§3030.
30.
Ὅσοι δὲ πηδήσαντες ἄνωθεν ἐστηρίξαντο τῇ πτέρνῃ, ὥστε διαστῆναι τὰ ὀστέα, καὶ φλέβασ ἐκχυμωθῆναι, καὶ νεῦρα ἀμφιθλασθῆναι, ὅταν γένηται οἷα τὰ δεινότατα, κίνδυνος μὲν σφακελίσαντα τὸν αἰῶνα πρήγματα παρασχεῖν.
Those who, having jumped from a height, pitch upon the heel, so that the bones are separated, the vessels pour out their blood, and the cords are contused around them, when the worst cases occur, there is danger that the part may mortify and cause trouble throughout life.
Καὶ ῥοικώδη μὲν τὰ ὀστέα, τὰ δὲ νεῦρα ἀλλήλοισι κοινωνέοντα.
And the bones become distorted, and the cords adhere to one another.
Ἐπεὶ καὶ οἷσιν ἂν καταγεῖσιν, ἢ ὑπὸ τρώματος οἷα ἐν κνήμῃ, ἢ μηρῷ, νεύρων ἀπολυθέντων, ἃ κοινωνέει τουτέοισιν, ἢ ἐξ ἄλλης κατακλίσιος ἀμελέος ἐμελάνθη ἡ πτέρνη, καὶ τουτέοισι παλίγκοτα ἐκ τοιουτέων.
For also in those who have fractures, or from a wound such as in the leg or thigh, when the cords connected with them are detached, or when from some other careless posture in bed the heel becomes black, in these cases too, noxious consequences result from such causes.
Ἔστιν ὅτε πρὸς σφακελισμῷ γίνονται πυρετοὶ ὑπεροξέες, λυγγώδεες, τρομώδεες, γνώμης ἁπτόμενοι, ταχυθάνατοι, καὶ ἔτι φλεβῶν αἱμοῤῥόων πελιώσιες, καὶ γαγγραινώσιες.
Sometimes, in addition to the mortification, there occur very acute fevers, hiccups, tremors, mental aberration, rapid death, and also lividity of the distended veins, and gangrene.
Σημεῖα τῶν παλιγκοτησάντων· ἢν τὰ ἐκχυμώματα, καὶ τὰ μελάσματα, καὶ τὰ περὶ ταῦτα ὑπόσκληρα καὶ ὑπέρυθρα ᾖ· ἢν γὰρ ξὺν σκληρύσματι πελιωθῇ, κίνδυνος μελανθῆναι·
The signs of those that are worsening are: if the extravasations, the blackenings, and the parts around them are somewhat hard and reddish; for if there is lividity with hardness, there is danger of mortification.
ἢν δ᾿ ὑποπέλια ἢ καὶ πέλια μάλα, καὶ κεχυμένα, ἢ ὑπόχλωρα καὶ μαλθακὰ, ταῦτα ἐν πᾶσι τοῖσι τοιούτοισιν ἀγαθά.
But if they are somewhat livid, or even very livid, but diffuse, or yellowish-green and soft, these are good signs in all such cases.
Ἴησις δὲ, ἢν μὲν ἀπύρετοι ἔωσιν, ἐλλεβορίζειν· ἢν δὲ μὴ, μή· ἀλλὰ ποτὸν διδόναι ὀξύγλυκυ, εἰ δέοι.
The treatment is: if they are without fever, to administer hellebore; but if not, do not do so; rather give an acid-sweet drink, if necessary.
Ἐπίδεσις δὲ, ἡ ἄρθρων σύνδεσις· ἔτι δὲ ταῦτα· μᾶλλον τοῖσι φλάσμασι, καὶ ὀθονίοισι πλέοσι καὶ μαλθακωτέροισι χρῆσθαι· πίεξις ἧσσον· ὕδωρ πλέον· προσπεριβάλλειν τὰ πλεῖστα τῇ πτέρνῃ.
The bandaging is like that for joints; furthermore, in these cases, use more and softer bandages for the contusions, with less pressure, more water, and wrap the most around the heel.
Τὸ σχῆμα, ὅπερ ἡ ἐπίδεσις, ὡς μὴ ἐς την πτέρνην ἀποπιέζηται· ἀνωτέρω γούνατος· ἔστω εὔθετος· νάρθηξι μὴ χρήσασθαι.
The posture, as in bandaging, should be such that pressure is not made upon the heel; let it be placed higher than the knee, in an easy position; do not use splints.
§3131.
31.
Ὅταν δὲ ἐκστῇ ὁ ποὺς, ἢ μοῦνος, ἢ ξὺν τῇ ἐπιφύσει, ἐκπίπτει μᾶλλον ἐς τὸ ἔσω.
When the foot is displaced, either alone or with the epiphysis, it dislocates more toward the inside.
Εἰ δὲ μὴ ἐμπέσοι, λεπτύνεται ἀνὰ χρόνον ἰσχίου καὶ μηροῦ καὶ κνήμης τὸ ἀντίον τοῦ ὀλισθήματος.
If it is not reduced, in the course of time the parts of the hip, thigh, and leg opposite to the dislocation become wasted.
ἐμβολὴ, ὡς ἡ καρποῦ, κατάτασις δὲ ἰσχυροτέρη.
Reduction is like that of the wrist, but the extension is stronger.
Ἴησις, νόμος ἄρθρων.
The treatment is according to the law of joints.
Παλιγκοτέει ἧσσον καρποῦ, ἢν ἡσυχάσῃ.
It is less prone to worsen than the wrist, if it is kept at rest.
Δίαιτα μείων, ἐλινύουσι γάρ.
The diet should be reduced, for they are inactive.
Τὰ δὲ ἐκ γενεῆς μὲν ἢ ἐν αὐξήσει, κατὰ λόγον τὸν πρότερον.
Cases from birth or during growth follow the proportion described before.
§3232.
32.
Ἐπεὶ τὰ σμικρὸν ὠλισθηκότα ἐκ γενεῆς, ἔνια οἷά τε διορθοῦσθαι· μάλιστα δὲ ποδὸς κύλλωσις· κυλλώσιος γὰρ οὐχ εἷς ἐστι τρόπος.
Since some of those born with slight displacements can be corrected, especially clubfoot, for there is not just one form of clubfoot.
Ἡ δὲ ἴησις τουτέου· κηροπλαστεῖν· κηρωτὴ ῥητινώδης, ὀθόνια συχνὰ, ἢ πέλμα, ἢ μολύβδιον προσεπιδεῖν, μὴ χρωτί· ἀνάληψις, τά τε σχήματα ὁμολογείτω.
The treatment of this is: to mould it like wax, using resinous cerate, many bandages, or a sole, or a lead plate bound on, not directly to the skin; let the suspension and the postures agree with the correction.
§3333.
33.
Ἢν δὲ ἐξαρθρήσαντα ἕλκος ποιησάμενα ἐξίσχῃ, ἐώμενα ἀμείνω, ὥστε δὴ μὴ ἀπαιωρέεσθαι, μηδ᾿ ἀπαναγκάζεσθαι.
If bones dislocate and make a wound so that they project, it is better if they are left alone, so that they are not suspended or forcibly reduced.
Ἴησις δὲ, πισσηρῇ, ἢ σπλήνεσιν οἰνηροῖσι θερμοῖσιν (ἅπασι γὰρ τουτέοισι τὸ ψυχρὸν κακὸν), καὶ φύλλοισιν· χειμῶνος δὲ, εἰρίοισι ῥευπωμένοισι τῆς σκέπης εἵνεκα· μὴ καταπλάσσειν, μηδὲ ἐπιδεῖν· δίαιτα λεπτή.
The treatment is with pitch cerate, or with warm wine compresses (for in all these cases cold is bad), and with leaves; and in winter, with greasy wool for protection; do not apply cataplasms, nor bandage; the diet should be light.
Ψῦχος, ἄχθος πουλὺ, πίεξις, ἀνάγκη, σχήματος τάξις· εἰδέναι μὲν οὖν ταῦτα πάντα ὀλέθρια.
Cold, heavy weight, pressure, force, constraint of posture—know that all these are destructive.
Μετρίως δὲ θεραπευθέντες, χωλοὶ αἰσχρῶς· ἢν γὰρ παρὰ πόδας γένηται, ποὺς ἀνασπᾶται καὶ ἤν πτ, ἄλλῃ, κατὰ λόγον.
Even if treated moderately well, they become shamefully lame; for if it happens at the foot, the foot is drawn upward, and if in any other part, in proportion.
Ὀστέα οὐ μάλα ἀφίστανται· μικρὰ γὰρ ψιλοῦται, περιωτειλοῦται λεπτῶς.
The bones do not separate much; they are bared only a little, and heal over with a thin scar.
Τουτέων τὰ μέγιστα κινδυνωδέστατα, καὶ τὰ, ἀνωτάτω.
Of these, the largest joints and those highest up are the most dangerous.
Ἐλπὶς δὲ μούνη σωτηρίης, ἐὰν μὴ ἐμβάλλῃ, πλὴν τὰ κατὰ δακτύλους, καὶ χεῖρα, ἄκρην· ταῦτα δὲ, προειπέτω τοὺς κινδύνους· ἐγχειρέειν ἐμβάλλειν ἢ τῇ πρώτῃ, ἢ τῇ δευτέρῃ· ἢν δὲ μὴ, πρὸς τὰς δέκα· ἥκιστα τεταρταῖα·
The only hope of safety is if one does not reduce them, except for those of the fingers, and the extremity of the hand; and for these, forewarn of the dangers; attempt reduction either on the first or second day, or if not, toward the tenth; least of all on the fourth day.
ἐμβολὴ δὲ, οἱ μοχλίσκοι· ἴησις δὲ, ὡς κεφαλῆς ὀστέων, καὶ θέρμη· ἐλλεβόρῳ δὲ καὶ αὐτίκα ἐπὶ τοῖσιν ἐμβαλλομένοισι βέλτιον χρῆσθαι.
The reduction is made with small levers; the treatment is like that for bones of the head, and warmth; and it is better to use hellebore immediately for those that are reduced.
Τὰ δ᾿ ἄλλα, εὖ εἰδέναι δεῖ, ὅτι, ἐμβαλλομένων, θάνατοι· τὰ μέγιστα καὶ τὰ ἀνωτάτω μάλιστα καὶ τάχιστα.
As for the others, one must well know that death follows if they are reduced, and the largest and highest joints bring death most certainly and quickly.
Ποὺς δὲ ἐκβὰς, σπασμὸς, γάγγραινα· καὶ ἢν ἐμβληθέντι ἐπιγένηταί τι τουτέων, ἐκβάλλοντι ἐλπὶς, εἴ τις ἄρα ἐλπίς· οὐ γὰρ ἀπὸ τῶν χαλώντων οἱ σπασμοὶ, ἀλλ᾿ ἀπὸ τῶν ἐντεινόντων.
When the foot is dislocated, spasm and gangrene occur; and if any of these supervene upon reduction, there is hope in dislocating it again, if indeed there is any hope; for spasms do not arise from relaxing, but from stretching.