Welcome
   Home | Texts by category | | Quick Search:   
Authors
Works by Hippocrates
Pages of On The Articulations



Previous | Next
                  

On The Articulations   


quiet as possible, lie in a recumbent position, and observe a
restricted regimen. And it will be better also that he should get some
gentle emetics. The sore is to be treated with dressings for fresh
wounds, which permit of allusions, or with the leaves of camomile,
or with the applications for fractured bones of the head, but
nothing very cold must be applied. The first (most distant?) joints
are least dangerous, but those still higher, are more so. Reduction
should be made the same day, or the next, but by no means on the third
or fourth, for it is on the fourth day that exacerbations especially
attack. In those cases, then, where immediate reduction cannot be
accomplished, we must wait until after the aforesaid days; for
whatever you reduce within ten days, may be expected to induce
spasm. But if the spasm supervene on its being reduced, the joint
should be quickly displaced, and bathed frequently with warm water,
and the whole body should be kept in a warm, soft, and easy condition,
and more especially about the joints, for the whole body should rather
be in a bent than in an extended state. Moreover, it is to be
expected, that the articular extremities of the bones of the fingers
will for this generally happens, if even the least degree of
inflammation take place, so that if it were not that the physician
would be exposed to censure, owing to the ignorance of the common
people, no reduction should be made at all. The reduction of the bones
of joints which have protruded through the skin, is attended with
the dangers which have been described.

68. When the articular bones of the fingers are fairly chopped
off, these cases are mostly unattended with danger, unless deliquium
come on in consequence of the injury, and ordinary treatment will be
sufficient to such sores. But when resection is made, not at the
articulations, but at some other point in the bones, these cases
also are free from danger, and are still more easily cured than the
others; and the fractured bones of the fingers which protrude
otherwise than at the joint admit of reduction without danger.
Complete resections of bones at the joints, whether the foot, the
hand, the leg, the ankle, the forearm, the wrist, for the most part,
are not unattended with danger, unless one be cut off at once by
deliquium animi, or if continual fever supervene on the fourth day.

69. With regard to the sphacelus of fleshy parts, it takes place
in wounds where there are large blood-vessels, which have been
strongly compressed, and in fractures of bones which have been bound
too tight, and in other cases of immoderate constriction, when the
parts which have been strangulated generally drop off; and the most of
such patients recover, even when a portion of the thigh comes away, or
of the arm, both bones and flesh, but less so in this case; and when
the fore-arm and leg drop off, the patients readily recover. In
cases then, of fracture of the bones, when strangulation and
blackening of the parts take place at first, the separation of the
dead and living parts quickly occurs, and the parts speedily drop off,
as the bones have already given way; but when the blackening
(mortification) takes place while the bones are entire, the fleshy
parts, in this case, also quickly die, but the bones are slow in
separating at the boundary of the blackening, and where the bones
are laid bare. Those parts of the body which are below the
boundaries of the blackening are to be removed at the joint, as soon
as they are fairly dead and have lost their sensibility; care being
taken not to wound any living part; for if the part which is cut off
give pain, and if it prove not to be quite dead, there is great danger
lest the patient may swoon away from the pain, and such swoonings
often are immediately fatal. I have known the thigh-bones, when
denuded in this manner, drop off on the eightieth day; but in the case
of this patient, the parts below were separated at the knee on the
twentieth day, and, as I thought, too early, for it appeared to me
that this should be done more guardedly. In a case which I had of such

Previous | Next
Site Search