on fistulae-第1部分
按键盘上方向键 ← 或 → 可快速上下翻页,按键盘上的 Enter 键可回到本书目录页,按键盘上方向键 ↑ 可回到本页顶部!
————未阅读完?加入书签已便下次继续阅读!
400 BC
ON FISTULAE
by Hippocrates
translated by Francis Adams
Fistulae are produced by contusions and tubercles; and they are also
occasioned by rowing; on horseback; when blood accumulates in the
nates near the anus。 For; having become putrid; it spreads to the soft
parts (the breech being of a humid nature; and the flesh in which it
spreads being soft); until the tubercle break and corrupt below at the
anus。 When this happens; a fistula is formed; having an ichorous
discharge; and faeces pass by it; with flatus and much and
abomination。 It is produced; then; by contusions when any of the parts
about the anus are bruised by a blow; or a fall; or a wound; or by
riding; or rowing; or any such cause。 For blood is collected; and
it; becoming corrupted; suppurates; and the from the the same
accidents happen; as have been described in the case of tubercles。
2。 In the first place; then; when you see any such tubercle
formed; you must cut it open while still unripe; before it suppurate
and burst into the rectum。 But if a fistula be already formed when you
undertake the case; take a stalk of fresh garlic; and having laid
the man on his back; and separated his thighs on both sides; push down
the stalk as far as it will go; and thereby measure the depth of the
fistula。 Then; having bruised the root of seseli to a very fine
powder; and poured in some water; let it macerate for four days;
and; mixing the water with honey; let the patient drink it; fasting;
to the amount of three cyathi; and at the same time purge away the
ascarides。 Those who are left without treatment die。
3。 In the next place; having moistened the strip of cotton cloth;
with the juice of the great tithymallus; and sprinkling on it the flos
aeris; roasted and triturated; and having made it into a tent equal in
length to the fistula; and having passed a thread through the ends
of the tent again through the stalk; and having placed the patient
in a reclining position; and having examined the ulcerated parts of
the rectum with a speculum; pass the stalk by it; and when it
reaches the rectum; take hold of it and draw it out until the tent
be pushed through; and be brought on a level above and below。 When
it (the tent?) has been pushed inward; introduce a ball of horn into
the rectum (the rectum having been previously smeared with Cimolian
chalk); and leave it there; and when the patient wants to go to stool;
let it be taken out and again replaced; and let this practice be
continued for five days。 On the sixth day let it be removed; and
drawing the tent out of the flesh; and afterwards pounding alum and
filling the ball (pessary) and introducing it into the rectum; leave
it until the alum melts。 Anoint the rectum with myrrh until the
parts appear to be united。
4。 Another method of cure:…Taking a very slender thread of raw lint;
and uniting it into five folds of the length of a span; and wrapping
them round with a horse hair; then having made a director
(specillum) of tin; with an eye at its extremity; and having passed
through it the end of raw lint wrapped round as above described;
introduce the director into the fistula; and; at the same time;
introduce the index finger of the left hand per anum; and when the
director touches the finger; bring it out with the finger; bending the
extremity of the director and the end of the threads in it; and the
director is to be withdrawn; but the ends of the threads are to be
knotted twice or thrice; and the rest of the raw threads is to be
twisted around and fastened into a knot。 Then the patient is to be
told that he may go and attend to his matters。 The rest of the
treatment:…Whenever any part of the thread gets loose owing to the
fistula becoming putrid; it is to be tightened and twisted every
day; and should the raw thread rot before the fistula is eaten
through; you must attach another piece of raw thread to the hair; pass
it through; and tie it; for it was for this purpose that the hair
was rolled round the raw lint; as it is not liable to rot。 When the
fistula has sloughed through; a soft sponge is to be cut into very
slender pieces and applied; and then the flowers of copper; roasted;
are to be frequently applied with a director; and the sponge smeared
with honey is to be introduced with the index finger of the left hand;
and pushed forward; and another bit of added; it is to be bound on
in the same manner as in the operation for hemorrhoids。 Next day;
having loosed the bandages; the fistula is to be washed with hot
water; and cleansed; as far as possible; with the finger of the left
hand by means of the sponge; and again the flos aeris is to be
applied。 This is to be done for seven days; for generally the coat
of the fistula takes that time to fistula takes that time to slouch
through。 The same mode of bandaging is to be persevered in afterwards;
until the cure be completed。 For in this way; the fistula being
forcibly expanded by the sponge will not fill up and heal unequally;
but it will all become whole together。 During the treatment; the
part should be bathed with plenty of warm water; and the patient
kept on a spare diet。
5。 When the fistula does not get eaten through; having first
examined it with a sound; cut down as far as it passes; and sprinkle
with the flos aeris; and let it remain for five days。 Then pour warm
water upon it; and above lay flour mixed with water; and bind on it
the leaves of beet。 When the flos aeris comes away; and the
fistulous sore becomes clean; cure it as before described。 But if
the fistula be in a part which does not admit of this treatment; and
if it be deep; syringe it with the flowers of copper; and myrrh; and
natron; diluted with urine; and introduce a piece of lead into the
orifice of the fistula so that it may not close。 Syringe the fistula
by means of a quill attached to a bladder; so that the injection may
distend the fistula。 But it does not heal unless it be cut open。
6。 If the anus gets inflamed; and there is pain; fever; a frequent
desire of going to stool without passing anything; and the anus
appears to protrude; owing to the inflammation; and if at times
strangury come on; this disease is formed; when phlegm; collected from
the whole body; is determined to the rectum。 Warm things are
beneficial in this case; for these; when applied; can attenuate and
dissolve the phlegm; and dilute the acrid and salt particles; so
that the heat subsides; and the irritation in the rectum is removed。
Wherefore it is to be treated thus: The patient is to be put into a
hip…bath of hot water; and sixty grains of the grana gnidia are to
be pounded and infused in a hemina of wine; with half a hemina of oil;
and injected。 This brings away phlegm and faeces。 When the patient
does not take the hip…bath; boil eggs in dark…colored fragrant wine;
and apply to the anus; and spread to the anus; and spread something
warm below; either a bladder filled with warm water; or linseed
toasted and ground; and its meal stirred up and mixed equally with
dark; fragrant wine; and oil; and this applied very warm as a
cataplasm; or; having mixed barley and Egyptian alum pulverized;
form into an oblong ball (suppository?) and warming it gently at the
fire; make it into a cataplasm; foment; form it into shape with the
fingers; and then making it quite tepid; introduce it into the anus。
The external parts are to be anointed with cerate; and a cataplasm
of boiled garlic; with dark wine diluted; is to be applied。 But if you
remove these things; let him take the hip…bath of hot water; and
having mixed together the juice of srychnos; the grease of a goose;
swine's seam; chrysocolla; resin; and white wax; and then having
melted in the same and mixed together; anoint with these things; and
while the inflammation lasts; use the cataplasm of boiled garlic。
And if by these means he be freed from the pain; it is enough; but
if not; give him the white meconium (Euphorbia peplus?); or; if not
it; any other phlegmagogue medicine。 While the inflammation lasts; the
diet should be light。
7。 The strangury comes on in this way:…The bladder being heated from
the rectum; phlegm is attracted by the heat; and by the phlegm
(inflammation?) the strangury is occasioned。 If; then; as is
frequently the case; it cease with the disease; well; but; not
withstanding; if not; give any of the medicines for strangury。
8。 If procidentia ani take place; having fomented the part with a
soft sponge; and anointed it with a snail; bind the man's hands
together; and suspend him for a short time; and the gut will return。
But if it still prolapse; and will not remain up; fasten a girdle
round his loins and attach a shawl behind; and having pushed up the
anus; apply to it a soft sponge; moistened with hot water in which the
shavings of lotus have been boiled; pour of this decoction upon the
anus by squeezing the sponge; then; bringing the shawl below between
the legs; fasten it at the navel。 But if he wish to evacuate the
bowels; let him do so upon a very narrow night…stool。 Or; if the
patient be a child; let him be placed on the feet of a woman; with his
back reclined to her knees; and when the bowels are evacuated; let the
legs be extended。 In this way the anus will be the least disposed to
fall out。 When a watery and ichorous discharge flows from the
rectum; wash it out with burnt lees of wine; and water from myrtle;
and having dried maiden…hair; pound and sift it; and apply as a
cataplasm。 But if there be a discharge of blood; having washed with
the same; and pounded chalcitis; and the shavings of cypress; or of
juniper; or of stone…pine; or of turpentine; the in equal
proportions the apply as a cataplasm。 Anoint the external parts with
thick cerate。
9。 When the gut protrudes and will not remain in its place;
scrape the finest and most compact silphium (assafoetida?) into
small pieces and apply as a cataplasm; and apply a sternutatory
medicine to the nose and provoke sneezing; and having moistened
pomegranate rind