§33.
3.
Οὖς κατεαγὲν, μὴ ἐπιδεῖν, μηδὲ καταπλάσσειν· ἢν δέ τι δέῃ, ὡς κουφότατον, ἡ κηρωτή· καὶ θείῳ κατακολλᾷν.
A broken ear must not be bandaged nor covered with a plaster; if anything is needed, let it be as light as possible, namely cerate; and glue it with sulfur.
Ὧν δὲ ἔμπυα τὰ ὦτα, διὰ παχέος εὑρίσκεται·
For those whose ears are suppurating, the pus is found through a thick layer of tissue.
πάντα δὲ τὰ ὑπόμυξα καὶ τῇ ὑγρῇ σαρκὶ πλήρεα ἐξαπατᾷ·
But all things that contain mucus and are full of moist flesh deceive.
οὐ μὴ βλάβη γένηται στομωθὲν τὸ τοιοῦτον· ἐστὶ γὰρ ἄσαρκα καὶ ὑδατώδεα, μύξης πλέα, ὅπου δὲ καὶ οἷα ἐόντα θανατώδεά ἐστι, παρεθέντα.
No harm will ever result if such a part is incised; for they are devoid of flesh, watery, full of mucus; and wherever and of whatever nature they are, if neglected, they are fatal.
Ὤτων καῦσις πέρην, τάχιστα ὑγιάζει· κυλλὸν δὲ καὶ μεῖον γίνεται τὸ οὖς, ἢν πέρην καυθῇ.
Cauterizing the ears right through heals most quickly; but the ear becomes distorted and smaller if cauterized right through.
Ἢν δὲ στομωθῇ, κούφῳ ἐναίμῳ δεήσει χρῆσθαι.
But if it is incised, it will be necessary to use a light, blood-staunching application.
§44.
4.
Γνάθοι δὲ κατασπῶνται μὲν πολλάκις καὶ καθίστανται· ἐκπίπτουσι δὲ ὀλιγάκις, μάλιστα μὲν χασμωμένοισιν· οὐ γὰρ ἐκπίπτει, ἢν μή τις χανὼν μέγα παρανάγῃ·
The jaws are often pulled down and replaced; but they are rarely dislocated, especially in yawning; for it does not dislocate unless one opens the mouth wide and shifts it to the side.
ἐκπίπτει δὲ μᾶλλον, ὅτι τὰ νεῦρα ἐν πλαγίῳ καὶ λελυγισμένα συνδιδοῖ.
And it dislocates more because the ligaments, being oblique and curved, yield.
Σημεῖα· προέχει ἡ κάτω γνάθος, καὶ παρέστραπται τἀναντία τοῦ ἐκπτώματος, ξυμβάλλειν οὐ δύνανται· ἢν δ᾿ ἀμφότεραι, προΐσχουσι μᾶλλον, συμβάλλουσιν ἧσσον, ἀστραβέες· δηλοῖ δὲ τὰ ὅρια τῶν ὀδόντων τὰ ἄνω τοῖσι κάτω κατ᾿ ἴξιν.
Signs: the lower jaw protrudes, and is turned to the side opposite to the dislocation, and they cannot close their mouth; but if both sides are dislocated, they protrude more, but can close it less, without being distorted; this is shown by the alignment of the upper teeth with the lower ones in a straight line.
Ἢν οὖν ἀμφότεραι ἐκπεσοῦσαι μὴ αὐτίκα ἐμπέσωσι, θνήσκουσι δεκαταῖοι οὗτοι μάλιστα πυρετῷ ξυνεχέϊ, νωθρῇ τε καρώσει· οἱ γὰρ μύες οὗτοι, τοιοῦτοι· γαστὴρ ἐπιταράσσεται ὀλίγα ἄκρητα· καὶ ἢν ἐμέωσι, τοιαῦτα ἐμέουσιν.
If, therefore, both jaws having been dislocated are not immediately replaced, these patients die about the tenth day, mostly with continuous fever and dull coma; for these muscles are of such a nature; the stomach is disturbed, discharging a small quantity of unmixed matters; and if they vomit, they vomit such things.
Ἡ δ᾿ ἑτέρη ἀσινεστέρη.
Dislocation of one side is less dangerous.
ἐμβολὴ δὲ ἡ αὐτὴ ἀμφοτέρων· κατακειμένου ἢ καθημένου τοῦ ἀνθρώπου, τῆς κεφαλῆς ἐχόμενον, περιλαβόντα τὰς γνάθους ἀμφοτέρας ἀμφοτέρῃσι χερσὶν ἔσωθεν καὶ ἔξωθεν, τρία ἅμα ποιῆσαι· ὦσαι ἐς ὀρθὸν, καὶ ἐς τοὐπίσω, καὶ συσχεῖν τὸ στόμα.
The reduction is the same for both: the person lying down or sitting, while the head is held, one grasping both jaws with both hands, inside and outside, must do three things at once: push into the proper direction, push backwards, and close the mouth.
Ἴησις, μαλάγμασι, καὶ σχήμασι, καὶ ἀναλήψει γενείου, ποιοῦσι ταὐτὰ τῇ ἐμβολῇ.
The treatment, by emollient applications, dressings, and supporting the chin, achieves the same results as the reduction.
§55.
5.
Ὦμος δὲ ἐκπίπτει κάτω. Ἄλλῃ δὲ οὔπω ἤκουσα.
The shoulder is dislocated downwards; I have never yet heard of it being dislocated in any other direction.
Δοκέει μὲν γὰρ ἐς τοὔμπροσθεν ἐκπίπτειν, ὧν αἱ σάρκες αἱ περὶ τὸ ἄρθρον μεμινυθήκασι διὰ τὴν φθίσιν, οἷον καὶ τοῖσι βουσὶ χειμῶνος φαίνεται διὰ λεπτότητα.
For it indeed appears to dislocate forwards in those whose flesh about the joint has wasted away through consumption, just as also appears to happen to cattle in winter because of thinness.
Καὶ ἐκπίπτει μᾶλλον, τοῖσι δὲ λεπτοῖσιν, ἢ ἰσχνοῖσι, [ἢ ξηροῖσι] καὶ τοῖσιν ὑγράσματα περὶ τὰ ἄρθρα ἔχουσιν ἄνευ φλεγμονῆς· αὐτὴ γὰρ συνδεῖ.
And it dislocates more, especially in those who are thin, or slender, and in those who have fluids about the joints without inflammation; for inflammation itself binds the joint together.
Οἱ δὲ καὶ βουσὶν ἐμβάλλοντες καὶ ἀποπερονῶντες ἐξαμαρτάνουσι, καὶ ὅτι διὰ τὴν χρῆσιν, ὡς χρῆται βοῦς σκέλεϊ, λήθει, καὶ ὅτι κοινὸν καὶ ἀνθρώπῳ οὕτως ἔχοντι τὸ σχῆμα τοῦτο· τό τε Ὁμήρειον· καὶ διότι λεπτότατοι βόες τηνικαῦτα.
And those who reduce and pin the shoulders of cattle err, both because the dislocation is unnoticed owing to the way the ox uses its leg, and because this appearance is common also to a man in such a state, as well as the Homeric passage, and because oxen are thinnest at that season.
Ὅσα τε τὸν πῆχυν πλάγιον ἀπὸ πλευρέων ἄραντες δρῶσιν, οὐ πάνυ δύνανται δρᾷν, οἷσιν ἂν μὴ ἐμπέσῃ.
And whatever things they do by raising the forearm obliquely away from the ribs, they cannot do at all, unless it is reduced.
Οἷσι μὲν οὖν ἐκπίπτει μάλιστα, καὶ ὡς ἔχουσιν, εἴρηται.
Thus, in whom it dislocates most, and how they are affected, has been told.
Οἷσι δὲ ἐκ γενεῆς, τὰ ἐγγύτατα μᾶλλον βραχύνεται ὀστέα, οἷον ἐν τούτῳ οἱ γαλιάγκωνες· πῆχυς δὲ ἧσσον, χεὶρ δὲ ἔτι ἧσσον, τὰ δ᾿ ἄνωθεν οὐδέν.
In those who have it from birth, the bones nearest to the joint are shortened most, as in this case those with weasel-arms; the forearm is shortened less, the hand still less, and the parts above not at all.
Καὶ ἀσαρκότατα ἐγγύς· μινύθει δὲ μάλιστα τὰ ἐναντία τῶν ὀλιθημάτων, καὶ τὰ ἐν αὐξήσει, ἧσσον δέ τινι τῶν ἐκ γενεῆς.
And the parts near are most devoid of flesh; and wasting occurs most on the side opposite to the displacements, and in those who are growing, but somewhat less in those who have it from birth.
Καὶ τὰ παραπυήματα, τὰ κατ᾿ ἄρθρον βαθέα, νεογενέσι μάλιστα παρ᾿ ὦμον γίνεται, καὶ τουτέοισιν ὥσπερ τὰ ἐξαρθρήσαντα ποιέει.
And deep-seated abscesses around the joint occur especially near the shoulder in newborns, and produce in them the same effects as dislocations.
Ἢν δὲ ηὐξημένοισι, τὰ μὲν ὀστέα οὐ μειοῦται, οὐδὲ γὰρ ἔχει, ᾗ ἄλλα οὐ ξυναύξεται ὁμοίως· αἱ δὲ μινυθήσιες τῶν σαρκῶν· τοῦτο γὰρ καθ᾿ ἡμέρην καὶ αὔξεται καὶ μειοῦται, καὶ καθ᾿ ἡλικίας.
But if it occurs in adults, the bones do not diminish, for there is no room where others do not grow together with them in like manner; but the wasting of the flesh occurs, for this daily both increases and diminishes, and also according to age.
Καὶ ἃ δύναται σχήματα, καὶ αὖ σημεῖον τὸ παρὰ τὸ ἀκρώμιον κατεσπασμένον καὶ κοῖλον, διότι, ὅταν τὸ ἀκρώμιον ἀποσπασθῇ, καὶ κοῖλον ᾖ, οἴονται τὸν βραχίονα ἐκπεπτωκέναι.
And the positions they can assume are also signs, and again, the sign of the part near the acromion being pulled down and hollowed; for when the acromion is separated and hollow, they think the humerus is dislocated.
Κεφαλὴ δὲ τοῦ βραχίονος ἐν τῇ μασχάλῃ φαίνεται· αἴρειν γὰρ οὐ δύνανται, οὐδὲ παράγειν ἔνθα καὶ ἔνθα ὁμοίως· ὁ ἕτερος ὦμος μηνύει.
And the head of the humerus is felt in the armpit; for they cannot raise the arm, nor move it this way and that in the same manner; the other shoulder indicates by comparison.
ἐμβολαὶ δέ· αὐτὸς μὲν τὴν πυγμὴν ὑπὸ μασχάλην ὑποθεὶς, τὴν κεφαλὴν ἀνωθέειν, τὴν δὲ χεῖρα ἐπιπαράγειν ἐπὶ τὸ στῆθος.
The methods of reduction: the practitioner himself putting his fist under the armpit, pushes the head upwards, while bringing the patient's arm over towards the breast.
Ἄλλη· ἐς τοὐπίσω περιαναγκάσαι, ὡς ἀμφισφαλῇ.
Another method: to force it backwards, so as to make it waver.
Ἄλλη· κεφαλῇ μὲν πρὸς τὸ ἀκρώμιον, χερσὶ δὲ ὑπὸ μασχάλην, κεφαλὴν ἀπάγειν βραχίονος, γούνασι δὲ ἀγκῶνα ἀπωθέειν, ἢ ἀντὶ τῶν γουνάτων τὸν ἀγκῶνα τὸν ἕτερον παράγειν, ὡς τὸ πρότερον.
Another: with the head of the operator pressed against the acromion, and the hands under the armpit, to draw the head of the humerus away, while pushing away the elbow with the knees; or, instead of the knees, to bring the other elbow in, as in the former case.
Ἢ κατ᾿ ὤμου ἵζεσθαι, ὑποθεὶς τῇ μασχάλῃ τὸν ὦμον· ἢ τῇ πτέρνῃ, ἐνθέντα ἐκπλήρωμα τῇ μασχάλῃ, δεξιῇ δεξιόν· ἢ περὶ ὕπερον· ἢ περὶ κλιμακτῆρα· ἢ περίοδος ξὺν τῷ ξύλῳ τῷ ὑπὸ χεῖρα τεινομένῳ.
Or to suspend the patient over the shoulder, having placed one's shoulder under the armpit; or with the heel, having placed a pad in the armpit, the right heel for the right armpit; or over a pestle; or over a rung of a ladder; or by the wheel method with the wood stretched under the arm.
Ἴησις· τὸ σχῆμα, πρὸς πλευρῇσι βραχίων, χεὶρ ἄκρη ἄνω, ὦμος ἄνω· οὕτως ἐπίδεσις, ἀνάληψις.
The treatment: the position being, the arm close to the ribs, the hand kept upwards, the shoulder upwards; in this position, bandaging and suspension.
Ἢν δὲ μὴ ἐμπέσῃ, ἀκρώμιον προσλεπτύνεται.
But if it is not reduced, the acromion becomes progressively thinner.