Kitap 5
26
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.
