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Hippocrates · On Ulcers §1-5

Fundamental Principles of Wound Treatment and Drying

Passage 1 of 6 · Greek

Summary

This text discusses the fundamental principles of wound treatment, emphasizing the importance of keeping wounds dry, the distinct treatments based on suppuration, the benefits of purging, and the influence of seasons.

§1## ΠΕΡΙ ΕΛΚΩΝ. 1.
## ON WOUNDS 1.
Ἕλκεα ξύμπαντα οὐ χρὴ τέγγειν, πλὴν οἴνῳ, ἢν μὴ ἐν ἄρθρῳ ἔῃ τὸ ἕλκος· τὸ γὰρ ξηρὸν τοῦ ὑγιέος ἐγγυτέρω ἐστὶ, καὶ τὸ ὑγρὸν τοῦ μὴ ὑγιέος· τὸ γὰρ ἕλκος ὑγρόν ἐστι, τὸ δὲ ὑγιὲς ξηρόν.
It is not proper to wet any wounds, except with wine, unless the wound is in a joint; for what is dry is nearer to the healthy state, and what is wet is nearer to the unhealthy; for a wound is wet, and the healthy is dry.
Ἀνεπίδετον δὲ ἐᾷν ἄμεινόν ἐστιν, ὅ τι γε μὴ καταπλάσσεται· οὐδὲ καταπλάσσειν ἐνδεχόμενόν ἐστιν ἔνια τῶν ἑλκέων, μᾶλλον δὲ τὰ νεότρωτα τῶν παλαιοτέρων, καὶ τὰ ἐν τοῖσιν ἄρθροισιν.
It is better to leave them unbandaged, unless indeed a plaster is applied; nor is it possible to apply a plaster to some of the wounds, rather to the fresh than the older ones, and those in the joints.
Ὀλιγοσιτέειν τε ὡς μάλιστα καὶ ὕδωρ ξυμφέρει πᾶσι τοῖσιν ἕλκεσι, μᾶλλον δὲ τοῖσι νεοτρώτοισι τῶν παλαιοτέρων, καὶ ὅ τι ἄλλο φλεγμαίνει ἕλκος ἢ μέλλει, καὶ ὅ τι σφακελίσαι κίνδυνος, καὶ τοῖσιν ἕλκεσι καὶ φλέγμασι τοῖσιν ἐν τοῖσιν ἄρθροισι, καὶ ὅκου σπασμοὺς κίνδυνος ἐπιγενέσθαι, καὶ τοῖσιν ἐν κοιλίῃ τρώμασι, παντῶν δὲ μάλιστα τοῖσιν ἐν κεφαλῇ καὶ μηρῷ κατεαγεῖσι, καὶ ἄλλῳ ᾧ κάτηξις ἂν γένηται.
Sparsity of food as much as possible and water are beneficial to all wounds, rather to the fresh than the older ones, and whatever other wound is inflamed or is about to be, and where there is danger of mortification, and to wounds and inflammations in the joints, and where there is danger of spasms supervening, and to wounds in the abdomen, and most of all to fractures in the head and thigh, and any other where a fracture may occur.
Ἑστάται δ’ ἕλκεσι ἥκιστα ξυμφέρει, καὶ ἄλλως ἢν ἐν τῷ σκέλεϊ ἔχῃ τὸ ἕλκος, οὐδὲ καθῆσθαι οὐδὲ πορεύεσθαι· ἀλλ’ ἡσυχίη καὶ ἀτρεμίη ξυμφέρει μάλιστα.
Standing is least beneficial to wounds, especially if the wound is in the leg, nor sitting nor walking; but rest and quietness are most beneficial.
Τὰ δὲ νεότρωτα ἕλκεα πάντα ἥκιστα ἂν φλεγμήναιεν αὐτά τε καὶ τὰ περιέχοντα, εἴ τις διαπυΐσκοι ὡς τάχιστα, καὶ τὸ πῦον μὴ ἀπολαμβανόμενον ἀπὸ τοῦ ἕλκεος τοῦ στόματος ἴσχοιτο, ἢ εἴ τις ἀποτρέποι ὅκως μηδὲ μελλήσει διαπυῆσαι πλὴν τοῦ ἀναγκαίου πύου ὀλιγίστου, ἀλλὰ ξηρὸν εἶναι ὡς μάλιστα φαρμάκῳ μὴ περισκελέϊ.
All fresh wounds would be least likely to inflame, both themselves and the surrounding parts, if one should bring them to suppuration as quickly as possible, and the pus is not shut up so as to be held back from the mouth of the wound, or if one should avert it so that it will not even tend to suppurate except for the necessary least amount of pus, but rather to be as dry as possible with a medicine that is not too harsh.
Πυρῶδες γὰρ γίνεται, ἐπὴν φρίκη ἐγγένηται καὶ σφυγμός· φλεγμαίνει γὰρ τὰ ἕλκεα τότε, ὁκόταν διαπυῆσαι μέλλῃ· διαπυεῖ δὲ, ἀλλοιουμένου τοῦ αἵματος καὶ θερμανθέντος, ἕως σαπὲν πῦον γένηται.
For it becomes burning hot when shivering and throbbing supervene; for wounds inflame at that time when they are about to suppurate; and it suppurates when the blood is altered and heated, until it putrefies and becomes pus.
Τῶν τοιούτων ἑλκέων, ὅταν δοκέῃ δεῖσθαι καταπλάσιος, οὐ χρὴ αὐτὸ τὸ ἕλκος καταπλάσσειν, ἀλλὰ τὰ περιέχοντα, ὅκως τὸ πῦον ἀποχωρέῃ, καὶ τὰ σκληρυνόμενα μαλαχθῇ.
Of such wounds, when it seems to need a plaster, one should not apply the plaster to the wound itself, but to the surrounding parts, so that the pus may escape and the hardened parts may be softened.
Τῶν δὲ ἑλκέων, ὅπερ μὲν ἂν ὀξέϊ βέλεϊ διατμηθῇ ἢ διακοπῇ, ἐνδέχεται ἔναιμον φάρμακον καὶ τὸ κωλῦον διαπυεῖν ἀναξηραῖνόν τι.
Of the wounds, whichever is cut through or cut open by a sharp weapon, it admits of a blood-stopping medicine and something which prevents suppuration by drying it up.
Ἥ τις δ’ ὑπὸ τοῦ βέλεος ἐφλάσθη καὶ ἐκόπη σὰρξ, ταύτην δὲ ἰητρεύειν, ὅκως διάπυος ὡς τάχιστα γένηται· ἧσσόν τε γὰρ φλεγμαίνει· καὶ ἀνάγκη τὰς σάρκας τὰς φλασθείσας καὶ κοπείσας σαπείσας καὶ πῦον γενομένας ἐκτακῆναι, ἔπειτα βλαστάνειν νέας σάρκας.
But whatever flesh has been bruised and cut by the weapon, this must be treated so that it may suppurate as quickly as possible; for it inflames less; and it is necessary that the bruised and cut flesh should putrefy, become pus, melt away, and then new flesh should grow.
§22.
2.
Ἕλκεϊ νεοτρώτῳ παντὶ, πλὴν ἐν κοιλίῃ, ξυμφέρει ἐκ τοῦ τρώματος αἷμα ῥυῆναι αὐτίκα πλέον ἢ ἔλασσον· φλεγμαίνει γὰρ ἧσσον αὐτὸ τὸ ἕλκος καὶ τὰ περιέχοντα.
For every fresh wound, except in the abdomen, it is beneficial for more or less blood to flow from the wound immediately; for the wound itself and the surrounding parts inflame less.
Καὶ ἀπὸ τῶν πεπαλαιωμένων ἑλκέων ξυμφέρει αἷμα ποιέειν ἀποῤῥέειν πυκνὰ, ὅκως ἂν δοκέῃ καιρὸς εἶναι, καὶ ἀπ’ αὐτῶν τῶν ἑλκέων καὶ τῶν περιεχόντων τὸ ἕλκος, ἄλλως τε καὶ ἢν ἐν κνήμῃ ἔῃ τὸ ἕλκος ἢ ἐν δακτύλῳ ποδὸς ἢ χειρὸς, μᾶλλον ἤ κου ἄλλοθι τοῦ σώματος· γίνεται γὰρ, ἀποῤῥέοντος τοῦ αἵματος, ξηρότερα καὶ μείονα ἰσχναινόμενα· κωλύει γὰρ μάλιστα μὲν τὰ τοιαῦτα ἕλκεα ὑγιαίνεσθαι, ἔπειτα δὲ καὶ τἄλλα ξύμπαντα αἵματος σηπεδὼν, καὶ ὅ τι ἐξ αἵματος μεταστάσιος γεγένηται.
And from old wounds it is beneficial to cause blood to flow frequently, when it seems to be the proper time, both from the wounds themselves and the parts surrounding the wound, especially if the wound is in the leg or in a toe or finger, rather than anywhere else in the body; for when the blood flows, they become drier and smaller as they are reduced; for the putrefaction of the blood, and whatever occurs from the congestion of blood, most of all prevents such wounds from healing, and then indeed all other wounds.
Ξυμφέρει δὲ μετὰ τὴν τοῦ αἵματος ἀποῤῥοὴν ἐπὶ τῶν τοιούτων ἑλκέων καὶ σπόγγον ἐπιδεῖν πυκνὸν καὶ μαλθακὸν, τετμημένον, ξηρότερον ἢ ὑγρότερον, καὶ ἐπὶ τῷ σπόγγῳ ἄνωθεν φύλλα συχνὰ τίθεσθαι.
It is beneficial, after the flow of blood, to bind a thick and soft sponge upon such wounds, cut to size, drier rather than wetter, and to place many leaves on top over the sponge.
Ἔλαιον δὲ καὶ ὅσα μαλθακώδεα ἢ ἐλαιώδεά ἐστι φάρμακα, οὐ ξυμφέρει τοῖσι τοιούτοισιν ἕλκεσιν, ἢν μὴ πάνυ ἤδη πρὸς ὑγιείην τείνῃ.
Olive oil and all medicines that are softening or oily are not beneficial to such wounds, unless they already tend entirely towards healing.
Οὐδὲ τοῖσι νεοτρώτοισιν ἕλκεσι ξυμφέρει ἔλαιον, οὐδὲ μαλθακώδεα οὐδὲ στεατώδεα φάρμακα, ἄλλως τε καὶ ὅ τι ἂν δέηται ἕλκος πλείονος καθάρσιος· τὸ δὲ ξύμπαν εἰπεῖν, ἐλαίῳ τὴν χρῆσιν ποιέεσθαι καὶ ἐν θέρει καὶ ἐν χειμῶνι, πρὸς ἃ τῶν τοιούτων φαρμάκων δεόμεθα.
Nor is olive oil beneficial to fresh wounds, nor softening nor fatty medicines, especially when the wound needs more cleansing; to speak generally, one should make use of olive oil both in summer and winter for those purposes for which we need such medicines.
§33.
3.
Ὑποκάθαρσις τῆς κάτω κοιλίης ξυμφέρει τοῖσι πλείστοισι τῶν ἑλκέων καὶ ἐν τρώμασιν ἐν κεφαλῇ ἐοῦσι, καὶ ἐν κοιλίῃ, καὶ ἐν ἄρθροισι, καὶ ὅσα σφακελίσαι κίνδυνος, καὶ ὅσα ῥαπτὰ, καὶ τοῖσιν ἐσθιομένοισι καὶ ἑρπυστικοῖσι, καὶ τοῖσιν ἄλλως πεπαλαιωμένοισιν ἕλκεσι, καὶ ὅκη ἂν μέλλῃ ἐπιδεῖν.
A gentle purging of the lower abdomen is beneficial for most wounds, both in injuries of the head, in the abdomen, in the joints, and those where there is danger of mortification, and those that are sutured, and those that are eating and creeping, and other old wounds, and wherever one is about to apply a bandage.
§44.
4.
Οὐ χρὴ οὐδ’ ἐμπλάσσειν τὰ φάρμακα, πρὶν ἂν πάνυ ξηρὸν ποιήσῃς τὸ ἕλκος· τότε δὲ δεῖ προστιθέναι, ἀνασπογγίζειν δὲ τὸ ἕλκος πολλάκις σπόγγῳ, καὶ αὖθις ὀθόνιον ξηρὸν καὶ καθαρὸν προσίσχων πολλάκις, οὕτω δὲ ἐπιθεὶς τὸ φάρμακον τὸ δοκέον ξυμφέρειν, ἐπιδεῖν ἢ μὴ ἐπιδεῖν.
One must not apply medicines until you have made the wound completely dry; then one must apply them, sponging the wound many times with a sponge, and again applying a dry and clean linen cloth many times, and having thus applied the medicine which seems beneficial, bind it up or do not bind it up.
§55.
5.
Ἕλκεσι τοῖσι πλείστοισιν ὥρη ἡ θερμοτέρη ξυμφορωτέρη τοῦ χειμῶνος, πλὴν τοῖσιν ἐν κεφαλῇ καὶ κοιλίῃ, μᾶλλον δὲ ἡ ἰσημερινή.
For most wounds, the warmer season is more beneficial than winter, except for those in the head and abdomen, and rather the equinoctial season.

Notes

  1. 1Ἕλκεα ξύμπαντα οὐ χρὴ τέγγειν, πλὴν οἴνῳ, ἢν μὴ ἐν ἄρθρῳ ἔῃ τὸ ἕλκος — Here, 'πλήν' functions as a conjunction rather than a preposition, introducing an exception ('except with wine') to the preceding 'οὐ χρὴ τέγγειν'. The subsequent 'ἢν μὴ...' introduces a further exception to this exception ('unless the wound is in a joint'—meaning joints should not be wetted even with wine), creating a double conditional restriction.
  2. 1Ἑστάται — The word 'Ἑστάται' is the Ionic form of the perfect active infinitive 'ἑστάναι' (to stand), functioning substantively here as the subject of the sentence ('standing').
  3. 1Ἥ τις δ’ ὑπὸ τοῦ βέλεος ἐφλάσθη καὶ ἐκόπη σὰρξ, ταύτην δὲ ἰητρεύειν — The antecedent 'σάρξ' is attracted into the relative clause 'ἥ τις...', and is picked up in the main clause by the demonstrative pronoun 'ταύτην'. The main verb 'ἰητρεύειν' is an infinitive used in an imperative sense (imperative infinitive).
  4. 2ὅτι ἂν δέηται ἕλκος πλείονος καθάρσιος — The relative pronoun 'ὅστις' (neuter 'ὅ τι') is followed by 'ἄν' + subjunctive 'δέηται', forming a conditional relative clause ('whatever... may need'). The verb 'δέομαι' takes the genitive case, here governing 'πλείονος καθάρσιος' (comparative genitive + Ionic genitive singular form).

Cite this passage

Hippocrates, On Ulcers §1-5. Humanitext Reader, https://reader.humanitext.ai/en/text/urn:cts:greekLit:tlg0627.tlg028.humanitext-grc1:1-5

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