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　h