第1章

Wemustavoidwettingallsortsofulcersexceptwithwine,unlesstheulcerbesituatedinajoint。For,thedryisnearertothesound,andthewettotheunsound,sinceanulceriswet,butasoundpartisdry。Anditisbettertoleavethepartwithoutabandageunlessaunlessacataplasmbeapplied。Neitherdocertainulcersadmitofcataplasms,andthisisthecasewiththerecentratherthantheold,andwiththosesituatedinjoints。Asparedietandwateragreewithallulcers,andwiththemorerecentratherthantheolder;andwithanulcerwhicheitherisinflamedorisabouttobeso;andwherethereisdangerofgangrene;andwiththeulcersaninflammationinjoints;andwherethereisdangerofconvulsion;andinwoundsofthebelly;butmostespeciallyinfracturesoftheheadandthigh,oranyothermemberinwhichafracturemayhaveoccurred。Inthecaseofanulcer,itisnotexpedienttostand;moreespeciallyiftheulcerbesituatedintheleg;butneither,also,isitpropertositorwalk。Butquietandrestareparticularlyexpedient。Recentulcers,boththeulcersthemselvesandthesurroundingparts,willbeleastexposedtoinflammation,ifoneshallbringthemtoasuppurationasexpeditiouslyaspossible,andifthematterisnotpreventedfromescapingbythemouthofthesore;or,ifoneshouldrestrainthesuppuration,sothatonlyasmallandnecessaryquantityofpusmaybeformed,andthesoremaybekeptdrybyamedicinewhichdoesnotcreateirritation。Forthepartbecomesinflamedwhenrigorandthrobbingsupervene;forulcersthengetinflamedwhensuppurationisabouttoform。Asoresuppurateswhenthebloodischangedandbecomesheated;sothatbecomingputrid,itconstitutesthepusofsuchulcers。Whenyouseemtorequireacataplasm,itisnottheulceritselftowhichyoumustapplythecataplasm,buttothesurroundingparts,sothatthepusmayescapeandthehardenedpartsmaybecomesoft。Ulcersformedeitherfromthepartshavingbeencutthroughbyasharpinstrument,orexcised,admitofmedicamentsforbloodywounds(\'enaima),andwhichwillpreventsuppurationbybeingdesiccanttoacertaindegree。But,whenthefleshhasbeencontusedandroughlycutbytheweapon,itistobesotreatedthatitmaysuppurateasquicklyaspossible;forthustheinflammationisless,anditisnecessarythatthepiecesoffleshwhicharebruisedandcutshouldmeltawaybybecomingputrid,beingconvertedintopus,andthatnewfleshshouldthengrowup。Ineveryrecentulcer,exceptinthebelly,itisexpedienttocausebloodtoflowfromitabundantly,andasmayseemseasonable;forthuswillthewoundandtheadjacentpartsbelessattackedwithinflammation。And,inlikemanner,fromoldulcers,especiallyifsituatedintheleg,inatoeorfinger,morethaninanyotherpartofthebody。Forwhenthebloodflowstheybecomedrierandlessinsize,asbeingthusdriedup。Itisthis(theblood?)

especiallywhichpreventssuchulcersfromhealing,bygettingintoastateofputrefactionandcorruption。But,itisexpedient,aftertheflowoftheblood,tobindovertheulcerathickandsoftpieceofsponge,ratherdrythanwet,andtoplaceabovethespongesomeslenderleaves。Oil,andallthingsofanemollientandoilynature,disagreewithsuchulcers,unlesstheyaregettingnearlywell。

Neitherdoesoilagreewithwoundswhichhavebeenrecentlyinflicted,noryetdomedicinesformedwithoilorsuet,moreespeciallyiftheulcerstandsinneedofmorecleansing。And,inaword,itisinsummerandinwinterthatwearetosmearwithoilthesesoresthatrequiresuchmedicines。

2。Gentlepurgingofthebowelsagreeswithmostulcers,andinwoundsofthehead,belly,orjoints,wherethereisdangerofgangrene,insuchasrequiresutures,inphagedaenic,spreadingandinotherwiseinveterateulcers。Andwhenyouwanttoapplyabandage,noplastersaretobeuseduntilyouhaverenderedthesoredry,andthenindeedyoumayapplythem。Theulceristobefrequentlycleanedwithasponge,andthenadryandcleanpieceofclothistobefrequentlyappliedtoit,andinthiswaythemedicinewhichitissupposedwillagreewithitistobeapplied,eitherwithorwithoutabandage。Thehotseasonagreesbetterthanwinterwithmostulcers,exceptthosesituatedintheheadandbelly;buttheequinoctialseasonagreesstillbetterwiththem。Ulcerswhichhavebeenproperlycleansedanddriedastheyshouldbe,donotusuallygetintoathestate。Whenabonehasexfoliated,orhasbeenburned,orsawed,orremovedinanyotherway,thecicatricesofsuchulcersbecomedeeperthanusual。Ulcerswhicharenotcleansed,arenotdisposedtouniteifbroughttogether,nordothelipsthereofapproximateoftheirownaccord。Whenthepointsadjoiningtoanulcerareinflamed,theulcerisnotdisposedtohealuntiltheinflammationsubside,norwhenthesurroundingpartsareblackenedbymortification,norwhenavarixoccasionsanoverflowofbloodinthepart,istheulcerdisposedtoheal,unlessyoubringthesurroundingpartsintoahealthycondition。

3。Circularulcers,ifsomewhathollow,youmustscarifyallalongtheiredges,ortotheextentofhalfthecircle,accordingtothenaturalstatureoftheman。Whenerysipelassupervenesuponanysore,youmustpurgethebody,inthewaymostsuitabletotheulcer,eitherupwardordownward。Whenswellingarisesaroundan。

ulcer,andiftheulcerremainfreefrominflammation,therewillbeadepositofmatterinprocessoftime。Andwhateverulcergetsswelledalongwithinflammationanddoesnotsubsideastheotherpartssubsidewhichbecameinflamedandswelledatthesametime,thereisadangerthatsuchanulcermaynotunite。Whenfromafall,orinanyotherway,aparthasbeentornorbruised,andthepartssurroundingtheulcerhavebecomeswelled,and,havingsuppurated,matterflowsfromtheswellingbytheulcer,ifinsuchcasesacataplasmberequired,itshouldnotbeappliedtothesoreitself,buttothesurroundingparts,sothatthepusmayhavefreeexit,andtheinduratedpartsmaybesoftened。Butwhenthepartsaresoftenedastheinflammationceases,thenthepartswhichareseparatedaretobebroughttowardoneanother,bindingonspongesandapplyingthem,beginningfromthesoundpartsandadvancingtotheulcerbydegrees。Butplentyofleavesaretobeboundabovethesponge。Whenthepartsarepreventedfromcomingtogetherbyapieceoffleshfullofhumors,itistoberemoved。Whentheulcerisdeepseatedintheflesh,itisswelledup,bothfromthebandagingandthecompression。Suchanulcershouldbecutupuponadirector(specillum)ifpossible,atthepropertime,soastoadmitafreedischargeofthematter,andthenthepropertreatmentistobeappliedasmaybeneeded。Forthemostpart,ineveryhollowulcerwhichcanbeseenintowhichcanbeseenintodirectwithoutbeinganyswellingpresent,iftherebeputrefactioninit,orifthefleshbeflabbyandputrid,suchanulcer,andthepartswhichsurroundit,willbeseentobeblackandsomewhatlivid。Andofcorrodingulcers,thosewhicharephagedaenic,spreadandcorrodemostpowerfully,and,inthiscase,thepartssurroundingthesorewillhaveablackandsub-lividappearance。

4。Cataplasmsforswellingsandinflammationinthesurroundingparts。Boiledmullein,therawleavesofthetrefoil,andtheboiledleavesoftheepipetrum,andthepoley,andiftheulcerstandinneedofcleansing,allthesethingsalsocleanse;andlikewisetheleavesofthefig-tree,andoftheolive,andthehorehound,allthesearetobeboiled;andmoreespeciallythechaste-tree,andthefig,andtheolive,andtheleavesofthepomegranatearetobeboiledinlikemanner。Thesearetobeusedraw:andtheleavesofthemallowpoundedwithwine,andtheleavesofrue,andthoseofthegreenorigany。Withallthese,linseedistobeboiledupandmixedbypoundingitasaveryfinepowder。Whenthereisdangeroferysipelasseizingtheulcers,theleavesofwoadaretobepoundedandappliedrawinacataplasmalongwithlinseed,orthelinseedistobemoistenedwiththejuiceofstrychnosorofwoad,andappliedasacataplasm。Whentheulcerisclean,butbothitandthesurroundingpartsareinflamed,lentilistobeboiledinwineandfinelytriturated,and,beingmixedwithalittleoil,itistobeappliedasacataplasm;andtheleavesofthehip-treearetobeboiledinwaterandpoundedinafinepowderandmadeintoacataplasm;andapplybelowathin,cleanpieceofclothwettedinwineandoil;andwhenyouwishtoproducecontraction,preparetheleavesofthehip-treelikethelentil,andthecress;wineandfinely-powderedlinseedaretobemixedtogether。Andthisisproper:linseed,andrawchaste-tree,andMelianalum,allthesethingsbeingmaceratedinvinegar。