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Hippocrates (460 BC -
377 BC) is a Greek physician also known as the Father of Medicine,
produced many writings on medicine collectively known as the
Hippocratic Collection.
One of the medical condition that Hippocrates wrote about
is about hemorrhoids and its treatment. The following is the
full text of On Hemorrhoids, from Hippocrates Works,
as translated by Francis Adams (London, 1849).
ON HEMORRHOIDS
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:
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.
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.
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.
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.
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.
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.
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