§2020.
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 οἰδήματος, 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 προσῴπῳ, καὶ ἄλλην ἁμαρτάδα μηδεμίαν ἔχοι τὸ οἴδημα τῆς ἄλλης διαίτης, τούτου χρὴ τὴν κάτω κοιλίην ὑποκαθῆραι φαρμάκῳ, ὅ τι χολὴν ἄγει·
But when, in the case of a wound on the head of a man, whether the bone has been sawed or not sawed, but with the bone bared, a red and erysipelas-like swelling arises on the face, and in both eyes or in one of them, and if anyone touches the swelling, it causes pain, and fever and chill seize him, while the wound itself appears in good condition both as regards the flesh and as regards the bone, and the parts surrounding the wound are in good condition, except for the swelling on the face, and the swelling has no other fault due to the rest of the regimen, in this case one must purge his lower belly with a drug that draws off bile; and when he is thus purged, the fever leaves him, the swelling subsides, and he becomes healthy.
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.
And one must give the medicine looking to the strength of the patient, according as he has strength.
§2121.
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 μήνιγγα ψιλὴν εἶναι τοῦ ὀστέου ἐπὶ πουλὺν χρόνον κακοπαθοῦσαν, ἀλλὰ τελευτῶσά πη καὶ διεμύδησεν.
Regarding sawing, when necessity arises to saw a man, know thus: if you undertake the treatment from the beginning and saw, you must not saw the bone all the way to the membrane immediately; for it is not beneficial for the membrane to be bared of the bone for a long time, suffering harm, but in the end it decays in some way.
Ἔστι δὲ καὶ ἕτερος κίνδυνος, ἢν αὐτίκα ἀφαιρέῃς πρὸς τὴν μήνιγγα ἐκπρίσας τὸ ὀστέον, τρῶσαι ἐν τῷ ἔργῳ τῷ πρίονι τὴν μήνιγγα.
And there is also another danger, if you remove the bone immediately by sawing it all the way to the membrane, namely, to wound the membrane with the saw during the work.
Ἀλλὰ χρὴ πρίοντα, ἐπειδὰν ὀλίγον πάνυ δέῃ διαπεπρίσθαι, καὶ ἤδη κινέηται τὸ ὀστέον, παύσασθαι πρίοντα, καὶ ἐᾷν ἐπὶ τὸ αὐτόματον ἀποστῆναι τὸ ὀστέον.
But in sawing, when very little remains to be sawed through, and the bone already moves, one must stop sawing, and allow the bone to separate of its own accord.
Ἐν γὰρ τῷ διαπριωτῷ δστέῳ καὶ ἐπιλελειμμένῳ τῆς πρίσιος οὐκ ἂν ἐπιγένοιτο κακὸν οὐδέν· λεπτὸν γὰρ τὸ λειπόμενον ἤδη γίνεται.
For in the case of the bone that is sawed through but left unfinished in the sawing, no harm would occur; for the part that is left is already thin.
Τὰ δὲ λοιπὰ ἰῆσθαι χρὴ, ὡς ἂν δοκέῃ ξυμφέρειν τῷ ἕλκεϊ.
And one must treat the rest as it seems to be beneficial to the wound.
Πρίοντα δὲ χρὴ πυκινὰ ἐξαιρέειν τὸν πρίονα τῆς θερμασίης εἵνεκα τοῦ ὀστέου, καὶ ὕδατι ψυχρῷ ἐναποβάπτειν.
And in sawing, one must frequently withdraw the saw because of the heating of the bone, and dip it in cold water.
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.
For the saw, being heated by its rotation, and overheating and drying up the bone, burns it, and causes a larger portion of the bone surrounding the saw-cut to separate than would otherwise have separated.
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.
And if you wish to saw all the way to the membrane immediately and then remove the bone, likewise you must frequently withdraw the saw and dip it in cold water.
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.
But if you do not undertake the treatment from the beginning, but receive it from another, coming late to the treatment, you must immediately saw the bone with a serrated saw down to the membrane, frequently withdrawing the saw and examining it, both in other ways and with the probe all around along the track of the saw.
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.
For indeed the bone is sawed through much more quickly if you saw when it is already suppurating and full of pus, and often the bone happens to be superficial, especially if the wound is in that part of the head where the bone happens to be thinner rather than thicker.
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.
But one must take care lest you accidentally press the saw, but wherever the bone seems to be thickest, in this you must always fix the saw, examining frequently, and try by shaking the bone to lift it out, and having removed it, treat the rest as it seems beneficial to the wound.
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.
And if, undertaking the treatment from the beginning, you wish immediately to saw through the bone and remove it from the membrane, likewise you must frequently examine the track of the saw with the probe, and always fix the saw in the thickest part of the bone, and try to remove the bone by shaking it.
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.
And if you use a trepan, do not reach all the way to the membrane if you bore while undertaking the treatment from the beginning, but leave a thin layer of the bone, just as has been written in the case of sawing.