SECT. XLV.—ON ULCERS REQUIRING CICATRIZATION.
By drying and constringing the flesh of ulcers requiring cicatrization to such a degree as not only to dissipate the preternatural superfluity, but also to touch upon that which is in its natural state, we may render the surface of the sore like skin, and make the ulcer cicatrize. This is promoted by immature galls, the moderately desiccant bark of pomegranate, and whatever else is desiccant without being possessed of pungent astringency. And such things as these promote cicatrization: myrrh, litharge, and oysters if burnt, for they must be sprinkled on the sore dry. And these things often produce cicatrization: pine bark with myrtle cerate, ivy flowers with cerate, the root of the lily with rose-oil, dried pine-rosin, burnt pumice stone, the flakes of copper; they are to be used in equal proportions dry. The following also repress: mix a small quantity of manna and of diphryges with levigated pumice, and use; or of litharge p. j; of diphryges p. ss, apply on a pledget with cerate. Birdlime with frankincense cicatrizes old ulcers, also verdigris with an equal portion of diphryges and with myrtle cerate, or the small centaury applied fresh. To the more humid apply the root of cypress. To those about the anus and pudendum, more particularly if inflamed, use levigated aloes, either in a dry state or with water, or squama æris; or soften chrysocolla in the sun with wax, and apply.
A dry application for producing cicatrization. Of oysters, dr. xij; of manna, dr. vj; of calamine, dr. iv. It applies also to spreading sores.—Another: Of birthwort, dr. vj; of pine bark, dr. vj; of manna, dr. vj; of pumice, dr. iv; of Colophonian rosin, dr. iv; of iris, dr. iv.—Another: Of hart’s horn burnt, dr. iv; of pine-bark, oz. vj: of ceruse, oz. iv; of scraped verdigris, oz. ix; of calamine, dr. xviij.—Another: Of the flowers of pomegranate, of copperas, of each, dr. xvj; of squama æris, of fissile alum, of each dr. viij; of galls, dr. j.—Another: Of ceruse, of litharge, of each, oz. viij; of the dross of lead, of galls, of dried myrrh, of each, dr. iv.
A cicatrizing application. Take of fissile alum, oz. j; and having levigated it, macerate in a sextarius of water: when dissolved in the water soak pledgets in it, and having dried them apply.
A plaster for cicatrizing the more simple ulcers. Of wax, dr. xl; of litharge, dr. xxxv; of diphryges, dr. viij; of myrtle-oil, half a hemina. The plaster called phœnicinum, that from calamine, the myrsinatum, and the like, are also applicable in such cases. For ulcers of difficult cicatrization: Of wax, of myrtle-oil, of each, dr. vj; of calamine, oz. vj; of lead, of frankincense, of each, dr. ij; of fissile alum, of burnt copper, of each, oz. j; of scraped verdigris, dr. ij; dissolve them singly. For chronic ulcers, and such as are of difficult cicatrization: Of calamine, dr. viij; of chrysocolla, dr. viij; of fissile alum, dr. viij; of verdigris, of the flakes of copper, of each, dr. j; of pine-rosin, dr. xl; of wax, dr. c; of myrtle-oil, q. s.—Another: Of wax, of pine-rosin, of each, oz. vj; of calamine, oz. vj; of crude chalcitis, oz. iij; of myrtle-oil, q. s. The calamine and the chalcitis are to be triturated with wine during the season of the dog-star; use it upon a broad compress, and apply above it a pledget and sponge out of wine.—Another: Of burnt copper, oz. ij; of fissile alum, oz. ij; of sal ammoniac, dr. ij; of wax, oz. vj; of Colophonian rosin, oz. vj; of myrtle-oil, oz. ij; the dry things are to be triturated in the vinegar in the sun for twenty days, and when it becomes of the consistence of honey, having melted the wax, mix it and soften. The medicine from pumice-stone, the isis, and the like, are also applicable in such cases.
Commentary. Celsus gives the following list of the more active articles of this class: Crustas ulceribus tanquam igne adustis inducunt, præcipue, chalcitis, utique si cocta est, flos æris, ærugo, auripigmentum, misy, et id quoque magis coctum.
For a variety of applications suitable to this class of ulcers, we refer the reader to Galen’s 4th book of ‘De Med. sec. gen.’ The ingredients of them are powerfully desiccative, astringent, and escharotic. Many of our author’s prescriptions will be recognized in it. For an account of the isis, and the other compound medicines mentioned towards the end of this section, we refer the reader to Galen (l. c.) and to the [Seventh Book] of this work. Galen, in another place, and after him Aëtius, give the following important directions for the use of these applications. The ulcers to which this mode of treatment is applicable, being very foul and filled with a vitiated discharge, are first to be wiped clean with a soft linen cloth, and then the cavity of them is to be filled with the medicine, and a splenium (oblong compress) applied externally. Then having put a piece of linen above the splenium and bound it on, we are to place over it a sponge squeezed out of cold water or wine, endeavouring to keep the sponge cold during the whole time of the treatment, which may easily be done by pouring cold water upon it without loosing the bandages. They are not be removed until the third day. Galen states that the articles which answer best in such applications are galls, pomegranate-rind, alum, chalcitis, misy, and the like.
A similar mode of treatment, without any material alteration, is described by the Arabians. Haly Abbas remarks, that cicatrizing medicines are powerfully desiccative with some astringency, such as galls, alum, and the like.