Treatment of fistulas and skin

As for the qualities and varieties of fistulas, this has already been mentioned before, the methods used to force ichor and spoiled fluids to flow out of the fistula, giving the patient an appropriate position or making an incision, have also been stated in many places preceding this paragraph. And with regard to special measures for the treatment of fistulas, it must be said that they are also different, since fistulas are either fresh, light, or old, callous, deeply penetrated into the meat, and such fistulas are difficult to treat. In this case, it is necessary to cut off the entire calloused part by radical excision on all sides with a staple or other instrument, or by cauterization with fire or medicine, and this is difficult and difficult, especially if the fistula is located in the vicinity of a nerve or noble organ, so the patient is sometimes more inclined leave the fistula and come to terms with it, rather than undergo painful treatment.

It is often possible to dry and eat away the greasy bad meat inside the ulcer, and the rest of the dead meat also dries and heals and remains calm for a long time, although there is no complete healing. Anyone who wishes this must cleanse the fistula from bad, greasy meat, then fill the cavity with drying medicines and leave them there. Then the fistula remains in a dry state until some mistake occurs - overflow or moistening of the nature or water does not penetrate into the fistula. The same will happen if the patient lies on the fistula and it causes pain, or coughs, or receives a blow or push, or will shake violently.

As for the method of removing and eradicating the fistula, then know that if the fistulas are malignant, old, long-standing, then there is no cure for them except excision of what has become callous, or cauterization with fire, as we will explain below, in this case the curved, tortuous passage is opened , to know how to carry out cauterization and how it will go, and act carefully and cautiously until the meat burns and comes off.

And sometimes they burn it with sharp medicines, for example, ammonia, arsenic, sulfur, verdigris, and mercury. Of these medicines, the mercury included in the composition is killed, mixed with an equal amount of iron filings, with half the amount of potash and with half the amount of nura and sublimated in usal or it is dried in a flask, as people who deal with such things know how to do, and sublimes , like salt. If you put a little of this medicine into the fistula, the stale crust becomes inflamed, fried and separated from the meat; it is grabbed with tongs and removed, and the ulcer on the organ is constantly, every hour, filled with ghee to soothe the pain, and then treated in the same way as ulcers are treated.

As for fresh, light fistulas, they should be washed successively with various strong substances - kitran, golden waters, salty sea water, soapy water mixed with arsenic or ammonia, as well as water sublimated with burnt copper or ammonia, which should be dry or crushed and moist, but not flowing, they also use water in which potash, calcined eggshells and nura were boiled. And when the ulcer is cleansed, put medicine with castor beans on it. An arsenic plaster, mentioned among the medicines for jarab, is amazingly helpful, as is Galen's medicine made from papyrus paper and medicines composed of vitriol, calcadis, burnt copper, verdigris and similar substances like centaury, lentil vetch flour, orris root, suku-tuna. They also tested scolopendra root - if you put it in the fistula, it heals - and harbak, if you fill the fistula with it, it also heals it after it remains there for three days. Suri and the squeezed juice of mad cucumber with resin, terpetine tree, or the squeezed juice of stinking ferula root, or verdigris with usshak and vinegar, or usshak with kalkadis, vitriol and kalkatar, or gum with vinegar also helps.

Or they take the baby's urine and stir it continuously in a tin mortar,  until it thickens and dries, and then consume it.

Description of the medicine used by the residents of Alexandria. They take ankhusa root, calcined vitriol, kalkatar, verdigris and alum - one part each, Spanish flies - half a part and prepare a powder or plaster, or medicines are tied with vinegar in which the Spanish flies were boiled, and Spanish flies are crossed out from the recipe sometimes to honey is added to this. Or they take sabur, verdigris, lead oxide and eggshells - calcined shells are much stronger - and mix them and also use strong medicines, which we mention in the paragraph about difficult-to-heal ulcers. When good meat appears, you use blinding and meat-enhancing substances, and if there is a damaged bone near it, it must be corrected and treated with appropriate means. If you notice that there is little ichorous fluid or it has turned purulent, then the medicine seems to be helping.