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Hippocrates · On Ulcers §6-11

Obstacles to Healing and Treatments for Swelling

Passage 2 of 6 · Greek

Summary

The text discusses the formation of proud flesh due to incomplete cleansing, depressed scars from bone exfoliation, obstacles to wound closure such as inflammation or varicose veins, and treatments for swellings including incision, bandaging, and various herbal plaster recipes.

§66.
6.
Τὰ ἕλκεα ὁκόσα μὴ καλῶς καθαρθέντα ἐς τὸ δέον ἀεὶ πρότερον ἄρξεται βλαστάνειν, ταῦτα ὑπερσαρκέει μάλιστα· ὁκόσα δ’ ἂν καθαρθέντα καλῶς τε καὶ ἐς τὸ δέον ἀεὶ ἐπὶ τὸ ξηρότερον θεραπεύηται, πλὴν εἰ θλασθῇ, ταῦτα δὲ οὐχ ὑπερσαρκέει ὡς ἐπὶ τὸ πουλύ.
As for wounds, such as are not properly cleansed, and always begin to grow new flesh too soon before it is fit, these most of all produce proud flesh; but such as are cleansed well and properly, and are always treated in a way to make them drier, except if they are bruised, these for the most part do not produce proud flesh.
§77.
7.
Ἢν ὁκοθενοῦν ὀστέον ἀφιστῆται ἢ καυθὲν ἢ πρισθὲν ἢ ἄλλῳ τῳ τρόπῳ, τῶν ἑλκέων τούτων αἱ οὐλαὶ κοιλότεραι γίνονται.
If a bone exfoliates from any part, whether having been burned, or sawed, or in any other way, the scars of these wounds become more depressed.
§88.
8.
Ἕλκεα οὐ κεκαθαρμένα οὐκ ἐθέλει ξυνιέναι ξυναγόμενα, οὐδ’ αὐτόματα ξυνέρχεται.
Wounds which are not cleansed do not tend to close when brought together, nor do they close of their own accord.
Ὧν τὰ περιέχοντα φλεγμαίνει τοῦ ἕλκεος, ἔστ’ ἂν μὴ παύσηται τῆς φλεγμασίης, οὐκ ἐθέλει ξυνιέναι· οὐδὲ ὧν τὰ περιέχοντα τοῦ ἕλκεος μελανθῇ αἵματος σηπεδόνι, ἢ καὶ κιρσοῦ παρέχοντος τὴν ἐπιῤῥοὴν τοῦ αἵματος, οὐδὲ ταῦτα ἐθέλει ξυνιέναι, ἢν μὴ τὰ περιέχοντα τοῦ ἕλκεος ὑγιέα ποιήσῃς.
Of wounds, those of which the surrounding parts are inflamed do not tend to close until the inflammation has ceased; nor do those of which the surrounding parts of the wound are blackened by the putrefaction of the blood, or where a varicose vein causes an influx of blood, even these do not tend to close, unless you make the surrounding parts of the wound healthy.
Τῶν ἑλκέων τὰ κυκλοτερέα ἢν ὑπόκοιλα ᾖ, ἐν κύκλῳ πάντη ἐπιτάμνειν χρὴ τὰ ἀφεστεῶτα, ἢ πάντα, ἢ τὰ ἡμίσεα τοῦ κύκλου, κατὰ μῆκος τῆς φύσιος τοῦ ἀνθρώπου.
If circular wounds are hollowed out, one should make incisions all around the detached edges, either the whole circle or half of the circle, along the length of the natural direction of the human body.
§99.
9.
Ἐπὶ παντὶ ἕλκεϊ ἐρυσιπέλατος ἐπιγενομένου, κάθαρσιν δεῖ ποιέεσθαι τοῦ σώματος, ἐφ’ ὁκότερα ἂν ξυμφέρῃ τῷ ἕλκεϊ, εἴτε ἄνω, εἴτε κάτω.
Upon any wound, if erysipelas supervenes, one must purge the body in whichever direction may be beneficial for the wound, whether upwards or downwards.
§1010.
10.
Ὅτῳ ἂν οἴδημα γένηται παρὰ τὸ ἕλκος, ἀφλεγμάντου ἐόντος τοῦ ἕλκεος, χρόνῳ ὕστερον πύου ὑπόστασιν ἴσχει τὸ οἴδημα.
In any case where a swelling occurs near the wound, while the wound itself is free from inflammation, after some time the swelling becomes suppurated.
Καὶ ὅ τι ἂν τῇ φλεγμασίῃ οἰδῆσαν μὴ καθιστῆται, τῶν ἄλλων καθισταμένων, ὅσα ἅμα ἤρξατο φλεγμαίνειν καὶ οἰδίσκεσθαι, καὶ τοῦτο κίνδυνος μηδ’ ἅμα ξυνιέναι.
And if any part swollen by inflammation does not subside, while the other parts which began to inflame and swell at the same time are subsiding, there is a danger that this part also will not close at the same time.
Ὅσα δὲ πιπτόντων ἢ ἄλλῳ τῳ τρόπῳ διακόπτεται καὶ φλᾶται, καὶ ἀνοιδίσκεται τὰ περιέχοντα τὸ ἕλκος, καὶ, διαπυήσαντα, πῦον ἀπὸ τῶν οἰδημάτων ἀποχωρέει κατὰ τὸ ἕλκος, τῶν τοιούτων ὅ τι ἂν δοκέῃ δεῖσθαι καταπλάσιος, οὐ χρὴ αὐτὸ τὸ ἕλκος καταπλάσσειν, ἀλλὰ τὰ περιέχοντα, ὅκως τὸ πῦον ἀποχωρέῃ, καὶ τὰ σκληρυνόμενα λαπαχθῇ ἐπειδὰν δὲ λαπαχθῇ, καὶ ἡ φλεγμασίη παύσηται, ἐπὶ τὰ ἀφεστηκότα σπόγγους ἐπιδέων προσιστάναι, ἀρχόμενος ἀπὸ τοῦ ὑγίεος ὀλίγον προσχωρέων· ἐπὶ δὲ τῷ σπόγγῳ ἄνωθεν φύλλα ἐπέστω συχνά.
When parts are cut and bruised by falls or in any other way, and the parts surrounding the wound swell, and, having suppurated, pus flows from the swellings towards the wound, of such cases, whichever seems to require a plaster, one must 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. But when they are softened, and the inflammation has ceased, one should apply sponges with bandages to the detached parts to make them adhere, beginning from the healthy part and advancing slightly; and over the sponge let many leaves be placed on top.
Ὅ τι δ’ ἂν μὴ δύνηται προστῆναι, ἡ σὰρξ ὑγρὴ ἐοῦσα αἰτίη ἐστίν· ταύτην ἐκβάλλειν.
If any part cannot be made to adhere, the cause is that the flesh is wet; this must be cut away.
Ἢν ὑπὸ βαθείῃ σαρκὶ τὸ ἕλκος ἔῃ, κατ’ ἄμφω κἀκ τῆς ἐπιδέσιος κἀκ τοῦ προσπιέζοντος ὑποκιρσοῦται· τὸ δὴ τοιοῦτον ἤν τις τάμνῃ, πρὸς μήλην, ἢν ἐνδέχηται, εὔροον ἀπὸ τοῦ στόματος τὸ ἕλκος ἀνατάμνειν, ὅπη ἂν δοκέῃ καιρὸς εἶναι, καὶ οὕτως ἰητρείην προσφέρειν, ὁκοίης ἂν δοκέῃ προσδεῖσθαι.
If the wound is under deep flesh, it becomes varicose both from the bandaging and from the pressure of the parts; if one makes an incision in such a case, one should, if possible, cut open the wound along a probe, to make a free flow from the mouth of the wound, wherever it seems to be the proper time, and then apply such treatment as seems to be required.
Ὡς δὲ τὰ πολλὰ ἐπὶ παντὶ ἕλκει, ὅ τι ἂν κοιλίην ἔχῃ πρὸς τὸ ἰθὺ, καταφανὲς ἰδεῖν, οἰδήματος μὴ προσεόντος· [ὅ τι δ’ ἂν κοιλίην ἔχῃ μὴ πρὸς τὸ ἰθὺ ἢ οἰδήματος προσεόντος,] ἢν μὲν ἔῃ ἐν αὐτῷ σηπεδὼν, ἢ ἡ σὰρξ ὑπέῃ μυδῶσα καὶ σαπρὴ, ἔσται τοῦτο τὸ ἕλκος καὶ τὰ περιέχοντα τὸ ἕλκος ἰδεῖν μέλανα ὑποπέλια· καὶ τῶν ἐσθιομένων ἑλκέων, ὅπη ἂν φαγέδαινα ἐνέῃ, ἰσχυρότατά τε νέμηται καὶ ἐσθίῃ, ταύτῃ τοῦ ἕλκεος τὸ περιέχον χροιὴν ἕξει μέλαιναν ὑποπέλιον.
For the most part, in every wound, whatever has a cavity leading straight inward is clearly visible, provided no swelling is present; [but whatever has a cavity not leading straight inward, or if a swelling is present,] if there is putrefaction in it, or if there is wet and rotten flesh beneath, this wound and the parts surrounding the wound will appear blackish-livid to the sight; and in eating wounds, wherever a phagedena is present, and spreads and eats most violently, there the surrounding part of the wound will have a blackish-livid color.
§1111.
11.
Καταπλάσματα οἰδημάτων καὶ φλεγμασίης τῆς ἐν τοῖσι περιέχουσιν· ἡ ἑφθὴ φλόμος, καὶ τῆς τριφύλλου τὰ φύλλα ὠμὰ, καὶ τοῦ ἐπιπέτρου τὰ φύλλα ἑφθὰ, καὶ τὸ πόλιον·
Plasters for swellings and inflammation in the surrounding parts: boiled mullein, the raw leaves of trefoil, the boiled leaves of stonecrop, and poly.
ἢν δὲ καὶ καθαίρεσθαι δέῃ τὸ ἕλκος, παντὰ μὲν καὶ ταῦτα καθαίρει· ἀτὰρ καὶ τῆς συκῆς τὰ φύλλα καὶ τῆς ἐλαίης, καὶ τὸ πράσιον.
If the wound also needs to be cleansed, all these have a cleansing effect; and also the leaves of the fig tree, of the olive, and horehound.
Ἕψειν δὲ ταῦτα πάντα, μάλιστα δὲ τούτων ἕψειν τὸν ἄγνον, καὶ τὴν συκῆν, καὶ τὴν ἐλαίην, καὶ τῆς σίδης τὰ φύλλα ὡσαύτως ἕψειν.
One should boil all these, and especially of these, the chaste tree, the fig tree, the olive, and the leaves of the pomegranate in like manner.
Ὠμοῖσι δὲ τοῖσίδε χρέεσθαι, τῆς μαλάχης τὰ φύλλα τρίβων ξὺν οἴνῳ, καὶ τοῦ πηγάνου τὰ φύλλα καὶ τῆς ὀριγάνου χλωρῆς· πᾶσι τούτοισι χρὴ τοῦ λίνου τὸν καρπὸν φρύξαντα καὶ κόψαντα ὡς λειότατον μιγνύναι.
And use these in a raw state: the leaves of mallow ground up with wine, and the leaves of rue, and fresh oregano; to all these one should mix the seed of flax having roasted and ground it as finely as possible.
Ὅκου δὲ ἐρυσίπελας κίνδυνος ἐφ’ ἕλκεσι γενέσθαι, τῆς ἰσάτιδος τὰ φύλλα τρίβων ὠμὰ καταπλάσσειν σὺν τῷ λίνῳ, ἢ τὸ λίνον δεύων στρύχνου χυλῷ ἢ ἰσάτιδος καταπλάσσειν.
Where there is a danger of erysipelas supervening on wounds, apply raw leaves of woad ground up as a plaster with linseed, or having soaked the linseed in the juice of nightshade or woad, apply it as a plaster.
Ὅταν δὲ τὸ ἕλκος καθαρὸν μὲν ἔῃ, φλεγμαίνῃ δὲ τό τε ἕλκος καὶ τὰ περιέχοντα τοῦ ἕλκεος, φακὸν ἐν οἴνῳ ἑψήσας καὶ τρίψας λεῖον, ἐλαίῳ ὀλίγῳ φυρήσας, καταπλάσας, ἐπιδεῖν· καὶ τοῦ κυνοσβάτου ἑψήσας τὰ φύλλα ἐν ὕδατι, τρίψας λεῖα, καταπλάσσειν, ὀθόνιον ὑποτείνας λεπτὸν καθαρὸν, οἴνῳ καὶ ἐλαίῳ τέγξας· καὶ ὅταν ξυνάγειν βούλῃ, τοῦ κυνοσβάτου τὰ φύλλα, ὥσπερ τὸν φακὸν σκευάζειν.
But when the wound is clean, but both the wound and the parts surrounding the wound are inflamed, boil lentils in wine, grind them smooth, mix with a little olive oil, apply as a plaster, and bind it up; and having boiled the leaves of dog-rose in water and ground them smooth, apply as a plaster, having laid a thin clean linen cloth underneath, wetted with wine and olive oil; and when you wish to close the wound, prepare the leaves of dog-rose in the same manner as the lentils.
Σαυρίδιον, οἶνος καὶ λίνου καρπὸς παραμίγνυται λεπτός· καὶ τόδε, ὁ τοῦ λίνου καρπὸς, καὶ ἄγνος ὠμὸς, καὶ μηλεία στυπτηρίη, ὄξει ταῦτα δευθέντα.
Sauridion, wine, and finely ground linseed are mixed together; and also this: linseed, raw chaste tree, and Melian alum, these being soaked in vinegar.

Notes

  1. 6πρότερον ἄρξεται βλαστάνειν — This indicates a temporal precedence: "always begin to grow flesh before (properly) cleansed." `πρότερον` expresses that the tissue regeneration starts before the cleansing process is fully completed.
  2. 8Ὧν τὰ περιέχοντα φλεγμαίνει τοῦ ἕλκεος — `ὧν` is a relative pronoun in the genitive case (partitive genitive), referring to the wounds ("of which..."). `τοῦ ἕλκεος` depends on `τὰ περιέχοντα` ("the surrounding parts of the wound").
  3. 10Ὅ τι δ’ ἂν μὴ δύνηται προστῆναι — A general conditional clause with the subjunctive. The verb `προστῆναι` is used in an intransitive sense (corresponding to the transitive `προσιστάναι` "to make adhere"), meaning "whatever part cannot be made to adhere."
  4. 11Ὠμοῖσι δὲ τοῖσίδε χρέεσθαι — An infinitive used as an imperative (imperative infinitive), expressing a direct instruction: "And use these in a raw state."

Cite this passage

Hippocrates, On Ulcers §6-11. Humanitext Reader, https://reader.humanitext.ai/en/text/urn:cts:greekLit:tlg0627.tlg028.humanitext-grc1:6-11

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