wounded by falling, or in whatever way the bone sustains a direct wound from this instrument. Those weapons which graze the bone obliquely are less apt to fracture, contuse, or depress the bone, even when the bone is denuded of flesh; for in some of those wounds thus inflicted the bone is not laid bare of the flesh. Those instruments more especially produce fractures in the bone, whether apparent or not, and contusions, and inward depression of the bone, which are rounded, globular, smooth on all sides, blunt, heavy, and hard; and such weapons bruise, compress, and pound the flesh; and the wounds inflicted by such instruments, whether obliquely or circularly, are round, and are more disposed to suppurate, and to have a discharge, and take longer time to become clean; for the flesh which has been bruised and pounded must necessarily suppurate and slough away. But weapons of an oblong form, being, for the most part, slender, sharp, and light, penetrate the flesh rather than bruise it, and the bone in like manner; and such an instrument may occasion a hedra and a cut (for a hedra and a cut are same thing); but weapons of this description do not produce contusions, nor fractures, nor depressions inwardly. And in addition the appearances in the bone, which you call detect by the sight, you should make inquiry as to all these particulars (for they are symptoms of a greater or less injury), whether the wounded person was stunned, and whether darkness was diffused over his eyes, and whether he had vertigo, and fell to the ground.

12. Ὅταν δὲ τύχῃ ψιλωθὲν τὸ ὀστέον τῆς σαρκὸς ὑπὸ τοῦ βέλεος, καὶ τύχῃ κατ’ αὐτὰς τὰς ῥαφὰς γενόμενον τὸ ἕλκος, χαλεπὸν γίγνεται καὶ τὴν ἕδρην τοῦ βέλεος φράσασθαι τὴν ἐν τῷ ἄλλῳ ὀστέῳ φανερὴν γιγνομένην, εἴτ’ ἔνεστιν ἐν τῷ ὀστέῳ, εἴτε μὴ ἔνεστιν, καὶ ἢν τύχῃ γενομένη ἡ ἕδρη ἐν αὐτέῃσι τῇσι ῥαφῇσιν. Ξυγκλέπτεται γὰρ αὐτὴ ἡ ῥαφὴ τρηχυτέρη ἐοῦσα τοῦ

ἄλλου ὀστέου, καὶ οὐ διάδηλον ὅ τι τε αὐτοῦ ῥαφή ἐ̣ιν, καὶ ὅ τι τοῦ βέλεος ἕδρη, ἢν μὴ κάρτα μεγάλη γένηται ἡ ἕδρη. Προσγίνεται δὲ καὶ ῥῆξις τῇ ἕδρῃ ὡς ἐπὶ τὸ πουλὺ, τῇ ἐν τῇσι ῥαφῇσι γιγνομένῃ, καὶ γίνεται καὶ αὐτὴ ἡ ῥήξις χαλεπωτέρη φράσασθαι, ἐρρωγότος τοῦ ὀστέου, διὰ τοῦτο, ὅτι κατ’ αὐτὴν τὴν ῥαφὴν ἡ ῥῆξις γίνεται ἢν ῥηγνύηται, ὡς ἐπὶ τὸ πουλύ. Ἕτοιμον γὰρ ταύτῃ ῥήγνυσθαι τὸ ὀστέον καὶ διαχαλᾷν, διὰ τὴν ἀσθένείην

τῆς φύσιος τοῦ ὀστέου ταύτῃ καὶ διὰ τὴν ἀραιότητα, καὶ δὴ ἅτε τῆς ῥαφῆς ἑτοίμης ἐούσης ῥήγνυσθαι καὶ διαχαλᾷν τὰ δ’ ἄλλα ὀστέα, τὰ περιέχοντα τὴν ῥαφὴν, μένει ἀρραγέα, ὅτι ἰσχυρότερά ἐστι τῆς ῥαφῆς. Ἡ δὲ ῥῆξις ἡ κατὰ τὴν ῥαφὴν γινομένη καὶ διαχάλασίς ἐστι τῆς ῥαφῆς, καὶ φράσασθαι οὐκ εὐμαρὴς,

οὔτε ἢν ὑπὸ ἕδρης τοῦ βέλεος γενομένης ἐν τῇ ῥαφῇ ῥαγῇ καὶ διαχαλάσῃ, οὔτε ἢν, φλασθέντος τοῦ ὀστέου κατὰ τὰς ῥαφὰς, ῥαγῇ καὶ διαχαλάσῃ ἀλλ’ ἔτι χαλεπώτερον φράσασθαι τὴν ἀπὸ τῆς φλάσιος ῥωγμήν. Ξυγκλέπτουσι γὰρ τὴν γνώμην καὶ τὴν ὄψιν τοῦ ἰητροῦ αὗται αἱ ῥαφαὶ ῥωγμοειδέες φαινόμεναι, καὶ τρηχύτεραι ἐοῦσαι τοῦ ἄλλου ὀστέου, ὅτι μὴ ἰσχυρῶς διεκόπη, καὶ διεχάλασεν διακοπὴ δὲ καὶ ἕδρη τωὐτόν ἐστιν. Ἀλλὰ χρὴ, εἰ κατὰ τὰς ῥαφὰς τὸ τρῶμα γένοιτο καὶ πρός γε τὸ ὀστέον καὶ ἐς τὸ ὀστέον στηρίξειε τὸ βέλος, προσέχοντα τὸν νόον, ἀνευρίσκειν ὅ τι πέπονθε τὸ ὀστέον. Ἀπὸ γὰρ ἴσων τε βελέων τὸ μέγεθος καὶ ὁμοίων, καὶ πολλὸν ἐλασσόνων, καὶ ὁμοίως τρωθεὶς καὶ πολὺ ἧσσον, πολλῷ μέζον ἐκτήσατο τὸ κακὸν ἐν τῷ ὀστέῳ ὁ ἐς τὰς ῥαφὰς δεξάμενος τὸ βέλος, ἢ ὁ μὴ ἐς τὰς ῥαφὰς δεξάμενος. Καὶ τουτέων τὰ πολλὰ πρίεσθαι δεῖ ἀλλ’ οὐ χρὴ αὐτὰς τὰς ῥαφὰς πρίειν, ἀλλ’ ἀποχωρήσαντα ἐν τῷ πλησίον ὀστέῳ τὴν πρίσιν ποιέεσθαι, ἢν πρίῃς.

12. When the bone happens to be denuded of flesh by the weapon, and when the wound occurs upon the sutures, it is difficult to distinguish the indentation ( hedra ) of a weapon which is clearly recognized in other parts of the bone, whether it exist or not, and especially if the hedra be seated in the sutures themselves. For the suture being rougher than the rest of the bone occasions confusion, and it is not clear which is the suture, and which the mark inflicted by the instrument, unless the latter ( hedra ) be large. Fracture also for the most part is combined with the indentation when it occurs in the sutures; and this fracture is more difficult to discern when the bone is broken, on this account, that if there be a fracture, it is situated for the most part in the suture. For the bone is liable to be broken and slackened there, owing to the natural weakness of the bone there, and to its porosity, and from the suture being readily ruptured and slackened: but the other bones which surround the suture remain unbroken, because they are stronger than the suture. For the fracture which occurs at the suture is also a slackening of the suture, and it is not easy to detect whether the bone be broken and slackened by the indentation of a weapon occurring in the suture, or from a contusion of the bone at the sutures; but it is still more difficult to detect a fracture connected with contusion. For the sutures, having the appearance of fissures, elude the discernment and sight of the physician, as being rougher than the rest of the bone, unless the bone be strongly cut and slackened (for a cut and a hedra are the same thing). But it is necessary, if the wound has occurred at the sutures, and the weapon has impinged on the bone or the parts about it, to pay attention and find out what injury the bone has sustained. For a person wounded to the same, or a much smaller, extent, and by weapons of the same size and quality, and even much less, will sustain a much greater injury, provided he has received the blow at the sutures, than if it was elsewhere. And many of these require trepanning, but you must not apply the trepan to the sutures themselves, but on the adjoining bone.

13. Περὶ δὲ ἰήσιος τρωσίων τῶν ἐν τῇ κεφαλῇ, καὶ ὡς χρὴ ἐξελέγχειν τὰς πάθας τὰς ἐν τῷ ὀστέῳ γινομένας τὰς μὴ φανερὰς, ὧδέ μοι δοκέει. Ἕλκος ἐν τῇ κεφαλῇ οὐ χρὴ τέγγειν οὐδενὶ, οὐδὲ οἴνῳ, ἀλλ’ ὡς ἥκιστα οὐδὲ καταπλάσσειν, οὐδὲ μοτῷ τὴν

ἴησιν ποιέεσθαι, οὐδ’ ἐπιδεῖν χρὴ ἕλκος ἐν κεφαλῇ, ἢν μὴ ἐν τῷ μετώπῳ ᾖ τὸ ἕλκος, ἐν τῷ ψιλῷ τῶν τριχῶν, ἢ περὶ τὴν ὀφρὺν καὶ τὸν ὀφθαλμόν. Ἐνταῦθα δὲ γινόμενα τὰ ἕλκεα καταπλάσιος καὶ ἐπιδέσιος μᾶλλον κέχρηται ἤ κου ἄλλοθι τῆς κεφαλῆς τῆς ἄλλης. Περιέχει γὰρ ἡ κεφαλὴ ἡ ἄλλη τὸ μέτωπον πᾶν ἐκ δὲ τῶν περιεχόντων τὰ ἕλκεα, καὶ ἐν ὅτῳ ἂν ᾖ τὰ ἕλκεα, φλεγμαίνει καὶ ἐπανοιδίσκεται δι’ αἵματος ἐπιρροήν. Χρὴ δὲ οὐδὲ τὰ ἐν τῷ μετώπῳ διὰ παντὸς τοῦ χρόνου καταπλάσσειν καὶ ἐπιδεῖν, ἀλλ’ ἐπειδὰν παύσηται φλεγμαίνοντα, καὶ τὸ οἴδημα καταστῇ, παύσασθαι καταπλάσσοντα καὶ ἐπιδέοντα. Ἐν δὲ τῇ ἄλλῃ κεφαλῇ ἕλκος οὔτε μοτοῦν χρὴ, οὔτε καταπλάσσειν, οὔτ’ ἐπιδεῖν, εἰ μὴ καὶ τομῆς δέοιτο. Τάμνειν δὲ χρὴ τῶν ἑλκέων τῶν ἐν τῇ κεφαλῇ γινομένων,

καὶ ἐν τῷ μετώπῳ, ὅκου ἂν τὸ μὲν ὀστέον ψιλὸν ᾖ τῆς σαρκὸς, καὶ δοκέῃ τι σίνος ἔχειν ὑπὸ τοῦ βέλεος, τὰ ἕλκεα μὴ ἱκανὰ τὸ μέγεθος τοῦ μήκεος καὶ τῆς εὐρύτητος ἐς τὴν σκέψιν τοῦ ὀστέου, εἴ τι πέπονθεν ὑπὸ τοῦ βέλεος κακὸν, καὶ ὁκοῖόν τι πέπονθε, καὶ ὅσον μὲν ἡ σὰρξ πέφλασται, καὶ τὸ ὀστέον ἔχει τὸ σίνος, καὶ δ’ αὖ εἰ ἀσινές τέ ἐστι τὸ ὀστέον ὑπὸ τοῦ βέλεος, καὶ μηδὲν πέπονθε κακὸν, καὶ ἐς τὴν ἴησιν, ὁκοίης τινὸς δεῖται τό τε ἕλκος, ἥ τε σὰρξ, καὶ ἡ πάθη τοῦ ὀστέου. Τὰ δὴ τοιαῦτα τῶν ἑλκέων τομῆς δεῖται. Καὶ ἂν μὲν τὸ ὀστέον ψιλωθῇ τῆς σαρκὸς, ὑπόκοιλα δὲ ᾖ ἐς πλάγιον ἐπιπολὺ, ἐπανατάμνειν τὸ κοῖλον, ὅκου μὴ

εὐχερὲς τῷ φαρμάκῳ ἐφικέσθαι, ὁκοίῳ ἄν τινι χρῇ καὶ τὰ κυκλοτερέα τῶν ἑλκέων καὶ ὑπόκοιλα ἐπὶ πουλὺ καὶ τὰ τοιαῦτα, ἐπανατάμνων τὸν κύκλον διχῆ κατὰ μῆκος, ὡς πέφυκεν ὥνθρωπος, μακρὸν ποιέειν τὸ ἕλκος. Τάμνοντι δὲ κεφαλὴν, τὰ μὲν ἄλλα τῆς κεφαλῆς ἀσφαλείην ἔχει ταμνόμενα ὁ δὲ κρόταφος, καὶ ἄνωθεν ἔτι τοῦ κροτάφου, κατὰ τὴν φλέβα τὴν διὰ τοῦ κροτάφου φερομένην, τοῦτο δὲ τὸ χωρίον μὴ τάμνειν. Σπασμὸς γὰρ ἐπιλαμβάνει τὸν τμηθέντα καὶ ἢν μὲν ἐπ’ ἀριστερὰ τμηθῇ κροτάφου, τὰ ἐπὶ δεξιὰ ὁ σπασμὸς ἐπιλαμβάνει ἢν δ’ ἐπὶ τὰ δεξιὰ τμηθῇ κροτάφου, τὰ ἐπ’ ἀριστερὰ ὁ σπασμὸς ἐπιλαμβάνει.

13. And with regard to the cure of wounds in the head, and the mode of detecting injuries in the bone which are not apparent, the following is my opinion:- In a wound of the head, you must not apply anything liquid, not even wine, but as little as possible, nor a cataplasm, nor conduct the treatment with tents, nor apply a bandage to an ulcer on the head, unless it be situated on the forehead, in the part which is bare of hairs, or about the eyebrow and eye, for wounds occurring there require cataplasms and bandages more than upon any other part of the head. For the rest of the head surrounds the whole forehead, and the wounds wherever situated become inflamed and swelled, owing to an influx of blood from surrounding parts. And neither must you apply cataplasms and bandages to the forehead at all times; but when the inflammation is stopped and the swelling has subsided, you must give up the cataplasms and bandages. A wound in any other part of the head must not be treated with tents, bandages, or cataplasms, unless it also requires incision. You must perform incision on wounds situated on the head and forehead, whenever the bone is denuded of flesh, and appears to have sustained some injury from the blow, but the wound has not sufficient length and breadth for the inspection of the bone, so that it may be seen whether it has received any mischief from the blow, and of what nature the injury is, and to what extent the flesh has been contused, and whether the bone has sustained any injury, or whether it be uninjured by the blow, and has suffered no mischief; and with regard to the treatment, what the wound, and the flesh, and the injury of the bone stand in need of. Ulcers of this description stand in need of incision; and, if the bone be denuded of the flesh, and if it be hollow, and extend far obliquely, we cut up the cavity wherever the medicine cannot penetrate readily, whatever medicine it may be; and wounds which are more inclined to be circular and hollow, and for the most part others of the like shape, are cut up by making double incision in the circle lengthways, according to the figure of the man, so as to make the wound of a long form. Incisions may be practiced with impunity on other parts of the head, with the exception of the temple and the parts above it, where there is a vein that runs across the temple, in which region an incision is not to be made. For convulsions seize on a person who has been thus treated; and if the incision be on the left temple, the convulsions seize on the right side; and if the incision be on the right side, the convulsions take place on the left side.

14. Ὅταν οὖν τάμνῃς ἕλκος ἐν κεφαλῇ ὀστέων εἵνεκα τῆς σαρκὸς ἐψιλωμένων, θέλων εἰδέναι εἴ τι ἔχει τὸ ὀστέον κακὸν ὑπὸ τοῦ βέλεος, ἢ καὶ οὐκ ἔχει, τάμνειν χρὴ τὸ μέγεθος τὴν ὠτειλὴν, ὅση ἂν δοκέῃ ἀποχρῆναι. Τάμνοντα δὲ χρὴ ἀναστεῖλαι τὴν σάρκα ἀπὸ τοῦ ὀστέου, ᾗ πρὸς τῇ μήνιγγι καὶ πρὸς τῷ ὀστέῳ

πέφυκεν ἔπειτα διαμοτῶσαι τὸ ἕλκος πᾶν μοτῷ, ὅστις εὐρύτατον τὸ ἕλκος παρέξει ἐς τὴν ὑστεραίην ξὺν ἐλαχίστῳ πόνῳ μοτώσαντα δὲ καταπλάσματι χρῆσθαι, ὅσον ἂν χρόνον καὶ τῷ μοτῷ, μάζην ἐκ λεπτῶν ἀλφίτων ἐν ὄξει διαμάσσειν, ἢ ἕψειν καὶ γλίσχρην ποιέειν ὡς μάλιστα. Τῇ δ’ ὑστεραίῃ ἡμέρῃ, ἐπειδὰν ἐξέλῃς τὸν μοτὸν, κατιδὼν τὸ ὀστέον ὅ τι πέπονθεν, ἐὰν μή σοι καταφανὴς ᾖ ἡ τρῶσις, ὁκοίη τίς ἐστιν ἐν τῷ ὀστέῳ, μηδὲ διαγινώσκῃς εἴ τέ τι ἔχει τὸ ὀστέον κακὸν ἐν ἑωυτέῳ, ἢ καὶ οὐκ ἔχει, τὸ δὲ βέλος δοκέῃ ἀφικέσθαι ἐς τὸ ὀστέον καὶ σίνασθαι, ἐπιξύειν χρὴ τῷ ξυστῆρι κατὰ βάθος καὶ κατὰ μῆκος τοῦ ἀνθρώπου ὡς πέφυκε, καὶ αὖθις ἐπικάρσιον τὸ ὀστέον, τῶν ῥηξίων εἵνεκα τῶν ἀφανέων ἰδεῖν, καὶ τῆς φλάσιος εἵνεκα τῆς ἀφανέος, τῆς οὐκ ἐσφλωμένης ἔσω ἐκ τῆς φύσιος τῆς κεφαλῆς τοῦ ἄλλου ὀστέου. Ἐξελέγχει γὰρ ἡ ξύσις μάλα τὸ κακὸν, ἢν μὴ καὶ ἄλλως καταφανέες ἔωσιν αὗται αἱ πάθαι ἐοῦσαι ἐν

τῷ ὀστέῳ. Καὶ ἢν ἕδρην ἴδῃς ἐν τῷ ὀστέῳ τοῦ βέλεος, ἐπιξύειν χρὴ αὐτήν τε τὴν ἕδρην, καὶ τὰ περιέχοντα αὐτὴν ὀστέα, μὴ πολλάκις τῇ ἕδρῃ προσγένηται ῥῆξις καὶ φλάσις, ἢ μούνη φλάσις, ἔπειτα λανθάνῃ οὐ καταφανέα ἐόντα. Ἐπειδὰν δὲ ξύσῃς τὸ ὀστέον τῷ ξυστῆρι, ἢν μὲν δοκέῃ ἐς πρίσιν ἀφίκειν ἡ τρῶσις τοῦ ὀστέου, πρίειν χρὴ, καὶ οὐ δεῖ τὰς τρεῖς ἡμέρας μὴ ὑπερβάλλειν ἀπρίωτον, ἀλλ’ ἐν ταύτῃσι πρίειν, ἄλλως τε καὶ τῆς θερμῆς ὥρης, ἢν ἐξ ἀρχῆς λαμβάνῃς τὸ ἴημα. Ἢν δὲ ὑποπτεύσῃς μὲν τὸ ὀστέον ἐρρωγέναι, ἢ πεφλάσθαι, ἢ ἀμφότερα ταῦτα, τεκμαιρόμενος, ὅτι ἰσχυρῶς τέτρωται, ἐκ τῶν λόγων τοῦ τρωματίου, καὶ ὅτι ὑπὸ ἰσχυροτέρου τοῦ τρώσαντος, ἢν ἕτερος ὑφ’ ἑτέρου τρωθῇ, καὶ τὸ βέλος ὅτῳ ἐτρώθη, ὅτι τῶν κακούργων βελέων ἦν, ἔπειτα τὸν ἄνθρωπον ὅτι δῖνός τε ἔλαβε καὶ σκότος, καὶ ἐκαρώθη καὶ κατέπεσεν τούτων δὲ οὕτω γιγνομένων, ἢν μὴ διαγινώσκῃς εἰ ἔρρωγε τὸ ὀστέον, ἢ πέφλασται, ἢ καὶ ἀμφότερα ταῦτα, μήτε ὅλως ὁρᾷν δύνῃ, δεῖ δὴ,

ἐπὶ τὸ ὀστέον τὸ τηκτὸν τὸ μελάντατον δεύσαντα, τῷ μέλανι φαρμάκῳ τῷ τηκομένῳ στεῖλαι τὸ ἕλκος, ὑποτείναντα ὀθόνιον, ἐλαίῳ τέγξαντα, εἶτα καταπλάσαντα τῇ μάζῃ ἐπιδῆσαι τῇ δ’ ὑστεραίῃ, ἀπολύσαντα, ἐκκαθήραντα τὸ ἕλκος, ἐπιξῦσαι. Καὶ ἢν μὴ ᾖ ὑγιὲς, ἀλλ’ ἐρρώγῃ καὶ πεφλασμένον ᾖ, τὸ μὲν ἄλλο ἔσται ὀστέον λευκὸν ἐπιξυόμενον ἡ δὲ ῥωγμὴ καὶ ἡ φλάσις, κατατακέντος τοῦ

φαρμάκου, δεξαμένη τὸ φάρμακον ἐς ἑωυτὴν μέλαν ἐὸν, ἔσται μέλαινα ἐν λευκῷ τῷ ὀστέῳ τῷ ἄλλῳ. Ἀλλὰ χρὴ αὖθις τὴν ῥωγμὴν ταύτην φανεῖσαν μέλαιναν ἐπιξέειν κατὰ βάθος καὶ ἢν μὲν ἐπιξύων τὴν ῥωγμὴν ἐξέλῃς καὶ ἀφανέα ποιήσῃς, φλάσις μὲν γεγένηται τοῦ ὀστέου ἢ μᾶλλον ἢ ἧσσον, ἥτις περιέρρηξε καὶ τὴν ῥωγμὴν τὴν ἀφανισθεῖσαν ὑπὸ τοῦ ξυστῆρος ἧσσον δὲ φοβερὸν καὶ ἧσσον ἂν πρῆγμα ἀπ’ αὐτέης γένοιτο ἀφανισθείσης τῆς ῥωγμῆς. Ἢν δὲ κατὰ βάθος ᾖ καὶ μὴ ἐθέλῃ ἐξιέναι ἐπιξυομένη, ἀφίκει ἐς πρίσιν ἡ τοιαύτη ξυμφορή. Ἀλλὰ χρὴ πρίσαντα τὰ λοιπὰ ἰητρεύειν τὸ ἔλκος.

14. When, then, you lay open a wound in the head on account of the bones having been denuded of the flesh, as wishing to ascertain whether or not the bone has received an injury from the blow, you must make an incision proportionate to the size of the wound, and as much as shall be judged necessary. And in making the incision you must separate the flesh from the bone where it is united to the membrane ( pericranium? ） and to the bone, and then fill the whole wound with a tent, which will expand the wound very wide next day with as little pain as possible; and along with the tents apply a cataplasm, consisting of a mass ( maza ） of fine flour pounded in vinegar, or boiled so as to render it as glutinous as possible. On the next day, when you remove the tent, having examined the bone to see what injury it has sustained, if the wound in the bone be not right seen by you, nor can you discover what mischief the bone itself has sustained, but the instrument seems to have penetrated to the bone so as to have injured it, you must scrape the bone with a raspatory to a depth and length proportionate to the suture of the patient, and again in a transverse direction, for the sake of the fractures which are not seen, and of the contusions which are not discovered, as not being accompanied with depression of the bone from its natural position. For the scraping discovers the mischief, if the injuries in the bone be not otherwise manifest. And if you perceive an indentation ( hedra ) left in the bone by the blow, you must scrape the dint itself and the surrounding bones, lest, as often happens, there should be a fracture and contusion, or a contusion alone, combined with the dint, and escape observation. And when you scrape the bone with the raspatory, and it appears that the wound in the bone requires the operation, you must not postpone it for three days, but do it during this period, more especially if the weather be hot, and you have had the management of the treatment from commencement. If you suspect that the bone is broken or contused, or has sustained both these injuries, having formed your judgement from the severity of the wound, and from the information of the patient, as that the person who inflicted the wound, provided it was done by another person, was remarkably strong, and that the weapon by which he was wounded was of a dangerous description, and then that the man had been seized with vertigo, dimness of vision, and stupor, and fell to the ground,- under these circumstances, if you cannot discover whether the bone be broken, contused, or both the one and the other, nor can see the truth of the matter, you must dissolve the jet-black ointment, and fill the wound with it when this dissolved, and apply a linen rag smeared with oil, and then a cataplasm of the maza with a bandage; and on the next day, having cleaned out the wound, scrape the bone with the raspatory. And if the bone is not sound, but fractured and contused, the rest of it which is scraped will be white; but the fracture and contusion, having imbibed the preparation, will appear black, while the rest of the bone is white. And you must again scrape more deeply the fracture where it appears black; and, if you thus remove the fissure, and cause it to disappear, you may conclude that there has been a contusion of the bone to a greater or less extent, which has occasioned the fracture that has disappeared under the raspatory; but it is less dangerous, and a matter of less consequence, when the fissure has been effaced. But if the fracture extend deep, and do not seem likely to disappear when scraped, such an accident requires trepanning. But having performed this operation, you must apply the other treatment to the wound.

15. Φυλάσσεσθαι δὲ χρὴ, ὅκως μή τι κακὸν ἀπολαύσῃ τὸ ὀστέον ἀπὸ τῆς σαρκὸς, ἢν κακῶς ἰητρεύηται. Ὀστέῳ γὰρ καὶ πεπρισμένῳ, καὶ ἄλλως ἐψιλωμένῳ, ὑγιεῖ δὲ ἐόντι, καὶ ἔχοντί τι σίνος ὑπὸ τοῦ βέλεος, δοκέοντι δὲ ὑγιεῖ εἶναι, κίνδυνός ἐστι μᾶλλον ὑπόπυον γενέσθαι ἢν καὶ ἄλλως μὴ μέλλᾐ, ἢν καὶ ἡ σὰρξ ἡ περιέχουσα τὸ ὀστέον κακῶς θεραπεύηται, καὶ φλεγμαίνηται, καὶ περισφίγγηται πυρετῶδες γὰρ γίγνεται, καὶ πολλοῦ φλογμοῦ πλέον. Καὶ δὴ τὸ ὀστέον ἐκ τῶν περιεχουσῶν σαρκέων ἐς ἑωυτὸ θέρμην τε καὶ φλογμὸν καὶ ἄραδον ἐμποιέει καὶ σφυγμὸν, καὶ ὅσα περ ἡ σὰρξ ἔχει κακὰ ἐν ἑωυτέῃ, καὶ ἐκ τουτέων ὧδε ὑπόπυον γίνεται. Κακὸν δὲ καὶ ὑγρήν τε εἶναι τὴν σάρκα ἐν τῷ ἕλκει καὶ μυδῶσαν, καὶ ἐπὶ πολλὸν χρόνον καθαίρεσθαι. Ἀλλὰ χρὴ διάπυον μὲν ποιῆσαι τὸ ἕλκος ὡς τάχιστα οὕτω γὰρ ἂν ἥκιστα φλεγμαίνοι τὰ περιέχοντα

τὸ ἕλκος, καὶ τάχιστα καθαρὸν εἴη ἀνάγκη γὰρ ἔχει τὰς σάρκας τὰς κοπείσας καὶ φλασθείσας ὑπὸ τοῦ βέλεος, ὑποπύους γενομένας, ἐκτακῆναι. Ἐπειδὰν δὲ καθαρθῇ, ξηρότερον χρὴ γίγνεσθαι τὸ ἕλκος οὕτω γὰρ ἂν τάχιστα ὑγιὲς γένοιτο, ξηρῆς σαρκὸς βλαστούσης καὶ μὴ ὑγρῆς, καὶ οὕτως οὐκ ἂν ὑπερσαρκήσειε τὸ ἕλκος. Ὁ δ’ αὐτὸς λόγος καὶ ὑπὲρ τῆς μήνιγγος τῆς περὶ τὸν ἐγκέφαλον ἢν γὰρ αὐτίκα ἐκπρίσας τὸ ὀστέον καὶ ἀφελὼν ἀπὸ τῆς μήνιγγος ψιλώσῃς, αὐτὴν καθαρὴν χρὴ ποιῆσαι ὡς τάχιστα καὶ ξηρὴν, ὡς μὴ ἐπὶ πουλὺν χρόνον ὑγρὴ ἐοῦσα μυδήῃ τε καὶ ἐξαίρηται τούτων γὰρ οὕτω γιγνομένων, σαπῆναι αὐτὴν κίνδυνος.

15. You must be upon your guard lest the bone sustain any injury from the fleshy parts if not properly treated. When the bone has been sawed and otherwise denuded, whether it be actually sound, or only appears to be so, but has sustained some injury from the blow, there may be danger of its suppurating (although it would not otherwise have done so), if the flesh which surrounds the bone be ill cured, and become inflamed and strangled; for it gets into a febrile state, and becomes much inflamed. For the bone acquires heat and inflammation from the surrounding flesh, along with irritation and throbbing, and the other mischiefs which are in the flesh itself, and from these it gets into a state of suppuration. It is a bad thing for the flesh ( granulations? ） in an ulcer to be moist and mouldy, and to require a long time to become clean. But the wound should be made to suppurate as quickly as possible; for, thus the parts surrounding the wound would be the least disposed to inflammation, and would become the soonest clean; for the flesh which has been chopped and bruised by the blow, must necessarily suppurate and slough away. But when cleaned the wound must be dried, for thus the wound will most speedily become whole, when flesh devoid of humors grows up, and thus there will be no fungous flesh in the sore. The same thing applies to the membrane which surrounds the brain: for when, by sawing the bone, and removing it from the meninx, you lay the latter bare, you must make it clean and dry as quickly as possible, lest being in a moist state for a considerable time, it become soaked therewith and swelled; for when these things occur, there is danger of its mortifying.

16. Ὀστέον δὲ, ὅ τι δεῖ ἀποστῆναι ἀπὸ τοῦ ἄλλου ὀστέου, ἕλκεος ἐν κεφαλῇ γενομένου, ἕδρης τε ἐούσης τοῦ βέλεος ἐν τῷ ὀστέῳ, ἢ ἄλλως ἐπὶ πουλὺ ψιλωθέντος τοῦ ὀστέου, ἀφίσταται ἐπὶ πουλὺ ἔξαιμον γινόμενον. Ἀναξηραίνεται γὰρ τὸ αἷμα ἐκ τοῦ ὀστέου ὑπό τε τοῦ χρόνου καὶ ὑπὸ φαρμάκων τῶν πλείστων τάχιστα δ’ ἂν ἀποσταίη, εἴ τις τὸ ἕλκος ὡς τάχιστα καθήρας ξηραίνοι τὸ λοιπὸν τό τε ἕλκος καὶ τὸ ὀστέον, καὶ τὸ μεῖζον καὶ τὸ ἧσσον. Τὸ γὰρ τάχιστα ἀποξηρανθὲν καὶ ἀποστρακωθὲν τούτῳ μάλιστα ἀφίεται ἀπὸ τοῦ ἄλλου ὀστέου τοῦ ἐναίμου τε καὶ ζῶντος αὐτέου, ἔξαιμόν τε γενόμενον καὶ ξηρὸν τῷ ἐναίμῳ καὶ ζῶντι μάλα ἐφίσταται.

16. A piece of bone that must separate from the rest of the bone, in consequence of a wound in the head, either from the indentation ( hedra ) of a blow in the bone, or from the bone being otherwise denuded for a long time, separates mostly by becoming exsanguous. For the bone becomes dried up and loses its blood by time and a multiplicity of medicines which are used; and the separation will take place most quickly, if one having cleaned the wound as quickly as possible will next dry it, and the piece of bone, whether larger or smaller. For a piece of bone which is quickly dried and converted, as it were, into a shell, is most readily separated from the rest of the bone which retains its blood and vitality; for, the part having become exsanguous and dry, more readily drops off from that which retains its blood and is alive.

17. Ὅσα δὲ τῶν ὀστέων ἐσφλᾶται ἔσω ἐκ τῆς φύσιος τῆς ἑωυτῶν, καταρραγέντα ἢ καὶ διακοπέντα πάνυ εὐρέα, ἀκινδυνότερα τὰ τοιαῦτα γίνεται, ἐπὴν ἡ μῆνιγξ ὑγιὴς ᾖ καὶ τὰ πλέοσι ῥωγμῇσιν ἐσκαταρραγέντα καὶ εὐρυτέρῃσιν, ἔτι ἀκινδυνότερα καὶ εὐμαρέστερα ἐς τὴν ἀφαίρεσιν γίνεται. Καὶ οὐ χρὴ πρίειν τῶν τοιούτων οὐδὲν, οὐδὲ κινδυνεύειν τὰ ὀστέα πειρώμενον ἀφαιρέειν, πρὶν ἢ αὐτόματα ἐπανίῃ, οἴδεος πρῶτον χαλάσαντος. Ἐπανέρχεται δὲ τῆς σαρκὸς

ὑποφυομένης ὑποφύεται δὲ ἐκ τῆς διπλόης τοῦ ὀστέου καὶ ἐκ τοῦ ὑγιέος, ἢν ἡ ἄνωθεν μοῖρα μούνη σφακελίσῃ. Οὕτω δ’ ἂν τάχιστα ἥ τε σὰρξ ὑποφύοιτο καὶ βλαστάνοι, καὶ τὰ ὀστέα ἐπανίοι, εἴ τις τὸ ἕλκος ὡς τάχιστα διάπυον ποιήσας καθαρὸν ποιήσηται. Καὶ ἢν διὰ παντὸς τοῦ ὀστέου ἄμφω αἱ μοῖραι ἐσφλασθῶσιν ἔσω ἐς τὴν μήνιγγα, ἥ τε ἄνω μοίρη τοῦ ὀστέου καὶ ἡ κάτω, ἰητρεύοντι ὡσαύτως τὸ ἕλκος ὑγιὲς τάχιστα ἔσται, καὶ τὰ ὀστέα τάχιστα ἐπάνεισι, τὰ ἐσφλασθέντα ἔσω.

17. Such pieces of bone as are depressed from their natural position, either being broken off or chopped off to a considerable extent, are attended with less danger, provided the membrane be safe; and bones which are broken by numerous and broader fractures are still less dangerous and more easily extracted. And you must not trepan any of them, nor run any risks in attempting to extract the pieces of bone, until they rise up of their own accord, upon the subsidence of the swelling. They rise up when the flesh ( granulations ) grows below, and it grows from the diploe of the bone, and from the sound portion, provided the upper table alone be in a state of necrosis. And the flesh will shoot up and grow below the more quickly, and the pieces of bone ascend, if one will get the wound to suppurate and make it clean as quickly as possible. And when both the tables of the bone are driven in upon the membrane, I mean the upper and lower, the wound, if treated in the same way, will very soon get well, and the depressed bones will quickly rise up.

18. Τῶν δὲ παιδίων τὰ ὀστέα καὶ λεπτότερά ἐστι καὶ μαλθακώτερα διὰ τοῦτο, ὅτι ἐναιμότερά ἐστι, καὶ κοῖλα, καὶ σηραγγώδεα, καὶ οὔτε πυκνὰ, οὔτε στερεά. Καὶ ὑπὸ τῶν βελέων ἴσων τε ἐόντων καὶ ἀσθενεστέρων, καὶ τρωθέντων ὁμοίως τε καὶ ἧσσον, τὸ τοῦ νεωτέρου παιδίου καὶ μᾶλλον καὶ θᾶσσον ὑποπυΐσκεται, ἢ τὸ τοῦ πρεσβυτέρου, καὶ ἐν ἐλάσσονι χρόνῳ καὶ ὅσα ἂν ἄλλως μέλλῃ ἀποθανεῖσθαι ἐκ τοῦ τρώματος, ὁ νεώτερος τοῦ πρεσβυτέρου θᾶσσον ἀπόλλυται. Ἀλλὰ χρὴ, ἢν ψιλωθῇ τῆς σαρκὸς τὸ ὀστέον, προσέχοντα τὸν νόον, πειρῆσθαι διαγινώσκειν ὅ τι μή ἐστι τοῖσιν ὀφθαλμοῖσιν ἰδεῖν, καὶ γνῶναι εἰ ἔρρωγε τὸ ὀστέον καὶ εἰ πέφλασται, ἢ μοῦνον πέφλασται, καὶ εἰ, ἕδρης γενομένης τοῦ βέλεος, πρόσεστι φλάσις, ἢ ῥωγμὴ, ἢ ἄμφω ταῦτα καὶ ἤν τι τούτων πεπόνθῃ τὸ ὀστέον, ἀφεῖναι τοῦ αἵματος τρυπῶντα τὸ ὀστέον σμικρῷ τρυπάνῳ, φυλασσόμενον ἐπ’ ὀλίγον λεπτότερον γὰρ τὸ ὀστέον, καὶ ἐπιπολαιότερον τῶν νέων ἢ τῶν πρεσβυτέρων.

18. The bones of children are thinner and softer, for this reason, that they contain more blood [than those of adults]; and they are porous and spongy, and neither dense nor hard. And when wounded to a similar or inferior degree by weapons of the same or even of an inferior power, the bone of a young person more readily and quickly suppurates, and that in less time than the bone of an older person; and in accidents, which are to prove fatal, the younger person will die sooner than the elder. But if the bone is laid bare of flesh, one must attend and try to find out, what even is not obvious to the sight, and discover whether the bone be broken and contused, or only contused; and if, when there is an indentation in the bone, whether contusion, or fracture, or both be joined to it; and if the bone has sustained any of these injuries, we must give issue to the blood by perforating the bone with a small trepan, observing the greatest precautions, for the bone of young persons is thinner and more superficial than that of elder persons.

19. Ὅστις δὲ μέλλει ἐκ τρωμάτων ἐν κεφαλῇ ἀποθνήσκειν, καὶ

μὴ δυνατὸν αὐτὸν ὑγιᾶ γενέσθαι, μηδὲ σωθῆναι, ἐκ τῶνδε τῶν σημείων χρὴ τὴν διάγνωσιν ποιέεσθαι τοῦ μέλλοντος ἀποθνήσκειν, καὶ προλέγειν τὸ μέλλον ἔσεσθαι. Πάσχει γὰρ τάδε ὁκόταν τις ὀστέον κατεηγὸς, ἢ ἐρρωγὸς, ἢ πεφλασμένον, ἢ ὅτῳ γοῦν τρόπῳ κατεηγὸς μὴ ἐννοήσας ἁμάρτῃ, καὶ μήτε ξύσῃ, μήτε πρίσῃ, δεόμενον, μεθῇ δὲ ὡς ὑγιέος ὄντος τοῦ ὀστέου, πρὸ τῶν τεσσαρεσκαίδεκα ἡμερέων πυρετὸς ἐπιλήψεται ὡς ἐπὶ πουλὺ ἐν χειμῶνι ἐν δὲ τῷ θέρει μετὰ τὰς ἑπτὰ ἡμέρας ὁ πυρετὸς ἐπιλαμβάνει. Καὶ ἐπειδὰν τοῦτο γένηται, τὸ ἕλκος ἄχροον γίνεται καὶ ἐξ αὐτοῦ ἰχὼρ ῥέει σμικρός καὶ τὸ φλεγμαῖνον ἐκτέθνηκεν ἐξ αὐτοῦ καὶ γλισχρῶδες γίνεται,

καὶ φαίνεται ὥσπερ τάριχος, χροιὴν πυρρὸν, ὑποπέλιον καὶ τὸ ὀστέον σφακελίζειν τηνικαῦτα ἄρχεται, καὶ γίνεται περκνὸν, λευκὸν ὂν, τελευταῖον δὲ ἔπωχρον γενόμενον ἢ ἔκλευκον. Ὅταν δ’ ἤδη ὑπόπυον ᾖ, ἐπὶ τῇ γλώσσῃ φλυκταῖναι γίνονται, καὶ παραφρονέων τελευτᾷ. Καὶ σπασμὸς ἐπιλαμβάνει τοὺς πλείστους τὰ ἐπὶ θάτερα τοῦ σώματος ἢν μὲν ἐν τῷ ἐπ’ ἀριστερὰ τῆς κεφαλῆς ἔχῃ τὸ ἕλκος, τὰ ἐπὶ δεξιὰ τοῦ σώματος ὁ σπασμὸς λαμβάνει ἢν δ’ ἐν τῷ ἐπὶ δεξιὰ τῆς κεφαλῆς ἔχῃ τὸ ἕλκος, τὰ ἐπ’ ἀριστερὰ τοῦ σώματος ὁ σπασμὸς ἐπιλαμβάνει. Εἰσὶ δ’ οἳ καὶ ἀπόπληκτοι γίνονται. Καὶ οὕτως ἀπόλλυνται πρὸ ἑπτὰ ἡμερέων ἐν θέρει, ἢ τεσσάρων καὶ δέκα ἐν χειμῶνι. Ὁμοίως δὲ τὰ σημεῖα ταῦτα σημαίνει, καὶ ἐν πρεσβυτέρῳ ἐόντι τῷ τρώματι, ἢ καὶ ἐν νεωτέρῳ. Ἀλλὰ χρὴ, εἰ ἐννοοίης τὸν πυρετὸν ἐπιλαμβάνοντα, καὶ τῶν ἄλλων τι σημεῖον τούτῳ προσγενόμενον, μὴ διατρίβειν, ἀλλὰ πρίσαντα τὸ ὀστέον πρὸς τὴν μήνιγγα, ἢ καταξύσαντα τῷ ξυστῆρι εὔπριστον δὲ γίνεται καὶ εὔξυστον, ἔπειτα τὰ λοιπὰ οὕτως ἰητρεύειν, ὅκως ἂν δοκέῃ ξυμφέρειν, πρὸς τὸ γινόμενον ὁρῶν.

19. When a person has sustained a mortal wound on the head, which cannot be cured, nor his life preserved, you may form an opinion of his approaching dissolution, and foretell what is to happen from the following symptoms which such a person experiences. When a bone is broken, or cleft, or contused, or otherwise injured, and when by mistake it has not been discovered, and neither the raspatory nor trepan has been applied as required, but the case has been neglected as if the bone were sound, fever will generally come on if in winter, and in summer the fever usually seizes after seven days. And when this happens, the wound loses its color, and the inflammation dies in it; and it becomes glutinous, and appears like a pickle, being of a tawny and somewhat livid color; and the bone then begins to sphacelate, and turns black where it was white before, and at last becomes pale and blanched. But when suppuration is fairly established in it, small blisters form on the tongue and he dies delirious. And, for the most part, convulsions seize the other side of the body; for, if the wound be situated on the left side, the convulsions will seize the right side of the body; or if the wound be on the right side of the head, the convulsion attacks the left side of the body. And some become apoplectic. And thus they die before the end of seven days, if in summer; and before fourteen, if in winter. And these symptoms indicate, in the same manner, whether the wound be older or more recent. But if you perceive that fever is coming on, and that any of these symptoms accompany it, you must not put off, but having sawed the bone to the membrane ( meninx ), or scraped it with a raspatory (and it is then easily sawed or scraped), you must apply the other treatment as may seem proper, attention being paid to circumstances.

20. Ὅταν δ’ ἐπὶ τρώματι ἐν κεφαλῇ ἀνθρώπου ἢ πεπριωμένου ἢ ἀπριώτου, ἐψιλωμένου δὲ τοῦ ὀστέου, οἴδημα ἐπιγένηται ἐρυθρὸν καὶ ἐρυσιπελατῶδες ἐν τῷ προσώπῳ, καὶ ἐν τοῖσιν ὀφθαλμοῖσιν

ἀμφοτέροισιν, ἢ τῷ ἑτέρῳ, καὶ, εἴ τις ἅπτοιτο τοῦ οἴδήματος, ὀδυνῷτο, καὶ πυρετὸς ἐπιλαμβάνοι καὶ ῥῖγος, τὸ δὲ ἕλκος αὐτό τε ἀπὸ τῆς σαρκὸς καλῶς ἔχοι ἰδέσθαι, καὶ τἀπὸ τοῦ ὀστέου, καὶ τὰ περιέχοντα τὸ ἕλκος ἔχοι καλῶς, πλὴν τοῦ οἰδήματος τοῦ ἐν τῷ προσώπῳ, καὶ ἄλλην ἁμαρτάδα μηδεμίαν ἔχοι τὸ οἴδημα τῆς ἄλλης διαίτης, τούτου χρὴ τὴν κάτω κοιλίην ὑποκαθῆραι φαρμάκῳ, ὅ τι χολὴν ἄγει καὶ οὕτω καθαρθέντος, ὅ τε πυρετὸς ἀφίησι, καὶ τὸ οἴδημα καθίσταται, καὶ ὑγιὴς γίνεται. Τὸ δὲ φάρμακον χρὴ διδόναι πρὸς τὴν δύναμιν τοῦ ἀνθρώπου ὁρῶν, ὡς ἂν ἔχῃ ἰσχύος.

20. When in any wound of the head, whether the man has been trepanned or not, but the bone has been laid bare, a red and erysipelatous swelling supervenes in the face, and in both eyes, or in either of them, and if the swelling be painful to the touch, and if fever and rigor come on, and if the wound look well, whether as regards the flesh or the bone, and if the parts surrounding the wound be well, except the swelling in the face, and if the swelling be not connected with any error in the regimen, you must purge the bowels in such a case with a medicine which will evacuate bile; and when thus purged the fever goes off, the swelling subsides, and the patient gets well. In giving the medicine you must pay attention to the strength of the patient.

21. Περὶ δὲ πρίσιος, ὅταν καταλάβῃ ἀνάγκη πρίσαι ἄνθρωπον, ὧδε γινώσκειν ἢν ἐξ ἀρχῆς λαβὼν τὸ ἴημα πρίῃς, οὐ χρὴ ἐκπρίειν τὸ ὀστέον πρὸς τὴν μήνιγγα αὐτίκα οὐ γὰρ συμφέρει τὴν μήνιγγαψιλὴν εἶναι τοῦ ὀστέου ἐπὶ πουλὺν χρόνον κακοπαθοῦσαν, ἀλλὰ τελευτῶσά πη καὶ διεμύδησεν. Ἔστι δὲ καὶ ἕτερος κίνδυνος, ἢν αὐτίκα ἀφαιρέῃς πρὸς τὴν μήνιγγα ἐκπρίσας τὸ ὀστέον, τρῶσαι ἐν τῷ ἔργῳ τῷ πρίονι τὴν μήνιγγα. Ἀλλὰ χρὴ πρίοντα,

ἐπειδὰν ὀλίγον πάνυ δέῃ διαπεπρίσθαι, καὶ ἤδη κινέηται τὸ ὀστέον, παύσασθαι πρίοντα, καὶ ἐᾷν ἐπὶ τὸ αὐτόματον ἀποστῆναι τὸ ὀστέον. Ἐν γὰρ τῷ διαπριωτῷ ὀστέῳ καὶ ἐπιλελειμμένῳ τῆς πρίσιος οὐκ ἂν ἐπιγένοιτο κακὸν οὐδέν λεπτὸν γὰρ τὸ λειπόμενον ἤδη γίνεται. Τὰ δὲ λοιπὰ ἰῆσθαι χρὴ, ὡς ἂν δοκέῃ ξυμφέρειν τῷ ἕλκεϊ. Πρίοντα δὲ χρὴ πυκινὰ ἐξαιρέειν τὸν πρίονα τῆς θερμασίης εἵνεκα τοῦ ὀστέου, καὶ ὕδατι ψυχρῷ ἐναποβάπτειν. Θερμαινόμενος γὰρ ὑπὸ τῆς περιόδου ὁ πρίων, καὶ τὸ ὀστέον ἐκθερμαίνων καὶ ἀναξηραίνων, κατακαίει, καὶ μεῖζον ποιέει ἀφίστασθαι τὸ ὀστέον τὸ περιέχον τὴν πρίσιν, ἢ ὅσον μέλλει ἀφίστασθαι. Καὶ ἢν αὐτίκα βούλῃ ἐκπρίσαι τὸ πρὸς τὴν μήνιγγα, ἔπειτα ἀφελέειν τὸ ὀστέον, ὡσαύτως χρὴ πυκινά τε ἐξαιρέειν τὸν πρίονα, καὶ ἐναποβάπτειν τῷ ὕδατι τῷ ψυχρῷ. Ἢν δὲ μὴ ἐξ ἀρχῆς λαμβάνῃς τὸ ἴημα, ἀλλὰ παρ’ ἄλλου παραδέχῃ ὐστερίζων τῆς ἰήσιος, πρίονι χρὴ χαρακτῷ ἐκπρίειν μὲν αὐτίκα τὸ ὀστέον πρὸς τὴν μήνιγγα, θαμινὰ δὲ ἐξαιρεῦντα τὸν πρίονα σκοπεῖσθαι καὶ ἄλλως καὶ τῇ μήλῃ πέριξ κατὰ τὴν ὁδὸν τοῦ πρίονος. Καὶ γὰρ πουλὺ θᾶσσον διαπρίεται τὸ ὀστέον, ἢν ὑπόπυόν τε ἐήν ἤδη καὶ διάπυον πρίῃς, καὶ πολλάκις τυγχάνει ἐπιπόλαιον ἐὸν τὸ ὀστέον, ἄλλως τε καὶ ἢν ταύτῃ τῆς κεφαλῆς ᾖ τὸ τρῶμα, ᾗ τυγχάνει λεπτότερον ἐὸν τὸ ὀστέον ἢ παχύτερον. Ἀλλὰ φυλάσσεσθαι χρὴ, ὡς μὴ λάθῃς προσβαλὼν τὸν πρίονα, ἀλλ’ ὅπη δοκέῃ παχύτατον εἶναι τὸ ὀστέον, ἐς τοῦτο αἰεὶ ἐνστηρίζειν τὸν πρίονα, θαμινὰ σκοπούμενος, καὶ πειρᾶσθαι ἀνακινέων τὸ ὀστέον

ἀναβάλλειν, ἀφελὼν δὲ, τὰ λοιπὰ ἰητρεύειν ὡς ἂν δοκέῃ ξυμφέρειν τῷ ἕλκεϊ. Καὶ ἢν, ἐξ ἀρχῆς λαβὼν τὸ ἴημα, αὐτίκα βούλῃ ἐκπρίσας τὸ ὀστέον ἀφελεῖν ἀπὸ τῆς μήνιγγος, ὡσαύτως χρὴ πυκινά τε σκοπεῖσθαι τῇ μήλῃ τὴν περίοδον τοῦ πρίονος, καὶ ἐς τὸ παχύτατον ἀεὶ τοῦ ὀστέου τὸν πρίονα ἐνστηρίζειν, καὶ ἀνακινέων βούλεσθαι ἀφελέειν τὸ ὀστέον. Ἢν δὲ τρυπάνῳ χρῇ, πρὸς δὲ τὴν μήνιγγα μὴ ἀφικνέεσθαι, ἢν ἐξ ἀρχῆς λαμβάνων τὸ ἴημα τρυπᾷς, ἀλλ’ ἐπιλιπεῖν τοῦ ὀστέου λεπτὸν, ὥσπερ καὶ ἐν τῇ πρίσει γέγραπται.

21. With regard to trepanning, when there is a necessity for it, the following particulars should be known. If you have had the management of the case from the first, you must not at once saw the bone down to the meninx; for it is not proper that the membrane should be laid bare and exposed to injuries for a length of time, as in the end it may become fungous. And there is another danger if you saw the bone down to the meninx and remove it at once, lest in the act of sawing you should wound the meninx. But in trepanning, when only a very little of the bone remains to be sawed through, and the bone can be moved, you must desist from sawing, and leave the bone to fall out of itself. For to a bone not sawed through, and where a portion is left of the sawing, no mischief can happen; for the portion now left is sufficiently thin. In other respects you must conduct the treatment as may appear suitable to the wound. And in trepanning you must frequently remove the trepan, on account of the heat in the bone, and plunge it in cold water. For the trepan being heated by running round, and heating and drying the bone, burns it and makes a larger piece of bone around the sawing to drop off, than would otherwise do. And if you wish to saw at once down to the membrane, and then remove the bone, you must also, in like manner, frequently take out the trepan and dip it in cold water. But if you have not charge of the treatment from the first, but undertake it from another after a time, you must saw the bone at once down to the meninx with a serrated trepan, and in doing so must frequently take out the trepan and examine with a sound (specillum), and otherwise along the tract of the instrument. For the bone is much sooner sawn through, provided there be matter below it and in it, and it often happens that the bone is more superficial, especially if the wound is situated in that part of the head where the bone is rather thinner than in other parts. But you must take care where you apply the trepan, and see that you do so only where it appears to be particularly thick, and having fixed the instrument there, that you frequently make examinations and endeavor by moving the bone to bring it up. Having removed it, you must apply the other suitable remedies to the wound. And if, when you have the management of the treatment from the first, you wish to saw through the bone at once, and remove it from the membrane, you must, in like manner, examine the tract of the instrument frequently with the sound, and see that it is fixed on the thickest part of the bone, and endeavor to remove the bone by moving it about. But if you use a perforator ( trepan? ), you must not penetrate to the membrane, if you operate on a case which you have had the charge of from the first, but must leave a thin scale of bone, as described in the process of sawing.

THE HIPPOCRATIC OATH - Ιπποκράτειος Όρκος

ὄμνυμι Ἀπόλλωνα ἰητρὸν καὶ Ἀσκληπιὸν καὶ Ὑγείαν καὶ Πανάκειαν καὶ θεοὺς πάντας τε καὶ πάσας, ἵστορας ποιεύμενος, ἐπιτελέα ποιήσειν κατὰ δύναμιν καὶ κρίσιν ἐμὴν ὅρκον τόνδε καὶ συγγραφὴν τήνδε: ἡγήσεσθαι μὲν τὸν διδάξαντά με τὴν τέχνην ταύτην ἴσα γενέτῃσιν ἐμοῖς, καὶ βίου κοινώσεσθαι, καὶ χρεῶν χρηΐζοντι μετάδοσιν ποιήσεσθαι, καὶ γένος τὸ ἐξ αὐτοῦ ἀδελφοῖς ἴσον ἐπικρινεῖν ἄρρεσι, καὶ διδάξειν 10. τὴν τέχνην ταύτην, ἢν χρηΐζωσι μανθάνειν, ἄνευ μισθοῦ καὶ συγγραφῆς, παραγγελίης τε καὶ ἀκροήσιος καὶ τῆς λοίπης ἁπάσης μαθήσιος μετάδοσιν ποιήσεσθαι υἱοῖς τε ἐμοῖς καὶ τοῖς τοῦ ἐμὲ διδάξαντος, καὶ μαθητῇσι συγγεγραμμένοις τε καὶ ὡρκισμένοις νόμῳ ἰητρικῷ, ἄλλῳ δὲ οὐδενί. διαιτήμασί τε χρήσομαι ἐπ᾽ ὠφελείῃ καμνόντων κατὰ δύναμιν καὶ κρίσιν ἐμήν, ἐπὶ δηλήσει δὲ καὶ ἀδικίῃ εἴρξειν. οὐ δώσω δὲ οὐδὲ φάρμακον οὐδενὶ αἰτηθεὶς θανάσιμον, οὐδὲ ὑφηγήσομαι συμ 20. βουλίην τοιήνδε: ὁμοίως δὲ οὐδὲ γυναικὶ πεσσὸν φθόριον δώσω. ἁγνῶς δὲ καὶ ὁσίως διατηρήσω βίον τὸν ἐμὸν καὶ τέχνην τὴν ἐμήν. οὐ τεμέω δὲ οὐδὲ μὴν λιθιῶντας, ἐκχωρήσω δὲ ἐργάτῃσιν ἀνδράσι πρήξιος τῆσδε. ἐς οἰκίας δὲ ὁκόσας ἂν ἐσίω, ἐσελεύσομαι ἐπ᾽ ὠφελείῃ καμνόντων, ἐκτὸς ἐὼν πάσης ἀδικίης ἑκουσίης καὶ φθορίης, τῆς τε ἄλλης καὶ ἀφροδισίων ἔργων ἐπί τε γυναικείων σωμάτων καὶ ἀνδρῴων, ἐλευθέρων τε καὶ δούλων. ἃ δ᾽ ἂν ἐν θεραπείῃ ἢ ἴδω ἢ ἀκούσω, ἢ καὶ ἄνευ 30. θεραπείης κατὰ βίον ἀνθρώπων, ἃ μὴ χρή ποτε ἐκλαλεῖσθαι ἔξω, σιγήσομαι, ἄρρητα ἡγεύμενος εἶναι τὰ τοιαῦτα. ὅρκον μὲν οὖν μοι τόνδε ἐπιτελέα ποιέοντι, καὶ μὴ συγχέοντι, εἴη ἐπαύρασθαι καὶ βίου καὶ τέχνης δοξαζομένῳ παρὰ πᾶσιν ἀνθρώποις ἐς τὸν αἰεὶ χρόνον: παραβαίνοντι δὲ 36. καὶ ἐπιορκέοντι, τἀναντία τούτων.

I SWEAR by Apollo the physician, and Aesculapius, and Health, and All-heal, and all the gods and goddesses, that, according to my ability and judgment, I will keep this Oath and this stipulation- to reckon him who taught me this Art equally dear to me as my parents, to share my substance with him, and relieve his necessities if required; to look upon his offspring in the same footing as my own brothers, and to teach them this art, if they shall wish to learn it, without fee or stipulation; and that by precept, lecture, and every other mode of instruction, I will impart a knowledge of the Art to my own sons, and those of my teachers, and to disciples bound by a stipulation and oath according to the law of medicine, but to none others. I will follow that system of regimen which, according to my ability and judgment, I consider for the benefit of my patients, and abstain from whatever is deleterious and mischievous. I will give no deadly medicine to any one if asked, nor suggest any such counsel; and in like manner I will not give to a woman a pessary to produce abortion. With purity and with holiness I will pass my life and practice my Art. I will not cut persons laboring under the stone, but will leave this to be done by men who are practitioners of this work. Into whatever houses I enter, I will go into them for the benefit of the sick, and will abstain from every voluntary act of mischief and corruption; and, further from the seduction of females or males, of freemen and slaves. Whatever, in connection with my professional practice or not, in connection with it, I see or hear, in the life of men, which ought not to be spoken of abroad, I will not divulge, as reckoning that all such should be kept secret. While I continue to keep this Oath unviolated, may it be granted to me to enjoy life and the practice of the art, respected by all men, in all times! But should I trespass and violate this Oath, may the reverse be my lot!

THE LAW - Νομοσ

1. Ἰητρικὴ τεχνέων μὲν πασέων ἐστὶν ἐπιφανεστάτη. διὰ δὲ ἀμαθίην τῶν τε χρεομένων αὐτῇ, καὶ τῶν εἰκῆ τοὺς τοιούσδε κρινόντων, πολύ τι πασέων ἤδη τῶν τεχνέων ἀπολείπεται. Ἡ δὲ τῶνδε ἁμαρτὰς τὰ μάλιστά μοι δοκέει ἔχειν αἰτίην τοιήνδε. πρόστιμον γὰρ ἰητρικῆς μούνης ἐν τῇσι πόλεσιν οὐδὲν ὥρισται, πλὴν ἀδοξίης. αὕτη δὲ οὐ τιτρώσκει τοὺς ἐξ αὐτέης συγκειμένους. Ὁμοιότατοι γάρ εἰσιν οἱ τοιοίδε τοῖσι παρεισαγομένοισι προσώποισιν ἐν τῇσι τραγῳδίῃσιν. ὡς γὰρ ἐκεῖνοι σχῆμα μὲν καὶ στολὴν καὶ πρόσωπον ὑποκριτοῦ ἔχουσιν, οὐκ εἰσὶ δὲ ὑποκριταὶ, οὕτω καὶ ἰητροὶ, φήμῃ μὲν πολλοὶ, ἔργῳ δὲ πάγχυ βαιοί.

1. Medicine is of all the Arts the most noble; but, not withstanding, owing to the ignorance of those who practice it, and of those who, inconsiderately, form a judgment of them, it is at present far behind all the other arts. Their mistake appears to me to arise principally from this, that in the cities there is no punishment connected with the practice of medicine (and with it alone) except disgrace, and that does not hurt those who are familiar with it. Such persons are like the figures which are introduced in tragedies, for as they have the shape, and dress, and personal appearance of an actor, but are not actors, so also physicians are many in title but very few in reality.

2. Χρὴ γὰρ, ὅστις μέλλει ἰητρικῆς ξύνεσιν ἀτρεκέως ἁρμόζεσθαι, τῶνδέ μιν ἐπήβολον γενέσθαι. φύσιος. διδασκαλίης. τόπου εὐφυέος. παιδομαθίης. φιλοπονίης. χρόνου. Πρῶτον μὲν οὖν πάντων δεῖ φύσιος. φύσιος γὰρ ἀντιπρησσούσης, κενεὰ πάντα. φύσιος δὲ ἐς τὸ ἄριστον ὁδηγεούσης, διδασκαλίη τέχνης γίνεται. ἣν μετὰ φρονήσιος δεῖ περιποιήσασθαι, παιδομαθέα γενόμενον ἐν τόπῳ, ὁκοῖος εὐφυὴς πρὸς μάθησιν ἔσται. ἔτι δὲ φιλοπονίην προσενέγκασθαι ἐς χρόνον πουλὺν, ὅκως ἡ μάθησις, ἐμφυσιωθεῖσα, δεξιῶς τε καὶ εὐαλδέως τοὺς καρποὺς ἐξενέγκηται.

2. Whoever is to acquire a competent knowledge of medicine, ought to be possessed of the following advantages: a natural disposition; instruction; a favorable position for the study; early tuition; love of labor; leisure. First of all, a natural talent is required; for, when Nature opposes, everything else is in vain; but when Nature leads the way to what is most excellent, instruction in the art takes place, which the student must try to appropriate to himself by reflection, becoming an early pupil in a place well adapted for instruction. He must also bring to the task a love of labor and perseverance, so that the instruction taking root may bring forth proper and abundant fruits.

3. Ὁκοίη γὰρ τῶν ἐν τῇ γῇ φυομένων [ἡ] θεωρίη, τοιήδε καὶ τῆς ἰητρικῆς ἡ μάθησις. Ἡ μὲν γὰρ φύσις ἡμέων, ὁκοῖον ἡ χώρη. τὰ δὲ δόγματα τῶν διδασκόντων, ὁκοῖον τὰ σπέρματα. ἡ δὲ παιδομαθίη, τὸ καθ᾿ ὥρην αὐτὰ πεσεῖν εἰς τὴν ἄρουραν. ὁ δὲ τόπος ἐν ᾧ ἡ μάθησις, ὁκοῖον ἡ ἐκ τοῦ περιέχοντος ἠέρος τροφὴ γιγνομένη τοῖσι φυομένοισιν. ἡ δὲ φιλοπονίη, ἐργασίη. ὁ δὲ χρόνος ταῦτα ἐνισχύει πάντα, ὡς τραφῆναι τελέως.

3. Instruction in medicine is like the culture of the productions of the earth. For our natural disposition is, as it were, the soil; the tenets of our teacher are, as it were, the seed; instruction in youth is like the planting of the seed in the ground at the proper season; the place where the instruction is communicated is like the food imparted to vegetables by the atmosphere; diligent study is like the cultivation of the fields; and it is time which imparts strength to all things and brings them to maturity.

4. Ταῦτα ὦν χρὴ ἐς τὴν ἰητρικὴν τέχνην ἐσενεγκαμένους, καὶ ἀτρεκέως αὐτέης γνῶσιν λαβόντας, οὕτως ἀνὰ τὰς πόλιας φοιτεῦντας, μὴ λόγῳ μοῦνον, ἀλλὰ καὶ ἔργῳ ἰητροὺς νομίζεσθαι. Ἡ δὲ ἀπειρίη, κακὸς θησαυρὸς καὶ κακὸν κειμήλιον τοῖσιν ἔχουσιν αὐτέην, καὶ ὄναρ καὶ ὕπαρ, εὐθυμίης τε καὶ εὐφροσύνης ἄμοιρος, δειλίης τε καὶ θρασύτητος τιθήνη. Δειλίη μὲν γὰρ ἀδυναμίην σημαίνει.  θρασύτης δὲ, ἀτεχνίην. Δύο γὰρ, ἐπιστήμη τε καὶ δόξα, ὧν τὸ μὲν ἐπίστασθαι ποιέει, τὸ δὲ ἀγνοεῖν.

4. Having brought all these requisites to the study of medicine, and having acquired a true knowledge of it, we shall thus, in traveling through the cities, be esteemed physicians not only in name but in reality. But inexperience is a bad treasure, and a bad fund to those who possess it, whether in opinion or reality, being devoid of self-reliance and contentedness, and the nurse both of timidity and audacity. For timidity betrays a want of powers, and audacity a want of skill. There are, indeed, two things, knowledge and opinion, of which the one makes its possessor really to know, the other to be ignorant.

5. Τὰ δὲ ἱερὰ ἐόντα πρήγματα ἱεροῖσιν ἀνθρώποισι δείκνυται. βεβήλοισι δὲ, οὐ θέμις, πρὶν ἢ τελεσθῶσιν ὀργίοισιν ἐπιστήμης.

5. Those things which are sacred, are to be imparted only to sacred persons; and it is not lawful to import them to the profane until they have been initiated in the mysteries of the science.

THE PHYSICIAN’S ESTABLISHMENT - Κατ’ ἰητρεῖον

1. Ἢ ὅμοια ἢ ἀνόμοια ἐξ ἀρχῆς ἀπὸ τῶν μεγίστων, ἀπὸ τῶν ῥηΐστων, ἀπὸ τῶν πάντη πάντως γιγνωσκομένων. Ἁ καὶ ἰδεῖν, καὶ θιγεῖν, καὶ ἀκοῦσαι ἔστιν ἃ καὶ τῇ ὄψει, καὶ τῇ ἁφῇ, καὶ τῇ ἀκοῇ, καὶ τῇ ῥινὶ, καὶ τῇ γλώσσῃ, καὶ τῇ γνώμῃ ἔστιν αἰσθέσθαι ἃ, οἷς γιγνώσκομεν ἅπασιν, ἔστι γνῶναι.

1. It’s the business of the physician to know, in the first place, things similar and things dissimilar; those connected with things most important, most easily known, and in anywise known; which are to be seen, touched, and heard; which are to be perceived in the sight, and the touch, and the hearing, and the nose, and the tongue, and the understanding; which are to be known by all the means we know other things.

2. Τὰ δ’ ἐς χειρουργίην κατ’ ἰητρεῖον ὁ ἀσθενέων ὁ δρῶν οἱ

ὑπηρέται τὰ ὄργανα τὸ φῶς ὅκου ὅκως ὅσα ὅκως ὅκου τὸ σῶμα, τὰ ἄρμενα ὁ χρόνος ὁ τρόπος ὁ τόπος.

2. The things relating to surgery, are- the patient; the operator; the assistants; the instruments; the light, where and how; how many things, and how; where the body, and the instruments; the time; the manner; the place.

3. Ὁ δρῶν, ἢ καθήμενος, ἢ ἑστεὼς, ξυμμέτρως πρὸς ἑωυτὸν, πρὸς τὸ χειριζόμενον, πρὸς τὴν αὐγήν. Αὐγέης μὲν οὖν δύο εἴδεα, τὸ μὲν κοινὸν, τὸ δὲ τεχνητόν. Τὸ μὲν οὖν κοινὸν οὐκ ἐφ’ ἡμῖν τὸ δὲ τεχνητὸν, καὶ ἐφ’ ἡμῖν. Ων ἑκατέρου δισσαὶ χρήσιες, ἢ πρὸς αὐγὴν, ἢ ὑπ’ αὐγήν. Ὑπ’ αὐγὴν μὲν οὖν ὀλίγη τε ἡ χρῆσις, καταφανής τε ἡ μετριότης. Τὰ δὲ πρὸς αὐγὴν ἐκ τῶν παρεουσέων, ἐκ τῶν ξυμφερουσέων αὐγέων, πρὸς τὴν λαμπροτάτην τρέπειν τὸ χειριζόμενον πλὴν ὁκόσα λαθεῖν δεῖ, ἢ ὁρῇν αἰσχρόν οὕτω δὲ τὸ μὲν χειριζόμενον ἐναντίον τῇ αὐγῇ, τὸν δὲ χειρίζοντα, ἐναντίον τῷ χειριζομένῳ, πλὴν ὥστε μὴ ἐπισκοτάζειν οὕτω

γὰρ ἂν ὁ μὲν δρῶν ὁρώη, τὸ δὲ χειριζόμενον οὐχ ὁρῷτο. Πρὸς ἑωυτὸν δὲ, καθημένῳ πόδες ἐς τὴν ἄνω ἴξιν κατ’ ἰθὺ γούνασιν διάστασιν δὲ, ὀλίγον ξυμβεβῶτες γούνατα δὲ ἀνωτέρω βουβώνων σμικρὸν, διάστασιν δὲ, ἀγκώνων θέσει καὶ παραθέσει. Ἰμάτιον, εὐσταλέως, εὐκρινέως, ἴσως, ὁμοίως, ἀγκῶσιν, ὤμοισιν. Πρὸς δὲ τὸ χειριζόμενον, τοῦ μὲν πρόσω καὶ ἐγγὺς, καὶ τοῦ ἄνω, καὶ τοῦ κάτω, καὶ ἔνθα ἢ ἔνθα, ἢ μέσον. Τοῦ μὲν πρόσω καὶ ἐγγὺς ὅριον, ἀγκῶνας ἐς μὲν τὸ πρόσθεν γούνατα μὴ ἀμείβειν, ἐς δὲ τὸ ὄπισθεν, πλευράς τοῦ δὲ ἄνω, μὴ ἀνωτέρω μαζῶν ἄκρας

χεῖρας ἔχειν τοῦ δὲ κάτω, μὴ κατωτέρω, ἢ ὡς τὸ στῆθος ἐπὶ γούνασιν ἔχοντα, ἔχειν ἄκρας χεῖρας ἐγγωνίους πρὸς βραχίονας τὰ μὲν κατὰ μέσον οὕτως τὰ δὲ ἔνθα, ἢ ἔνθα, μὴ ἔξω τῆς ἔδρης, κατὰ λόγον δὲ τῆς ἐπιτροφῆς προσβαλλόμενον τὸ σῶμα, καὶ τοῦ σώματος τὸ ἐργαζόμενον. Ἑστεῶτα δὲ, ἰδεῖν μὲν ἐπ’ ἀμφοτέρων βεβῶτα ἐξ ἴσου τῶν ποδῶν ἅλις, δρῇν δὲ τῷ ἑτέρῳ ἐπιβεβῶτα, μὴ τῷ κατὰ τὴν δρῶσαν χεῖρα ὕψος γούνα τος πρὸς βουβῶνας, ὡς ἐν ἕδρῃ καὶ τὰ ἄλλα ὅρια τὰ αὐτά. Ὁ δὲ χειριζόμενος τῷ χειρίζοντι τῷ ἄλλῳ τοῦ σώματος μέρει ὑπηρετείτω, ἢ ἑστεὼς, ἢ καθήμενος, ἢ κείμενος, ὅκως ἂν ῥήϊστα, ὃ δεῖ, σχῆμα ἔχων διατελέῃ, φυλάσσων ὑπόῤΡυσιν,

ὑπόστασιν, ἔκτρεψιν, καταντίαν, ὡς ὃ δεῖ, σώζηται καὶ σχῆμα καὶ εἶδος τοῦ χειριζομένου, ἐν παρέξει, ἐν χειρισμῷ, ἐν τῇ ἔπειτα ἕξει.

3. The operator is either sitting or standing, conveniently for himself, for the person operated upon, for the light. There are two kinds of light, the common and the artificial; the common is not at our disposal, the artificial is at our disposal. There are two modes of using each, either to the light, or from the light (to the side?). There is little use of that which is from ( or oblique to the light), and the degree of it is obvious. As to opposite the light, we must turn the part to be operated upon to that which is most brilliant of present and convenient lights, unless those parts which should be concealed, and which it is a shame to look upon; thus the part that is operated upon should be opposite the light, and the operator opposite the part operated upon, except in so far as he does not stand in his own light; for in this case the operator will indeed see, but the thing operated upon will not be seen. With regard to himself when sitting, his feet should be raised to a direct line with his knees, and nearly in contact with one another; the knees a little higher than the groins, and at some distance from one another, for the elbows to rest upon them. The robe, in a neat and orderly manner, is to be thrown over the elbows and shoulders equally and proportionally. With regard to the part operated upon; we have to consider how far distant, and how near, above, below, on this side on that side, or in the middle. The measure as to distance and proximity is, that the elbows do not press the knees before, nor the sides behind; that the hands be not raised higher than the breasts, nor lower than so as that when the breast reposes on the knees he may have the hands at right angles with the arm: thus it is as regards the medium; but as concerns this side or that, the operator must not be beyond his seat, but in proportion as he may require turning he must shift the body, or part of the body, that is operated upon. When standing, he must make his inspection, resting firmly and equally on both feet; but he must operate while supporting himself upon either leg, and not the one on the same side with the hand which he makes use of; the knee being raised to the height of the groins as while sitting; and the other measures in like manner. The person operated upon should accommodate the operator with regard to the other parts of his body, either standing, sitting, or lying; so as that he may continue to preserve his figure, avoid sinking down, shrinking from, turning away; and may maintain the figure and position of the part operated upon, during the act of presentation, during the operation, and in the subsequent position.

4. Ὄνυχας μήτε ὑπερέχειν, μήτε ἐλλείπειν δακτύλων κορυφῇσι

χρῆσις ἀσκέειν, δακτύλοισι μὲν ἄκροις, τὰ πλεῖστα λιχανῷ πρὸς μέγαν ὅλῃ δὲ, καταπρηνεῖ ἀμφοτέρῃσι δὲ, ἐναντίῃσιν δακτύλων εὐφυΐα, μέγα τὸ ἐν μέσῳ τῶν δακτύλων, καὶ ἀπεναντίον τὸν μέγαν τῷ λιχανῷ. Νοῦσος δὲ δι’ ἣν καὶ βλάπτονται, οἷσιν ἐκ γενεῆς ἢ ἐν τροφῇ εἴθισται ὁ μέγας ὑπὸ τῶν ἄλλων

δακτύλων κατέχεσθαι, δῆλον. Τὰ ἔργα πάντα ἀσκέειν ἑκα τέρῃ δρῶντα, καὶ ἀμφοτέρῃσιν ἅμα ὅμοιαι γάρ εἰσιν ἀμφότεραἰ, στοχαζόμενον ἀγαθῶς, καλῶς, ταχέως, ἀπόνως, εὐρύθμως, εὐπόρως.

4. The nails should be neither longer nor shorter than the points of the fingers; and the surgeon should practice with the extremities of the fingers, the index-finger being usually turned to the thumb; when using the entire hand, it should be prone; when both hands, they should be opposed to one another. It greatly promotes a dexterous use of the fingers when the space between them is large, and when the thumb is opposed to the index. But it is clearly a disease when the thumb is impaired from birth, or when, from a habit contracted during the time of nursing, it is impeded in its motions by the fingers. One should practice all sorts of work with either of them, and with both together (for they are both alike), endeavouring to do them well, elegantly, quickly, without trouble, neatly, and promptly.

5. Ὅργανα μὲν, καὶ ὅτε, καὶ οἵως, εἰρήσεται ὅκου δεῖ μὴ ἐμποδὼν τῷ ἔργῳ, μηδὲ ἐμποδὼν τῇ ἀναιρέσει, παρὰ τὸ ἐργαζόμενον δὲ τοῦ σώματος ἄλλος δὲ ἢν διδῷ, ἕτοιμος ὀλίγῳ πρότερον ἔστω, ποιείτω δὲ, ὅταν κελεύῃς.

5. The instruments, and when and how they should be prepared, will be treated of afterwards; so that they may not impede the work, and that there may be no difficulty in taking hold of them, with the part of the body which operates. But if another gives them, he must be ready a little beforehand, and do as you direct.

6. Οἱ δὲ περὶ τὸν ἀσθενέοντα τὸ μὲν χειριζόμενον παρεχόντων, ὡς ἂν δοκῇ τὸ δὲ ἄλλο σῶμα κατεχόντων, ὡς ἂν ἀτρεμέῃ, σιγῶντες, ἀκούοντες τοῦ ἐφεστεῶτος.

6. Those about the patient must present the part to be operated upon as may seem proper, and they must hold the rest of the body steady, in silence, and listening to the commands of the operator.

7. Ἐπιδέσιος δύο εἴδεα, εἰργασμένον, καὶ ἐργαζόμενον. Ἐργαζόμενον μὲν, ταχέως, ἀπόνως, εὐπόρως, εὐρύθμως ταχέως μὲν, ἀνύειν τὰ ἔργα ἀπόνως δὲ, ῥηῖδίως δρῇν εὐπόρως δὲ, ἐς πᾶν ἑτοίμως εὐρύθμως δὲ, ὁρῆσθαι ἡδέως ἄφ’ ὧν δὲ ταῦτα ἀσκημάτων, εἴρηται. Εἰργασμένον δὲ ἀγαθῶς, καλῶς καλῶς μὲν, ἁπλῶς, εὐκρινέως ἢ ὅμοια καὶ ἴσα, ἴσως καὶ ὁμοίως ἢ ἄνισα καὶ ἀνόμοια [, ἀνίσως καὶ ἀνομοίως] τὰ δὲ εἴδεα, ἁπλοῦν,

σκέπαρνον, σιμὸν, ὀφθαλμὸς, ῥόμβος, καὶ ἡμίτομον ἁρμόζον τὸ εἶδος τῷ εἴδει καὶ τῷ πάθει τοῦ ἐπιδεομένου.

7. There are two views of bandaging: that which regards it while doing, and that which regards it when done. It should be done quickly, without pain, with ease, and with elegance; quickly, by despatching the work; without pain, by being readily done; with ease, by being prepared for everything; and with elegance, so that it may be agreeable to the sight. By what mode of training these accomplishments are to be acquired has been stated. When done, it should fit well and neatly; it is neatly done when with judgment, and when it is equal and unequal, according as the parts are equal or unequal. The forms of it (the bandage?) are the simple, the slightly winding (called ascia), the sloping (sima), the monoculus, the rhombus, and the semi-rhombus. The form of bandage should be suitable to the form and the affection of the part to which it is applied.

8. Ἀγαθὰ δὲ δύο εἴδεα τοῦ ἐπιδεομένου ἰσχύος μὲν,

ἢ πιέξει, ἢ πλήθει ὀθονίων. Τὸ μὲν οὖν, αὕτη ἡ ἐπίδεσις ἰῆται, τὸ δὲ τοῖσιν ἰωμένοισιν ὑπηρετέει. Ἐς μὲν οὖν ταῦτα νόμος ἐν δὲ τουτέοισι μέγιστα ἐπιδέσιος πίεξις μὲν, ὥστε τὰ ἐπικείμενα μὴ ἀφεστάναι, μηδὲ ἐρηρεῖσθαι κάρτα, ἀλλὰ ἡρμόσθαι μὲν, προσηναγκάσθαι δὲ μὴ, ἧσσον μὲν τὰ ἔσχατα, ἥκιστα δὲ τὰ μέσα. Ἅμμα, καὶ ῥάμμα νεμόμενον

μὴ κάτω, ἀλλ’ ἄνω, ἐν παρέξει, καὶ σχέσει, καὶ ἐπιδέσει, καὶ πιέξει. Ἀρχὰς βάλλεσθαι μὴ ἐπὶ τὸ ἕλκος, ἀλλ’ ἔνθα τὸ ἅμμα. Τὸ δὲ ἅμμα μήτε ἐν τρίβῳ, μήτε ἐν ἔργῳ,

μήτε ἐκεῖσε, ὅκου ἐνεόν. Ἅμμα δὲ καὶ ῥάμμα μαλθακὸν, οὐ μέγα.

8. There are two useful purposes to be fulfilled by bandaging: ( first ,) strength, which is imparted by the compression and the number of folds. In one case the bandage effects the cure, and in another it contributes to the cure. For these purposes this is the rule- that the force of the constriction be such as to prevent the adjoining parts from separating, without compressing them much, and so that the parts may be adjusted but not forced together; and that the constriction be small at the extremities, and least of all in the middle. The knot and the thread that is passed through should not be in a downward but in an upward direction, regard being had to the circumstances under which the case is presented; to position, to the bandaging, and to the compression. The commencement of the ligatures is not to be placed at the wound, but where the knot is situated. The knot should not be placed where it will be exposed to friction, nor where it will be in the way, nor where it will be useless. The knot and the thread should be soft, and not large.

9. Εὖ γε μὴν γνόντα, ὅτι ἐς τὰ κατάντη καὶ ἀπόξη φεύγει

πᾶς ἐπίδεσμος, οἷον, κεφαλῆς μὲν τὸ ἄνω, κνήμης δὲ τὸ κάτω. Ἐπιδεῖν δεξιὰ ἐπ’ ἀριστερὰ, ἀριστερὰ ἐπὶ δεξιὰ, πλὴν τῆς κεφαλῆς ταύτην δὲ κατ’ ἴξιν. Τὰ δ’ ὑπεναντία, ἀπὸ δύο ἀρχέων ἢν δὲ ἀπὸ μιῆς, ἐφ’ ὅμοιον ἐς τὸ μόνιμον, οἷον τὸ μέσον τῆς κεφαλῆς, ἢ ὅ τι ἄλλο τοιοῦτον. Τὰ δὲ κινεύμενα, οἷον ἄρθρα, ὅπη μὲν ξυγκάμπτεται, ὡς ἥκιστα, καὶ εὐσταλέστατα περιβάλλειν, οἷον ἰγνύῃ ὅπη δὲ περιτείνεται, ἁπλᾶ τε καὶ πλατέα, οἷον μύλῃ προσπεριβάλλειν δὲ καταλήψιος μὲν τῶν περὶ ταῦτα εἵνεκα, ἀναλήψιος δὲ τοῦ ξύμπαντος ἐπιδέσμου, ἐν τοῖσιν ἀτρεμέουσι

καὶ λαπαρωτέροισι τοῦ σώματος, οἷον τὸ ἄνω καὶ τὸ κάτω τοῦ γούνατος ὁμολογέει δὲ ὤμου μὲν ἡ περὶ τὴν ἑτέρην μασχάλην περιβολὴ, βουβῶνος δὲ, ἡ περὶ τὸν ἕτερον ̣ενεῶνα, καὶ κνήμης, ἡ ὑπὲρ γαστροκνημίης. Ὁκόσοισι μὲν ἄνω ἡ φυγὴ, κάτωθεν ἡ ἀντίληψις οἷσι δὲ κάτω, τοὐναντίον οἷσι δὲ μὴ ἔστι, οἷον κεφαλῇ, τουτέων ἐν τῷ ὁμαλωτάτῳ τὰς καταλήψιας ποιέεσθαι, καὶ ἥκιστα λοξῷ τῷ ἐπιδέσμῳ χρέεσθαι, ὡς τὸ μονιμώτατον ὕστατον περιβληθὲν τὰ πλανωδέστατα κατέχῃ. Ὁκόσοισι δὲ τοῖσιν ὀθονίοισι μὴ εὐκαταλήπτως, μηδὲ εὐαναλήπτως ἔχει, ῥάμμασι τὰς ἀναλήψιας ποιέεσθαι ἐκ καταβολῆς ἢ ξυῤΡαφῆς.

9. ( Second. ) One ought to be well aware that every bandage has a tendency to fall off towards the part that declines or becomes smaller; as, for example, upwards, in the case of the head, and downwards, in the case of the leg. The turns of the bandage should be made from right to left, and from left to right, except on the head, where it should be in a straight direction. When opposite parts are to be bandaged together, we must use a bandage with two heads; or if we make use of a bandage with one head, we must attach it in like manner at some fixed point: such, for example, as the middle of the head; and so in other cases. Those parts which are much exposed to motion, such as the joints, where there is a flexion, should have few and slight bandages applied to them, as at the ham; but where there is much extension, the bandage should be single and broad, as at the kneepan; and for the maintenance of the bandage in its proper place, some turns should be carried to those parts which are not much moved, and are lank, such as the parts above and below the knee. In the case of the shoulder; a fold should be carried round by the other armpit; in that of the groin, by the flanks of the opposite side; and of the leg, to above the calf of the leg. When the bandage has a tendency to escape above, it should be secured below, and vice versa ; and where there is no means of doing this, as in the case of the head, the turns are to be made mostly on the most level part of the head, and the folds are to be done with as little obliquity as possible, so that the firmest part being last applied may secure the portions which are more movable. When we cannot secure the bandaging by means of folds of the cloth, nor by suspending them from the opposite side, we must have recourse to stitching it with ligatures, either passed circularly or in the form of a seam.

10. Ἐπιδέσματα καθαρὰ, κοῦφα, μαλθακὰ, λεπτά. Ἑλίσσειν ἀμφοτέρῃσιν ἅμα, καὶ ἑκατέρῃ χωρὶς ἀσκέειν. Τῇ πρεπούσῃ δὲ, ἐς τὰ πλάτη καὶ τὰ πάχη τῶν μορίων τεκμαιρόμενον,

χρέεσθαι. Ἑλίξιος κεφαλαὶ σκληραὶ, ὁμαλαὶ, εὐκρινέες. Τὰ δὲ δὴ μέλλοντα ἀποπίπτειν κακίω ταχέως ἀποπεσόντων τὰ δὲ, ὡς μήτε πιέζειν, μήτε ἀποπίπτειν.

10. The bandages should be clean, light, soft, and thin. One should practice rolling with both hands together, and with either separately. One should also choose a suitable one, according to the breadth and thickness of the parts. The heads of the bandages should be hard, smooth, and neatly put on. That sort of bandaging is the worst which quickly falls off; but those are bad bandages which neither compress nor yet come off.

11. Ων δὲ ἔχεται ἢ ἐπίδεσις, ἢ ὑπόδεσις, ἢ ἀμφότερα ὑπόδεσις μὲν αἰτίη, ὥστε ἢ ἀφεστεῶτα προστεῖλαι, ἢ ἐκπεπταμένα συστεῖλαι, ἢ ξυνεσταλμένα διαστεῖλαι, ἢ διεστραμμένα διορθῶσαι, ἢ τἀναντία. Παρασκευάζειν δὲ ὀθόνια κοῦφα, λεπτὰ, μαλθακὰ, καθαρὰ, πλατέα, μὴ ἔχοντα ξυῤΡαφὰς, μηδ’ ἐξαστίας, καὶ ὑγιέα, ὥστε τάνυσιν φέρειν, καὶ ὀλίγῳ κρέσσω, μὴ ξηρὰ, ἀλλ’ ἔγχυμα χυμῷ, ᾧ ἕκαστα ξύντροφα. Ἀφεστεῶτα μὲν, ὥστε τὰ μετέωρα τῆς ἕδρης ψαύειν μὲν, πιέζειν δὲ μή ἄρχεσθαι δὲ ἐκ τοῦ ὑγιέος, τελευτᾷν δὲ

πρὸς τὸ ἕλκος, ὡς τὸ μὲν ὑπεὸν ἐξαθέλγηται, ἕτερον δὲ μὴ ἐπιξυλλέγηται ἐπιδεῖν τὰ μὲν ὀρθὰ ἐς ὀρθὸν, τὰ δὲ λοξὰ λοξῶς, ἐν σχήματι ἀπόνῳ, ἐν ᾧ μήτε ἀπόσφιγξις, μήτε ἀπόστασις ἔσται τις, ἐξ οὗ, ὅταν μεταλλάσσῃ ἢ ἐς ἀνάληψιν ἢ ἐς θέσιν, οὐ μεταλλάξουσιν, ἀλλ’ ὅμοια ταῦτα ἕξούσι, μύες, φλέβες, νεῦρα, ὀστέα, ᾗ μάλιστα εὔθετα καὶ εὔσχετα ἀναλελάφθαι δὲ, ἢ κέεσθαι ἐν σχήματι ἀπόνῳ τῷ κατὰ φύσιν ὧν δὲ

ἂν ἀποστῇ, τἀναντία. Ων δὲ ἐκπεπταμένα ξυστεῖλαι, τὰ μὲν ἄλλα κατὰ τὰ αὐτὰ, ἐκ πολλοῦ δέ τινος δεῖ τὴν ξυναγωγὴν, καὶ ἐκ προσαγωγῆς τὴν πίεξιν, τὸ πρῶτον ἥκιστα, ἔπειτα ἐπὶ μᾶλλον, ὅριον τοῦ μάλιστα τὸ ξυμψαύειν. Ων δὲ ξυνεσταλμένα διαστεῖλαι, ξὺν μὲν φλεγμονῇ τἀναντία ἄνευ δὲ ταύτης, παρασκευῇ μὲν τῇ αὐτῇ, ἐπιδέσει δὲ ἐναντίῃ. Διεστραμμένα δὲ διορθῶσαι, τὰ μὲν ἄλλα κατὰ τὰ αὐτά δεῖ δὲ τὰ μὲν ἀπεληλυθότα ἐπαγαγεῖν ὑποδέσει, παρακολλήσει, ἀναλήψει τὰ δὲ ἐναντία, ἐναντίως.

11. The following are the object which the upper bandage, the under bandage, or both aim at: The object of the under bandage is either to bring together parts that are separated, or to compress such as are expanded, or to separate what are contracted, or to restore to shape what are distorted, or the contrary. It is necessary to prepare pieces of linen cloth, which are light, thin, soft, clean, having no seams nor protuberances on them, but sound, and able to bear some stretching, or even a little more than required; not dry, but wetted with a juice suitable to the purpose required. We must deal with parts separated ( in a sinus? ) in such wise, that the parts which are raised may touch the bottom without producing pressure; we must begin on the sound part, and terminate at the wound; so that whatever humor is in it may be expelled, and that it may be prevented from collecting more. And straight parts are to be bandaged in a straight direction, and oblique obliquely, in such a position as to create no pain; and so that there may be no constriction nor falling off on a change of position, either for the purpose of taking hold of anything, or laying the limb; and that muscles, veins, nerves, and bones may be properly placed and adjusted to one another. It should be raised or laid in a natural position, so as not to occasion pain. In those cases in which an abscess is formed, we must act in a contrary way. When our object is to bring together parts which have become expanded, in other respects we must proceed on the same plain; and we must commence the bringing together from some considerable distance; and after their approach, we must apply compression, at first slight, and afterwards stronger, the limit of it being the actual contact of the parts. In order to separate parts which are drawn together, when attended with inflammation, we must proceed on the opposite plan; but when without inflammation, we must use the same preparations, but bandage in the opposite direction. In order to rectify distorted parts, we must proceed otherwise on the same principles; but the parts which are separated must be brought together by an underbandage, by agglutinants, and by suspending it ( the limb? ) in its natural position. And when the deformities are the contrary, this is to be done on the contrary plan.

12. Κατήγμασι δὲ, σπληνῶν μήκεα, πλάτεα, πάχεα, πλήθεα

μῆκος, ὅση ἡ ἐπίδεσις πλάτος τριῶν ἢ τεσσάρων δακτύλων πάχος, τριπτύχους ἢ τετραπτύχους πλῆθος, κυκλεῦντας μὴ ὑπερβάλλειν, μηδὲ ἐλλείπειν οἷσι δὲ ἐς διόρθωσιν, μῆκος, κυκλεῦντα πλάτος καὶ πάχος τῇ ἐνδείῃ τεκμαίρεσθαι, μὴ ἀθρόα πληρεῦντα. Τῶν δὲ ὀθονίων ὑποδεσμίδες εἰσὶ δύο τῇ πρώτῃ ἐκ τοῦ σίνεος ἐς τὸ ἄνω τελευτώσῃ, τῇ δὲ δευτέρῃ, ἐκ τοῦ σίνεος ἐς τὸ κάτω, ἐκ τοῦ κάτω ἐς τὸ ἄνω τελευτώσῃ τὰ κατὰ τὸ σίνος πιέζειν μάλιστα, ἥκιστα τὰ ἄκρα, τὰ δὲ ἄλλακατὰ λόγον. Ἡ δὲ ἐπίδεσις πουλὺ τοῦ ὑγιέος προσλαμβανέτω. Ἐπιδέσμων δὲ πλῆθος, μῆκος, πλάτος πλῆθος μὲν, μὴ ἡσσᾶσθαι τοῦ σίνεος, μηδὲ νάρθηξιν ἐνέρεισιν εἶναι, μηδὲ ἄχθος, μηδὲ περίῤΡεψιν, μηδὲ ἐκθήλυνσιν μῆκος δὲ καὶ πλάτος, τριῶν, ἢ τεσσάρων,

ἢ πέντε, ἢ ἓξ, πήχεων μὲν μῆκος, δακτύλων δὲ πλάτος. Καὶ παραιρήματος περιβολαὶ τοσαῦται, ὥστε μὴ πιέζειν μαλθακὰ δὲ, μὴ παχέα ταῦτα πάντα, ὡς ἐπὶ μήκει καὶ πλάτει καὶ πάχει τοῦ παθόντος. Νάρθηκες δὲ λεῖοι, ὁμαλοὶ, σιμοὶ κατ’ ἄκρα, σμικρῷ μείους ἔνθεν καὶ ἔνθεν τῆς ἐπιδέσιος, παχύτατοι δὲ, ᾗ ἐξήριπε τὸ κάτηγμα. Ὁκόσα δὲ κυρτὰ καὶ ἄσαρκα φύσει, φυλασσόμενον τῶν ὑπερεχόντων, οἷον κατὰ δακτύλους ἢ σφυρὰ, ἢ τῇ θέσει, ἢ τῇ βραχύτητι. Παραιρήμασι δὲ ἑρμάζειν,

μὴ πιέζειν τὸ πρῶτον. Κηρωτῇ μαλθακῇ, καὶ λείῃ, καὶ καθαρῇ ἑλισσέσθω.

12. In fractures we must attend to the length, breadth, thickness, and number of the compresses. The length should be that of the bandaging; the breadth, three or four fingers; thickness, three or fourfold; number so as to encircle the limb, neither more nor less; those applied for the purpose of rectifying a deformity, should be of such a length as to encircle it; the breadth and thickness being determined by the vacuity, which is not to be filled up at once. The upper bandages are two, the first of which is to be carried from the seat of the injury upwards, and the second from the seat of the injury downwards, and from below upwards; the parts about the seat of the injury being most compressed, the extremities least, and the rest in proportion. The upper bandages should take in a considerable portion of the sound parts. We must attend to the number, length, and breadth of the bandages; the number must be such as not to be inferior to what the injury requires, nor occasion compression with the splints, nor prove cumbersome, nor occasion any slipping of them, nor render them inefficient. As to length and breadth, they should be three, four, five, or six cubits in length, and as many fingers broad. The folds of the strings ( selvages? ) should be such as not to occasion pressure; they are to be soft and not thick; and all these things are to be proportionate to the length, breadth, and thickness of the part affected. The splints are to be smooth, even, and rounded at the extremities; somewhat less all along than the upper bandaging, and thickest at the part to which fracture inclines. Those parts where there are tuber-osities, and which are devoid of flesh, such as the ankles or fingers, we must guard from the splints which are placed over them, either by position, or by their shortness. They are to be secured by the strings in such a manner as not to occasion pressure at first. A soft, consistent, and clean cerate should be rubbed into the folds of the bandage.

13. Ὕδατος θερμότης, πλῆθος θερμότης μὲν, κατὰ τῆς ἑωυτοῦ χειρὸς καταχεῖν πλῆθος δὲ, χαλάσαι μὲν καὶ ἰσχνῆναι τὸ

πλεῖστον, ἄριστον, σαρκῶσαι δὲ καὶ ἁπαλῦναι, τὸ μέτριον μέτρον δὲ τῆς καταχύσιος, ἔτι μετεωριζομένου, δεῖ, πρὶν ξυμπίπτειν, παύεσθαι τὸ μὲν γὰρ πρῶτον αἴρεται, ἔπειτα δὲ ἰσχναίνεται.

13. As to the temperature and quantity of the water used, its heat should be just such as the hand can bear, and it ought to be known that a large quantity is best for producing relaxation and attenuation, whereas a moderate quantity is best for incarnating and softening. The limit to the affusion is, to stop when the parts become swelled up, and before the swelling subsides; for the parts swell up at first, and fall afterward.

14. Θέσις δὲ μαλθακὴ, ὁμαλὴ, ἀνάῤΡοπος τοῖσιν ἐξέχουσι τοῦ σώματος, οἷον πτέρνῃ καὶ ἰσχίῳ, ὡς μήτε ἀνακλᾶται, μήτε ἀποκλᾶται, μήτε ἐκτρέπηται. Σωλῆνα παντὶ τῷ σκέλει, ἢ ἡμίσει ἐς τὸ πάθος δὲ βλέπειν καὶ τἄλλα ὅσα βλάπτει δῆλα.

14. The object on which to ( the limb? ) is laid should be soft, smooth, and sloping upwards toward the protuberant parts of the body, such as the heel or hips, so that there may be no projection, nor bending inwards, nor turning aside. The canal ( spout or gutter? ) should rather comprehend the whole limb than the half of it, attention being paid to the injury and to whatever else appears to create inconvenience.

15. Πάρεξις δὲ, καὶ διάτασις, καὶ ἀνάπλασις, καὶ τὰ ἄλλα κατὰ φύσιν. Φύσις δὲ ἐν μὲν ἔργοις, τοῦ ἔργου τῇ πρήξει, ὃ βούλεται, τεκμαρτέον ἐς δὲ ταῦτα, ἐκ τοῦ ἐλινύοντος, ἐκ τοῦ κοινοῦ,

ἐκ τοῦ ἔθεος ἐκ μὲν τοῦ ἐλινύοντος καὶ ἀφειμένου, τὰς ἰθυωρίας σκέπτεσθαι, οἷον τὸ τῆς χειρός ἐκ δὲ τοῦ κοινοῦ, ἔκτασιν, ξύγκαμψιν, οἷον τὸ ἐγγὺς τοῦ ἐγγωνίου πήχεος πρὸς βραχίονα ἐκ δὲ τοῦ ἔθεος, ὅτι οὐκ ἄλλα σχήματα φέρειν δυνατώτερον, οἷον σκέλεᾳ ἔκτασιν ἀπὸ τουτέων γὰρ ῥήϊστα πλεῖστον χρόνον ἔχοι ἂν μὴ μεταλλάσσοντα. Ἐν δὲ τῇ μεταλλαγῇ ἐκ διατάσιος ὅμοια ταῦτα ἕξουσιν ἐς ἕξιν ἢ θέσιν μύες, φλέβες, νεῦρα, ὀστέα, ᾗ μάλιστα εὔθετα καὶ εὔσχετα.

15. The presentation of the injured part to the physician, the extension, the arrangement, and so forth, are to be regulated according to nature. What is nature in these operations is to be determined by the accomplishment of the object which we have in view, and for this purpose we must look to the part in the state of rest, in its middle state, and to habit; in regard to the state of rest and relaxation, as in the arm, that it be in a line with the hand; and with regard to the medium between flexion and extension, that the forearm be at right angles to the arm; and with regard to habit, it should be considered that some limbs bear certain positions preferably, as, for example, the thighs extension; for in such attitudes the parts can best bear to be placed for a considerable time without a change of posture. And in the change from the state of distention, the muscles, veins, nerves, and bones, when properly arranged and secured, will preserve their relations to one another while the limb is raised or placed.

16. Διάτασις μάλιστα, τὰ μέγιστα καὶ πάχιστα, καὶ ὅκου ἀμφότερα δεύτερα, ὧν τὸ ὑποτεταγμένον ἥκιστα, ὧν τὸ ἄνω

μᾶλλον δὲ τοῦ μετρίου, βλάβη, πλὴν παιδίων ἔχειν ἀνάντη σμικρόν. Διορθώσιος παράδειγμα, τὸ ὁμώνυμον, τὸ ὁμόζυγον, τὸ ὅμοιον, τὸ ὑγιές.

16. The extension should be most powerful when the largest and thickest bones, or when both are broken; next when the under-bone, and least of all, when the upper. When immoderate, it is injurious, except in the case of children. The limb should be a little elevated. The model by which we judge if the part be properly set is the sound part of the same name, or the part which is its pair.

17. Ἀνάτριψις δύναται λῦσαι, δῆσαι, σαρκῶσαι, μινυθῆσαι ἡ σκληρὴ, δῆσαι ἡ μαλακὴ, λῦσαι ἡ πολλὴ, μινυθῆσαι ἡ μετρίη, παχῦναι.

17. Friction can relax, brace, incarnate, attenuate: hard braces, soft relaxes, much attenuates, and moderate thickens.

18. Ἐπιδεῖν δὲ τὸ πρῶτον ὁ μὲν ἐπιδεδεμένος μάλιστα φάτω πεπιέχθαι κατὰ τὸ σίνος, ἥκιστα τὰ ἄκρα ἡρμάσθαι δὲ, μὴ πεπιέχθαι πλήθει, μὴ ἰσχύϊ τὴν δὲ ἡμέρην ταύτην καὶ νύκτα, ὀλίγῳ μᾶλλον, τὴν δ’ ὑστέρην, ἧσσον τρίτη, χαλαρά. Εὑρεθήτω δὲ τῇ μὲν ὑστεραίῃ ἐν ἄκροισιν οἴδημα μαλθακόν τῇ τρίτῃ δὲ τὸ ἐπιδεθὲν λυθὲν, ἰσχνότερον, παρὰ πάσας τὰς

ἐπιδέσιας τοῦτο. Τῇ δὲ ὑστεραίῃ ἐπιδέσει, ἢν δικαίως ἐπιδεδεμένον φανῇ, μαθεῖν δεῖ ἐντεῦθεν δὲ μᾶλλον καὶ ἐπὶ πλέοσι πιεχθήτω τῇ δὲ τρίτῃ ἐπὶ μᾶλλον καὶ ἐπὶ πλέοσιν. Τῇ δὲ ἑβδόμῃ ἀπὸ τῆς πρώτης ἐπιδέσιος λυθέντα, εὑρεθήτω ἰσχνὰ, χαλαρὰ τὰ ὀστέα. Ἐς δὲ νάρθηκας, δεθέντα, ἢν ἰσχνὰ καὶ ἄκνησμα καὶ ἀνέλκεα ᾖ, ἐᾷν μέχρις εἴκοσιν ἡμερέων ἀπὸ τοῦ σίνεος ἢν δέ τι ὑποπτεύηται, λῦσαι ἐν τῷ μέσῳ νάρθηκας διὰ τρίτης ἐρείδειν.

18. The following should be the state of matters on the first application of the bandage. The person to whom it has been applied should say that he feels the compression particularly at the seat of the injury, but very little at the extremities; the parts should be adjusted but not pressed together, and that rather by the number of the bandages than by the force of the constriction; and the tightness should rather be on the increase during the first day and night; but on the next it should be less, and on the third the bandages should be loose. On the next day a soft swelling should be observed in the extremities; and on the third day, when the bandaging is loosed, the swelling should be found diminished in size, and this should be the case every time the bandages are removed. At the second application of the bandage, it should be ascertained whether the dressing has been properly done, and then greater compression should be made, and with more bandages; and on the third, still greater, and still more. On the seventh day from the first dressing, when the bandages are loosed, the limb should be found slender and the bones mobile. We must then have recourse to the splints, provided the limb be free of swelling, pruritus, and ulceration, and allow them to remain until twenty days after the accident; but if any suspicions arise, the bandages must be loosed in the interval. The splints should be tightened every third day.

19. Ἡ ἀνάληψις, ἡ θέσις, ἡ ἐπίδεσις, ὡς ἐν τῷ αὐτῷ σχήματι διαφυλάσσειν. Κεφάλαια σχημάτων, ἔθεα, φύσιες ἑκάστου τῶν μελέων τὰ εἴδεα, ἐκ τοῦ τρέχειν, ὁδοιπορέειν, ἑστάναι, κατακεῖσθαι, ἐκ τοῦ ἔργου, ἐκ τοῦ ἀφεῖσθαι.

19. The suspending of a fractured limb in a sling, the disposition of it, and the bandaging, all have for their object to preserve it in position. The principal considerations with regard to the position are the habits and the peculiar nature of each of the limbs: the varieties are shown in running, walking, standing, lying, action, repose.

20. Ὅτι χρῆσις κρατύνει, ἀργίη δὲ τήκει.

20. It should be kept in mind that exercise strengthens, and inactivity wastes.

21. Ἡ πίεξις πλήθει, μὴ ἰσχύϊ.

21. Compression should be produced by the number of bandages, rather than by the force of the constriction.

22. Ὁκόσα δὲ ἐκχυμώματα, ἢ φλάσματα, ἢ σπάσματα, ἢ οἰδήματα ἀφλέγμαντα, ἐξερύεται αἷμα ἐκ τοῦ τρώματος, ἐς μὲν τὸ ἄνω τοῦ σώματος πλεῖστον, βραχὺ δέ τι καὶ ἐς τὸ κάτω μὴ κατάντη τὴν χεῖρα ἔχοντα, ἢ τὸ σκέλος τιθέμενον τὴν ἀρχὴν

κατὰ τὸ τρῶμα, καὶ μάλιστα ἐρείδοντα, ἥκιστα τὰ ἄκρα, μέσως τὰ διὰ μέσου τὸ ἔσχατον πρὸς τὰ ἄνω τοῦ σώματος νεμόμενον ἐπιδέσει, πιέξει ἀτὰρ καὶ ταῦτα, πλήθει μᾶλλον, ἢ ἰσχύϊ μάλιστα δὲ τουτέοισιν ὀθόνια λεπτὰ, κοῦφα, μαλθακὰ, καθαρὰ, πλατέα, ὑγιέα, ὡς ἂν ἄνευ ναρθήκων καὶ καταχύσει χρῆσθαι.

22. In cases of ecchymosis, contusions, sprains, or swellings not attended with inflammations, blood is to be expelled from the wound, in greatest quantity to the upper part, and in smallest to the inferior; neither the arm nor the leg should be placed in a declining position: the head of the bandage should be placed on the wound, and there the greatest pressure should be made; the least at the extremities, and intermediately in the middle; the last fold of the bandage should be at the upper part of the body. As to binding and compression, these objects are to be attained rather by the number of the bandages than the force of the constriction; and moreover, in these cases the bandages should be thin, light, soft, clean, broad, sound, so that they may effect their purpose, even without splints. And we must use affusions.

23. Τὰ δὲ ἐκπτώματα, ἢ στρέμματα, ἢ διαστήματα, ἢ ἀποσπάσματα, ἢ ἀποκλάσματα, ἢ διαστρέμματα, οἷα τὰ κυλλὰ, τὰ ἑτερόῤΡοπα, ὅθεν μὲν ἐξέστη, ξυνδιδόντα, ὅπη δὲ ξυντείνοντα, ὡς ἐς τἀναντία ῥέπῃ, ἐπιδεθέντα, ἢ πρὶν ἐπιδεθῆναι, σμικρῷ μᾶλλον, ἢ ὥστε ἐξ ἴσου εἶναι καὶ τοῖσιν ἐπιδέσμοισι, καὶ τοῖσι σπλήνεσι, καὶ τοῖσιν ἀναλήμμασι, καὶ τοῖσι σχήμασι, κατατάσει, ἀνατρίψει, διορθώσει, ταῦτα καὶ καταχύσει πλείονι.

23. Dislocations, sprains, diastases of bones, violent separation, abruption of the extremities of bones, and distrainings, so as to induce varus or valgus , in these cases we must apply the bandages so as not to compress the part whence the displacement took place, and that we may render them tight at the side to which the displacement was, and give the limb an inclination in the opposite direction, and that in an excessive degree. We employ bandages, compresses, suspension of the limb in a sling, attitude, extension, friction, rectification; and along with these the affusion of much water.

24. Τὰ δὲ μινυθήματα, πουλὺ προσλαμβάνοντα τοῦ ὑγιέος, ἐπιδεῖν ὡς ἂν ἐξ ἐπιδρομῆς τὰ ξυντακέντα πλέον ἢ αὐτὰ ἐμινύθει,

ἀλλοίῃ τῇ ἐπιδέσει παραλλάξαντα, ἐκκλίνειν ἐς τὴν αὔξησιν καὶ ἀνάπλασιν τῶν σαρκῶν ποιήσηται. Βέλτιον δὲ καὶ τὸ ἄνωθεν, οἷον κνήμης, καὶ τὸν ἕτερον μηρὸν, καὶ τὸ σκέλος τὸ ὑγιὲς συνεπιδεῖν, ὡς ὁμοιότερον ᾖ, καὶ ὁμοίως ἐλινύῃ, καὶ ὁμοίως τῆς τροφῆς ἀποκλείηται καὶ δέχηται ὀθονίων πλήθει, μὴ πιέξει ἀνιέντα πρῶτον τὸ μάλιστα δεόμενον, καὶ ἀνατρίψει χρώμενον σαρκούσῃ, καὶ καταχύσει ἄνευ ναρθήκων.

24. In treating parts which are atrophied, we must comprehend a considerable part of the sound limb with the bandage, so that by the influx thereby produced, the wasted part may acquire a supply greater than its loss, and may be thus disposed to growth and restoration of its fleshy parts. It is better also to bandage the parts above, as the thigh in the case of the leg, and also the thigh and leg of the opposite side, so that they may be placed in similar circumstances, and may both equally be deprived of motion; and that the supply of nourishment may be alike curtailed and open to both. The compression should be the effect rather of the number of the bandages than of their tightness. We relax first the part most requiring it, and have recourse to that kind of friction which will promote the growth of flesh, and to affusion. No splints.

25. Τὰ δὲ ἑρμάσματα καὶ ἀποστηρίγματα, οἷον στήθει, πλευρῇσι, κεφαλῇ, καὶ τοῖσιν ἄλλοισιν, ὅσα τοιαῦτα τὰ μὲν, σφυγμῶν ἕνεκεν, ὡς μὴ ἐνσείηται τὰ δὲ, καὶ τῶν διαστασίων τῶν κατὰ τὰς ἁρμονίας ἐν τοῖσι κατὰ τὴν κεφαλὴν ὀστέοισιν, ἐρεισμάτων χάριν ἐπί τε βηχέων, ἢ πταρμέων, ἢ ἄλλης κινήσιος, οἷα τὰ κατὰ θώρηκα καὶ κεφαλὴν ἀποστηρίγματα γίγνεται. Τουτέων ἁπάντων αἱ αὐταὶ ξυμμετρίαι τῆς ἐπιδέσιος ᾗ μὲν γὰρ τὰ σίνη, μάλιστα πιέζει ὑποτιθέναι οὖν μαλθακόν τι ἁρμόζον τῷ πάθει ἐπιδεῖν δὲ μὴ μᾶλλον πιεζεῦντα, ἢ ὥστε τοὺς σφυγμοὺς μὴ ἐνσείειν, μηδὲ μᾶλλον ἢ ὥστε τῶν διεστηκότων τὰ ἔσχατα τῶν ἁρμονιῶν ψαύειν ἀλλήλων, μηδὲ τὰς

βῆχας καὶ τοὺς πταρμοὺς ὥστε κωλύειν, ἀλλ’ ὥστε ἀποστήριγμα εἶναι, ὡς μήτε διαναγκάζηται, μήτε ἐνσείηται.

25. Those things which are for the purpose of giving support and strength to the part, as to the breast, side, head, and so forth, are used in such cases as the following: for pulsations, that there may be no motion in the part; and in separation at the sutures of the skull, in order to give support; and in order to strengthen the chest and head, in coughs, sneezings, and other movements. In all these cases the same measure of bandaging is to be observed, for where the injury is, there the bandage should compress most, and something soft is to be placed below that suits with the complaint; and we must not apply the bandages tighter than just to stop the pulsations from creating disturbance, and that the separated parts at the sutures may be brought into contact, they must not be such as absolutely to stop the coughs and sneezings, but so as to give support, and, without occasioning uneasiness, prevent the parts from being shaken.

The Biographies

A mosaic located in Kos’ Asklepieion, depicting Hippocrates (left) with Asklepius in the middle