Hippocrates of Cos, Fistulas

LCL 482: 388-389

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δὲ ἔνθα, τὴν φύσιγγα καθιέναι ἔστ᾿ ἂν προσκόψῃ, μετρῆσαί τε τὸ βάθος τῆς σύριγγος τῇ φύσιγγι, καὶ σεσέλιος δὲ ῥίζαν κόψας ὡς λεπτοτάτην, ὕδωρ ἐπιχέας, βρέχειν τέσσαρας ἡμέρας· καὶ προνηστεύσας πινέτω μέλιτι παραμίσγων τὸ ὕδωρ κατὰ τρεῖς κυάθους. [ἐν τούτῳ κάθαιρε καὶ τὰς ἀσκαρίδας. ὁκόσοι δ᾿ ἂν καταλείφθωσιν ἀθεράπευτοι, θνῄσκουσιν.]2 ἔπειτα ὀθόνιον βύσσινον τιθυμάλλου ὀπῷ τοῦ μεγάλου δεύσας, καταπάσσων ἄνθος χαλκοῦ ὀπτὸν τετριμμένον στροβίλην ποιήσας ἴσην τῇ σύριγγι τὸ μῆκος, | 450ῥάμμα διεὶς δι᾿ ἄκρας τῆς στροβίλης καὶ αὖθις διὰ τῆς φύσιγγος, ὕπτιον κατακλίνας τὸν ἄνθρωπον, κατοπτῆρι κατιδὼν τὸ διαβεβρωμένον τοῦ ἀρχοῦ, ταύτῃ τὴν φύσιγγα διεῖναι· καὶ ὁκόταν παρακύψῃ ἐς τὸν ἀρχόν, ἐπιλαμβανόμενος ἕλκειν, ἄχρις οὗ ἡ στροβίλη διωσθῇ καὶ ἰσωθῇ τῷ τε ἄνω καὶ τῷ κάτω· ἐπὴν δὲ ἐσωσθῇ, βάλανον ἐνθεὶς κερατίνην ἐς τὸν ἀρχόν, γῇ διαχρίσας σμηκτρίδι, τὸν ἀρχὸν ἐᾶν· ἐπὴν δὲ ἀποπατέῃ, ἐξαιρέειν, καὶ αὖθις προστιθέναι, ἕως ἂν πεμπταίη γένηται· ἕκτῃ δὲ ἡμέρῃ ἐξαιρέειν, ἕλκων τὴν στροβίλην ἔξω τῆς σαρκός· καὶ τρίψαι στυπτηρίην μετὰ ταῦτα, καὶ πλήσας τὴν βάλανον καὶ ἐς τὸν ἀρχὸν ἐμβαλών, ἐᾶν ἄχρις οὗ ἡ στυπτηρίη ὑγρὴ γένηται· τὸν δὲ ἀρχὸν σμύρνῃ ἀλείφειν, ἄχρις οὗ ἂν δοκέῃ ξυμπεφυκέναι.

4. Ἑτέρη θεραπείη· ὠμόλινον λαβὼν ὡς λεπτότατον, συμβάλλειν ὅσον σπιθαμιαῖον πεντάπλουν, καὶ ξυμπεριλαβεῖν ἱππείην τρίχα· ἔπειτα ποιησάμενος

  • 2Del. Ermerins.
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Fistulas

touches the end, and so measure the depth of the fistula. Pound root of hartwort very fine, add water, and moisten the fistula with this for four days. Let the patient first fast, and then drink water mixed with honey, three cyathoi at a time. [This patient should also be cleaned of intestinal worms. Any patients that are left untreated die.] Then dip a linen cloth in the juice of great spurge,1 sprinkle ground burnt flower of copper over it, form it into a plug equal in length to the fistula, and pass a thread through the end of the plug and also through the garlic stalk; lay the person on his back, inspect the eroded part of the rectum with a speculum, and pass the stalk through to there; when its end emerges into the rectum, take hold of it and pull until the plug is drawn in and resides in the middle of the fistula between its top and bottom. With the plug in place, insert into the anus a horn suppository smeared with fullers’ earth, and leave it there. Whenever the patient wants to pass stools, let him remove the suppository and reinsert it afterwards; continue for five days. On the sixth day, remove the suppository and draw out the plug from the flesh. After that, grind up alum, apply it to the suppository, and insert into the rectum, leaving it in place until the alum becomes moist. Continue to anoint the rectum with myrrh until it appears to have united.

4. Another therapy. Take about a span of very fine thread of raw linen, fold it in five, twist it together, and wrap it around a horsehair. Then make a tin probe with an

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DOI: 10.4159/DLCL.hippocrates_cos-fistulas.1995