Humanitext Reader

Hippocrates · On Injuries of the Head §14

Scraping and Staining for Bone Fissures, and Timing of Sawing

Passage 8 of 11 · Greek

Summary

This chapter describes the method of cutting and scraping the bone to inspect for invisible head injuries, the use of a melting black medicine to stain and detect hidden cracks, and the proper timing for the sawing procedure (trepanning).

§1414.
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.
When, therefore, you cut open a wound in the head on account of the bones bared of flesh, wishing to know whether the bone has suffered any mischief from the missile, or has not, you must cut the wound to such a size as seems to be sufficient.
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·
And when cutting, one must strip the flesh from the bone, where it is attached to the pericranium and to the bone; then one must plug the whole wound with lint, which will keep the wound as wide as possible on the next day with the least pain.
μοτώσαντα δὲ καταπλάσματι χρῆσθαι, ὅσον ἂν χρόνον καὶ τῷ μοτῷ, μάζην ἐκ λεπτῶν ἀλφίτων ἐν ὄξει διαμάσσειν, ἢ ἕψειν καὶ γλίσχρην ποιέειν ὡς μάλιστα.
And having plugged it, one must use a plaster, for as long a time as the lint is also applied, kneading a cake of fine barley-meal in vinegar, or boiling it and making it as sticky as possible.
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.
On the next day, when you have removed the lint, looking to see what the bone has suffered, if the injury in the bone is not clear to you as to what kind it is, and you cannot discern whether the bone has any mischief in itself, or has not, but the missile seems to have reached the bone and damaged it, you must scrape the bone with the scraper both deeply and along the length of the patient, as is natural, and again crosswise, in order to see the invisible cracks and the invisible bruising which is not depressed inward from the natural state of the rest of the skull bone.
Ἐξελέγχει γὰρ ἡ ξύσις μάλα τὸ κακὸν, ἢν μὴ καὶ ἄλλως καταφανέες ἔωσιν αὗται αἱ πάθαι ἐοῦσαι ἐν τῷ ὀστέῳ.
For scraping makes the mischief very manifest, if these injuries in the bone are not otherwise manifest.
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.
And if you see a mark of the missile on the bone, you must scrape the mark itself and the surrounding bones, lest perhaps a crack and bruising, or bruising alone, should accompany the mark and subsequently escape notice because they are not manifest.
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.
And when you scrape the bone with the scraper, if the injury of the bone seems to require sawing, you must saw it, and you must not let three days pass without sawing, but you must saw within these days, especially in the hot season, if you undertake the treatment from the beginning.
Ἢν δὲ ὑποπτεύσῃς μὲν τὸ ὀστέον ἐῤῥωγέναι, ἢ πεφλάσθαι, ἢ ἀμφότερα ταῦτα, τεκμαιρόμενος, ὅτι ἰσχυρῶς τετρωται, 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 ἔῤῥωγε 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·
But if you suspect that the bone is cracked, or bruised, or both, conjecturing from the words of the wounded man that he was severely wounded, and that he was wounded by someone stronger, if he was wounded by another, and that the missile by which he was wounded was of the harmful kind, and next that dizziness and darkness seized the man, and he was stunned and fell down—these things being so, if you cannot discern whether the bone is cracked, or bruised, or both, and you cannot see it at all, then indeed you must pour the most black liquid medicine upon the bone, and dress the wound with the melting black medicine, having laid a piece of fine linen under it, wetted with oil, then apply a plaster of barley-meal and bandage it.
τῇ δ᾿ ὑστεραίῃ, ἀπολύσαντα, ἐκκαθήραντα τὸ ἕλκος, ἐπιξῦσαι.
On the next day, having untied it and cleansed the wound, you must scrape it.
Καὶ ἢν μὴ ᾖ ὑγιὲς, ἀλλ᾿ ἐῤῥώγῃ 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.
And if it is not sound, but is cracked and bruised, the rest of the bone will be white when scraped, but the crack and the bruising, because the medicine has melted down and been received into them being black, will show black in the rest of the bone which is white.
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 περιέῤῥηξε καὶ τὴν ῥωγμὴν τὴν ἀφανισθεῖσαν ὑπὸ τοῦ ξυστῆρος·
But you must again scrape this crack, which has appeared black, in depth; and if by scraping you remove the crack and make it invisible, a bruising of the bone has occurred to a greater or lesser degree, which also caused the crack around it, which has been effaced by the scraper.
ἧσσον δὲ φοβερὸν καὶ ἧσσον ἂν πρῆγμα ἀπ᾿ αὐτέης γένοιτο ἀφανισθείσης τῆς ῥωγμῆς.
And it would be less formidable and less trouble would come from it if the crack is effaced.
Ἢν δὲ κατὰ βάθος ᾖ καὶ μὴ ἐθέλῃ ἐξιέναι ἐπιξυομένη, ἀφίκει ἐς πρίσιν ἡ τοιαύτη ξυμφορή.
But if it is deep and does not want to disappear when scraped, such a condition reaches the necessity of sawing.
Ἀλλὰ χρὴ πρίσαντα τὰ λοιπὰ ἰητρεύειν τὸ ἔλκος.
Therefore, having sawed it, you must treat the wound for the rest of the time.

Notes

  1. 14ὀστέων εἵνεκα τῆς σαρκὸς ἐψιλωμένων — The preposition εἵνεκα governs the entire genitive phrase ὀστέων ... ἐψιλωμένων, expressing the purpose: 'for the sake of the bones bared of flesh' (i.e., to inspect them).
  2. 14μὴ πολλάκις... προσγένηται — A clause of precaution or fear (μὴ with subjunctive). The adverb πολλάκις in conditional or fearing clauses functions not as 'often', but as 'perhaps' or 'by any chance' (lest perhaps).
  3. 14οὐ δεῖ... μὴ ὑπερβάλλειν ἀπρίωτον — An impersonal construction with a double negation. οὐ δεῖ ('it is not necessary / one must not') and μὴ ὑπερβάλλειν ('not to exceed') combine to express a strong necessity: 'one must not exceed three days without sawing' (i.e., the head must be sawed within three days).
  4. 14Ἢν δὲ ὑποπτεύσῃς... δεῖ δὴ — A long and complex conditional sentence. Starting with Ἢν δὲ ὑποπτεύσῃς ('if you suspect'), it inserts various circumstantial evidence (the patient's words, the assailant's strength, the type of missile, symptoms like vertigo) through the participle τεκμαιρόμενος, proceeds to the secondary condition of not being able to discern (ἢν μὴ διαγινώσκῃς), and finally reaches the main verb δεῖ δὴ in ¦p.240¦.
  5. p.242κατατακέντος τοῦ φαρμάκου — Genitive absolute construction. It expresses time or condition: 'when the medicine has melted down (and penetrated into the cracks)'.

Cite this passage

Hippocrates, On Injuries of the Head §14. Humanitext Reader, https://reader.humanitext.ai/en/text/urn:cts:greekLit:tlg0627.tlg007.humanitext-grc1:14

Please note the AI-draft status of the translation and the date accessed.

Translation, notes and summary are AI-generated drafts, revised through reader feedback.