Treatment of hard-to-heal ulcers and hoyrads

Know that ulcers that are difficult to heal, generally speaking, are as different from corroding and putrefactive ones as the general differs from the specific. Both of the latter ulcers are creeping, and difficult-to-heal ulcers sometimes do not spread and remain for some time as they were. They are also not fistulas, because they do not have to be crock-shaped. In general, corrosive ulcers, putrefactive ulcers and fistulas are considered difficult to heal, but this statement is not reversible As for the Khoyrads, they are extremely putrid and far from healing.

The rule for treating these ulcers is that if the cause is bad nature, then it is corrected; in case of bad blood, substances are prescribed for food that generate good blood, the opposite of bad blood; and in case of scarcity of blood, their quantity is increased, giving more good food. If the cause is laxity or contamination, then treat with remedies for laxity and contamination, and if the problem is excessive dryness, but the ulcer has not yet developed into a fistula, then treat with moderate moisturizing. To do this, it is good to water the organ with hot water until it sweats, turns red and swells, but then stop watering and do not go beyond this limit - otherwise you will attract a lot of matter to the organ and cause great trouble. After that, choose a medicine that is less drying.

Sometimes it is useful to apply a cloth moistened with warm water to the ulcer, but often you have to scrape out the ulcer, cause it to bleed, rub the diseased organ and use stretching patches from zift.

If the cause is the bad condition of the meat surrounding the ulcer, then they are treated as you already know, by making an incision, extracting the blood and correcting the damage with drying substances, and if the source is the dilated vein irrigating the ulcer, cut it and let the blood flow out or pull the vein out - this often gets rid of trouble. However, if there is overflow, start with bloodletting and remove the black gall juice, if any, and then take on the dilated vein and release as much blood as possible from it, so that after your encroachment on the vein, something worse than the initial ulcer does not happen. And then treat the wound caused by opening the vein, and only then treat the difficult-to-heal ulcer.

Often the cause of poor healing is the weakness of the organ, and this occurs from a disorder of nature, but not from any one, but from an excessive disorder of nature, far from its inherent balance in relation to warmth and coldness, and also due to the extreme loosening or strong compaction that accompanies the disorder of nature tissues, the first most often occurs from warmth and moisture or only from moisture, and the second from cold and dryness or only dryness. The cause of this should be treated with substances that are opposite to the state of nature or generate qualities opposite to it. Often the cause arises from heat, which attracts matter and sends it into the ulcer, and then cooling and astringent substances are needed for treatment. If the cause is a fistula, then treat as fistulas are treated, and if the cause lies in the rotting of the bone surrounding the ulcer, then we make an incision and expose the bone. If it is possible to remove the rot covering it by scraping, we do so, going far into the depths, and if not, then we cut out the bone and proceed as described in the paragraph on bone rotting.

Galen says: One young man had a fistula in his chest, which reached the bone in the middle of the sternum. We stripped the sternum bone of its surroundings and found that it was rotten and would have to be cut out. And the rotting place was exactly the place where the heart bag lies. Seeing this, we took great care in removing the rotting bone and were most concerned about preserving the membrane covering the bone from the inside, but the part of this membrane adjacent to the sternum was also already rotten. And we looked at the heart and saw it clearly, just as you see it when we deliberately expose it during dissection.

And this young man,” he continues, “remained intact, and in the place of the sternum where we cut out the bone, meat grew until the cut was filled, and its edges connected to the other, and the meat began to cover and protect the heart, as the end used to do heart bag.

Such an incision is no worse than those wounds in which they pierce through the chest, says Galen, and adds that if the ulcer is old and long-standing, it would be reasonable to cause bleeding from it in an appropriate amount with a jar.

As for the medicines intended in most cases for difficult-to-heal ulcers, these are, for example, copper scale, verdigris, burnt and unburnt, shaburkan scale, scale of other types of iron, or lazzak az-zahab - from all this wax is prepared ointments - as well as kalkatar, vitriol and the like with some substances that prevent the seepage of matter into the organ, if this occurs, for example, with alum and galls.

Here is one of the remedies used to treat difficult-to-heal ulcers: take eight parts of kalimiyya, gold glue and alum and one part of verdigris and copper scale, as well as pine gum - four parts, wax and oil - as much as you see fit.

They also take ten parts of wax, nine parts of pine gum, three parts of kalimiya, six parts of kalkatara, and plenty of myrtle oil.

They also take kalkatar and kalimiyya with sea water or with the juice of unripe grapes, or with water in which potash and nuru have been lightly boiled, in accordance with the nature of the organ, marinated well in the sun and then the liquid is filtered, not allowing sea water or water covered with potash and salt. Or they also take burnt copper, ratiyanaja and Andarani salt - two uqiyas each, wax and myrtle oil - in sufficient quantities. Medicines for fistulas also help, if dried and crushed, and in particular, lenticular vetch flour, orris root, burnt aristolochia, burnt copper and incense powder - in various combinations appropriate to the nature of the body of a given patient.

Good medicine. They take copper filings and iron filings, mix them with alum water, coat them with red clay and burn them in a bread oven, and then take them out, grind them and use them as powder or make a plaster with lead oxide from it.

Description of a good gold patch. They take lead oxide with gold - one mann, wax and wolf bast root - thirty-six mithqals, verdigris - eighteen mithqals, carefully ground gold filings with a small amount of lead oxide - forty mithqals, old olive oil - three rittles in the oil, first put the oxide lead with gold and verdigris and then other medicines.

Or they take oven clay, shell ash, burnt and washed tin and prepare a myrtle oil plaster from this. The oil must be thickened with lead oxide, and here is a description of this: take lead oxides, for example, one uqiya and three times the same amount of very strong vinegar, as well as two uqiyas of olive oil or myrtle oil, or any other oil, carefully burn all this and stir so that the lead oxide blooms and thickens, but does not burn.

And against hoyrads they use copper scale with verdigris, washed, but carefully make a powder from it. Grated alum is also used in the form of powder, or lanolin - four parts and soda - two. Or the ulcer is first smeared with honey, and then this medicine is sprinkled with copper dross - two parts, alum - two parts, wax ointment - ten, kneaded in the sun and consumed.

Or they take lead white and alum - eight parts each, copper scale, Andaran salt, incense, verdigris, pomegranate peels - two parts each, nura - one part, wax - ten and two thirds parts, myrtle oil - a sufficient amount.

They also take oxides of lead and olive oil - one rittl, one aristolochia, unpierced galls - one ukiyya, ushshak - ukiyya, crushed incense - two ukiyya, from this they prepare a mud cake over the fire, stirring the composition with reed root.