The bandage too for binding up a wound is best made of linen, and it should be so wide as to cover it in a single turn, not the wound alone but somewhat of its edges on either side. If the flesh has receded more from one edge, the traction is better made from that side. If equally from both, the bandage, put crosswise, should press the margins together; or if the character of the wound does not admit of that, the middle of the bandage is to be applied first, so that it may then be drawn to either side. Moreover, the wound is to be bandaged so that it is held together, yet not constricted. When it is not so held, it gapes; if it is constricted too much, there is a risk of canker. In winter there should be more turns of the bandage, in summer just those necessary; finally, the end of the bandage is to be stitched by means of a needle to the deeper turns; for a knot hurts the wound, unless, indeed, it is at a distance from it.
Fascia uero ad uulnus deligandum lintea aptissima est eaque lata esse debet, ut semel iniecta non uulnus tantum sed paululum utrimque etiam oras eius conprehendat. Si ab altera parte caro magis recessit, ab ea melius adtrahitur; si aeque ab utraque, transuersa conprehendere oras debet; aut si id uulneris ratio non patitur, media primum inicienda est, ut tum in utramque partem ducatur. Sic autem deliganda est, ut et contineat neque adstringat. Quod non continetur, elabitur: quod nimis adstrictum est, cancro periclitabitur. Hieme saepius fascia circumire debet, aestate quotiens necesse est; tum extrema pars eius inferioribus acu adsuenda est: nam nodus ulcus laedit, nisi tamen longe est. Illo neminem decipi decet, ut propriam uiscerum curationem requirat: de quibus supra posui.
On the following point no practitioner should be ignorant so that he has to enquire as to the special treatment required for the internal organs, which I have spoken of above. For whilst an external wound is to be treated either by suture, or by some sort of medicine; in the case of the internal organs, nothing is to be moved, unless it be to cut away some bit of liver or spleen or lung which hangs outside. Otherwise internal wounds will be cured by the regulation of diet, and by those medicaments which I have stated in the preceding book to suit each individual organ.
Nam plaga ipsa curanda extrinsecus uel sutura uel alio medicinae genere est: in uisceribus nihil mouendum est, nisi ut, si quid ex iocinere aut liene aut pulmone dumtaxat extremo dependet, praecidatur. Alioqui uolnus interius ea uictus ratio eaque medicamenta sanabunt, quae cuique uisceri conuenire superiore libro posui. His ita primo die ordinatis, homo lecto conlocandus est; isque, si graue uulnus est, abstinere, quantum uires patiuntur, ante inflammationem cibo debet: bibere, donec sitim finiat, aquam calidam;
So then, after this has been done on the first day, the patient is to be put to bed; if the wound is severe, before inflammation sets in, he should abstain from food, as far as his strength permits; he should drink warm water until his thirst is quenched; or, if it is summer and he has neither fever nor pain, even cold water. There is, however, in this no standing order, for always account has to be taken of the bodily strength, since weakness may render it necessary for him to take food even from the first, light of course and scanty, just enough to sustain him; and many who are actually fainting from loss of blood must, before any treatment, be resuscitated by wine, which in other cases is most inimical to a wound.
uel, si aestas est ac neque febris neque dolor est, etiam frigidam. Adeo tamen nihil perpetuum est, sed semper pro ui corporis aestimandum, ut inbecillitas etiam cibum protinus facere necessarium possit, tenuem scilicet ⟨et⟩ exiguum, qui tantum sustineat; multique etiam ex profluuio sanguinis intermorientes ante ullam curationem uino reficiendi sunt, quod alioqui inimicissimum uulneri est. Nimis uero intumescere uulnus periculosum; nihil intumescere periculosissimum est: illud indicium est magnae inflammationis, hoc emortui corporis. Protinusque, si mens homini consistit, si nulla febris accessit, scire licet mature uulnus sanum fore.
It is dangerous when a wound swells overmuch; no swelling at all is the worst danger: the former is an indication of severe inflammation; the latter that the part is dead. And from the first if the patient retains his senses, if no fever follows, we may recognize that the wound will soon heal. And even fever should not cause alarm in the case of a large wound, if it persists while there is inflammation. That fever is harmful which either supervenes upon a slight wound, or lasts beyond the inflammatory period, or excites delirium; or which does not put an end to the rigor or spasm of sinews which has originated from the wound. Also involuntary bilious vomiting either immediately after the injury, or during the inflammatory period, is a bad sign only when sinews or even the neighbourhood of sinews have been wounded. The induction of a vomit, however, is not inappropriate, especially in those habituated to it; provided that this is not done immediately after food, or just when the inflammation has arisen, or when the wound is situated in the upper part of the body.
Ac ne febris quidem terrere debet, si in magno uulnere, dum inflammatio est, permanet. Illa perniciosa est, quae uel leui uulneri superuenit, uel ultra tempus inflammationis durat, uel delirium mouet; uel, si neruorum rigor aut distentio, quae ex uulnere orta est, eam non finit. Vomitus quoque bilis non uoluntarius, uel protinus ut percussus est aliquis, uel dum inflammatio manet, malum signum est in is dumtaxat, quorum uel nerui, uel etiam neruosi loci uulnerati sunt. Sponte tamen uomere non alienum est, praecipue is, quibus in consuetudine fuit: sed neque protinus post cibum, neque iam inflammatione orta, neque cum in superioribus partibus plaga est. Biduo sic uulnere habito, tertio die id aperiundum, ⟨de⟩tergendaque sanies ex aqua frigida est, eademque rursus inicienda. Quinto iam die, quanta inflammatio futura est, se ostendit.
When the wound has been so treated for two days, on the third it should be uncovered, sanies washed away with cold water, and then the same dressing applied again. By the fifth day the extent of inflammation in prospect is apparent. And on that day, when the wound has been uncovered again, its colour must be considered. If it is livid or pallid or patchy or dusky, it can be recognized that the wound is a bad one, and whenever this is observed, it should alarm us. It is best for the wound to be white or rubicund; also if the skin is hardened, thickened, or painful, danger is indication. Good signs are for the skin to be thin and soft without pain. But if the wound is agglutinating or swollen slightly, the same dressings as at first are to be applied; if there is severe inflammation and no hope of agglutination, then such applications are to be made as promote suppuration. And now the use of hot water as well is a necessity, in order to disperse diseased matter and to soften hardening and bring out pus. The temperature of the water must be pleasant to the hand when put into it, and the affusion is to be continued until the swelling is seen to have diminished and a more natural colour to have returned to the wound. After this fomentation, if the wound is not gaping widely, a plaster should be put on at once, particularly that tetrapharmacum if it is a large wound; in the case of wounds of joints, fingers, cartilaginous places, the plaster rhypodes; if the wound gapes more widely, that same plaster should be liquefied by iris unguent, and lint smeared with this laid all over the wound; upon this put the plaster, and above that greasy wool. The bandages are to be even less tight than at first.
Quo die rursus detecto uulnere considerandus color est. Qui si liuidus aut pallidus aut uarius aut niger est, scire licet malum uulnus esse; idque quandocumque animaduersum est, terrere nos potest. Album aut rubicundum esse ulcus commodissimum est: item cutis dura, crassa, dolens periculum ostendit. Bona signa sunt, ubi haec sine dolore tenuis et mollis est. Sed si glutinatur uulnus aut leuiter intumuit, eadem sunt inponenda, quae primo fuerunt: si grauis inflammatio est neque glutinandi spes est, ea, quae pus moueant. Iamque aquae quoque calidae necessarius usus est, ⟨ut⟩ et materiam digerat et duritiam emolliat et pus citet. Ea sic temperanda est, ut manu contingenti iucunda sit, usque adeo adhibenda, donec aliquid ex tumore minuisse coloremque ulceri magis naturalem reddidisse uideatur. Post id fomentum, si lat⟨e⟩ plaga non patet, inponi protinus emplastrum debet,maximeque si grande uulnus est, tetrapharmacum; si in articulis, digitis, locis cartilaginosis, rhypodes: et si latius hiat, idem illud emplastrum liquari ex irino unguento oportet eoque inlita li⟨n⟩amenta disponi per plagam; deinde emplastrum supra dari, et super id sucidam lanam. Minusque etiam quam primo fasciae adstringendae sunt. Proprie quaedam in articulis uisenda sunt, in quibus, si praecisi nerui sunt, qui continebant, debilitas eius partis sequitur. Si id dubium est, et ex acuto telo plaga est, ea transuersa commodior est;
As to joints, there are certain special points to be noticed as, if the controlling sinews have been divided, weakness of the part concerned follows. If this is in doubt, and the wound has been made by a sharp weapon, a transverse wound is the more favourable; if by a blunt and heavy weapon, the shape of the wound makes no difference. But it is to be observed whether pus is being formed above the joint or beneath. If it is produced underneath, and thick and white discharge continues for some time, it is probable that a sinew has been cut, and the more so the greater the pains and inflammation, and the earlier these occur. But even though no sinew is divided, yet, if a hard swelling persists for a long while round about, the wound will last a long time and even after healing a swelling will persists; and in future that limb will be bent or stretched out slowly. There is, however, more delay in extending a limb which has been kept bent while treated, than in bending a limb which has been kept straight. Also there should be a definite rule as to position for a limb which has been wounded. If the wound is seem to be agglutinated, the limb is kept raised; it must not be bent either way if there is still inflammation; if pus is already being discharged it should be hanging down. The best medicament too is rest; movement and walking before healing are adverse. The danger, however, from movement is less for wounds of the head and arms than for the lower limbs. Walking about is least of all suited to an injured thigh or leg or foot. The patient's room should be kept warm. Bathing, too, while the wound is not yet clean, is one of the worst things to do; for this makes the wound both wet and dirty, and then there is a tendency for gangrene to occur. It is advantageous to apply light rubbing, but in those parts which are rather far away from the wound.
si retuso et graui, nullum in figura discrimen est. Sed uidendum est, pus supra articulum an infra nascatur. Si sub eo nascitur albumque et crassum diu fertur, neruum praecisum credibile est, magisque quo maiores dolores inflammationesque et quo maturius excitatae sunt. Quamuis autem non abscisus neruus est, tamen si circa tumor durus diu permanet, necesse est et diuturnum ulcus esse et sano quoque eo tumorem permanere; futurumque est ut tarde membrum id uel extendatur uel contrahatur. Maior tamen in extendendo mora est, ubi recuruato curatio adhibita est, quam in recuruando eo, quod rectum continuerimus. Conlocari quoque membrum quod ictum est ratione certa debet. Si glutinandum est, ut superius sit: si in inflammationibus est, ut in neutram partem inclinatum sit: si iam pus profluit, ut deuexum sit. Optimum etiam medicamentum quies est: moueri, ambulare nisi sanis alienum est. Minus tamen is periculosum, qui in capite uel brachiis quam qui in inferioribus partibus uulnerati sunt. Minimeque ambulatio conuenit femine aut crure aut pede laborante. Locus, in quo cubabit, tepidus esse debebit. Balneum quoque, dum parum uulnus purum est, inter res infestissimas est: nam id et umidum et sordidum reddit, ex quibus ad cancrum transitus esse consueuit. Leuis frictio recte adhibetur, sed is partibus, quae longius absunt a uulnere. Inflammatione finita uulnus purgandum est. Et id optime faciunt tincta in melle li⟨n⟩amenta, supraque idem emplastrum uel enneapharmacum dandum est. Tum demum uero purum ulcus est, cum rubet, ac nimium neque siccum neque umidum est.
When the inflammation has ended, the wound must be cleaned. And that is best done by putting on lint soaked in honey, and over it the plaster called tetrapharmacum or that called enneapharmacum. Then at length the wound is really clean when it is red, and neither too dry nor too moist. But a wound is not clean when it lacks sensation, when there is sensation which is not natural, when it is either too dry or too wet, when it is either whitish or pallid or livid or blackish.
At quodcumque sensu caret, quod non naturaliter sen⟨t⟩it, quod nimium aut aridum aut umidum est, quod aut albidum aut pallidum aut liuidum aut nigrum est, id purum non est. Purgato, sequitur ut impleatur; iamque calida aqua eatenus necessaria est, ut sanies remoueatur. Lanae sucidae superuacuus usus est: lota melius circumdatur.
When the wound is clean, there follows the growth of new flesh; and now warm water is necessary in order to remove sanies. The use of unscoured wool is superfluous; scoured wool is the better wrapping. But for filling up a wound certain medicaments also are useful; therefore it is not inappropriate to make use of such things as butter with rose-oil and a little honey; or the tetrapharmacum with the said rose-oil, or lint soaked in rose-oil. More beneficial, however, is an occasional bath, a nourishing diet, while avoiding everything acrid, but now somewhat fuller, for both poultry and venison and boiled pork can be given. In all cases, while fever and inflammation are present, wine is inappropriate; also, until the scar is formed, if either sinews or muscles have been wounded; or even if there is a deep flesh wound. But when the wound is of the safer kind, only skin deep, wine if not too old, given in moderation, can even aid the growth of flesh. If any part is to be softened, which is necessary in the region of sinews and muscles, cerate also is to be used upon the wound. But if flesh fungates, dry lint is a moderate repressant, copper scales a more active one. If more fungation needs to be removed the still more active corrosives are to be employed. After all such applications, lycium dissolved in raisin wine or in milk, or even only an application of dry lint, is useful in inducing a scar.
Ad implendum autem uulnus proficiunt quidem etiam medicamenta aliqua: itaque ea adhiberi non alienum est, ut buturum cum rosa et exigua mellis parte; aut cum eadem rosa tetrapharmacum; aut ex rosa li⟨n⟩amenta. Plus tamen proficit balneum rarum, cibi boni suci, uitatis omnibus acribus, sed iam pleniores: nam et auis et uenatio et suilla elixa dari potest. Vinum omnibus, dum febris, inflammatio inest, alienum est: itemque usque cicatricem, si nerui musculiue uulnerati sunt; etiam, si alte caro. At si plaga in summa cute generis tutioris est, potest non peruetus, modice tamen datum, ad implendum quoque proficere. Si quid molliendum est, quod in neruosis locis musculosisque necessarium est, cerato quoque super uulnus utendum est. At si caro supercreuit, modice reprimit siccum lin⟨a⟩mentum, uehementius squama aeris. Si plus est, quod tolli opus est, adhibenda sunt etiamnum uehementiora, quae corpus exedunt. Cicatricem post omnia haec commode inducit Lycium ex passo aut lacte dilutum, uel etiam per se impositum siccum lin⟨a⟩mentum. Hic ordo felicis curationis est. Sed quaedam tamen periculosa incidere consuerunt: interdum enim uetustas ulcus occupat, induciturque ei callus, et circum orae crassae liuent;
Such is the procedure of a successful treatment; dangerous complications, however, are wont to occur. Sometimes the wound becomes the seat of chronic ulceration, and it becomes hardened, and the thickened margins are a livid colour; after which whatever medicament is applied is of little service; and this commonly occurs when the wound has been carelessly treated. At times, whether owing to excess of inflammation, or to unusually hot weather, or to excessively cold weather, of because the wound has been bandaged too tightly, or on account of old age, or of a bad habit of body, canker sets in. The Greeks divided this genus into species for which there are no terms in our language.
post quae quicquid medicamentorum ingeritur, parum proficit; quod fere neglegenter ⟨curato ulceri superuenit. Inter⟩dum uel ex nimia inflammatione, uel ob aestus inmodicos, uel ob nimia frigora, uel quia nimis uulnus adstrictum est, uel quia corpus aut senile aut mali habitus est, cancer occupat. Id genus a Graecis diductum in species est, nostris uocabulis non est. Omnis autem cancer non solum id corrumpit, quod occupauit, sed etiam serpit; deinde aliis aliisque signis discernitur. Nam modo super inflammationem rubor ulcus ambit, isque cum dolore procedit (erysipelas Graeci nominant);
Now canker, whatever its species, corrupts not only the part it attacks, but it also spreads; next it is distinguished by differing signs. For sometimes a redness, over and above the inflammation, surrounds the wound, and this spreads with pain (the Greeks term it erysipelas); at times the wound is black because its flesh has become corrupted, and this is still more intensified by putrefaction when the wound is moist, and from the black wound is discharged a pallid humour, which has a foul odour, and the granulations break down: at times also sinews and membranes undergo dissolution, and when a probe is introduced it passes to the side or downwards, and this lesion not infrequently affects the bone too; sometimes there arises what the Greeks call gangrene. The former varieties occur in any part of the body; gangrene in the extremities, that is, in the nails, armpits or groins, and generally in aged people or in those of a bad habit of body. The flesh in the wound becomes either black or livid, but dry and shrivelled; the skin near it is for the most part occupied by dusky pustules; then the skin around these becomes either pallid or livid, and usually wrinkled, deficient in sensation: farther away from the wound the skin is inflamed. All these things spread simultaneously, the ulceration into the pustules, the pustules into the pallid or livid part, that into the inflamed part, and that again into the sound flesh. Now together with the above an acute fever arises and great thirst: in some also delirium: others, although in their right minds, nevertheless stammer so that they can scarcely explain their feelings; the stomach begins to be affected: even the breath gets a foul odour. This disorder at its commencement admits of treatment; but when thoroughly established it is incurable, and most patients die in a cold sweat.
modo ulcus nigrum est, quia caro eius corrupta est, idque uehementius etiam put⟨r⟩escendo intenditur ubi uulnus umidum est et ex nigro ulcere umor pallidus fertur malique odoris [est] carunculaeque corruptae: interdum etiam nerui ac membranae resoluuntur, specillumque demissum descendit aut in latus aut deorsum, eoque uitio nonnumquam os quoque adficitur; modo oritur ea, quam Graeci gangrenam appellant. Priora in qualibet parte corporis fiunt: hoc in prominentibus membris, id est, inter ungues et alas uel inguina, fereque in senibus uel in is, quorum corpus mali habitus est. Caro in ulcere uel nigra uel liuida est, sed sicca et arida; proxumaque cutis plerumque subnigris pustulis impletur; deinde ei proxima uel pallida uel liuida, fereque rugosa, sine sensu est; ulterior ⟨in⟩ inflammatione est. Omniaque ea simul serpunt; ulcus in locum pus⟨t⟩ulosum, pus⟨t⟩ulae in eum, qui pallet aut liuet, pallor aut liuor in id, quod inflammatum est, inflammatio in id, quod integrum est, transit. Inter haec deinde febris acuta oritur ingensque sitis: quibusdam etiam delirium: alii, quamuis mentis suae compotes sunt, balbutiendo tamen uix sensus suos explicant; incipit adfici stomachus; fit foedi spiritus ipse odoris. Atque initium quidem eius mali recipit curationem; ubi uero penitus insedit, insanabile est; plurimique sub frigido sudore moriuntur. Ac pericula quidem uulnerum haec sunt. Vetus autem ulcus scalpello concidendum est, excidendaeque eius orae, et, quicquid super eas liuet, aeque incidendum.
And such are the dangers following upon wounds. Now a wound when of long standing should be cut with a scalpel, its margins excised, and incisions made at the same time into any livid area surrounding the margins. If there is a small varix inside the wound which hinders healing, it also is to be excised. Then when the blood has been let out and the wound made like a new one, the same treatment is to be adopted as that described for recent wounds. If any one does not want to use the scalpel, healing may be secured by using the plaster made up with ladanum, and, when that has eaten away the ulcer, by the one which induces a scar.
Si uaricula intus est, quae id sanari prohibet, ea quoque excidenda. Deinde, ubi sanguis emissus nouatumque uulnus est, eadem curatio adhibenda, quae in recentibus uulneribus exposita est. Si scalpello aliquis uti non uult, potest sanare id emplastrum, quod ex ladano fit, et cum ulcus sub eo exesum est, id, quo cicatrix inducitur. Id autem, quod erysipelas uocari dixi, non solum uulneri superuenire sed sine hoc quoque oriri consueuit, atque interdum periculum maius adfert, utique si circa ceruices aut caput constitit.— Oportet, si uires patiuntur, sanguinem mittere;
But what I have said is called erysipelas, not only follows upon a would, but is wont also to arise without a wound, and sometimes brings with it some danger, especially when it sets in about the neck or head. If strength permits, blood should be let; then repressives and refrigerants applied together, particularly white-lead with nightshade juice, or Cimolian chalk with rain-water as an excipient; or flour made into a paste with the same, with cyprus shoots added, or lentil meal if the skin is more delicate. Whatever is put on is to be covered over with beet leaves, and over that with lint wetted with cold water. If refrigerants by themselves have little effect, they are to be combined with the following: sulphur 4 grams, white-lead and saffron, 50 grams each; and these are pounded up with wine and the place smeared with them: or when the skin is more hardened, nightshade leaves are pounded, mixed with lard, and applied spread on lint.
deinde imponere simul reprimentia et refrigerantia, maximeque cerussam solani suco, aut Cimoliam cretam aqua pluuiali exceptam; aut ex eadem aqua subactam farinam cupresso adiecta aut, si tenerius corpus est, lenticulam. Quicquid inpositum est, betae folio contegendum et super linteolum frigida aqua madens inponendum. Si per se refrigerantia parum proderunt, miscenda erunt hoc modo: sulpuris P. #1108 I; cerussae, croci singulorum P. #1108 X⟨II S.⟩; eaque cum uino conterenda sunt, et id his inlinendum: aut si durior locus est, solani folia contrita suillae adipi miscenda sunt et inlita linteolo superinicienda. At si nigrities est nequedum serpit, imponenda sunt, quae carnem putrem lenius edunt, repurgatumque ulcus sic ut cetera nutriendum est.
But if there is a blackening which is not yet spreading, the milder corrosives of putrid flesh are to be put on, and the wound having been thus cleaned out, is cared for like other wounds. If there is more corruption, and it is already spreading, stronger corrosives are needed. If even these are not effective, the place should be burnt by a cautery until no more humour escapes from it; for sound flesh is dry when it is burnt. After the cauterizing of a putrid wound, such drugs are to be applied as will loosen from the living flesh the crusts which the Greeks call eschara. When these have fallen off, the wound is to be cleaned by honey and resin in particular; but it can also be cleaned by the other materials with which suppurating wounds are treated and in the same way brought to healing.
Si magis putre est, iamque procedit ⟨ac serpit,⟩ opus est uehementius erodentibus. Si ne haec quidem euincunt, aduri locus debet, donec ex eo nullus umor feratur: nam quod sanum est, siccum est, cum aduritur. Post ustionem putris ulceris superponenda sunt, quae crustas a uiuo resoluant: eas escharas Graeci nominant. Vbi eae exciderunt, purgandum ulcus maxime melle et resina est: sed aliis quoque purgari potest, quibus purulenta curantur; eodemque modo ad sanitatem perducendum est. Gangrenam uero, si nondum plane tenet, sed adhuc incipit, curare non difficillimum est, utique in corpore iuuenili;
But gangrene, when not yet widespread, but only beginning, is not very difficult to cure, at any rate in a young subject; and even more so if muscles are intact, sinews uninjured or but slightly affected, and no large joint opened, or if there is little flesh in the part, and so not much to putrefy, and if the lesion is limited to one place; and this mostly happens in a finger. In such a case the first thing to be done, when strength permits, is to let blood; then whatever has become dry, and by stretching out, as it were, in injuring also what is next to it, is cut away up to this point the sound tissue. Whilst the gangrene is spreading, medicaments which tend to promote suppuration are not to be applied; and therefore not even hot water. Weighty dressings also, although repressant, are unsuitable; but the lightest are needed; and over the parts which are inflamed refrigerants are to be used. If the malady is still not checked, the part between what is sound and diseased ought to be cauterized; and in such a case especially assistance is to be sought, not only from medicaments, but also from a system of diet; for this malady only occurs in a corrupt and diseased body. Therefore at first, unless weakness prohibits it, the patient should fast; after that he should be given light food and drink to tone up the bowels, and so also the body in general. Later if the lesion has been checked, the same things should be put on the wound which were prescribed for putrid ulceration. And it is now also permissible to make use of a fuller diet — foods of the middle class, but only such as dry up the bowels and the body generally; and cold rain-water to drink. The bath is harmful until it is quite certain that soundness has returned; for a wound, if softened in the bath, is quickly again affected by the same malady. But it still happens sometimes that none of these remedies is effectual, and in spite of everything this canker spreads. In such circumstances there is one sad by solitary remedy to secure the safety of the rest of the body, that is to cut away the limb which is gradually dying.
et magis etiam si musculi integri sunt, si nerui uel laesi non sunt uel leuiter adfecti sunt, neque ullus magnus articulus nudatus est, aut carnis in eo loco paulum est, ideoque non multum, quod putresceret, fuit, consistitque eo loco uitium; quod maxime fieri in digito potest.—In eiusmodi casu primum est, si uires patiuntur, sanguinem mittere; deinde quicquid aridum est et intentione quadam proximum quoque locum male habet, usque eo [sanum corpus] concidere. Medicamenta uero, dum malum serpit, adhibenda nulla sunt, quae pus mouere consuerunt; ideoque ne aqua quidem calida. Grauia quoque, quamuis reprimentia, aliena sunt; sed his quam leuissimis opus est; superque ea, quae inflammata sunt, utendum est refrigerantibus. Si nihilo magis malum constitit, uri, quod est inter integrum ac uitiatum locum, debet: praecipueque in hoc casu petendum non a medicamentis solum sed etiam a uictus ratione praesidium est: neque enim id malum nisi corrupti uitiosique corporis est. Ergo primo, nisi inbecillitas prohibet, abstinentia utendum; deinde danda quae per cibum potionemque aluum ideoque etiam corpus adstringant, sed ea leuia. Postea si uitium constitit, inponi super uulnus eadem debent, quae in putri ulcere praescripta sunt. Ac tum quoque ut plenioribus cibis uti licebit ex media materia, sic tamen non nisi aluum corpusque siccantibus; aqua uero pluuia[ti]li frigida. Balneum, nisi iam certa fiducia redditae sanitatis est, alienum est: siquidem emollitum in eo uulnus cito rursus eodem malo adficitur. Solent uero nonnumquam nihil omnia auxilia proficere ac nihilo minus serpere is cancer. Inter quae, miserum sed unicum auxilium est, ut cetera pars corporis tuta sit, membrum, quod paulatim emoritur, abscidere. Hae grauissimorum uulnerum curationes sunt. Sed ne illa quidem neglegenda, ubi integra cute interior pars conlisa est;
Such are the treatments of the gravest wounds. But there should be no neglect of those in which the skin is intact, but some inner part has been contused; or where something has been scraped or rubbed off: or what a splinter has become fixed in the body, or where the wound is small but deep.
⟨aut ubi derasum adtritumue aliquid est;⟩ aut ubi surculus corpori infixus est; aut ubi tenue sed altum uulnus insedit.
In the first case the best thing is to cook the rind of a pomegranate in wine, and pound up its interior and mix with rose-oil cerate, and so apply it: next, when the skin has been actually abraded, to lay on a soothing medicament such as lipara.
In primo casu commodissimum est malicorium ex uino coquere, interioremque eius partem conterere et cerato miscere ex rosa facto, idque superponere: deinde, ubi cutis ipsa exasperata est, inducere lene medicamentum, quale lipara est. Dera⟨s⟩so uero detritoque imponendum est emplastrum tetrapharmacum, minuendusque cibus et uinum subtrahendum.
When the skin has been scraped and rubbed off, the plaster tetrapharmacum is to be applied, the food reduced and wine withdrawn. Such wounds are not to be disregarded because deeper structures are uninjured; for often from injuries of this kind canker develops. But if the hurt is trifling, and of small extent, we may be content with the same soothing application.
Neque id, quia non habebit altiores ictus, contemnendum erit: siquidem ex eiusmodi casibus saepe cancri fiunt. Quod si leuius id erit et in parte exigua, contenti esse poterimus eodem leni medicamento. Surculum uero, si fieri potest, oportet uel manu uel etiam ferramento eicere.
A splinter too, whenever possible, should be extracted either by the hand or even by the help of an instrument. But if the splinter has been broken off or has penetrated too deeply for this to be done, it must be drawn towards the surface by a medicament. The best thing to draw it out is an application of pole-reed root pound up straight away if soft, but if already rather hard, boiled first in honey wine; to which honey should always be added, or birthwort also with honey. Of splinters the pole-reed is the worst because it is rough; there is the same harmfulness in fern. But by experience it has been learnt that either, when pounded up and applied, serves as a medicament against the other. Any medicament which has an extractive property has the same effect on splinters of all kinds.
Si uel praefractus est uel altius descendit, quam ut id ita fieri possit, medicamento euocandus est. Optume autem educit superinposita harundinis radix, si tenera est, protinus contrita; si iam durior, ante in mulso decocta; cui semper mel adiciendum est aut aristolochia cum eodem melle. Pessima ex surculis harundo est, quia aspera est: eademque offensa etiam in f⟨i⟩lice est. Sed usu cognitum est utramque aduersus alteram medicamentum esse, si contrita superinposita est. Facit autem idem in omnibus surculis, quodcumque medicamentum extrahendi uim habet. Idem altis tenuibusque uulneribus aptissimum est.
The same treatment is best for deep and narrow wounds. The plaster of Philocrates is especially good for the former, that of Hecataeus for the latter.
Priori rei Philocratis, huic Hecataei emplastrum maxime conuenit.
Whatever the kind of wound, when the time has come for inducing the scar, which must be after the wound has cleaned and filled with new flesh, first lint is applied, wetted by cold water while the flesh is being nourished; afterwards, when it has to be checked, dry lint must be applied until the scar is induced. Then plumbum album should be bandaged on in order to keep down the scar, and to give it a colour as much as possible like sound skin. Wild cucumber root has the same property, so has the present contain in: elaterium 4 grams, litharge 8 grams, unguent 16 grams. These are taken up in turpentine until the whole is of the consistency of a plaster. Further, equal parts of verdigris and washed lead mixed together with rose-oil gently clean black scars; either the scar may be anointed, as can be done on the face; or the above may be applied as a plaster, which is more convenient for other parts of the body. But if the scar is either elevated or depressed, it is foolish, just for the sake of appearance, to submit to pain and medicinal applications. Else both conditions can be remedied, since either scar can be made into a wound by the use of a scalpel. Or if a medicament is preferred, corrosive compositions have the same effect. After the skin has been wounded, to an elevated cicatrix corrosives are applied, to a depressed one medicaments which make flesh, until the wound, in each case, is on a level with the sound skin; and then the scar is induced.
Vbi uero in quolibet uulnere uentum ad inducendam cicatricem est, quod perpurgatis iam repletisque ulceribus necessarium est, primum ex aqua frigida lin⟨a⟩mentum, dum caro alitur; deinde iam, cum continenda est, ⟨siccum imponendum est,⟩ donec cicatrix inducatur. Tum deligari super album plumbum oportet quo et reprimitur cicatrix et colorem maxime corpori sano similem accipit. Idem radix siluestris cucumeris praestat, idem compositio, quae habet: elateri P. #1108 I; spumae argenti P. #1108 II; unguenti pondo #1108 IIII. Quae excipiuntur resina terebenthina, donec emplastri crassitudo ex omnibus fiat. Ac nigras quoque cicatrices leniter purgant paribus portionibus mixta aerugo, plumbum elotum, eademque rosa coacta; siue unguitur cicatrix, quod in facie fieri potest; siue id ut emplastrum inponitur, quod in aliis partibus commodius est. At si uel excreuit cicatrix uel concaua est, stultum est decoris causa rursus et dolorem et medicinam sustinere. Alioqui res utrique succurri patitur, siquidem utraque cicatrix exulcerari scalpello potest. Si medicamentum aliquis mauult, idem efficiunt compositiones eae, quae corpus exedunt. Cute exulcerata super eminentem carnem exedentia medicamenta coicienda sunt, super concauam implentia, donec utrumque ulcus sanae cuti aequetur; et tum cicatrix inducatur.
27. 27 I have spoken of those wounds which are mostly inflicted by weapons. My next task is to speak of those which are caused by the bite, at times of a man, at times of an ape, often of a dog, not infrequently of wild animals or of snakes. For almost every bite has in it poison of some sort. Therefore if the wound is severe, a cup should be applied straightway of it; if slighter a plaster, especially that of Diogenes. If that is not at hand, then one of the others I have recommended against bites; failing such, the green plaster called Alexandrian; if not even that is to be had, then any one which suits recent wounds, so long as it is not greasy. Salt is also a remedy for bites, especially dog-bite, if a hand is then placed over the bite and struck by two fingers of the other hand; for this brings out sanies; and brine-pickle may also be appropriately bandaged upon such a wound.
27. Dixi de is uulneribus, quae maxime per tela inferuntur. Sequitur, ut de is dicam, quae morsu fiunt, interdum hominis, interdum simiae, saepe canis, nonnumquam ferorum animalium aut serpentium. Omnis autem fere morsus habet quoddam uirus: itaque si uehemens uulnus est, cucurbitula admouenda est; si leuius, protinus emplastrum iniciendum, praecipueque Diogen⟨i⟩. Si id non est, quodlibet ex is, quae aduersus morsus proposui: si ea non sunt, uiride Alexandrinum: si ne id quidem est, quodlibet non pingue ex is, quae recentibus uulneribus accommodantur. Sal quoque his, praecipueque ei, quod canis fecit, medicamentum est, si manus uulneri inponitur superque id duobus digitis uerberatur: exaniat enim; ac salsamentum quoque recte super id uulnus deligatur.
But especially if the dog was mad, the poison must be drawn out by a cup; next, if the wound is not among sinews and muscles, it must be cauterized; if it cannot be cauterized, it is not amiss to bleed the man. After cauterizing, applications are to be put on as for other burns; if the wound is not cauterized, such medicaments as are powerful corrosives. After this the wound should be filled in and brought to healing, not by any new method, but as already described above. After the bite of a mad dog some send the patients at once to the bath, and there let them sweat as much as their bodily strength allows, the wound being kept open in order that the poison may drop out freely from it; then follows the administration of much wine, undiluted, which is an antidote to all poisons. And when this has been carried out for three days, the patient is deemed to be out of danger.
Vtique autem si rabiosus canis fuit, cucurbitula uirus eius extrahendum est; deinde si locus neque neruosus neque musculosus est, uulnus id adurendum est: si uri non potest, sanguinem homini mitti non alienum est. Tum usto quidem uulneri superimponenda quae ceteris ustis sunt: ei uero, quod expertum ignem non est, ea medicamenta, quae uehementer exedunt. Post quae nullo nouo magisterio, sed iam supra posito ulcus erit implendum et ad sanitatem perducendum. Quidam post rabiosi canis morsum protinus in balineum mittunt ibique patiuntur desudare, dum uires corporis sinunt, ulcere adaperto, quo magis ex eo quoque uirus destillet; deinde multo mera⟨c⟩oque uino accipiunt, quod omnibus uenenis contrarium est. Idque cum ita per triduum factum est, tutus esse homo a periculo uidetur.
But when too little has been done for such a wound, it usually gives rise to a fear of water which the hands call hydrophobia, a most distressing disease, in which the patient is tortured simultaneously by thirst and by dread of water. In these cases there is very little help for the sufferer. But still there is just one remedy, to throw the patient unawares into a water tank which he has not seen beforehand. If he cannot swim, let him sink under and drink, then lift him out; if he can swim, push him under at intervals so that he drinks his fill of water even against his will; for so his thirst and dread of water are removed at the same time. Yet this procedure incurs a good danger, that a spasm of sinews, provoked by the cold water, may carry off a weakened body. Lest this should happen, he must be taken straight from the tank and plunged into a bath of hot oil. But as an antidote we should give especially the one which I put first, when that is not at hand, another; it is to be given in a draught of water, if the patient does not dread water yet; and if the bitterness is objected to, honey is to be added; if dread of water has already seized him, the antidote can be swallowed as a pill.
Solet autem ex eo uulnere, ubi parum occursum est, aquae timor nasci (hydrophobas Graeci appellant), miserrimum genus morbi, in quo simul aeger et siti et aquae metu cruciatur; quo oppressis in angusto spes est. Sed unicum tamen remedium est, neque opinantem in piscinam non ante ei prouisam proicere. Et si natandi scientiam non habet, modo mersum bibere pati, modo attollere: si habet, interdum deprimere, ut inuitus quoque aqua satietur: sic enim simul et sitis et aquae metus tollitur. Sed aliud periculum excipit, ne infirmum corpus in aqua frigida uexatum neruorum distentio absumat. Id ne incidat, a piscina protinus in oleum calidum demittendus est. Antidotum autem praecipue id, quod primo loco posui, ubi id non est, aliud, si nondum aeger aquam horret, potui ex aqua dandum est; et si amaritudine offendit, mel adiciendum est: si iam is morbus occupauit, per catapotia sumi potest.
Serpents' bites again need a not very different treatment, although in this the ancients had very various methods so that for each kind of snake some prescribed one special kind of remedy, some another; but in all it is the same measures which are the most efficacious. Therefore first the limb is to be constricted above this kind of wound, but not too tightly, lest it become numbed; next, the poison is to be drawn out. A cup does this best. But it is not amiss beforehand to according to incisions with a scalpel around the wound, in order that more of the vitiated blood may be extracted. If there is no cup at hand, although this can hardly happen, use any similar vessel which can do what you want; if there is not even this, a man must be got to suck the wound. I declare there is no particular science in those people who are called Psylli, but a boldness confirmed by experience. For serpent's poison, like certain hunter's poisons, such as the Gauls in particular use, does no harm when swallowed, but only in a wound. Hence the snake itself may be safely eaten, whilst its stroke kills; and if one is stupefied, which mountebanks effect by certain medicaments, and if anyone puts his finger into its mouth and is not bitten, its saliva is harmless. Anyone, therefore, who follows the example of the Psylli and sucks out the wound, will himself be safe, and will promote the safety of the patient. He must see to it, however, beforehand that he has no sore place on his gums or palate or other parts of the mouth. After the suction, the patient should be put into a warm room, in such a position that the part bitten is inclined downwards. If there is no one at hand to suck out the wound, or to cup it, the patient should sip goose or mutton or veal broth and provoke a vomit; further a live chicken should be cut through the middle, and whilst warm applied forthwith over the wound so that its inner part is in contact with the patient's body. It will also do to slaughter a kid or lamb, and immediately to put the hot flesh upon the wound. The plasters also should be applied which have been mentioned above; the most suitable is the Ephesian plaster, or that noted next after it. There is ready help in on of the antidotes; if none is at hand, it is necessary to take in sips a draught of strong wine with pepper, or anything else which will stir up heat, to prevent humour from coagulating internally; for most poisons cause death by cold. All diuretics also are useful, because they dilute the diseased matter.
Serpentium quoque morsus non nimium distantem curationem desiderant, quamuis in ea multum antiqui uariarunt, ut in singula anguium genera singula medendi genera praeciperent aliique alia: sed in omnibus eadem maxime proficiunt.—Igitur in primis super uulnus id membrum deligandum est, non tamen nimium uehementer, ne torpeat; deinde uenenum extrahendum est. Id cucurbitula optume facit. Neque alienum est ante scalpello circa uulnus incidere, quo plus uitiati iam sanguinis extrahatur. Si cucurbitula non est, quod tamen uix incidere potest, tum quodlibet simile uas, ⟨quod⟩ idem possit; ⟨si ne id quidem est,⟩ homo adhibendus est, qui id uulnus exsugat. Neque Hercules scientiam praecipuam habent ii, qui Psylli nominantur, sed audaciam usu ipso confirmatam. Nam uenenum serpentis, ut quaedam etiam uenatoria uenena, quibus Galli praecipue utuntur, non gustu, sed in uulnere nocent. Ideoque colubra ipsa tuto estur, ictus eius occidit; et si stupente ea, quod per quaedam medicamenta circulatores faciunt, in os digitum quis indidit neque percussus est, nulla in ea saliua noxa est. Ergo quisquis exemplum Psylli secutus id uulnus exsuxerit, et ipse tutus erit et tutum hominem praestabit. Illud [ne intereat] ante debebit adtendere, ne quod in gingiuis palatoue aliaue parte oris ulcus habeat. Post haec is homo loco calido conlocandus est, sic ut id quod percussum erit, in inferiorem partem inclinetur. Si neque qui exsugat neque cucurbitula est, sorbere oportet ius anserinum uel ouillum uel uitulinum et uomere, uiuum autem gallinaceum pullum per medium diuidere et protinus calidum super uolnus imponere, sic ut pars interior corpori iungatur. Facit id etiam haedus agnusue discissus, et calida eius caro statim super uolnus imposita. Emplastra quoque si qua * * supra conprehensa sunt; aptissimumque est uel Ephesium uel id, quod ei subiectum est. Praesensque in aliquo antidoto praesidium est: si id non est, necessarium est exsorbere potionem meri uini cum pipere, uel quidlibet aliud quod calori mouendo est, ne umorem intus coire patiatur: nam maxima pars uenenorum frigore interemit. Omnia etiam urinam mouentia, quia materiam extenuant, utilia sunt. Haec aduersus omnes ictus communia sunt. Vsus tamen ipse docuit eum, quem aspis percussit, acetum potius bibere ⟨debere⟩.