§88.
8.
Τὰς δὲ ἐπὶ τῶν βραχιόνων φλέβας τῇσι καταλήψεσι χρὴ φυλάσσειν· ἡ γὰρ καλύπτουσα σὰρξ πολλοῖς οὐ καλῶς συνήρμοσται τῇ φλεβί·
One must guard the veins in the arms during compression; for in many people the covering flesh is not well joined with the vein.
τῆς γὰρ σαρκὸς ὀλισθηρῆς οὔσης, οὐ καθ’ ἑαυτὰς ξυμβαίνει τὰς τομὰς ἀμφοτέρων γίνεσθαι· τὴν γὰρ φλέβα ἐκφυσᾶσθαι ξυμβαίνει καλυφθεῖσαν, καὶ τὴν ῥύσιν τοῦ αἵματος κωλύεσθαι, πολλοῖσι δὲ καὶ πῦος διὰ τοῦτο ξυνίστασθαι·
For since the flesh is slippery, it does not happen that the incisions of both occur in alignment with each other; for it happens that the vein, having been covered, swells up, and the flow of blood is prevented, and because of this pus collects in many people.
δοκεῖ δὴ δύο βλάβας φέρειν ἡ τοιαύτη χειρουργίη, τῷ μὲν τμηθέντι πόνον, τῷ δὲ τέμνοντι πολλὴν ἀδοξίην·
Indeed, such a surgical operation seems to bring two harms: pain to the one who is cut, and great disrepute to the one who cuts.
τὸ δ’ αὐτὸ κατὰ πασῶν παρήγγελται γίνεσθαι.
And the same has been recommended to be done in all cases.
§99.
9.
Τὰ μὲν οὖν κατ’ ἰητρεῖον ἀναγκαῖα ὄργανα, καὶ περὶ ἃ δεῖ τεχνικὸν εἶναι τὸν μανθάνοντα, ταῦτ’ ἐστίν· ὀδοντάγρῃσι γὰρ καὶ σταφυλάγρῃσι χρῆσθαι τὸν τυχόντα ἐστίν· ἁπλῆ γὰρ ἡ χρῆσις αὐτῶν εἶναι δοκεῖ.
These, then, are the necessary instruments in the clinic, and those in which the learner must be skilled; for using tooth-forceps and uvula-forceps is within the reach of anyone, since their use seems to be simple.
§1010.
10.
Περὶ δὲ φυμάτων καὶ ἑλκέων, ὁκόσα μειζόνων ἐστὶ νοσημάτων, τὰ μὲν φύματα τεχνικώτατον ὑπειληφέναι δεῖ δύνασθαι διαλύειν, καὶ τὰς συστάσεις αὐτῶν κωλύειν·
Concerning tumors and ulcers, as many as belong to major diseases, one must consider it the most highly skilled part to be able to disperse the tumors and to prevent their formation.
ἐχόμενον δὲ τουτέων, στέλλειν εἰς τὸν ἐπιφανῆ τόπον ὡς εἰς βραχύτατον, καὶ τὴν σύστασιν ὁμαλῶς διὰ παντὸς ποιεῖσθαι τοῦ φύματος· ἀνωμάλως γὰρ ἔχοντος αὐτοῦ, ῥαγῆναί τε καὶ δυσθεράπευτον τὸ ἕλκος κίνδυνός ἐστι γενέσθαι·
Next to this, one must reduce them to as small an area on the surface as possible, and make the formation uniform throughout the entire tumor; for if it is uneven, there is a danger that the ulcer will rupture and become difficult to treat.
ἐξομαλίζειν τε χρὴ πέσσοντα πανομοίως, καὶ μήτε διαιρεῖν πρότερον μήτε αὐτόματον ἐῇν ῥαγῆναι·
One must make it even while bringing it to maturity uniformly, and neither make an incision beforehand nor allow it to rupture spontaneously.
τὰ δὲ ἐκπέψαι δυνάμενα ὁμαλῶς ἐν ἑτέροις εἴρηται.
The things that are able to bring them to maturity uniformly have been discussed in other writings.
§1111.
11.
Τὰ δὲ ἕλκεα δοκεῖ πορείας ἔχειν τέσσαρας, μίαν μὲν ἐς βάθος· ταῦτα δ’ ἔστι τὰ συριγγώδη καὶ ὅσα ὕπουλά ἐστι, καὶ ἔνδοθεν κεκοιλασμένα·
But ulcers seem to have four courses: one into depth; these are the fistulous ones and those which are festering underneath, and hollowed out from within.
ἡ δ’ ἑτέρη εἰς ὕψος, τὰ ὑπερσαρκεῦντα·
The second is into height, those with excessive growth of flesh.
τρίτη δέ ἐστιν εἰς πλάτος· ταῦτα δέ ἐστι τὰ καλεόμενα ἑρπηστικά·
The third is into breadth; these are those called herpetic.
τετάρτη ὁδός ἐστιν [ἐς ξύμφυσιν]· αὕτη δὲ μόνη κατὰ φύσιν εἶναι δοκέει κίνησις.
The fourth course is toward healing; this alone seems to be a movement according to nature.
Αὗται μὲν οὖν ξυμφοραὶ τοιαῦται σαρκός εἰσι· πᾶσαι δὲ κοιναὶ τοῦ ξυμφύοντος·
These, then, are such afflictions of the flesh, and all are common to that which heals.
καὶ τὰ μὲν τούτων ἐν ἑτέροις σημεῖα δεδήλωται, καὶ ᾗ χρηστέον ἐστὶν ἐπιμελείᾳ·
And the signs of these, and with what care one must treat them, have been shown in other writings.
δι’ ὧν δὲ τὸ ξυμφυόμενον διελεύσεται, καὶ τὸ πληρεύμενον, ἢ κοῖλον γενόμενον, ἢ τὴν εἰς πλάτος πορείαν ποιούμενον, προσηκόντως περὶ τουτέων ἐν ἄλλοις εἴρηται.
But through what stages that which heals will pass, and that which is filled up, or that which becomes hollow, or that which makes its course into breadth, has been appropriately spoken of in others.
§1212.
12.
Περὶ δὲ καταπλασμάτων ὧδε· τῶν ἐπιτιθεμένων ὀθονίων ὅκου ἂν ἡ χρῆσις κατὰ τοῦ νοσεύματος ἀκριβὴς εἶναι δοκέῃ, [καὶ] τῷ ἕλκει ἁρμόζου τὸ ἐπιτιθέμενον ὀθόνιον, τῷ δὲ καταπλάσματι πρὸς τὸν κύκλῳ τόπον τοῦ ἕλκεος χρῶ·
Concerning poultices, it is as follows: where the use of the applied linen cloths seems to be precise against the disease, adapt the applied linen cloth to the ulcer, and use the poultice for the area around the ulcer.
χρῆσις γὰρ αὕτη καταπλάσματός ἐστιν ἔντεχνός τε καὶ πλεῖστα ὠφελεῖν δυναμένη· ἐδόκει γὰρ τῷ μὲν ἕλκει βοηθεῖν ἡ τῶν περιτιθεμένων δύναμις, τὸ δ’ ὀθόνιον φυλάσσειν· τὰ δ’ ἔξω μὲν τοῦ ἕλκεος τὸ κατάπλασμα ὠφελέει.
For this use of a poultice is skillful and capable of bringing the greatest benefit; for the power of the surrounding applications seems to help the ulcer, and the linen cloth protects it, while the poultice benefits the parts outside the ulcer.
Τὴν μὲν οὖν χρῆσιν αὐτέων εἶναι δεῖ τοιαύτην.
Therefore, their use must be of this kind.
§1313.
13.
Περὶ δὲ καιρῶν, ὁκότε τούτοις ἑκάστοις χρηστέον ἐστὶ, καὶ τὰς δυνάμιας ὡς χρὴ τῶν γεγραμμένων καταμανθάνειν, παραλέλειπται δὲ τὰ τοιαῦτα, ἐπεὶ πλεῖον προῆκται τῆς κατ’ ἰητρικὴν ἐπιμελείας καὶ πόῤῥω τοῦ τῆς τέχνης ἤδη προεληλυθότος ἐστίν.
Concerning the seasons, when each of these must be used, and how one must understand the powers of what has been written, such things have been omitted, since they have advanced beyond medical care and are already far ahead of the technical skill.
§1414.
14.
Ἐχόμενον δὲ τούτων ἐστὶ καὶ κατὰ στρατιὴν γινομένων τρωμάτων χειρουργίη περὶ τὴν ἐξαίρεσιν τῶν βελέων.
Next to these is the surgery concerning the extraction of missiles from wounds that occur in military campaigns.
Ἐν τῇσι κατὰ πτόλιν διατριβῇσι βραχεῖά τίς ἐστι τουτέων ἡ χρῆσις· ὀλιγάκις γὰρ ἐν παντὶ τῷ χρόνῳ γίνονται πολιτικαὶ στρατιαὶ καὶ πολεμικαί· ξυμβαίνει δὲ τὰ τοιαῦτα πλειστάκις καὶ ξυνεχέστατα περὶ τὰς ξενικὰς στρατιὰς γίνεσθαι.
In city life, their use is very small; for rarely in all time do civic and public armies occur, but such things happen most frequently and continuously in mercenary armies.
Τὸν μὲν οὖν μελλοντα χειρουργεῖν στρατεύεσθαι δεῖ καὶ παρηκολουθηκέναι στρατεύμασι ξενικοῖς· οὕτω γὰρ ἂν εἴη γεγυμνασμένος πρὸς ταύτην τὴν χρείαν.
Therefore, the one who is going to practice surgery must go to war and accompany mercenary armies; for thus he would be trained for this service.
Ὃ δὲ εἶναι δοκεῖ περὶ ταῦτα τεχνικώτερον, εἰρήσεται· τῶν γὰρ ὅπλων ἐνόντων καὶ σημεῖα πεπορίσθαι τέχνης ἐστὶ πλεῖστον μέρος καὶ τῆς πρὸς ταῦτα χειρουργίης· τούτου γὰρ ὑπάρξαντος, οὐκ ἂν παραλίποιτο τρωματίας ἀγνοηθεὶς ὅταν χειρουργῆται μὴ προσηκόντως· μόνος δ’ ἂν ὁ τῶν σημείων ἔμπειρος εἰκότως ἐπιχειροίη.
What seems to be more highly technical concerning these things will be stated: for when weapons are in the body, to have provided oneself with signs is the greatest part of the art and of the surgery for these cases; for if this is present, a wounded man would not be overlooked and neglected when he is operated on inappropriately; and only the one experienced in the signs would naturally undertake it.
Περὶ δὲ τουτέων ἁπάντων ἐν ἑτέροις γεγραμμένον ἐστίν.
Concerning all these things, it has been written in other places.