Hippocrates of Cos, Fistulas

LCL 482: 390-391

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μήλην κασσιτερίνην ἐπ᾿ ἄκρου τετρημένην, ἐνείρας ἐς τὴν μήλην τὴν ἀρχὴν τοῦ ὠμολίνου συμβεβλημένου, καθιέναι τὴν μήλην ἐς τὴν σύριγγα, καὶ ἅμα τῆς ἀριστερῆς χειρὸς τὸν δάκτυλον τὸν λιχανὸν καθιέναι ἐς τὴν ἕδρην· ἐπὴν δὲ ψαύσῃ ἡ μήλη τοῦ δακτύλου, ἄγειν ἔξω τῷ δακτύλῳ, ἀποκάμψας τῆς μήλης τὸ ἄκρον καὶ τὴν ἀρχὴν τὴν ἐν τῇ μήλῃ· καὶ τὴν μὲν μήλην πάλιν ἐξαιρέειν, τοῦ δὲ ὠμολίνου τὰς ἀρχὰς ἀφάψαι δὶς ἢ τρίς· καὶ τὸ λοιπὸν τοῦ ὠμολίνου ἐπιστρέψας, ἐπιδῆσαι πρὸς τὸ ἅμμα· ἔπειτα κελεύειν ἀπελθόντα διαπρήσσεσθαι τὰ ἑωυτοῦ. ὁκόσον δή, σηπομένης τῆς σύριγγος, χαλᾶται τοῦ ὠμολίνου, τοῦτο ἐπιτείνειν καὶ ἐπιστρέφειν ἀεὶ καθ᾿ ἑκάστην ἡμέρην· ἢν δέ σοι τὸ ὠμόλινον διασαπῇ πρόσθεν ἢ τὴν σύριγγα διαβρωθῆναι, πρὸς τὴν τρίχα προσάψας ἕτερον ὠμόλινον διεῖναι καὶ ἀφάψαι (ἡ γὰρ θρὶξ διὰ 452τοῦτο παραβάλλεται | τῷ ὠμολίνῳ ὅτι ἄσηπτός ἐστιν)· ἐπὴν δὲ διασαπῇ ἡ σύριγξ, τάμνεσθαι χρὴ σπόγγον μαλθακὸν ὡς λεπτότατον προστεθέντα· ἔπειτα ἐς μὲν τὴν σύριγγα ἄνθος χαλκοῦ ὀπτὸν συχνὸν τῇ μήλῃ ἐνθεῖναι, τὸν δὲ σπόγγον ἀλεῖψαι μέλιτι, καὶ ὑποβαλὼν μέσον3 τῷ λιχανῷ δακτύλῳ τῆς ἀριστερῆς χειρὸς ὦσαι πρόσω, καὶ προσθεὶς ἕτερον σπόγγον ἀναδῆσαι τὸν αὐτὸν4 τρόπον, ὅν περ καὶ ἐπὶ τῇσιν αἱμορροΐσι· τῇ δὲ αὔριον ἀπολύσας, περινίψαι5 ὕδατι θερμῷ, καὶ σπόγγῳ τῷ δακτύλῳ τῆς ἀριστερῆς χειρὸς πειρᾶν διακαθαίρειν τὴν σύριγγα, καὶ αὖθις πάλιν τὸ ἄνθος ἐπιδῆσαι· ταῦτα ποιέειν ἑπτὰ ἡμέρας, ἐν ταύτῃσι

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Fistulas

eye at one end, thread the end of the twisted linen into the probe, and, passing the probe into the fistula, at the same time introduce the index finger of your left hand into the anus. When the probe touches your finger, use the finger to draw it out through the anus by bending aside its end and the thread in it; remove the probe, and tie together the ends of the thread with a double or treble knot; turn back the rest of the thread, and tie it against the knot with a bandage. Then let the person go about his business. Any slackness in the thread that arises as the fistula suppurates should be tightened up daily; again turn back the ends. If you find that the thread dissolves before the fistula is eaten through, attach another thread to the horsehair, pull it through, and fasten it in the same way (the horsehair is run along with the thread for the reason that it is not liable to dissolution the way the thread is). When the fistula suppurates through, you must trim a soft, very fine piece of sponge and apply it. Then introduce burnt flower of copper into the fistula with a probe several times, anoint a sponge with honey, place its centre over the index finger of the left hand, and press it into place; apply another sponge and hold it in place with the same kind of bandage used on haemorrhoids. On the following day, remove the bandage, wash the area with warm water, and attempt to clean out the fistula with a sponge on the finger of your left hand; apply flower of copper again and rebandage. Do this for seven days, for in that time the tunic of the fistula is usually

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DOI: 10.4159/DLCL.hippocrates_cos-fistulas.1995