§3434.
34.
Αἱ δὲ ἀποκοπαὶ ἢ ἐν ἄρθρῳ, ἢ κατὰ τὰ ὀστέα, μὴ ἄνω, ἀλλ᾿ ἢ παρὰ τῷ ποδὶ, ἢ παρὰ τῇ χειρὶ, ἐγγὸς περιγίνονται, ἢν μὴ αὐτίκα μάλα λειποθυμίῃ ἀπόλωνται.
Amputations, whether in a joint or at the bones, if they are not high up, but near the foot or near the hand, almost always recover, unless they perish immediately from syncope.
Ἴησις, ὡς κεφαλῆς, θέρμη.
The treatment is like that of the head, and warmth.
§3535.
35.
Ἀποσφακελίσιος μέντοι σαρκῶν, καὶ ἐν τρώμασιν αἱμοῤῥόοις ἀποσφιγχθὲν, καὶ ἐν ὀστέων κατήγμασι πιεχθὲν, καὶ ἐν δεσμοῖς ἀπομελανθέν. Καὶ οἷσι μηροῦ μέρος ἀποπίπτει καὶ βραχίονος, ὀστέα τε καὶ σάρκες [ἀποπίπτουσι], πολλοὶ περιγίνονται, ὡς τά γε ἄλλα εὐφορώτερα.
However, as for mortification of the flesh, both that constricted in bloody wounds, and that compressed in fractures of bones, and that blackened in tight bandages; and in those where a portion of the thigh or arm drops off, where bones and flesh [drop off], many survive, as the other circumstances are more tolerable.
Οἷσι μὲν οὖν καταγέντων ὀστέων, αἱ μὲν περιῤῥήξιες ταχεῖαι, αἱ δὲ τῶν ὀστέων ἀποπτώσιες, ᾗ ἂν τὰ ὅρια τῆς ψιλώσιος ᾖ, ταύτῃ ἀποπίπτουσι, βραδύτερον δέ.
In those, then, who have fractured bones, the sloughing of the flesh is rapid, but the shedding of the bones occurs at the boundary of the denudation, and they drop off there, but more slowly.
Δεῖ δὲ τὰ κατωτέρω τοῦ τρώματος προσαφαιρέειν καὶ τοῦ σώματος τοῦ ὑγιέος (προθνήσκει γὰρ), φυλασσόμενον ὀδύνην· ἅμα γὰρ λειποθυμίῃ θνήσκουσιν.
One must cut away beforehand the parts below the wound and even some of the healthy body (for it dies beforehand), while guarding against pain; for they die along with syncope.
Μηροῦ ὀστέον ἀπελύθη ἐκ τοιούτου ὀγδοηκοσταῖον, ἡ δὲ κνήμη ἀφῃρέθη εἰκοσταίη· κνήμης δὲ ὀστέα κατὰ μέσην, ἑξηκοσταῖα ἀπελύθη.
The bone of the thigh was detached from such a cause on the eightieth day, and the leg was removed on the twentieth day; and the bones of the middle of the leg were detached on the sixtieth day.
Ἐκ τοιουτέων ταχὺ καὶ βραδέως, αἱ πιέξιες αἱ ἰητρικαί.
In such cases, the medical compressions make the process fast or slow.
Τὰ δ᾿ ἄλλα ὅσα ἡσυχαίως, τὰ μὲν ὀστέα οὐκ ἀποπίπτει, οὐδὲ σαρκῶν ψιλοῦται, ἀλλ᾿ ἐπιπολαιότερον.
But in all other cases which proceed quietly, the bones do not drop off, nor is the flesh denuded, but the lesion is more superficial.
Προσδέχεσθαι ταῦτα χρή· τὰ γὰρ πλεῖστα φοβερώτερα ἢ κακίω.
One should expect these things, for most of them are more frightening than bad.
Ἡ ἴησις πραεῖα· θέρμῃ, διαίτῃ ἀκριβεῖ· κίνδυνος αἱμοῤῥαγιῶν, ψύχεος·
The treatment is mild: with warmth and a strict diet; there is danger of hemorrhages and cold.
σχήματα δὲ, ὡς μὲν ἀνάῤῥοπα, ἔπειτα ὑποστάσιος πύου εἵνεκα ἐξ ἴσου ἢ ὅσα ξυμφέρει.
As for postures, they should be elevated at first, and then, to prevent the stagnation of pus, level or as may be beneficial.
Ἐπὶ τοῖσι τοιουτέοισι καὶ ἐπὶ τοῖσι μελασμοῖσιν, αἱμοῤῥαγίαι· δυσεντερίαι· , περὶ κρίσιν, λαῦροι μὲν, ὀλιγήμεροι δέ· οὐκ ἀπόσιτοι δὲ πάνυ, οὐδὲ πυρετώδεες, οὐδέ τι κενεαγγητέον.
In such cases and during blackenings, hemorrhages and dysenteries occur, which at the crisis are severe but last few days; the patients are not altogether without appetite, nor feverish, nor should the vessels be emptied by starvation.
§3636.
36.
Ὕβωσις, ἡ μὲν εἴσω, ἐπιθάνατος, οὔρων σχέσιος, οὔρων σχέσιος, ἀποναρκώσιος·
Kyphosis, when inward, is fatal, with retention of urine and numbness.
τὰ δὲ ἔξω, τουτέων ἀσινέα τὰ πλεῖστα, πουλὺ μᾶλλον, ἢ ὅσα σεισθέντα μὴ ἐξέστη· αὐτὰ μὲν ἑωυτοῖσι κρίσιν ποιησάμενα, κεῖνα δὲ ἐπὶ πλέον τῷ σώματι ἐπιδιδόντα, καὶ ἐν ἐπικαίροις ἔοντα.
But when outward, most of these cases are harmless, much more so than those where the spine was shaken but did not dislocate; for the former achieve a crisis of themselves, whereas the latter affect the body more widely and involve vital parts.
Οἷον πλευραὶ κατεαγεῖσαι μὲν, ὀλίγαι πυρετώδεες, καὶ αἵματος πτύσιος, καὶ σφακελισμοῦ, ἤν τε μία, ἤν τε πλείους, μὴ κατασχισθεῖσαι δέ·
For instance, broken ribs, whether one or more, if they are not splintered, cause few fevers, spitting of blood, or mortification.
καὶ ἴησις φαύλη, μὴ κενεαγγοῦντα, ἢν ἀπύρετος ἔῃ· ἐπίδεσις, ὡς νόμος· ἡ δὲ πώρωσις, ἐν εἴκοσιν ἡμέρῃσι, χαῦνον γάρ.
And the treatment is simple, without restricting diet if the patient is without fever; bandaging as customary; and consolidation occurs within twenty days, for the bone is spongy.
Ἢν δ᾿ ἀμφιφλασθῇ, φυματίαι, καὶ βηχώδεες, καὶ ἔμμοτοι, καὶ πλευρὰς ἐσφακέλισαν· παρὰ γὰρ πλευρὴν ἑκάστην, ἀπὸ πάντων τόνοι εἰσίν.
But if they are contused, tubercles form, with cough, and they require tents, and the ribs mortify; for along each rib, cords run from all parts.
Πολλοὶ δὲ καὶ αἷμα ἔπτυσαν, καὶ ἔμπυοι ἐγένοντο.
Many also spit blood and become empyemic.
Ἡ δὲ μελέτη, ἴησις, ἐπίδεσις, ὡς νόμος· διαίτης τὰ πρῶτα ἀτρεκέως, ἔπειτα ἁπαλύνειν· ἡσυχίῃ, σιγῇ· σχήματα, κοιλίη, ἀφροδίσια.
The management, treatment, and bandaging should be as customary; the diet should be strict at first, then relaxed; with rest and silence; attention to postures, bowel movements, and venery.
Ἀτὰρ οἷς ἄναιμα, ἐπωδυνώτερα τῶν καταγνυμένων, καὶ φιλυποστροφώτερα χρόνοισιν· οἷσι δὲ καταλείπεται μυξῶδες, ὑπομιμνήσκει ἐν πόνοισιν.
However, contusions without blood are more painful than fractures, and more prone to recur over time; and in those where a mucous substance is left behind, it reminds them in times of pain.
Ἴησις, καῦσις, τοῖσι μὲν ἀπ᾿ ὀστέου, μέχρις ὀστέου, μὴ αὐτὸ δέ· ἢν δὲ μεταξὺ, μὴ πέρην, μηδὲ ἐπιπολῆς.
The treatment is cauterization: for those arising from bone, down to the bone, but not the bone itself; if in between, neither too deep nor too superficial.
Σφακελισμός· καὶ τὰ ἔμμοτα πειρᾶσθαι· εἰρήσεται ἅπαντα τὰ ἐπεσιόντα.
Mortification; and one must try tents; all subsequent matters will be explained.
Ὁρατὰ, λόγοις δ᾿ οὐ μὴ, βρώματα, πόματα, θάλπος, ψῦχος, σχῆμα, ὅτι καὶ φάρμακα, τὰ μὲν ξηρὰ, τὰ δὲ ὑγρὰ, τὰ δὲ πυῤῥὰ, τὰ δὲ μέλανα, τὰ δὲ λευκὰ, τὰ δὲ στρυφνὰ, ἐπὶ ἕλκη, οὕτω καὶ δίαιται.
These are visible things, and by no means [explainable] by words; food, drink, warmth, cold, posture, and indeed medicines, whether dry, wet, red, black, white, or astringent, just as they are applied to wounds, so are the diets.
§3737.
37.
Τὰ δ᾿ ἀπὸ καταπτώσιος ἧσσον δύναται ἐξιθύνεσθαι· χαλεπώτερα δὲ τὰ ἄνω φρενῶν ἐξιθύνεσθαι.
Distortions from a fall are less capable of being straightened; and those above the diaphragm are more difficult to straighten.
Οἷσι δὲ παισὶν, οὐ συναύξεται, ἀλλ᾿ ἢ σκέλη καὶ χεῖρες καὶ κεφαλή.
In those who are children, the body does not grow together with them, except the legs, hands, and head.
Ηὐξημένοισιν ὕβωσις, παραχρῆμα μὲν τῆς νούσου ῥύεται, ἀνὰ χρόνον δ᾿ ἐπισημαίνεται, δι᾿ ὧνπερ καὶ τοῖσι νεωτέροισιν, ἧσσον δὲ κακοήθως.
In those who have grown up, kyphosis immediately relieves them of the disease, but in course of time it manifests itself through the same symptoms as in younger persons, though less maliciously.
Εἰσὶ δὲ οἳ εὐφόρως ἤνεγκαν, οἷσιν ἂν ἐς εὔσαρκον καὶ πιμελῶδες τράπηται.
There are some who bear it easily, in whom it turns to a fleshy and fat condition.
Ὀλίγοι δὲ τουτέων περὶ ἑξήκοντα ἔτεα ἐβίωσαν.
Few of these, however, live to about sixty years.
Ἀτὰρ καὶ ἐς τὰ πλάγια διαστρέμματα γίνεται· συναίτια δὲ καὶ τὰ σχήματα, ἐν οἷσιν ἂν κατακέωνται· καὶ ἔχει προγνώσιας.
But also lateral curvatures occur; the postures in which they lie are cooperating causes, and there are prognoses for these.