Translated by Francis Adams
PART 1
The disease of the hemorrhoids is formed in this way: if bile or phlegm
be determined to the veins in the rectum, it heats the blood in the veins;
and these veins becoming heated attract blood from the nearest veins, and
being gorged the inside of the gut swells outwardly, and the heads of the
veins are raised up, and being at the same time bruised by the faeces passing
out, and injured by the blood collected in them, they squirt out blood,
most frequently along with the faeces, but sometimes without faeces. It
is to be cured thus:
PART 2
In the first place it should be known in what sort of a place they are
formed. For cutting, excising, sewing, binding, applying putrefacient means
to the anus,-all these appear to be very formidable things, and yet, after
all, they are not attended with mischief. I recommend seven or eight small
pieces of iron to be prepared, a fathom in size, in thickness like a thick
specillum, and bent at the extremity, and a broad piece should be on the
extremity, like a small obolus. Having on the preceding day first purged
the man with medicine, on the day of the operation apply the cautery. Having
laid him on his back, and placed a pillow below the breech, force out the
anus as much as possible with the fingers, and make the irons red-hot,
and burn the pile until it be dried up, and so as that no part may be left
behind. And burn so as to leave none of the hemorrhoids unburnt, for you
should burn them all up. You will recognize the hemorrhoids without difficulty,
for they project on the inside of the gut like dark-colored grapes, and
when the anus is forced out they spurt blood. When the cautery is applied
the patient's head and hands should be held so that he may not stir, but
he himself should cry out, for this will make the rectum project the more.
When you have performed the burning, boil lentils and tares, finely triturated
in water, and apply as a cataplasm for five or six days. But on the seventh,
cut a soft sponge into a very slender slice, its width should be about
six inches square. Then a thin smooth piece of cloth, of the same size
as the sponge, is to be smeared with honey and applied; and with the index
finger of the left hand the middle of the sponge is to be pushed as far
up as possible; and afterward wool is to be placed upon the sponge so that
it may remain in the anus. And having girded the patient about the loins
and fastened a shawl to the girdle, bring up this band from behind between
the legs and attach it to the girdle at the navel. Then let the medicine
which I formerly said is calculated to render the skin thick and strong,
be bound on. These things should be kept on for not less than twenty days.
The patient should once a day take a draught from flour or millet, or bran,
and drink water. When the patient goes to stool the part should be washed
with hot water. Every third day he should take the bath.
PART 3
Another method of cure:-Having got the anus to protrude as much as possible,
foment with hot water, and then cut off the extremities of the hemorrhoids.
But this medicine should be prepared beforehand, as an application to the
wound:-Having put urine into a bronze vessel, sprinkle upon the urine the
flower of bronze calcined and finely triturated; then, when it is moistened,
shake the vessel and dry in the sun. When it becomes dry, let it be scraped
down and levigated, and apply with the finger to the part, and having oiled
compresses, apply them, and bind a sponge above.
PART 4
Another method:-There grows upon the bleeding condyloma, a protuberance
like the fruit of the mulberry, and if the condyloma be far without, an
envelope of flesh is adherent to it. Having placed the man over two round
stones upon his knees, examine, for you will find the parts near the anus
between the buttocks inflated, and blood proceeding from within. If, then,
the condyloma below the cover be of a soft nature, bring it away with the
finger, for there is no more difficulty in this than in skinning a sheep,
to pass the finger between the hide and the flesh. And this should be accomplished
without the patient's knowledge, while he is kept in conversation. When
the condyloma is taken off, streaks of blood necessarily flow from the
whole of the torn part. It must be speedily washed with a decoction of
galls, in a dry wine, and the bleeding vein will disappear along with the
condyloma, and its cover will be replaced. The older it is, the more easy
the cure.
PART 5
But if the condyloma be higher up, you must examine it with the speculum,
and you should take care not to be deceived by the speculum; for when expanded,
it renders the condyloma level with the surrounding parts, but when contracted,
it shows the tumor right again. It is to be removed by smearing it with
black hellebore on the finger. Then, on the third day, wash it out with
a dry wine. You need not be surprised that there is no discharge of blood
when you remove the condyloma, for neither, if you cut off the hands or
legs at the articulations will there be any flow of blood; but if you cut
them off above or below the joints, you will find there hollow veins which
pour out blood, and you will have difficulty in stopping the bleeding.
In the same manner, the bleeding vein in the anus, if you cut it above
or below the point of separation of the condyloma, will pour forth blood;
but if you take away the condyloma at its junction (with the natural parts?)
there will be no flow of blood. If matters then be thus put to rights,
it will be well; but otherwise burn it, taking care not to touch the place
with the iron, but bringing it close so as to dry it up, and apply the
flos aeris in the urine.
PART 6
Another method of curing hemorrhoids:-You must prepare a cautery like
the arundo phragmites, and an iron that exactly fits is to be adapted to
it; then the tube being introduced into the anus, the iron, red hot, is
to be passed down it, and frequently drawn out, so that the part may bear
the more heat, and no sore may result from the heating, and the dried veins
may heal up. But if you are neither disposed to burn nor excise, having
first fomented with plenty hot water and turned out the anus, levigate
myrrh, and having burnt galls and Egyptian alum, in the proportion of one
and a half to the other things, and as much of melanteria; these things
are all to be used in a dry state. The hemorrhoid will separate under the
use of these medicines, like a piece of burnt hide. You are to proceed
thus until the whole are removed, and a half part of burnt chalcitis does
the same thing. But if you wish to effect the cure by suppositories, take
the shell of the part fish a third part of plumbago, bitumen, alum, a little
of the flos aeris, galls, a little verdigris; having poured a small quantity
of boiled honey on these, and formed an oblong suppository, apply until
you remove them.
PART 7
An hemorrhoid in a woman may be thus cured. Having fomented with plenty of hot water, boil in the water certain of the fragrant medicines, add pounded tamarisk, roasted litharge and galls, and pour on them white wine, and oil, and the grease of a goose, pounding all together. Give to use after fomenting. In fomenting the anus is to be made to protrude as much as possible.
End of Etext On Hemorrhoids by Hippocrates
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