---
title: "On Fractures · Περὶ ἀγμῶν"
author: "Hippocrates"
translator: "Francis Adams"
languages: [grc, en]
shelf: "Classical Greek"
section: 2 of 3
url: https://scriptura.si/works/hippocrates-on-fractures/2/
cite: "Hippocrates, tr. Francis Adams, On Fractures · Περὶ ἀγμῶν, section 2. Scriptura (scriptura.si), https://scriptura.si/works/hippocrates-on-fractures/2/"
---

# On Fractures · Περὶ ἀγμῶν

*Hippocrates, tr. Francis Adams*

Setting broken bones.

> Greek: ed. Émile Littré, from the Perseus Digital Library (canonical-greekLit, tlg0627.tlg009, CC BY-SA 4.0).

> English: Francis Adams, from the Perseus Digital Library (tlg0627.tlg009.perseus-eng2). Notes are not included.

> Rows follow the references the two texts share (chapters and sections), cut where both reach the end of a sentence.

## 2. Sections 14–29

Source: https://scriptura.si/works/hippocrates-on-fractures/2/ · cite a paragraph as https://scriptura.si/works/hippocrates-on-fractures/2/#p-N

[¶0] 14. When you have made proper extension, it is easy reduce the joint, for the displaced bone is thus raised into a line with the other. And the bones are to be adjusted with the palms of the hands, pressing upon the projecting bone with the one, and making counter-pressure below the ankle with the other. When you have replaced the bones, you must apply the bandages while the parts are upon the stretch, if you possibly can; but if prevented by the thongs, you must loose them, and make counter-extension until you get the bandages applied. The bandage is to be applied in the manner formerly described, the heads of the bandages being placed on the projecting part, and the first turns made in like manner, and so also with regard to the number of compresses and the compression; and turns of the bandages are to be brought frequently round on this and on that side of the ankle. But this joint must be bound more tight at the first dressing than in the case of the hand. But when you have applied the bandage, you must place the bandaged part somewhat higher than the rest of the body, and in such a position that the foot may hang as little as possible. The attenuation of the body is to be made proportionate to the magnitude of the luxation, for one luxation is to be a small, and another to a great extent. But in general we must reduce more, and for a longer time, in injuries about the legs, than in those about the hands; for the former parts are larger and thicker than the latter, and it is necessary that the body should be kept in a state of rest, and in a recumbent position. There is nothing to prevent or require the limb to be bandaged anew on the third day. And all the treatment otherwise is to be conducted in like manner, as in the preceding cases. And if the patient have resolution to lie quiet, forty days will be sufficient for this purpose, if only the bones be properly reduced, but if he will not lie quiet, he will not be able to use the limb with ease, and he will find it necessary to wear a bandage for a long time. When the bones are not properly replaced, but there has been some defect in this respect, the hip, the thigh, and the leg become wasted, and if the dislocation be inward, the external part of the thigh is wasted, and vice versa. But for the most part the dislocation is inward.

> Greek: 14. 14. ἐπὴν δὲ ἱκανῶς κατατανύσῃς, ῤηΐδιον ἤδη τὸ ἄρθρον ἐμβαλεῖν· ὑπεραιωρέεται γὰρ ἐς ἰθυωρίην ὑπὲρ τῆς αρχαίης ἕδρης. κατορθοῦσθαι οὖν χρὴ τοῖσι θέναρσι τῶν χειρῶν, τοῖσι μὲν ἐς τὸ ἐξεστηκὸς ἐρείδοντα, τοῖσι δὲ ἐπὶ θάτερα κατώτερον τοῦ σφυροῦ ἀντερείδοντα. ἐπὴν δὲ ἐμβάλῃς, ἢν μὲν οἷόν τε ᾖ, κατατεταμένα ἐπιδεῖν χρή· ἢν δὲ κωλύηται ὑπὸ τῶν ἱμάντων, ἐκείνους λύσαντα ἀντικατατείνειν, ἔστʼ ἄν ἐπιδήσῃς. ἐπιδεῖν δὲ τὸν αὐτὸν τρόπον, καὶ τὰς ἀρχὰς ὡσαύτως βαλλόμενον κατὰ τὸ ἐξεστηκὸς, καὶ τὰς περιβολὰς τὰς πρώτας πλείστας κατὰ τοῦτο ποιέεσθαι, καὶ τοὺς σπλῆνας πλείστους κατὰ τοῦτο, καὶ τὴν πίεξιν μάλιστα κατὰ τωὐτό· προσεπιδεῖν δὲ καὶ ἔνθεν καὶ ἔνθεν ἐπὶ συχνόν. μᾶλλον δέ τι τοῦτο τὸ ἄρθρον πεπιέχθαι χρὴ ἐν τῇ πρώτῃ ἐπιδέσει, ἢ τὸ ἐν τῇ χειρί. ἐπὴν δὲ ἐπιδήσῃς, ἀνωτέρω μὲν τοῦ ἄλλου σώματος ἐχέτω τὸ ἐπιδεθὲν, τὴν δὲ θέσιν δεῖ ποιέεσθαι οὕτως, ὅκως ἥκιστα ἀπαιωρηθήσεται ὁ πούς. τὸν δὲ ἰσχνασμὸν τοῦ σώματος οὕτω ποιέεσθαι, ὁκοίην τινὰ δύναμιν ἔχει καὶ τὸ ὀλίσθημα· τὰ μὲν γὰρ σμικρὸν, τὰ δὲ μέγα ὀλισθάνει. τὸ ἐπίπαν δὲ ἰσχναίνειν μᾶλλον καὶ ἐπὶ πλείω χρόνον χρὴ ἐν τοῖσι κατὰ τὰ σκέλεα τρώμασιν, ἢ ἐν τοῖσι κατὰ τὰς χεῖρας· καὶ γὰρ μέζω καὶ παχύτερα ταῦτα ἐκείνων· καὶ δὴ καὶ ἀναγκαῖον ἐλινύειν τὸ σῶμα καὶ κατακεῖσθαι. μετεπιδῆσαι δὲ τὸ ἄρθρον, οὔτε τι κωλύει τριταῖον, οὔτε κατεπείγει. καὶ τὰ ἄλλα πάντα παραπλησίως χρὴ ἰητρεύειν, ὥσπερ καὶ τὰ παροιχόμενα. καὶ ἢν μὲν τολμᾷ ἀτρέμα κατακεῖσθαι, ἱκαναὶ τεσσαράκοντα ἡμέραι, ἢν μοῦνον ἐς τὴν ἑωυτῶν χώρην τὰ ὀστέα αὖθις καθίζηται· ἢν δὲ μὴ θέλῃ ἀτρεμέειν, χρῷτο μὲν ἂν οὐ ῤᾳδίως τῶ σκέλεϊ, ἐπιδεῖσθαι δὲ ἀναγκάζοιτʼ ἂν πουλὺν χρόνον. ὁκόσα μέντοι τῶν ὀστέων μὴ τελέως ἵζει ἐς τὴν ἑωυτῶν χώρην, ἀλλά τι ἐπιλείπει, τῷ χρόνῳ λεπτύνεται ἰσχίον καὶ μηρὸς καὶ κνήμη· καὶ ἢν μὲν εἴσω ὀλίσθῃ, τὸ ἔξω μέρος λεπτύνεται, ἢν δὲ ἔξω, τὸ εἴσω. τὰ πλεῖστα δὲ ἐς τὸ ἔσω ὀλισθάνει.

[¶1] 15. And when both bones of the leg are broken without a wound of the skin, stronger extension is required. We may make extension by some of the methods formerly described, provided the bones ride over one another to a considerable degree. But extension by men is also sufficient, and for the most part two strong men will suffice, by making extension and counterextension. Extension must naturally be made straight in a line with the leg and thigh, whether on account of a fracture of the bones of the leg or of the thigh. And in both cases they are to be bandaged while in a state of extension, for the same position does not suit with the leg and the arm. For when the fractured bones of the arm or fore-arm are bandaged, the fore-arm is suspended in a sling, and if you bind them up while extended, the figures of the fleshy parts will be changed in bending the arm at the elbow, for the elbow cannot be kept long extended, since persons are not in the custom of keeping the joint long in this form, but in a bent position, and persons who have been wounded in the arm, and are still able to walk about, require to have the arm bent at the elbow-joint. But the leg, both in walking and standing, is habitually extended, either completely or nearly so, and is usually in a depending position from its construction, and in order that it may bear the weight of the rest of the body. Wherefore it readily bears to be extended when necessary, and even when in bed the limb is often in this position. And when wounded, necessity subdues the understanding, since the patients become incapable of raising themselves up, so that they neither think of bending the limb nor of getting up erect, but remain lying in the same position. For these reasons, neither the same position nor the same mode of bandaging applies to the arm and to the leg. If, then, extension by means of men be sufficient, we should not have recourse to any useless contrivances, for it is absurd to employ mechanical means when not required; but if extension by men be not sufficient, you may use any of the mechanical powers which is suitable. When sufficiently extended, it will be easy to adjust the bones and bring them into their natural position, by straightening and arranging them with the palms of the hand.

> Greek: 15. 15. ἐπὴν δὲ κνήμης ὀστέα ἀμφότερα καταγῇ ἄνευ ἑλκώσιος, κατατάσιος ἰσχυροτέρης δεῖται. τείνειν δὲ τουτέων τῶν τρόπων ἐνίοισι τῶν προειρημένων, ἢν μεγάλαι αἱ παραλλάξιες ἔωσιν. ἱκαναὶ δὲ καὶ αἱ ἀπὸ τῶν ἀνδρῶν κατατάσιες· τὰ πλεῖστα γὰρ ἀρκέοιεν ἂν δύο ἄνδρες ἐῤῥωμένοι, ὁ μὲν ἔνθεν, ὁ δʼ ἔνθεν ἀντιτείνοντες. τείνειν δὲ ἐς τὸ ἰθὺ χρὴ κατὰ φύσιν καὶ κατὰ τὴν ἰθυωρίην τῆς κνήμης καὶ τοῦ μηροῦ, καὶ ἢν κνήμης ὀστέα κατεηγυίης κατατείνῃς, καὶ ἢν μηροῦ. καὶ ἐπιδεῖν δὲ οὕτως, ἐκτεταμένων ἀμφοτέρων, ὁκότερον ἂν τουτέων ἐπιδέῃς· οὐ γὰρ ταὐτὰ ξυμφέρει σκέλει τε καὶ χειρί. πήχεος μὲν γὰρ καὶ βραχίονος ἐπὴν ἐπιδεθῶσιν ὀστέα κατεηγότα, ἀναλαμβάνεται ἡ χεὶρ, καὶ ἢν ἐκτεταμένα ἐπιδέῃς, τὰ σχήματα τῶν σαρκῶν ἑτεροιοῦται ἐν τῇ ξυγκάμψει τοῦ ἀγκῶνος· ἀδύνατος γὰρ ὁ ἀγκὼν ἐκτετάσθαι πουλὺν χρόνον· οὐ γὰρ πολλάκις ἐν τοιούτῳ εἴθισται ἐσχηματίσθαι, ἀλλʼ ἐν τῷ ξυγκεκάμφθαι· καὶ δὴ καὶ ἅτε δυνάμενοι οἱ ἄνθρωποι περιιέναι, ἐπὴν κατὰ χεῖρα τρωθῶσι, ξυγκεκάμφθαι κατὰ τὸν ἀγκῶνα δέονται. σκέλος δὲ ἔν τε τῇσιν ὁδοιπορίῃσιν καὶ ἐν τῷ ἑστάναι εἴθισται ὁτὲ μὲν ἐκτετάσθαι, ὁτὲ δὲ σμικροῦ δεῖν ἐκτετάσθαι· καὶ εἴθισται καθεῖσθαι ἐς τὸ κάτω κατὰ φύσιν, καὶ δὴ καὶ πρὸς τὸ ὀχέειν τὸ ἄλλο σῶμα· διὰ τοῦτο εὔφορον αὐτῷ ἐστι τὸ ἐκτετάσθαι, ὅταν ἀνάγκη ἔχῃ· καὶ δὴ καὶ ἐν τῇσι κοίτῃσι πολλάκις ἐν τῷ σχήματι τουτέῳ ἐστίν· ἐπὴν δὲ δὴ τρωθῇ, ἀνάγκη καταδουλοῦται τὴν γνώμην, ὅτι ἀδύνατοι μετεωρίζεσθαι γίνονται, ὥστε οὐδὲ μέμνηνται περὶ τοῦ ξυγκαμφθῆναι καὶ ἀναστῆναι, ἀλλὰ ἀτρεμέουσιν ἐν τουτέῳ τῷ σχήματι κείμενοι. διὰ οὖν ταύτας τὰς προφάσιας χειρὸς καὶ σκέλεος, οὔτε ἡ κατάτασις, οὔτε ἡ ἐπίδεσις τοῦ σχήματος ξυμφέρει ἡ αὐτή. ἢν μὲν οὖν ἱκανὴ ἡ κατάτασις ἡ ἀπὸ τῶν ἀνδρῶν ᾖ, οὐ δεῖ μάτην πονέεσθαι· καὶ γὰρ σολοικότερον μηχανοποιέειν μηδὲν δέον· ἢν δὲ μὴ ἱκανὴ ἡ κατάτασις ἡ ἀπὸ τῶν ἀνδρῶν, καὶ τῶν ἄλλων τινὰ τῶν ἀναγκέων προσφέρειν, ἥν τινά γε προσχωρέοι. ὅταν δὲ δὴ ἱκανῶς καταταθῇ, ῤηΐδιον ἤδη κατορθώσασθαι τὰ ὀστέα καὶ ἐς τὴν φύσιν ἀγαγεῖν, τοῖσι θέναρσι τῶν χειρέων ἀπευθύνοντα καὶ ἐξευκρινέοντα.

[¶2] 16. When the parts are adjusted, you should apply the bandages while the limb is in a stretched position, making the first turns to the right or to the left, as may be most suitable; and the end of the bandage should be placed over the fracture, and the first turns made at that place; and then the bandage should be carried up the leg, as described with regard to the other fractures. But the bandages should be broader and longer, and more numerous, in the case of the leg than in that of the arm. And when it is bandaged it should be laid upon some smooth and soft object, so that it may not be distorted to the one side or the other, and that there may be no protrusion of the bones either forward or backward; for this purpose nothing is more convenient than a cushion, or something similar, either of linen or wool, and not hard; it is to be made hollow along its middle, and placed below the limb. With regard to the canals (gutters?) usually placed below fractured legs, I am at a loss whether to advise that they should be used or not. For they certainly are beneficial, but not to the extent which those who use them suppose. For the canals do not preserve the leg at rest as they suppose; nor, when the rest of the body is turned to the one side or the other, does the canal prevent the leg from following, unless the patient himself pay attention; neither does the canal prevent the limb from being moved without the body to the one side or the other. And a board is an uncomfortable thing to have the limb laid upon, unless something soft be placed above it. But it is a very useful thing in making any subsequent arrangements of the bed and in going to stool. A limb then may be well or ill arranged with or without the canal. But the common people have more confidence, and the surgeon is more likely to escape blame, when the canal is placed under the limb, although it is not secundum artem. For the limb should by all means lie straight upon some level and soft object, since the bandaging must necessarily be overcome by any distortion in the placing of the leg, whenever or to whatever extent it may be inclined. The patient, when bandaged, should return the same answers as formerly stated, for the bandaging should be the same, and the same swellings should arise in the extremities, and the slackening of the bandages in like manner, and the new bandaging on the third day; and the bandaged part should be found reduced in swelling; and the new bandagings should be more tightly put on, and more pieces of cloth should be used; and the bandages should be carried loosely about the foot, unless the wound be near the knee. Extension should be made and the bones adjusted at every new bandaging; for, if properly treated, and if the swelling progress in a suitable manner, the bandaged limb will have become more slender and attenuated, and the bones will be more mobile, and yield more readily to extension. On the seventh, the ninth, or the eleventh day, the splints should be applied as described in treating of the other fractures. Attention should be paid to the position of the splints about the ankles and along the tendon of the foot which runs up the leg. The bones of the leg get consolidated in forty days, if properly treated. But if you suspect that anything is wanting to the proper arrangement of the limb, or dread any ulceration, you should loose the bandages in the interval, and having put everything right, apply them again.

> Greek: 16. 16. ἐπὴν δὲ κατορθώσῃ, ἐπιδεῖν τοῖσιν ὀθονίοισι κατατεταμένα, ἤν τʼ ἐπὶ δεξιὰ, ἤν τʼ ἐπʼ ἀριστερὰ περιφέρειν ξυμφέρῃ αὐτέοισι τὰ πρῶτα ὀθόνια· βαλλέσθω δὲ τὴν ἀρχὴν τοῦ ὀθονίου κατὰ τὸ κάτηγμα, καὶ περιβαλλέσθω κατὰ τοῦτο τὰς πρώτας περιβολάς· κἄπειτα νεμέσθω ἐπὶ τὴν ἄνω κνήμην ἐπιδέων, ὥσπερ ἐπὶ τοῖσιν ἄλλοισι κατήγμασιν εἴρηται. τὰ δὲ ὀθόνια πλατύτερα χρὴ εἶναι, καὶ μακρότερα καὶ πλέω πουλὺ τὰ κατὰ τὸ σκέλος τῶν ἐν τῇ χειρί. ἐπὴν δὲ ἐπιδήσῃς, καταθεῖναι ἐφʼ ὁμαλοῦ τινος καὶ μαλθακοῦ, ὥστε μὴ διεστράφθαι ἢ τῇ, ἢ τῇ, μήτε λορδὸν, μήτε κυφὸν εἶναι· μάλιστα δὲ ξυμφέρει προσκεφάλαιον, ἢ λίνεον, ἢ ἐρίνεον, μὴ σκληρὸν, λαπαρὸν μέσον κατὰ μῆκος ποιήσαντα, ὑποθεῖναι, ἢ ἄλλο τι ὃ τούτῳ ἔοικεν. περὶ γὰρ τῶν σωλήνων τῶν ὑποτιθεμένων ὑπὸ τὰ σκέλεα τὰ κατεηγότα, ἀπορέω ὅ τι ξυμβουλεύσω, εἰ ὑποτιθέναι χρὴ ἢ οὔ. Ὠφελέουσι μὲν γὰρ, οὐχ ὅσον δὲ οἱ ὑποτιθέντες οἴονται. οὐ γὰρ ἀναγκάζουσιν οἱ σωλῆνες ἀτρεμέειν, ὡς οἴονται· οὔτε γὰρ τῷ ἄλλῳ σώματι στρεφομένῳ ἢ ἔνθα, ἢ ἔνθα, ἐπαναγκάζει ὁ σωλὴν μὴ ἐπακολουθέειν τὸ σκέλος, ἢν μὴ ἐπιμελῆται αὐτὸς ὥνθρωπος. οὔτε αὖ τὸ σκέλος ἄνευ τοῦ σώματος κωλύει ὁ σωλὴν κινηθῆναι ἢ τῇ ἢ τῇ. ἀλλὰ μὴν ἀστεργέστερον ξύλον ὑποτετάσθαι, ἢν μὴ ὁμῶς ἄν τις μαλθακόν τι ἐς αὐτὸ ἐντεθῇ. Εὐχρηστότατον δέ ἐστιν ἐν τῇσι μεθυποστρώσεσι, καὶ ἐν τῇσιν ἐς ἄφοδον προχωρήσεσιν. ἔστιν οὖν σὺν σωλῆνι καὶ ἄνευ σωλῆνος καὶ καλῶς καὶ αἰσχρῶς κατασκευάσασθαι· πιθανώτερον δὲ τοῖσι δημότῃσίν ἐστι, καὶ τὸν ἰητρὸν ἀναμαρτητότερον εἶναι, ἢν σωλὴν ὑποκέηται· καίτοι ἀτεχνέστερόν γέ ἐστιν. δεῖ μὲν γὰρ ἐφʼ ὁμαλοῦ καὶ μαλθακοῦ κεῖσθαι πάντη πάντως ἐς ἰθύ· ἐπεί τοί γε ἀνάγκη κρατηθῆναι τὴν ἐπίδεσιν ὑπὸ τῆς διαστροφῆς τῆς ἐν τῇ θέσει, ὅποι ἂν ῤέπῃ, καὶ ὁκόσα ἂν ῤέπῃ. ὑποκρινέσθω δὲ ὁ ἐπιδεδεμένος ταὐτὰ, ἅπερ καὶ πρότερον εἴρηται· καὶ γὰρ τὴν ἐπίδεσιν χρὴ τοιαύτην εἶναι, καὶ τὸ οἴδημα οὕτως ἐξαείρεσθαι ἐς τὰ ἄκρεα, καὶ τὰς χαλάσιας οὕτω, καὶ τὰς μετεπιδέσιας διὰ τρίτης, καὶ εὑρισκέσθω ἰσχνότερον τὸ ἐπιδεόμενον, καὶ τὰς ἐπιδέσιας ἐπὶ μᾶλλον ποιέεσθαι, καὶ πλέοσι τοῖσιν ὀθονίοισιν· περιλαμβάνειν τε καὶ τὸν πόδα χαλαρῶς, ἢν μὴ ἄγαν ἐγγὺς ᾖ τοῦ γούνατος τὸ τρῶμα. κατατείνειν δὲ μετρίως καὶ ἐπικατορθοῦν ἐφʼ ἑκάστῃ ἐπιδέσει χρὴ τὰ ὀστέα· ἢν γὰρ ὀρθῶς μὲν ἰητρεύηται, κατὰ λόγον δὲ τὸ οἴδημα χωρέῃ, ἔτι μὲν λεπτότερον καὶ ἰσχνότερον τὸ ἐπιδεόμενον χωρίον ἔσται, ἔτι δὲ αὖ παραγωγότερα τὰ ὀστέα, ἐνακούοντα τῆς κατατάσιος μᾶλλον. ἐπὴν δὲ ἑβδομαῖος, ἢ ἐναταῖος, ἢ ἑνδεκαταῖος γένηται, τοὺς νάρθηκας προστιθέναι, ὥσπερ καὶ ἐπὶ τοῖσιν ἄλλοισι κατήγμασιν εἴρηται. τῶν δὲ ναρθήκων τὰς ἐνέδρας χρὴ φυλάσσεσθαι κατά τε τῶν σφυρῶν τὴν ἴξιν, καὶ κατὰ τὸν τένοντα τὸν ἐν τῇ κνήμῃ τοῦ ποδός. ὀστέα δὲ κνήμης κρατύνεται ἐν τεσσαράκοντα ἡμέρῃσιν, ἢν ὀρθῶς ἰητρεύηται. ἢν δὲ ὑποπτεύῃς τῶν ὀστέων τι δεῖσθαί τινος διορθώσιος, ἤ τινα ἕλκωσιν ὀῤῥωδέῃς, ἐν τῷ μεσηγὺ χρόνῳ χρὴ λύσαντα καὶ εὐθετισάμενον μετεπιδῆσαι.

[¶3] 17. But if the other bone (fibula?) of the leg be broken, less powerful extension is required, and yet it must not be neglected, nor be performed slovenly, more especially at the first bandaging. For in all cases of fracture this object should be attained then as quickly as possible. For when the bandage is applied tight while the bones are not properly arranged, the properly arranged, the part becomes more painful. The treatment otherwise is the same.

> Greek: 17. 17. ἢν δὲ τὸ ἕτερον ὀστέον κατεηγῇ ἐν κνήμῃ, κατατάσιος μὲν ἀσθενεστέρης δεῖται, οὐ μὴν ἐπιλείπειν χρὴ, οὐδὲ βλακεύειν ἐν τῇ κατατάσει, μάλιστα μὲν ἐν τῇ πρώτῃ ἐπιδέσει κατατείνεσθαι, ὅσον ἐφικνέεται αἰεί ποτε πάντα τὰ κατήγματα, εἰ δὲ μὴ, ὡς τάχιστα· ὅ τι γὰρ ἂν μὴ κατὰ τροπον ηὐθετισμένων τῶν ὀστέων ἐπιδέων τις πιέζῃ, ὀδυναίτερον τὸ χωρίον γίνεται. ἡ δὲ ἄλλη ἰητρείη ἡ αὐτή.

[¶4] 18. Of the bones of the leg, the inner one, called the tibia, is the more troublesome to manage, and requires the greater extension; and if the broken bones are not properly arranged, it is impossible to conceal the distortion, for the bone is exposed and wholly uncovered with flesh; and it is much longer before patients can walk on the leg when this bone is broken. But if the outer bone be broken, it causes much less trouble, and the deformity, when the bones are not properly set, is much more easily concealed, the bone being well covered with flesh; and the patients speedily get on foot, for it is the inner bone of the leg which supports the most of the weight of the body. For along with the thigh, as being in a line with weight thrown upon the thigh, the inner bone has more work to sustain; inasmuch as it is the head of the thigh-bone which sustains the upper part of the body, and it is on the inner and not on the outer side of the thigh, being in a line with the tibia; and the other half of the body approximates more to this line than to the external one; and at the same time the inner bone is larger than the outer, as in the fore-arm the bone in the line of the little finger is the slenderer and longer. But in the joint of the inferior extremity, the disposition of the longer bone is not alike, for the elbow and the ham are bent differently. For these reasons when the external bone is broken, the patients can soon walk about; but in fractures of the inner, it is a long time before they can walk.

> Greek: 18. 18. τῶν δὲ ὀστέων τὸ μὲν ἔσω τοῦ ἀντικνημίου καλεομένου ὀχλω δέστερον ἐν τῇ ἰητρείῃ ἐστὶ, καὶ κατατάσιος μᾶλλον δεόμενον, καὶ ἢν μὴ ὀρθῶς τὰ ὀστέα τεθῇ, ἀδύνατον κρύψαι, φανερὸν γὰρ καὶ ἄσαρκον πᾶν ἐστιν· καὶ ἐπιβαίνειν ἐπὶ τὸ σκέλος πολλῷ βραδύτερον δύναιντʼ ἂν, τουτέου κατεηγότος. ἢν δὲ τὸ ἔξω ὀστέον κατεηγῇ, πουλὺ μὲν εὐφορώτερον φέρουσι, πουλὺ δʼ εὐκρυπτότερον, καὶ ἢν μὴ καλῶς ξυντεθῇ, ἐπίσαρκον γάρ ἐστιν· ἐπὶ πόδας τε ταχέως ἵστανται, τὸ πλεῖστον γὰρ τοῦ ἄχθεος ὀχέει τὸ ἔσωθεν τοῦ ἀντικνημίου ὀστέον. ἅμα μὲν γὰρ αὐτῷ τῷ σκέλει καὶ τῇ ἰθυωρίῃ τοῦ ἄχθεος τοῦ κατὰ τὸ σκέλος, τὸ πλεῖον ἔχει τοῦ πόνου τὸ ἔσω ὀστέον· τοῦ γὰρ μηροῦ ἡ κεφαλὴ ὑπεροχέει τὸ ὕπερθεν τοῦ σώματος, αὕτη δὲ εἴσωθεν πέφυκε τοῦ σκέλεος, καὶ οὐκ ἔξωθεν, ἀλλὰ κατὰ τὴν τοῦ ἀντικνημίου ἴξιν· ἅμα δὲ τὸ ἄλλο ἥμισυ τοῦ σώματος γειτονεύεται μᾶλλον ταύτῃ τῇ ἴξει, ἀλλʼ οὐχὶ τῇ ἔξωθεν· ἅμα δὲ, ὅτι παχύτερον τὸ ἔσω τοῦ ἐξωθεν, ὥσπερ τὸ ἐν τῷ πήχει τὸ κατὰ τὴν τοῦ μικροῦ δακτύλου ἴξιν λεπτότερον καὶ μακρότερον. ἐν μέντοι τῷ ἄρθρῳ τῷ κάτω οὐχ ὁμοίη ἡ ὑπότασις τοῦ ὀστέου τοῦ μακροτέρου· ἀνομοίως γὰρ ὁ ἀγκὼν καὶ ἡ ἰγνύη κάμπτεται. διὰ οὖν ταύτας τὰς προφάσιας, τοῦ μὲν ἔξωθεν ὀστέου κατεηγότος, ταχεῖαι αἱ ἐπιβάσιες, τοῦ δὲ ἔσωθεν κατεηγότος, βραδεῖαι αἱ ἐπιβάσιες.

[¶5] 19. When the thigh-bone is broken, particular pains should be taken with regard to the extension that it may not be insufficient, for when excessive, no great harm results from it. For, if one should bandage a limb while the extremities of the bone are separated to a distance from one another by the force of the extension, the bandaging will not keep them separate, and so the bones will come together again as soon as the persons stretching it let go their hold; for the fleshy parts (muscles?) being thick and strong, are more powerful than the bandaging, instead of being less so. In the case then which we are now treating of, nothing should be omitted in order that the parts may be properly distended and put in a straight line; for it is a great disgrace and an injury to exhibit a shortened thigh. For the arm, when shortened, might be concealed, and the mistake would not be great; but a shortened thigh-bone would exhibit the man maimed. For when the sound limb is placed beside it, being longer than the other, it exposes the mistake, and therefore it would be to the advantage of a person who would be improperly treated that both his legs should be broken, rather than either of them; for in this case the one would be of the same length as the other. When, then, proper extension has been made, you must adjust the parts with the palms of the hands, and bandage the limb in the manner formerly described, placing the hands of the bandages as was directed, and making the turns upward. And the patient should return the same answers to the same questions as formerly, should be pained and recover in like manner, and should have the bandaging renewed in the same way; and the application of the splints should be the same. The thigh-bone is consolidated in forty days.

> Greek: 19. 19. ἢν δὲ τὸ τοῦ μηροῦ ὀστέον καταγῇ, τὴν κατάτασιν χρὴ ποιέεσθαι περὶ παντὸς, ὅκως μὴ ἐνδεεστέρως σχήσει· πλεονασθεῖσα μὲν γὰρ οὐδὲν ἂν σίνοιτο. οὐδὲ γὰρ, εἰ διεστεῶτα τὰ ὀστέα ὑπὸ τῆς ἰσχύος τῆς κατατάσιος ἐπιδέοι τις, οὐκ ἂν δύναιτο κρατέειν ἡ ἐπίδεσις, ὥστε διεστάναι, ἀλλὰ συνέλθοι ἂν πρὸς ἄλληλα τὰ ὀστέα, ὡς τάχιστα ἂν ἀφείησαν οἱ τείνοντες· παχεῖαι γὰρ καὶ ἰσχυραὶ αἱ σάρκες ἐοῦσαι, κρατήσουσι τῆς ἐπιδέσιος, ἀλλʼ οὐ κρατηθήσονται. περὶ οὗ οὖν ὁ λόγος, διατείνειν εὖ μάλα καὶ ἀδιαστρέπτως χρὴ, μηδὲν ἐπιλείποντα· μεγάλη γὰρ ἡ αἰσχύνη καὶ βλάβη βραχύτερον τὸν μηρὸν ἀποδεῖξαι. χεὶρ μὲν γὰρ, βραχυτέρη γενομένη, καὶ ξυγκρυφθείη ἂν, καὶ οὐ μέγα τὸ σφάλμα· σκέλος δὲ βραχύτερον γενόμενον, χωλὸν ἀποδείξειε τὸν ἄνθρωπον· τὸ γὰρ ὑγιὲς ἐλέγχει παρατιθέμενον, μακρότερον ἐὸν, ὥστε λυσιτελέει τὸν μέλλοντα κακῶς ἰητρεύεσθαι, ἀμφότερα καταγῆναι τὰ σκέλεα μᾶλλον ἢ τὸ ἕτερον· ἰσόῤῥοπος γοῦν ἂν εἴη αὐτὸς ἑωυτῷ. ἐπὴν μέντοι ἱκανῶς κατατανύσῃς, κατορθωσάμενον χρὴ τοῖσι θέναρσι τῶν χειρῶν ἐπιδεῖν τὸν αὐτὸν τρόπον, ὥσπερ καὶ πρόσθεν γέγραπται, καὶ τὰς ἀρχὰς βαλλόμενον, ὥσπερ εἴρηται, καὶ νεμόμενον ἐς τὸ ἄνω τῇ ἐπιδέσει. καὶ ὑποκρινέσθω ταὐτὰ ὥσπερ καὶ πρόσθεν, καὶ πονεέτω κατὰ ταὐτὰ καὶ ῤηϊζέτω, καὶ μετεπιδείσθω ὡσαύτως· καὶ ναρθήκων πρόσθεσις ἡ αὐτή. κρατύνεται δὲ ὁ μηρὸς ἐν πεντήκοντα ἡμέρῃσιν.

[¶6] 20. But this also should be known, that the thigh-bone is curved rather to the outside than to the inside, and rather forward than backward; when not properly treated, then, the distortions are in these directions; and the bone is least covered with flesh at the same parts, so that the distortion cannot be concealed. If, therefore, you suspect anything of this kind, you should have recourse to the mechanical contrivances recommended in distortion of the arm. And a few turns of the bandage should be brought round by the hip and the loins, so that the groin and the articulation near the perineum may be included in the bandage; and moreover, it is expedient that the extremities of the splints should not do mischief by being placed on parts not covered with the bandages. The splints, in fact, should be carefully kept off the naked parts at both ends; and the arrangement of them should be so managed, as that they may not be placed on the natural protuberances of the bone at the knee-joint, nor on the tendon which is situated there.

> Greek: 20. 20. Προσξυνιέναι δὲ χρὴ καὶ τόδε, ὅτι ὁ μηρὸς γαῦσός ἐστιν ἐς τὸ ἔξω μέρος, ἢ ἐς τὸ ἔσω, καὶ ἐς τὸ ἔμπροσθεν μᾶλλον, ἢ ἐς τοὔπισθεν· ἐς ταῦτα τοίνυν τὰ μέρεα καὶ διαστρέφεται, ἐπὴν μὴ καλῶς ἰητρεύηται· καὶ δὴ καὶ κατὰ ταῦτα ἀσαρκότερος αὐτὸς ἑωυτοῦ ἐστιν, ὥστε οὐδὲ ξυγκρυπτειν δύνανται ἐν τῇ διαστροφῇ. ἢν οὖν τι τοιοῦτον ὑποπτεύῃς, μηχανοποιέεσθαι χρὴ οἷά περ ἐν τῷ βραχίονι τῷ διεστραμμένῳ παρῄνηται. προσπεριβάλλειν δὲ χρὴ ὀλίγα τῶν ὀθονίων κύκλῳ ἀμφὶ τὸ ἰσχίον καὶ τὰς ἰξύας, ὅκως ἂν οἱ βουβῶνές τε καὶ τὸ ἄρθρον τὸ κατὰ τὴν πλιχάδα καλεομένην προσεπιδέηται· καὶ γὰρ ἄλλως ξυμφέρει, καὶ ὅκως μὴ τὰ ἄκρεα τῶν ναρθήκων σίνηται πρὸς τὰ ἀνεπίδετα προσβαλλόμενα. ἀπολείπειν δὲ χρὴ ἀπὸ τοῦ γυμνοῦ αἰεὶ τοὺς νάρθηκας, καὶ ἔνθεν καὶ ἔνθεν, ἱκανῶς· καὶ τὴν θέσιν αἰεὶ τῶν ναρθήκων προμηθέεσθαι χρὴ, ὅκως μήτε κατὰ τὸ ὀστέον, τῶν ἐξεχόντων παρὰ τὰ ἄρθρα φύσει πεφυκότων, μήτε κατὰ τὸ νεῦρον ἔσται.

[¶7] 21. The swellings which arise in the ham, at the foot, or in any other part from the pressure, should be well wrapped in unscoured and carded wool, washed with wine and oil, and anointed with cerate, before bandaging; and if the splints give pain they should be slackened. You may sooner reduce the swellings, by laying aside the splints, and applying plenty of bandages to them, beginning from below and rolling upward; for thus the swellings will be most speedily reduced, and the humors be propelled to the parts above the former bandages. But this form of bandaging must not be used unless there be danger of vesications or blackening in the swelling, and nothing of the kind occurs unless the fracture be bound too tight, or unless the limb be allowed to hang, or it be rubbed with the hand, or some other thing of an irritant nature be applied to the skin.

> Greek: 21. 21. τὰ δὲ οἰδήματα τὰ κατʼ ἰγνύην, ἢ κατὰ πόδα, ἢ κατά τι ἄλλο ἐξαειρεύμενα ὑπὸ τῆς πιέξιος, εἰρίοισι πουλλοῖσι, ῤυπαροῖσιν, εὖ κατεργασμένοισιν, οἴνῳ καὶ ἐλαίῳ ῤήνας, κηρωτῇ ὑποχρίων, καταδεῖν, καὶ ἢν ζωσιν οἱ νάρθηκες, χαλᾷν. θᾶσσον ἰσχναίνοις δʼ ἂν, εἰ, ἀφιεὶς τοὺς νάρθηκας, ὀθονίοισι συχνοῖσιν ἐπιδέοις τὰ οἰδήματα, ἀρξάμενος ἀπὸ τοῦ κατωτάτω ἐπὶ τὸ ἄνω νεμόμενος· οὕτω γὰρ ἄν τάχιστα ἰσχνὸν τὸ οἴδημα γένοιτο, καὶ ὑπερθοίη ἂν ὑπὸ τὰ ἀρχαῖα ἐπιδέσματα. ἀλλʼ οὐ χρὴ τούτῳ τῷ τρόπῳ χρῆσθαι τῆς ἐπιδέσιος, ἢν μὴ κίνδυνος ᾖ ἐν τῷ οἰδήματι φλυκταινώσιος ἢ μελασμοῦ· γίνεται δὲ οὐδὲν τοιοῦτο, ἢν μὴ ἄγαν τις πιέζῃ τὸ κάτηγμα, ἢ κατακρεμάμενον ἔχῃ, ἢ κνῆται τῇ χειρὶ, ἢ ἄλλο τι προσπίπτῃ ἐρεθιστικὸν πρὸς τὸν χρῶτα.

[¶8] 22. More injury than good results from placing below the thigh a canal which does not pass farther down than the ham, for it neither prevents the body nor the leg from being moved without the thigh. And it creates uneasiness by being brought down to the ham, and has a tendency to produce what of all things should be avoided, namely, flexion at the knee, for this completely disturbs the bandages; and when the thigh and leg are bandaged, if one bend the limb at the knee, the muscles necessarily assume another shape, and the broken bones are also necessarily moved. Every endeavor then should be made to keep the ham extended. But it appears to me, that a canal which embraces the limb from the nates to the foot is of use. And moreover, a shawl should be put loosely round at the ham, along with the canal, as children are swathed in bed; and then, if the thigh-bone gets displaced either upward or to the side, it can be more easily kept in position by this means along with the canal. The canal then should be made so as to extend all along the limb or not used at all.

> Greek: 22. 22. Σωλῆνα δὲ εἰ μέν τις ὑπʼ αὐτὸν τὸν μηρὸν ὑποθείη μὴ ὑπερβάλλοντα τὴν ἰγνύην, βλάπτοι ἂν μᾶλλον ἢ ὠφελέοι· οὔτε γὰρ ἂν τὸ σῶμα κωλύοι, οὔτε τὴν κνήμην, ἄνευ τοῦ μηροῦ κινέεσθαι. ἀσηρὸν γὰρ εἴη πρὸς τὴν ἰγνύην προσβαλλόμενον· καὶ ὃ ἥκιστα δεῖ, τοῦτʼ ἂν ἐποτρύνοι ποιέειν· ἥκιστα γὰρ δεῖ κατὰ τὸ γόνυ κάμπτειν· πᾶσαν γὰρ ἂν τύρβην παρέχοι τῇσιν ἐπιδέσεσιν· καὶ μηροῦ ἐπιδεδεμένου καὶ κνήμης, ὅστις κατὰ τὸ γόνυ κάμπτοι, ἀνάγκη ἂν εἴη τούτῳ τοὺς μύας ἄλλοτε ἄλλο σχῆμα ἴσχειν· ἀνάγκη δʼ ἂν εἴη καὶ τὰ ὀστέα τὰ κατεηγότα κίνησιν ἔχειν. περὶ παντὸς οὖν ποιητέον τὴν ἰγνύην ἐντετάσθαι. δοκέοι ἂν οὖν μοι ὁ σωλὴν, ὁ περιέχων πρὸς τὸν πόδα ἀπὸ τοῦ ἰσχίου, ὠφελέειν ὑποτιθέμενος· καὶ ἄλλως κατʼ ἰγνύην ταινίην χαλαρῶς περιβάλλειν ξὺν τῷ σωλῆνι, ὥσπερ τὰ παιδία ἐν τῇσι κοίτῃσι σπαργανοῦται· εἶτα ἐπὴν ὁ μηρὸς ἐς τὸ ἄνω διαστρέφοιτο, ἢ ἐς τὸ πλάγιον, εὐκατασχετώτερον εἴη ἂν ξὺν τῷ σωλῆνι οὕτως. ἢ οὖν διαμπερὲς εἴη ποιητέος ὁ σωλὴν, ἢ οὐ ποιητέος.

[¶9] 23. The extremity of the heel should be particularly attended to, so that it may be properly laid, both in fractures of the leg and of the thigh. For if the foot be placed in a dependent position, while the rest of the body is supported, the limb must present a curved appearance at the forepart of the leg; and if the heel be placed higher than is proper, and if the rest of the leg be rather too low, the bone at the forepart of the leg must present a hollow, more especially if the heel of the patient be naturally large. But all the bones get consolidated more slowly, if not laid properly, and if not kept steady in the same position, and in this case the callus is more feeble.

> Greek: 23. 23. πτέρνης δὲ ἄκρης κάρτα χρὴ ἐπιμελέεσθαι, ὡς εὐθέτως ἔχοι, καὶ ἐν τοῖσι κατὰ κνήμην, καὶ ἐν τοῖσι κατὰ μηρὸν κατήγμασιν. ἢν μὲν γὰρ ἀπαιωρῆται ὁ ποὺς, τῆς ἄλλης κνήμης ἡρματισμένης, ἀνάγκη κατὰ τὸ ἀντικνήμιον τὰ ὀστέα κυρτὰ φαίνεσθαι· ἢν δὲ ἡ μὲν πτέρνη ὑψηλοτέρη ᾖ τοῦ μετρίου ἡρματισμένη, ἡ δὲ ἄλλη κνήμη ὑπομετέωρος ᾖ, ἀνάγκη τὸ ὀστέον τοῦτο κατὰ τὸ ἀντικνήμιον κοιλότερον φανῆναι τοῦ μετρίου, προσέτι καὶ ἢν ἡ πτέρνη τυγχάνῃ ἐοῦσα τοῦ ἀνθρώπου φύσει μεγάλη. ἀτὰρ καὶ κρατύνεται πάντα τὰ ὀστέα βραδύτερον, ἢν μὴ κατὰ φύσιν κείμενα ᾖ, καὶ τὰ μὴ ἀτρεμέοντα ἐν τῷ αὐτέῳ σχήματι, καὶ αἱ πωρώσιες ἀσθενέστεραι.

[¶10] 24. These things relate to cases in which there is fracture of the bones without protrusion of the same or wound of any other kind. In those cases in which the bones are simply broken across, and are not comminuted, but protrude, if reduced the same day or next, and secured in their place, and if there be no reason to anticipate that any splintered bones will come away; and in those in which the broken bones do not protrude, nor is the mode of fracture such that there is reason to expect the splinters will come out, some physicians heal the sores in a way which neither does much good nor harm, by means of a cleansing application, applying pitch ointment, or some of the dressings for fresh wounds, or anything else which they are accustomed to do, and binding above them compresses wetted with wine, or greasy wool, or something else of the like nature. And when the wounds become clean and are new healed, they endeavor to bind up the limb with plenty of bandages, and keep it straight with treatment does some good, and never much harm. The bones, however, can never be equally well restored to their place, but the part is a little more swelled than it should be; and the limb will be somewhat shortened, provided both bones either of the leg or fore-arm have been fractured.

> Greek: 24. 24. ταῦτα μὲν δὴ, ὅσοισι τὰ μὲν ὀστέα κατέηγεν, ἐξέχει δὲ μὴ, μηδὲ ἄλλως ἕλκος ἐγένετο. οἷσι δὲ τὰ ὀστέα κατέηγεν ἁπλῷ τῷ τρόπῳ, καὶ μὴ πουλυσχιδεῖ, ἐξέσχε δὲ, αὐθήμερα ἐμβληθέντα, ἢ τῇ ὑστεραίῃ, καὶ κατὰ χώρην ἱζόμενα, καὶ μὴ ἐπίδοξος ἡ ἀπόστασις παρασχίδων ὀστέων ἀπιέναι, ἢ καὶ οἷσιν ἕλκος μὲν ἐγένετο, τὰ δὲ ὀστέα τὰ κατεηγότα οὐκ ἐξίσχει, οὐδʼ ὁ τρόπος τῆς κατήξιος τοιοῦτος, οἷος παρασχίδας ὀστέων εἶναι ἐπιδόξους ἀναπλῶσαι, τοὺς τοιούτους οἱ μὲν μήτε μέγα ἀγαθὸν, μήτε μέγα κακὸν ποιέοντες, ἰητρεύουσι τὰ μὲν ἕλκεα καθαρτικῷ τινι, ἢ πισσηρὴν ἐπιθέντες, ἢ ἔναιμον, ἢ ἄλλο τι ὧν εἰώθασι ποιέειν· ἐπάνω δὲ τοὺς οἰνηροὺς σπλῆνας ἢ εἴρια ῤυπαρὰ ἐπιδέουσιν, ἢ ἄλλο τι τοιοῦτον. ἐπὴν δὲ τὰ ἕλκεα καθαρὰ γένηται, καὶ ἤδη ξυμφύηται, τότε τοῖσιν ὀθονίοισί συχνοῖσι πειρῶνται ἐπιδεῖν, καὶ νάρθηξι κατορθοῦν. αὕτη μὲν ἡ ἴησις ἀγαθόν τι ποιέει, κακὸν δὲ οὐ μέγα. τὰ μέντοι ὀστέα οὐχ ὁμοίως δύναται ἱδρύεσθαι ἐς τὴν ἑωυτῶν χώρην, ἀλλά τινι ὀγκηρότερα τὰ ὀστέα τοῦ καιροῦ ταύτῃ γίνεται· γένοιτο δʼ ἂν καὶ βραχύτερα, ὧν ἀμφότερα τὰ ὀστέα κατέηγεν ἢ πήχεος, ἢ κνήμης.

[¶11] 25. There are others who treat such cases at first with bandages, applying them on both sides of the seat of the injury, but omit them there, and leave the wound uncovered, and afterward they apply to the wound some cleansing medicine, and complete the dressing with compresses dipped in wine and greasy wool. This plan of treatment is bad, and it is clear that those who adopt this mode of practice are guilty of great mistakes in other cases of fracture as well as these. For it is a most important consideration to know in what manner the head of the bandage should be placed and at what part the greatest pressure should be, and what benefits would result from applying the end of the bandage and the pressure at the proper place, and what mischiefs would result from applying the head of the bandage and the pressure otherwise than at the proper place. Wherefore it has been stated in the preceding part of the work what are the results of either; and the practice of medicine bears witness to the truth of it, for in a person thus bandaged, a swelling must necessarily arise on the wound. For, if even a sound piece of skin were bandaged on either side, and a part were left in the middle, the part thus left unbandaged would become most swelled, and would assume a bad color; how then could it be that a wound would not suffer in like manner? The wound then must necessarily become discolored and its lips everted, the discharge will be ichorous and without pus, and the bones, which should not have got into a state of necrosis, exfoliate; and the wound gets into a throbbing and inflamed condition. And they are obliged to apply a cataplasm on account of the swelling, but this is an unsuitable application to parts which are bandaged on both sides, for a useless load is added to the throbbing which formerly existed in it. At last they loose the bandages when matters get very serious, and conduct the rest of the treatment without bandaging; and notwithstanding, if they meet with another case of the same description, they treat it in the same manner, for they do not think that the application of the bandages on both sides, and the exposure of the wound are the cause of what happened, but some other untoward circumstance. Wherefore I would not have written so much on this subject, if I had not well known that this mode of bandaging is unsuitable, and yet that many conduct the treatment in this way, whose mistake it is of vital importance to correct, while what is here said is a proof, that what was formerly written as to the circumstances under which bandages should be tightly applied to fractures or otherwise has been correctly written.

> Greek: 25. 25. ἄλλοι δʼ αὖ τινές εἰσιν, οἳ ὀθονίοισι τὰ τοιαῦτα ἰητρεύουσιν εὐθέως, καὶ ἔνθεν μὲν καὶ ἔνθεν ἐπιδέουσι τοῖσιν ὀθονίοισι, κατὰ δὲ τὸ ἕλκος αὐτὸ διαλείπουσι, καὶ ἐῶσιν ἀνεψύχθαι· ἔπειτα ἐπιτιθέασιν ἐπὶ τὸ ἕλκος τῶν καθαρτικῶν τι, καὶ σπλήνεσιν οἰνηροῖσιν, ἢ εἰρίοισι ῤυπαροῖσι θεραπεύουσιν. αὕτη ἡ ἴησις κακὴ, καὶ εἰκὸς τοὺς οὕτως ἰητρεύοντας τὰ μέγιστα ἀσυνετέειν, καὶ ἐν τοῖσιν ἄλλοισι κατήγμασι, καὶ ἐν τοῖσι τοιούτοισιν. μέγιστον γάρ ἐστι τὸ γινώσκειν, καθʼ ὁποῖον τρόπον χρὴ τὴν ἀρχὴν βάλλεσθαι τοῦ ὀθονίου, καὶ καθʼ ὁποῖον μάλιστα πεπιέχθαι, καὶ οἷά τε ὠφελέονται, ἢν ὀρθῶς τις βάλληται τὴν ἀρχὴν καὶ πιέζῃ ᾗ μάλιστα χρὴ, καὶ οἷα βλάπτονται, ἢν μὴ ὀρθῶς τις βάλληται, μηδὲ πιέζῃ ᾗ μάλιστα χρὴ, ἀλλὰ ἔνθεν καὶ ἔνθεν. εἴρηται μὲν οὖν καὶ ἐν τοῖσι πρόσθεν γεγραμμένοισιν, ὁποῖα ἀφʼ ἑκατέρου ἀποβαίνει· μαρτυρέει δὲ καὶ αὐτὴ ἡ ἰητρική· ἀνάγκη γὰρ τῷ οὕτως ἐπιδεομένῳ τὸ οἶδος ἐξαείρεσθαι ἐς αὐτὸ τὸ ἕλκος. καὶ γὰρ εἰ ὑγιὴς χρὼς ἔνθεν καὶ ἔνθεν ἐπιδεθείη, ἐν μέσῳ δὲ διαλειφθείη, μάλιστα κατὰ τὴν διάλειψιν οἰδήσειεν ἂν, καὶ ἀχροιήσειεν· πῶς οὖν οὐχὶ ἕλκος γε ταῦτα ἂν πάθοι; ἀναγκαίως οὖν ἔχει ἄχροον μὲν καὶ ἐκπεπλιγμένον τὸ ἕλκος εἶναι, δακρυῶδές τε καὶ ἀνεκπύητον, ὀστέα δὲ, καὶ μὴ μέλλοντα ἀποστῆναι, ἀποστατικὰ γενέσθαι· σφυγμῶδές τε καὶ πυρῶδες τὸ ἕλκος ἂν εἴη. ἀναγκάζονται δὲ διὰ τὸ οἶδος ἐπικαταπλάσσειν· ἀσύμφορον δὲ καὶ τοῦτο τοῖσιν ἔνθεν καὶ ἔνθεν ἐπιδεομένοισιν· ἄχθος γὰρ ἀνωφελὲς πρὸς τῷ ἄλλῳ σφυγμῷ ἐπιγίνεται. τελευτῶντες δὲ ἀπολύουσι τὰ ἐπιδέσματα, ὁπόταν σφιν παλιγκοτέῃ, καὶ ἰητρεύουσι τὸ λοιπὸν ἄνευ ἐπιδέσιος· οὐδὲν δʼ ἧσσον, καὶ ἤν τι ἄλλο τρῶμα τοιοῦτο λάβωσι, τῷ αὐτῷ τρόπῳ ἰητρεύουσιν· οὐ γὰρ οἴονται τὴν ἐπίδεσιν τὴν ἔνθεν καὶ ἔνθεν, καὶ τὴν ἀνάψυξιν τοῦ ἕλκεος αἰτίην εἶναι, ἀλλʼ ἄλλην τινὰ ἀτυχίην. οὐ μέντοι γε ἂν ἔγραφον περὶ τουτέου τοσαῦτα, εἰ μὴ εὖ μὲν ᾔδειν ἀσύμφορον ἐοῦσαν τὴν ἐπίδεσιν, συχνοὺς δὲ οὕτως ἰητρεύοντας, ἐπίκαιρον δὲ τὸ ἀπομάθημα, μαρτύριον δὲ τοῦ ὀρθῶς γεγράφθαι τὰ πρόσθεν γεγραμμένα, εἴτε μάλιστα πιεστέα τὰ κατήγματα, εἴτε ἥκιστα.

[¶12] 26. As a general rule it may be said, that in those cases in which a separation of bone is not expected, the same treatment should be applied as when the fractures are not complicated with an external wound; for the extension, adjustment of the bones, and the bandaging, are to be conducted in the same manner. To the wound itself a cerate mixed with pitch is to be applied, a thin folded compress is to be bound upon it, and the parts around are to be anointed with white cerate. The cloths for bandages and the other things should be torn broader than in cases in which there is no wound, and the first turn of the bandage should be a good deal broader than the wound. For a narrower bandage than the wound binds the wound like a girdle, which is not proper, or the first turn should comprehend the whole wound, and the bandaging should extend beyond it on both sides. The bandage then should be put on in the direction of the wound, and should be not quite so tight as when there is no wound, but the bandage should be otherwise applied in the manner described above. The bandages should be of a soft consistence, and more especially so in such cases than in those not complicated with a wound. The number of bandages should not be smaller, but rather greater than those formerly described. When applied, the patient should have the feeling of the parts being properly secured, but not too tight, and in particular he should be able to say that they are firm about the wound. And the intervals of time during which the parts seem to be properly adjusted, and those in which they get loose, should be the same as those formerly described. The bandages should be renewed on the third day, and the after treatment conducted in the same manner as formerly described, except that in the latter case the compression should be somewhat less than in the former. And if matters go on properly, the parts about the wound should be found at every dressing always more and more free of swelling, and the swelling should have subsided on the whole part comprehended by the bandages. And the suppurations will take place more speedily than in the case of wounds treated otherwise; and the pieces of flesh in the wound which have become black and dead, will sooner separate and fall off under this plan of treatment than any other, and the sore will come more quickly to cicatrization when thus treated than otherwise. The reason of all this is, that the parts in which the wound is situated, and the surrounding parts, are kept free of swelling. In all other respects the treatment is to be conducted as in cases of fracture without a wound of the integuments. Splints should not be applied. On this account the bandages should be more numerous than in the former case, both because they must be put on less tight, and because the splints are later of being applied. But if you do apply the splints, they should not be applied along the wound, and they are to be put on in a loose manner, especial care being taken that there may be no great compression from the splints. This direction has been formerly given. And the diet should be more restricted, and for a longer period, in those cases in which there is a wound at the commencement, and when the bones protrude through the skin; and, in a word, the greater the wound, the more severe and protracted should the regimen be.

> Greek: 26. 26. χρὴ δὲ, ὡς ἐν κεφαλαίῳ εἰρῆσθαι, οἷσιν ἂν μὴ ἐπίδοξος ᾖ ἡ τῶν ὀστέων ἀπόστασις ἔσεσθαι, τὴν αὐτὴν ἰητρείην ἰητρεύειν, ὥσπερ ἂν οἷσιν ὀστέα μὲν κατεηγότα εἴη, ἕλκος δὲ μὴ ἔχοντα· τάς τε γὰρ κατατάσιας καὶ κατορθώσιας τῶν ὀστέων τὸν αὐτὸν τρόπον ποιέεσθαι, τήν τε ἐπίδεσιν παραπλήσιον τρόπον. ἐπὶ μὲν γὰρ αὐτὸ τὸ ἕλκος πισσηρὴν κηρωτὴν χρίσαντα, σπλῆνα λεπτὸν διπλόον ἐπιδεθῆναι, τὰ δὲ πέριξ κηρωτῇ λευκῇ χρίειν. τὰ δὲ ὀθόνια καὶ τὰ ἀλλα πλατύρερά τινι ἐσχισμένα ἔστω, ἢ εἰ μὴ έλκος εἶχεν· καὶ ᾧ ἂν πρώτῳ ἐπιδέηται, συχνῷ ἔστω τοῦ ἕλκεος πλατύτερον. τὰ γὰρ στενότερα τοῦ ἕλκεος ζώσαντα ἔχει τὸ ἕλκος· τὸ δὲ οὐ χρή· ἀλλʼ ἡ πρώτη περιβολὴ ὅλον κατεχέτω τὸ ἕλκος, καὶ ὑπερεχέτω τὸ ὀθόνιον ἔνθεν τε καὶ ἔνθεν. βάλλεσθαι μὲν οὖν χρὴ τὸ ὀθόνιον κατʼ αὐτὴν τὴν ἴξιν τοῦ ἕλκεος, πιέζειν δὲ ὀλίγῳ ἧσσον ἢ εἰ μὴ ἕλκος εἶχεν, ἐπινέμεσθαι δὲ τῇ ἐπιδέσει ὥσπερ καὶ πρόσθεν εἴρηται. τὰ δὲ ὀθόνια αἰεὶ μὲν τοῦ τρόπου τοῦ μαλθακοῦ ἔστωσαν, μᾶλλον δέ τι δεῖ ἐν τοῖσι τοιούτοισιν, ἢ εἰ μὴ ἕλκος εἶχεν. πλῆθος δὲ τῶν ὀθονίων, μὴ ἐλάσσω ἔστω τῶν πρότερον εἰρημένων, ἀλλά τινι καὶ πλείω. ἢν δὲ ἐπιδεθῇ, δοκείτω τῷ ἐπιδεδεμένῳ ἡρμόσθαι μὲν, πεπιέχθαι δὲ μή· φάτω δὲ κατὰ τὸ ἕλκος μάλιστα ἡρμόσθαι. τοὺς δὲ χρόνους τοὺς αὐτοὺς μὲν χρὴ εἶναι ἐπὶ τὸ μᾶλλον δοκέειν ἡρμόσθαι, τοὺς αὐτοὺς δὲ ἐπὶ τὸ μᾶλλον δοκέειν χαλᾷν, ὥσπερ καὶ ἐν τοῖσι πρόσθεν εἴρηται. Μετεπιδεῖν δὲ διὰ τρίτης, πάντα μεταποιέοντα ἐς τοὺς τρόπους τοὺς παραπλησίους, ὥσπερ καὶ πρόσθεν εἴρηται, πλὴν ἐς τὸ σύμπαν ἧσσόν τινι πιέζειν ταῦτα ἢ ἐκεῖνα. καὶ ἢν κατὰ λόγον τὰ εἰκότα γένηται, ἰσχνότερον μὲν αἰεὶ εὑρεθήσεται τὸ κατὰ τὸ ἕλκος, ἰσχνὸν δὲ καὶ τὸ ἄλλο πᾶν τὸ ὑπὸ τῆς ἐπιδέσιος κατεχόμενον· καὶ αἵ τε ἐκπυήσιες ἔσονται θάσσους ἢ τῶν ἄλλως ἰητρευμένων ἑλκέων, ὅσα τε σαρκία ἐν τῷ τρώματι ἐμελάνθη καὶ ἐθανατώθη, θᾶσσον περιῤῥήγνυται καὶ ἐκπίπτει ἐπὶ ταύτῃ τῇ ἰητρείῃ, ἢ ἐν τῇσιν ἄλλῃσιν, ἐς ὠτειλάς τε θᾶσσον ὁρμᾶται τὸ ἕλκος οὕτως ἢ ἄλλως ἰητρευμένον. πάντων δὲ τούτων αἴτιον, ὅτι ἰσχνὸν μὲν τὸ κατὰ τὸ ἕλκος χωρίον γίνεται, ἰσχνὰ δὲ τὰ περιέχοντα. τὰ μὲν οὖν ἄλλα πάντα παραπλησίως χρὴ ἰητρεύειν, ὡς τὰ ἄνευ ἑλκώσιος ὀστέα κατηγνύμενα. τοὺς δὲ νάρθηκας οὐ χρὴ προστιθέναι. διὰ τοῦτο καὶ τὰ ὀθόνια χρὴ τούτοισι πλείω εἶναι ἢ τοῖσιν ἑτέροισιν, ὅτι τε ἧσσον πιέζεται, ὅτι τε οἱ νάρθηκες βραδύτεροι προστίθενται. ἢν μέντοι τοὺς νάρθηκας προστιθῇς, μὴ κατὰ τὴν ἴξιν τοῦ ἕλκεος προστιθέναι, ἄλλως τε καὶ χαλαρῶς προστιθέναι, προμηθεύμενος ὅκως μηδεμία σφίγξις μεγάλη ἔσται ἀπὸ τῶν ναρθήκων. εἴρηται δὲ τοῦτο καὶ ἐν τοῖσι πρότερον γεγραμμένοισιν. τὴν μέντοι δίαιταν ἀκριβεστέρην καὶ πλείω χρόνον χρὴ ποιέεσθαι οἷσιν ἐξ ἀρχῆς ἕλκεα γίνεται, καὶ οἷσιν ὀστέα ἐξίσχει· καὶ τὸ ξύμπαν δὲ εἰρῆσθαι, ἐπὶ τοῖσι ἰσχυροτάτοισι τρώμασιν ἀκριβεστέρην καὶ πουλυχρονιωτέρην εἶναι χρὴ τὴν δίαιταν.

[¶13] 27. The treatment of the sores is the same in those cases of fracture in which there was no wound of the skin at first, but one has formed in the course of treatment, owing to the pressure of the splints occasioned by the bandages, or from any other cause. In such cases it is ascertained that there is an ulcer, by the pain and the throbbing; and the swelling in the extremities becomes harder than usual, and if you apply your finger the redness disappears, but speedily returns. If you suspect anything of the kind you must loose the dressing, if there be any itching below the under-bandages, or in any other part that is bandaged, and used a pitched cerate instead of the other. If there be nothing of that, but if the ulcer be found in an irritable state, being very black and foul, and the fleshy parts about to suppurate, and the tendons to slough away, in these cases no part is to be exposed to the air, nor is anything to be apprehended from these suppurations, but the treatment is to be conducted in the same manner as in those cases in which there was an external wound at first. You must begin to apply the bandages loosely at the swelling in the extremities, and then gradually proceed upward with the bandaging, so that it may be tight at no place, but particularly firm at the sore, and less so elsewhere. The first bandages should be clean and not narrow, and the number of bandages should be as great as in those cases in which the splints were used, or somewhat fewer. To the sore itself a compress, anointed with white cerate, will be sufficient, for if a piece of flesh or nerve (tendon?) become black, it will fall off; for such sores are not to be treated with acrid, but with emollient applications, like burns. The bandages are to be renewed every third day, and no splints are to be applied, but rest is to be more rigidly maintained than in the former cases, along with a restricted diet. It should be known, that if any piece of flesh or tendon be to come away, the mischief will spread much less, and the parts will much more speedily drop off, and the swelling in the surrounding parts will much more completely subside, under this treatment, than if any of the cleansing applications be put upon the sore. And if any part that is to come away shall fall off, the part will incarnate sooner when thus treated than otherwise, and will more speedily cicatrize. Such are the good effects of knowing how a bandage can be well and moderately applied. But a proper position, the other parts of the regimen, and suitable bandages cooperate.

> Greek: 27. 27. ἡ αὐτὴ δὲ ἰητρείη τῶν ἑλκέων, καὶ οἷσιν ὀστέα μὲν κατέηγεν, ἕλκος δὲ ἐξ ἀρχῆς μηδὲν ἦν, ἐν δὲ τῇ ἰητρείῃ ἐπιγίνεται, ἢ τοῖσιν ὀθονίοισιν μᾶλλον πιεχθέντος νάρθηκος ὑπὸ ἐνέδρης, ἢ ὑπὸ ἄλλης τινὸς προφάσιος. γινώσκεται μὲν οὖν τὰ τοιαῦτα, ἢν ἕλκος ὑπῇ, τῇ τε ὀδύνῃ καὶ τοῖσι σφυγμοῖσιν· καὶ τὸ οἴδημα τὸ ἐν τοῖσιν ἄκροισι, σκληρότερον γίνεται τῶν τοιουτέων, καὶ εἰ τὸν δάκτυλον ἐπαγάγοις, τὸ ἔρευθος ἐξαιρέεται, ἀτὰρ καὶ αὖθις ὑποτρέχει ταχέως. ἢν οὖν τι τοιοῦτον ὑποπτεύῃς, λύσαντα χρὴ, ἢν μὲν ᾖ κνησμὸς κατὰ τὰς ὑποδεσμίδας, ἢ ἐπὶ τὸ ἄλλο τὸ ἐπιδεδεμένον, πισσηρῇ κηρωτῇ ἀντὶ τῆς ἑτέρης χρῆσθαι. ἢν δὲ τούτων μὲν μηδὲν ᾖ, αὐτὸ δὲ τὸ ἕλκος ἠρεθισμένον εὑρίσκηται, μέλαν ἐπὶ πουλὺ ἢ ἀκάθαρτον, καὶ τῶν μὲν σαρκῶν ἐκπυησομένων, τῶν δὲ νεύρων προσεκπεσουμένων, τουτέους οὐδὲν χρὴ ἀναψύχειν παντάπασιν, οὐδέ τι φοβεῖσθαι τὰς ἐκπυήσιας ταύτας, ἀλλʼ ἰητρεύειν, τὰ μὲν ἄλλα παραπλήσιον τρόπον, ὥσπερ καὶ οἷσιν ἐξ ἀρχῆς ἕλκος ἐγένετο. τοῖσι δὲ ὀθονίοισιν ἄρχεσθαι χρὴ ἐπιδέοντα ἀπὸ τοῦ οἰδήματος τοῦ ἐν τοῖσιν ἀκραίοις πάνυ χαλαροῖσι, καὶ ἔπειτα ἐπινέμεσθαι τῇ ἐπιδέσει αἰεὶ ἐς τὸ ἄνω, καὶ πεπιέχθαι μὲν μηδαμῇ, ἡρμόσθαι δὲ μάλιστα κατὰ τὸ ἕλκος, τὰ δὲ ἄλλα ἐπὶ ἧσσον. τὰ δὲ ὀθόνια τὰ πρῶτα, ταῦτα μὲν καθαρὰ ἔστω καὶ μὴ στενά· τὸ δὲ πλῆθος τῶν ὀθονίων ἔστω, ὅσον περ καὶ ἐν τοῖσι νάρθηξιν εἰ ἐπιδέοιντο, ἢ ὀλίγῳ ἔλασσον. ἐπὶ δὲ αὐτὸ τὸ ἕλκος ἱκανὸν σπληνίον τῇ λευκῇ κηρωτῇ κεχρισμένον· ἤν τε γὰρ σὰρξ, ἤν τε νεῦρον μελανθῇ, προσεκπεσεῖται· τὰ γὰρ τοιαῦτα οὐ χρὴ δριμέσιν ἰητρεύειν, ἀλλὰ μαλθακοῖσιν, ὥσπερ τὰ πυρίκαυστα. Μετεπιδεῖν δὲ διὰ τρίτης, νάρθηκας δὲ μὴ προστιθέναι· ἀτρεμέειν δὲ ἐπὶ μᾶλλον, ἢ τὸ πρόσθεν, καὶ ὀλιγοσιτέειν. εἰδέναι δὲ χρὴ, εἴ τε σὰρξ, εἴ τε νεῦρον τὸ ἐκπεσούμενόν ἐστιν, ὅτι οὕτω πολλῷ μὲν ἧσσον νέμεται ἐπὶ πλεῖον, πολλῷ δὲ θᾶσσον ἐκπεσεῖται, πολλῷ δὲ ἰσχνότερα τὰ περιέχοντα ἔσται, ἢ εἴ τις, ἀπολύσας τὰ ὀθόνια, ἐπιθείη τι τῶν καθαρτικῶν φαρμάκων ἐπὶ τὸ ἕλκος. καίτοι καὶ ἢν ἐκπέσῃ τὸ ἐκπεσούμενον, θᾶσσόν τε σαρκοῦται ἐκείνως ἢ ἑτέρως ἰητρευόμενον, καὶ θᾶσσον ὠτειλοῦται. πάντα μήν ἐστι ταῦτα ὀρθῶς ἐπιδεῖν καὶ μετρίως ἐπίστασθαι. Προσσυμβάλλεται δὲ καὶ τὰ σχήματα, καὶ οἷα χρὴ, εἶναι, καὶ ἡ ἄλλη δίαιτα, καὶ τῶν ὀθονίων ἡ ἐπιτηδειότης.

[¶14] 28. If you are deceived with regard to a recent wound, supposing there will be no exfoliation of the bones, while they are on the eve of coming out of the sore, you must not hesitate to adopt this mode of treatment; for no great mischief will result, provided you have the necessary dexterity to apply the bandages well and without doing any harm. And this is a symptom of an exfoliation of bone being about to take place under this mode of treatment; pus runs copiously from the sore, and appears striving to make its escape. The bandage must be renewed more frequently on account of the discharge, since otherwise fevers come on; if the sore and surrounding parts be compressed by the bandages they become wasted. Cases complicated with the exfoliation of very small bones, do not require any change of treatment, only the bandages should be put on more loosely, so that the discharge of pus may not be intercepted, but left free, and the dressings are to be frequently renewed until the bone exfoliate, and the splints should not be applied until then.

> Greek: 28. 28. ἢν δʼ ἄρα ἐξαπατηθῇς ἐν τοῖσι νεοτρώτοισι, μὴ οἰόμενος ὀστέων ἀπόστασιν ἔσεσθαι, τὰ δʼ ἐπίδοξα ᾖ ἀναπλῶσαι, οὐ χρὴ ὀῤῥωδέειν τοῦτον τὸν τρόπον τῆς ἰητρείης· οὐδὲν γὰρ ἂν μέγα φλαῦρον γένοιτο, ἢν μοῦνον οἷός τε ᾖς τῇ χειρὶ τὰς ἐπιδέσιας ἀγαθὰς καὶ ἀσινέας ποιέεσθαι. σημεῖον δὲ τόδε, ἢν μέλλῃ ὀστέων ἀπόστασις ἔσεσθαι ἐν τῷ τρόπῳ τούτῳ τῆς ἰητρείης· πῦον γὰρ συχνὸν ῤέει ἐκ τοῦ ἕλκεος, καὶ ὀργᾷν φαίνεται. πυκνότερον οὖν μετεπιδέεσθαι διὰ τὸν πλάδον· ἐπεὶ ἄλλως τε καὶ ἀπύρετοι γίνονται, ἢν μὴ κάρτα πιέζωνται ὑπο τῆς ἐπιδέσιος, καὶ τὸ ἕλκος, καὶ τὰ περιέχοντα ἰσχνά. ὅσαι μὲν οὖν λεπτῶν πάνυ ὀστέων ἀποστάσιες, οὐδεμιῆς μεγάλης μεταβολῆς δέονται, ἀλλʼ ἢ χαλαρωτέρως ἐπίδεῖν, ὡς μὴ ἀπολαμβάνηται τὸ πῦον, ἀλλʼ εὐαπόῤῥυτον ᾖ, καὶ πυκνότερον μετεπιδεῖν, ἔστʼ ἂν ἀποστῇ τὸ ὀστέον, καὶ νάρθηκας μὴ προστιθέναι.

[¶15] 29. Those cases in which the exfoliation of a larger piece of bone is expected, whether you discover this at the commencement, or perceive subsequently that it is to happen, no longer require the same mode of treatment, only that the extension and arrangement of the parts are to be performed in a manner that has been described; but having formed double compresses, not less than half a fathom in breadth (being guided in this by the nature of the wound), and considerably shorter than what would be required to go twice round the part that is wounded, but considerably longer than to go once round, and in number what will be sufficient, these are to be dipped in a black austere wine; and beginning at the middle, as is done in applying the double-headed bandage, you are to wrap the part around and proceed crossing the heads in the form of the bandage called “ascia.” These things are to be done at the wound, and on both sides of it; and there must be no compression, but they are to be laid on so as to give support to the wound. And on the wound itself is to be applied the pitched cerate, or one of the applications to recent wounds, or any other medicine which will suit with the embrocation. And if it be the summer season, the compresses are to be frequently damped with wine; but if the winter season, plenty of greasy wool, moistened with wine and oil, should be applied. And a goat’s skin should be spread below, so as to carry off the fluids which run from the wound; these must be guarded against, and it should be kept in mind, that parts which remain long in the same position are subject to excoriations which are difficult to cure.

> Greek: 29. 29. Ὁκόσοισι δὲ μείζονος ὀστέου ἀπόστασις ἐπίδοξος γένηται, ἤν τε ἐξ ἀρχῆς προγνῷς, ἤν τε καὶ ἔπειτα μεταγνῷς, οὐκ ἔτι τῆς αὐτῆς ἰητρείης δεῖται· ἀλλὰ τὰς μὲν κατατάσιας, καὶ τὰς διορθώσιας οὕτω ποιέεσθαι, ὥσπερ εἴρηται· σπλῆνας δὲ χρὴ διπλοῦς, πλάτος μὲν ἡμισπιθαμιαίους, μὴ ἐλάσσους (ὁκοῖον δὲ ἄν τι καὶ τὸ τρῶμα ἦ, πρὸς τοῦτο τεκμαίρεσθαι), μῆκος δὲ βραχυτέρους μὲν μὴ ὀλίγῳ, ἢ ὥστε δὶς περιικνέεσθαι περὶ τὸ τετρωμένον, μακροτέρους δὲ συχνῷ, ἢ ὥστε ἅπαξ περιικνέεσθαι, πλῆθος δὲ, ὁκόσους ἂν ξυμφέρῃ, ποιησάμενον, τούτους ἐν οἴνῳ μέλανι αὐστηρῷ βρέχοντα, χρὴ ἐκ μέσου ἀρχόμενον, ὡς ἀπὸ δύο ἀρχῶν ὑποδεσμὶς ἐπιδεῖται, περιελίσσειν, κἄπειτα σκεπαρνηδὸν παραλλάσσοντα τὰς ἀρχὰς ἀφιέναι. ταῦτα κατά τε αὐτὸ τὸ ἕλκος ποιέειν, καὶ κατὰ τὸ ἔνθεν καὶ ἔνθεν τοῦ ἕλκεος· καὶ πεπιέχθω μὲν μὴ, ἀλλʼ ὅσον ἑρμασμοῦ ἕνεκεν τοῦ ἕλκεος προσκείσθω. ἐπὶ δὲ αὐτὸ τὸ ἕλκος ἐπιτιθέναι χρὴ πισσηρὴν, ἤ τι τῶν ἐναίμων, ἤ τι τῶν ἄλλων φαρμάκων, ὅ τι ξύντροφόν ἐστιν ἐπιτέγξει. καὶ ἢν μὲν ἡ ὥρη θερινὴ ᾖ, ἐπιτέγγειν τῷ οἴνῳ τοὺς σπλῆνας πυκνά· ἢν δὲ χειμερινὴ ἡ ὥρη ᾖ, εἰρία πουλλὰ ῤυπαρὰ, νενοτισμένα οἴνῳ καὶ ἐλαίῳ, ἐπικείσθω. Ἰξαλῆν δὲ χρὴ ὑποτετάσθαι, καὶ εὐαπόῤῥυτα ποιέειν, φυλάσσοντα τοὺς ὑποῤῥόους, μεμνημένον ὅτι οἱ τόποι οἱ ἐν τοῖσιν αὐτοῖσι σχήμασι πολλὸν χρόνον κείμενοι, ἐκτρίμματα δυσάκεστα ποιέουσιν.