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　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　400　BC

　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　ON　THE　SURGERY

　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　by　Hippocrates

　　　　　　　　　　　　　　　　　　　　　　　　　　Translated　by　Francis　Adams









　　IT　IS　the　business　of　the　physician　to　know；　in　the　first　place；

things　similar　and　things　dissimilar；　those　connected　with　things　most

important；　most　easily　known；　and　in　anywise　known；　which　are　to　be

seen；　touched；　and　heard；　which　are　to　be　perceived　in　the　sight；

and　the　touch；　and　the　hearing；　and　the　nose；　and　the　tongue；　and

the　understanding；　which　are　to　be　known　by　all　the　means　we　know

other　things。

　　2。　The　things　relating　to　surgery；　are…　the　patient；　the　operator；

the　assistants；　the　instruments；　the　light；　where　and　how；　how　many

things；　and　how；　where　the　body；　and　the　instruments；　the　time；　the

manner；　the　place。

　　3。　The　operator　is　either　sitting　or　standing；　conveniently　for

himself；　for　the　person　operated　upon；　for　the　light。　There　are　two

kinds　of　light；　the　common　and　the　artificial；　the　common　is　not　at

our　disposal；　the　artificial　is　at　our　disposal。　There　are　two　modes

of　using　each；　either　to　the　light；　or　from　the　light　（to　the

side？）。　There　is　little　use　of　that　which　is　from　（or　oblique　to　the

light）；　and　the　degree　of　it　is　obvious。　As　to　opposite　the　light；

we　must　turn　the　part　to　be　operated　upon　to　that　which　is　most

brilliant　of　present　and　convenient　lights；　unless　those　parts　which

should　be　concealed；　and　which　it　is　a　shame　to　look　upon；　thus　the

part　that　is　operated　upon　should　be　opposite　the　light；　and　the

operator　opposite　the　part　operated　upon；　except　in　so　far　as　he

does　not　stand　in　his　own　light；　for　in　this　case　the　operator　will

indeed　see；　but　the　thing　operated　upon　will　not　be　seen。　With

regard　to　himself　when　sitting；　his　feet　should　be　raised　to　a

direct　line　with　his　knees；　and　nearly　in　contact　with　one　another；

the　knees　a　little　higher　than　the　groins；　and　at　some　distance　from

one　another；　for　the　elbows　to　rest　upon　them。　The　robe；　in　a　neat　and

orderly　manner；　is　to　be　thrown　over　the　elbows　and　shoulders

equally　and　proportionally。　With　regard　to　the　part　operated　upon；

we　have　to　consider　how　far　distant；　and　how　near；　above；　below；　on

this　side　on　that　side；　or　in　the　middle。　The　measure　as　to　distance

and　proximity　is；　that　the　elbows　do　not　press　the　knees　before；　nor

the　sides　behind；　that　the　hands　be　not　raised　higher　than　the

breasts；　nor　lower　than　so　as　that　when　the　breast　reposes　on　the

knees　he　may　have　the　hands　at　right　angles　with　the　arm：　thus　it　is

as　regards　the　medium；　but　as　concerns　this　side　or　that；　the　operator

must　not　be　beyond　his　be　beyond　his　seat；　but　in　proportion　as　he　may

require　turning　he　must　shift　the　body；　or　part　of　the　body；　that　is

operated　upon。　When　standing；　he　must　make　his　inspection；　resting

firmly　and　equally　on　both　feet；　but　he　must　operate　while

supporting　himself　upon　either　leg；　and　not　the　one　on　the　same　side

with　the　hand　which　he　makes　use　of；　the　knee　being　raised　to　the

height　of　the　groins　as　while　sitting；　and　the　other　measures　in

like　manner。　The　person　operated　upon　should　accommodate　the

operator　with　regard　to　the　other　parts　of　his　body；　either

standing；　sitting；　or　lying；　so　as　that　he　may　continue　to　preserve

his　figure；　avoid　sinking　down；　shrinking　from；　turning　away；　and

may　maintain　the　figure　and　position　of　the　part　operated　upon；　during

the　act　of　presentation；　during　the　operation；　and　in　the　subsequent

position。

　　4。　The　nails　should　be　neither　longer　nor　shorter　than　the　points　of

the　fingers；　and　the　surgeon　should　practice　with　the　extremities　of

the　fingers；　the　index…finger　being　usually　turned　to　the　thumb；

when　using　the　entire　hand；　it　should　be　prone；　when　both　hands；

they　should　be　opposed　to　one　another。　It　greatly　promotes　a　dexterous

use　of　the　fingers　when　the　space　between　them　is　large；　and　when

the　thumb　is　opposed　to　the　index。　But　it　is　clearly　a　disease　when

the　thumb　is　impaired　from　birth；　or　when；　from　a　habit　contracted

during　the　time　of　nursing；　it　is　impeded　in　its　motions　by　the

fingers。　One　should　practice　all　sorts　of　work　with　either　of　with

either　of　them；　and　with　both　together　（for　they　are　both　alike）；

endeavouring　to　do　them　well；　elegantly；　quickly；　without　trouble；

neatly；　and　promptly。

　　5。　The　instruments；　and　when　and　how　they　should　be　prepared；　will

be　treated　of　afterwards；　so　that　they　may　not　impede　the　work；　and

that　there　may　be　no　difficulty　in　taking　hold　of　them；　with　the

part　of　the　body　which　operates。　But　if　another　gives　them；　he　must　be

ready　a　little　beforehand；　and　do　as　you　direct。

　　6。　Those　about　the　patient　must　present　the　part　to　be　operated　upon

as　may　seem　proper；　and　they　must　hold　the　rest　of　the　body　steady；　in

silence；　and　listening　to　the　commands　of　the　operator。

　　7。　There　are　two　views　of　bandaging：　that　which　regards　it　while

doing；　and　that　which　regards　it　when　done。　It　should　be　done　quickly；

without　pain；　with　ease；　and　with　elegance；　quickly；　by　despatching

the　without　pain；　by　being　readily　done；　with　ease；　by　being

prepared　for　everything；　and　with　elegance；　so　that　it　may　be

agreeable　to　the　sight。　By　what　mode　of　training　these　accomplishments

are　to　be　acquired　has　been　stated。　When　done；　it　should　fit　well

and　neatly；　it　is　neatly　done　when　with　judgment；　and　when　it　is　equal

and　unequal；　according　as　the　parts　are　equal　or　unequal。　The　forms　of

it　（the　bandage？）　are　the　simple；　the　slightly　winding　（called　ascia）；

the　sloping　（sima）；　the　monoculus；　the　rhombus；　and　the

semi…rhombus。　The　form　of　bandage　should　be　suitable　to　the　form　and

the　affection　of　the　part　to　which　it　is　applied。

　　8。　There　are　two　useful　purposes　to　be　fulfilled　by　bandaging：

（first；）　strength；　which　is　imparted　by　the　compression　and　the　number

of　folds。　In　one　case　the　bandage　effects　the　cure；　and　in　another

it　contributes　to　the　cure。　For　these　purposes　this　is　the　rule…

that　the　force　of　the　constriction　be　such　as　to　prevent　the　adjoining

parts　from　separating；　without　compressing　them　much；　and　so　that

the　parts　may　be　adjusted　but　not　forced　together；　and　that　the

constriction　be　small　at　the　extremities；　and　least　of　all　in　the

middle。　The　knot　and　the　thread　that　is　passed　through　should　not　be

in　a　downward　but　in　an　upward　direction；　regard　being　had　to　the

circumstances　under　which　the　case　is　presented；　to　position；　to　the

bandaging；　and　to　the　compression。　The　commencement　of　the　ligatures

is　not　to　be　placed　at　the　wound；　but　where　the　kriot　is　situated。　The

knot　should　not　be　placed　where　it　will　be　exposed　to　friction；　nor

where　it　will　be　in　the　way；　nor　where　it　will　be　useless。　The　knot

and　the　thread　should　be　soft；　and　not　large。

　　9。　（Second。）　One　ought　to　be　well　aware　that　every　bandage　has　a

tendency　to　fall　off　towards　the　part　that　declines　or　becomes

smaller；　as；　for　example；　upwards；　in　the　case　of　the　head；　and

downwards；　in　the　case　of　the　leg。　The　turns　of　the　bandage　should

be　made　from　right　to　left；　and　from　left　to　right；　except　on　the

head；　where　it　should　be　in　a　straight　direction。　When　opposite

parts　are　to　be　bandaged　together；　we　must　use　a　bandage　with　two

heads；　or　if　we　make　use　of　a　bandage　with　one　head；　we　must　attach　it

in　like　manner　at　some　fixed　point：　such；　for　example；　as　the　middle

of　the　head；　and　so　in　other　cases。　Those　parts　which　are　much　exposed

to　motion；　such　as　the　joints；　where　there　is　a　flexion；　should　have

few　and　slight　bandages　applied　to　them；　as　at　the　ham；　but　where

there　is　much　extension；　the　bandage　should　be　single　and　broad；　as　at

the　kneepan；　and　for　the　maintenance　of　the　bandage　in　its　proper

place；　some　turns　should　be　carried　to　those　parts　which　are　not

much　moved；　and　are　lank；　such　as　the　parts　above　and　below　the

knee。　In　the　case　of　the　shoulder；　a　fold　should　be　carried　round　by

the　other　armpit；　in　that　of　the　groin；　by　the　flanks　of　the

opposite　side；　and　of　the　leg；　to　above　the　calf　of　the　leg。　When

the　bandage　has　a　tendency　to　escape　above；　it　should　be　secured

below；　and　vice　versa；　and　where　there　is　no　means　of　doing　this；　as

in　the　case　of　the　head；　the　turns　are　to　be　made　mostly　on　the　most

level　part　of　the　head；　and　the　folds　are　to　be　done　with　as　little

obliquity　as　possible；　so　that　the　firmest　part　being　last　applied　may

secure　the　portions　which　are　more　movable。　When　we　cannot　secure

the　bandaging　by　means　of　folds　of　the　cloth；　nor　by　suspending　them

from　the　opposite　side；　we　must　have　recourse　to　stitching　it　with

ligatures；　either　passed　circularly　or　in　the　form　of　a　seam。

　　10。　The　bandages　should　be　clean；　light；　soft；　and　thin。　One

should　practice　rolling　with　both　hands　together；　and　with　either

separately。　One　should　also　choose　a　suitable　one；　according　to　the

breadth　and　thickness　of　the　parts。　The　heads　of　the　bandages　should

be　hard；　smooth；　and　neatly　put　on。　That　sort　of　bandaging　is　the

worst　which　quickly　falls　off；　but　tho