When you see that the boil has thick skin and there is no hope that it will open after ripening, and there are many vessels, tendons and nerves in this place, then it should be pierced. If you leave pus in it, it will rot and spoil and corrode the blood vessels and nerve fibers; this is especially dangerous when the boil is near the joints. When puncturing, look for the place where pus has accumulated, and try to ensure that the puncture hole is directed downward, unless this is impossible. If the tissues above the boil are fatty, then make only a hole when cutting, otherwise the fatty tissues will stick to what lies behind them, and if the tissues are skinny, then cut the entire boil longitudinally.
Know that the place where pus has accumulated can be determined by touch, especially if you press with your finger, and with another finger, or even the finger of your other hand, check whether the pus goes away under pressure. The location of the pus can also be seen by the whitening of the skin, which was reddish before maturation; sometimes the place where pus accumulates, if the pus is not good, turns green or yellow; You should rely on touch rather than vision, although vision also helps.
When making a cut, you should follow natural lines and folds, deviating from them only if necessary, that is, on those organs in which the longitudinal direction of the fibers diverges from the direction of the folds. For example, if, when opening a boil on your forehead, you go in the direction of the skin folds, then the skin of your forehead will fall onto your face; therefore, you have to deviate from the direction of the folds. As for, for example, boils in the groins, then you should follow the transverse folds.
When you open the abscess and extract its contents, you need to quickly apply the skin to the meat so that it does not tear, harden or stick, and so that depressions do not form in it, which are constantly filled with pus and again turn into the same boil; every time they are cleaned, they immediately fill up again and, in essence, turn into something like fistulas. Before applying the skin, the cavity must be cleaned immediately; if necessary, then insert a knitting needle with a coarse rag at the end into it, with which you will clean and scrape out the cavity, and then apply the skin and cover it with a bandage, doing as we say in the paragraph about dressing cavities and deep ulcers; it will be good and right. When piercing, you must comply with the conditions we mentioned above and pierce in the most mature and fleshy place, farthest from the arteries, veins and tendons.
Antillus says: If the boil is on the head, then open it with a straight cut, and let it go along the roots of the growing hair, and not across them, so that the hair does not cover it and you can see whether the boil has passed.
He says: If the boil is on the eye, then we open it across; if it has formed in the nose, we make a straight cut along the entire length of the nose, and if the boil is somewhere near the eye, then we open it with a cut similar to the tip of a crescent, directing the bend downwards If a boil has formed on the jaws, we open it in a straight direction, because the structure of this place is straight, as can be seen from the faces of old people. As for boils behind the ears, we open them with a straight cut, and we always open boils on the elbow, wrist, hands, fingers and groins longitudinally.
Boils near the hips,” he says, “we open with a circular incision, and a circular incision is such that, going along the body, we take a little across; If a circular incision is not made in this place, matter may accumulate there and a fistula may form. In the same way, we open boils near the anus, since moisture accumulates there. On the side and on the ribs we open boils obliquely, and on the testicles and penis - in a straight direction.
At the same time, continues Antill, we always strive to ensure that the cut, as far as possible, follows the natural contours of the body. As for the lower leg and forearm, you open it longitudinally in these places, being careful not to touch the nerves.
Know,” Antillus further says, “that the cuts differ depending on the place. If the boil is near the eye, then open it in an arched manner, similar to the place where the eye is located; For boils in the nose, cut along the nose, and on the jaw and near the ear, make a straight cut, because the structure of this place is straight, and this can be seen in the faces of old people. Open the boil behind the ear with a straight cut, and on the elbow, shin, thigh and forearm always open it with a straight cut, directing it lengthwise; also open boils on the abdominal muscles and on the back. And in the groins and under the armpits, make an incision, also taking it across so that a sinus does not form there, turning into a fistula. The same applies to boils near the anus - there, too, take it across to avoid the formation of a sinus that turns into a fistula. On the testicles and penis, open in a straight direction, and on the side and on the ribs, make an incision, following along the ribs, in the shape of a crescent, so that the incision is curved, because the ribs and the meat covering them are located in this way.
Antillus says: And always check how the meat and muscle fibers lie in a given place, because we strive to make a cut that corresponds to this place, so as not to cut the fibers and so that the place of the scar is beautiful, not ugly. Under all circumstances, you should have one concern: how not to cut a large artery or vein, or a nerve, or muscle fibers. The opening is carried out in accordance with the size of the boil: if it is small and all its contents flow out from one place, then open it in one place, and if it is large, then open it in several places and then insert the index finger of your left hand into the wound and open it deeper until you won't reach the end. Then insert your finger into the second cut and do this until you get rid of the boil. If there is a place in the boil facing downwards through which its contents can be removed, we open it in this place, and if it is round or of such a shape that its contents will not come out through one cut, we open it in two or three places at once, until we are convinced that everything that has accumulated in it will immediately flow out.
If the abscess is on a joint, says Antillus, or on a noble organ, or close to a bone or membrane, then we hasten to open it before it is thoroughly ripe, so that the pus does not spoil anything in these organs.
We say: this is the way to act when you cannot find a way to avoid a puncture. If you hope that the boil will open on its own, do not pierce it, just as if you hope that it will burst from the action of drugs that promote the opening: I have more than once found among the drugs that help to open boils, drugs that replace a puncture. Often the skin is pierced or a piece of skin is cut off and a medicine is placed on the boil to promote opening, because this way it penetrates deeper.