Ulcers arise from wounds, from open boils and from pimples. A break in continuity in the meat, if it drags on and festeres, is called an ulcer. Suppuration occurs for the reason that the nutrient sent to the organ begins to deteriorate due to the weakness of the organ, and also because, due to its weakness, excesses from neighboring organs pour out and seep into it, or it comes from plasters that loosen and moisturize the organ its moisture and oiliness.
The liquid type of pus is called ichor, and what is thick is called mud; it is a dense frozen mass, white or blackish, similar to wine grounds. Ichor is born from liquid, watery, hot juices, and dirt is born from thick juices. Ichor often forms tumors, and drying drugs are required for ichor, and tearing drugs for dirt.
Ulcers are sometimes superficial, and sometimes they are deep. If the ulcer is deep, then inevitably one of the two, either the meat surrounding the ulcer hardens, and then it is called a fistula - and a fistula is something like a tube penetrating into the depths, or it does not harden, and such an ulcer is called a hiding place or a cave. Sometimes some doctors call an ulcer that penetrates under the skin, from which the skin has peeled off, a hiding place, and a cave - an ulcer that has gone under the meat and expanded, while others say No - a wide ulcer is a cave, and a narrow and deep one is a fistula, but there is no need to argue about the names . When induration forms on an external ulcer, it is called a cranial ulcer.
A malignant fistula is an insensitive fistula, and its degree of malignancy depends on the degree of insensitivity. The fistula can be straight or curved. If it reaches the nerve, it causes severe pain, especially when its bottom is touched with a knitting needle; sometimes such a fistula impedes the action of the affected organ.
The moisture in such fistulas is liquid, sparse, as in fistulas that reach the bone, and if the fistula ends at a ligament, then something close to this flows from it, but with a fistula that reaches the bone or ligament, the pain is sometimes not very strong . The moisture in a fistula that penetrates to the bone is thinner and more yellowish, and from a fistula that leads to a vein or artery something like wine grounds often comes out. If the fistula ends at a vein, in some cases a lot of pure blood comes out of it, and scarlet blood is released from the artery, pouring out in abundance and in jerks from the fistula, reaching the meat, a viscous, thick, cloudy, immature liquid flows.
Often one fistula has many mouths, and then the matter becomes difficult and it is not known whether there is one fistula or many of them. If colored moisture flows out of any hole, then when there is only one fistula, the same liquid comes out of other holes; the color of the fistula can be different - white, dark, red or some other.
Ulcers are divided into a number of varieties, and doctors say that ulcers are sometimes painful, and sometimes painless, sometimes swollen, and sometimes without swelling, sometimes clean and sometimes unclean. Unclean ulcers are weeping, that is, containing a lot of juice and abounding in moisture, although not malignant, but they can also be dirty or ichorous. Some ulcers are putrid and the worst thing for them is the south wind and humid, moreover, hot air, while others are corrosive or creeping and loose - either cold or hot loose ulcers cause hair loss from the adjacent areas of the skin.
There are sometimes sweating ulcers, from which yellow, hot ichor oozes, and sometimes hot liquid flows from there, burning everything around - such ulcers are malignant and destructive - and, finally, there are ulcers that are difficult to heal. Putrefactive ulcers differ from corrosive ones, although both are creeping. Sometimes a corrosive ulcer eats up the tissues adjacent to it with its sharpness, without causing putrefaction and without any fever, but with a creeping putrefactive ulcer, the fever occurs often or does not leave the patient at all. Galen calls, for example, Persian fire and creeping herpes corrosive ulcers and believes that a putrefactive ulcer is combined from a pure ulcer and a putrefactive disease.
Each of these ulcers has its own qualities. Hard ulcers that begin to turn blue or blacken, cold ulcers are malignant - flabby, white and calmed by warming drugs, and hot ulcers - reddish and calmed by cooling ones. If malignant ulcers are accompanied by a bad body color, for example, white, lead or yellow, then this is a sign of a disorder in the nature of the liver and depravity of the blood flowing to the ulcer, the healing of which is made more difficult. Ulcers that have a hot bottom and are accompanied by itching give off sharp excesses, while ulcers with a wide white base and little itching have a cold nature. Ulcers that form after an illness are malignant, because nature drives to them the remnants of spoiled excess ulcers, which cause hair loss in the areas adjacent to them, and are also not good.
The cause of malignant ulcers is sometimes a wound that has found bad excesses in the body or poorly treated, and sometimes they arise after bad pimples, which, having erupted, quickly become ulcerated. A sign of the malignancy of an ulcer is its decay and spread, as well as the fact that it destroys the tissues surrounding it and itself is difficult to heal even with proper treatment.
The best sign of the benign nature of ulcers or boils in relation to the consequences is the appearance of pus from a suppurating medicine or due to the influence of nature, for this occurs from the action of nature during the natural course of the disease. Pus does not form except after natural ripening, if it is not accompanied by bad phenomena that accompany malignant ulcers, especially praiseworthy pus is white, smooth and even, which is not characterized by stench and putrefaction. Sometimes pus, however, is not without a slight stench, for it is formed during the interaction of innate heat and other, extraneous heat. We have already talked about pus elsewhere.
As for ulcers that cause spasms, or putrefactive and cancerous ulcers, as well as hoyrads, corrosive and similar ulcers, pus does not form from them. If pus or swelling appears with an ulcer, this is a good sign, and then there is no need to fear spasms, confusion of mind, or anything of the like, even when this happens in a place where the ulcer entails something similar, for example, in the back and anterior organs, unless the disease is too severe and does not exceed the usual limit. This happens, for example, when a tumor suddenly disappears and goes deep, without being resolved by pus or in any other way, or when ulcers are located in the vicinity of organs rich in nerves, such as, say, ulcers on the back, located near the spine and spinal cord, or ulcers on the front of the thigh and on the knee, they also arise on organs rich in nerves, and then it comes to spasms and clouding of the mind. When an ulcer forms on organs rich in blood vessels - most often this happens in the front part of the body - then you can be afraid of bloody diarrhea if the ulcer is in the lower half of the body, and often this threatens with clouding of the mind. Sometimes there is also a danger that pleurisy will occur and then suppuration if the ulcer is located in the upper half of the oven. From Book Three you already know what suppuration in the chest means, and sometimes they also fear clouding of the mind. One of the good signs of an ulcer is when hair begins to grow around it after it has fallen out.
The body that is most accessible to treatment for ulcers is the one with the best nature and the least amount of excess moisture in the presence of good blood; a very moist or very dry body is slow to accept treatment for ulcers, although creatures that are moist by nature, for example, children, are easier to treat than the elderly, especially , if the main nature is dry and the body is devoid of pure blood, and the secondary nature is loose and wet, as is also the case with old people. Therefore, it turns out to be difficult to treat ulcers in dropsy and in pregnant women too, because their excess is locked up due to the lack of monthly cleansing.
As for old people, their ulcers do not go away for the reason mentioned and due to the scarcity of good blood, and sometimes the ulcer heals, but then ruptures again, since the meat grows before complete cleansing when unclean excesses are retained in it, this necessarily leads to secondary disruption of the existing continuity. Sometimes it seems that the fistula has healed, and a state of dryness and cessation of flow sets in, and the doctor is confident in his soul that the fistula is cured, because this state of it looks like a cure, as we will talk about this later, but then the ulcer breaks again from the slightest movement or shock , from a cough or jolt, or when the patient lies down uncomfortably, or for other reasons.
If meat grows in ulcers, then in some of them the meat grows in excess, while in others this does not happen. Most likely, the appearance of excess meat is in those ulcers where they try to grow the meat quickly, before cleansing, and excess meat most likely does not grow in such ulcers where it is grown only after cleansing.
When the case of an ulcer drags on and it corrodes and rots, and a significant part of the tissue substance is lost, then expect that it will heal only over the top of the depression, especially if the ulcer is old and has existed for a year or so, or if it has turned into a cranial ulcer, and cranial a part, that is, a fistula, is removed; an old ulcer necessarily expels some bone from the bones located in its vicinity. Black gall ulcers cannot be cured unless you remove everything that has gone bad, down to the healthy meat or bone.
The reasons that, having arisen, cause the rotting of an ulcer are the weakness of the organ, which as a result receives all matter, the bad nature of the organ and the bad state of the blood going to it - either in quality or in quantity. As for quality, this most often happens either due to the bad nature of the liver, and then the color of the blood is whitish-lead or yellowish, or because of the bad nature of the spleen, and then the color of the blood is blackish, spotted, and this is accompanied by the malignancy of all the juices of the body . From such blood the body cannot borrow substances that can turn into meat, and at the same time it suffers from it, because this blood turns into something dirty. And in terms of quantity, blood is not good; if it is in excess or there is not enough of it, then there is no substance to grow the meat for the ulcer.
If the ulcer is clean and uncontaminated, it quickly becomes covered with a scab and only manages to fill when the body is clean and there is little blood in it. The ulcer does not heal due to hardening that occurs in its walls and at the edges, or due to the expansion of the vessels leading to it, or rotting of adjacent bones, or when the bones deteriorate and begin to darken, turn blue and blacken, or due to the bad nature of the organ located with it Next door.
Intractable ulcers - such as round ulcers or the like - are deadly for children, because children cannot stand the severe pain they cause and the difficult, difficult treatment of such ulcers.