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Full text of "Ancient Classic Texts before 400 B.C."

On Ulcers 

By Hippocrates 



Translated by Francis Adams 



PART 1 

We must avoid wetting all sorts of ulcers except with wine, unless 

the ulcer be situated in a joint. For, the dry is nearer to the sound, 

and the wet to the unsound, since an ulcer is wet, but a sound part 

is dry. And it is better to leave the part without a bandage unless 

a unless a cataplasm be applied. Neither do certain ulcers admit of 

cataplasms, and this is the case with the recent rather than the old, 

and with those situated in joints. A spare diet and water agree with 

all ulcers, and with the more recent rather than the older; and with 

an ulcer which either is inflamed or is about to be so; and where 

there is danger of gangrene; and with the ulcers an inflammation in 

joints; and where there is danger of convulsion; and in wounds of 

the belly; but most especially in fractures of the head and thigh, 

or any other member in which a fracture may have occurred. In the 

case of an ulcer, it is not expedient to stand; more especially if 

the ulcer be situated in the leg; but neither, also, is it proper 

to sit or walk. But quiet and rest are particularly expedient. Recent 

ulcers, both the ulcers themselves and the surrounding parts, will 

be least exposed to inflammation, if one shall bring them to a suppuration 

as expeditiously as possible, and if the matter is not prevented from 

escaping by the mouth of the sore; or, if one should restrain the 

suppuration, so that only a small and necessary quantity of pus may 

be formed, and the sore may be kept dry by a medicine which does not 

create irritation. For the part becomes inflamed when rigor and throbbing 

supervene; for ulcers then get inflamed when suppuration is about 

to form. A sore suppurates when the blood is changed and becomes heated; 

so that becoming putrid, it constitutes the pus of such ulcers. When 

you seem to require a cataplasm, it is not the ulcer itself to which 

you must apply the cataplasm, but to the surrounding parts, so that 

the pus may escape and the hardened parts may become soft. Ulcers 

formed either from the parts having been cut through by a sharp instrument, 

or excised, admit of medicaments for bloody wounds ('enaima), and 

which will prevent suppuration by being desiccant to a certain degree. 

But, when the flesh has been contused and roughly cut by the weapon, 

it is to be so treated that it may suppurate as quickly as possible; 

for thus the inflammation is less, and it is necessary that the pieces 

of flesh which are bruised and cut should melt away by becoming putrid, 

being converted into pus, and that new flesh should then grow up. 

In every recent ulcer, except in the belly, it is expedient to cause 

blood to flow from it abundantly, and as may seem seasonable; for 

thus will the wound and the adjacent parts be less attacked with inflammation. 

And, in like manner, from old ulcers, especially if situated in the 

leg, in a toe or finger, more than in any other part of the body. 

For when the blood flows they become drier and less in size, as being 

thus dried up. It is this (the blood?) especially which prevents such 

ulcers from healing, by getting into a state of putrefaction and corruption. 

But, it is expedient, after the flow of the blood, to bind over the 

ulcer a thick and soft piece of sponge, rather dry than wet, and to 

place above the sponge some slender leaves. Oil, and all things of 

an emollient and oily nature, disagree with such ulcers, unless they 

are getting nearly well. Neither does oil agree with wounds which 

have been recently inflicted, nor yet do medicines formed with oil 

or suet, more especially if the ulcer stands in need of more cleansing. 

And, in a word, it is in summer and in winter that we are to smear 

with oil these sores that require such medicines. 



PART 2 

Gentle purging of the bowels agrees with most ulcers, and in wounds 
of the head, belly, or joints, where there is danger of gangrene, 
in such as require sutures, in phagedaenic, spreading and in otherwise 
inveterate ulcers. And when you want to apply a bandage, no plasters 
are to be used until you have rendered the sore dry, and then indeed 
you may apply them. The ulcer is to be frequently cleaned with a sponge, 
and then a dry and clean piece of cloth is to be frequently applied 
to it, and in this way the medicine which it is supposed will agree 
with it is to be applied, either with or without a bandage. The hot 
season agrees better than winter with most ulcers, except those situated 
in the head and belly; but the equinoctial season agrees still better 
with them. Ulcers which have been properly cleansed and dried as they 
should be, do not usually get into a the state. When a bone has exfoliated, 
or has been burned, or sawed, or removed in any other way, the cicatrices 
of such ulcers become deeper than usual. Ulcers which are not cleansed, 
are not disposed to unite if brought together, nor do the lips thereof 
approximate of their own accord. When the points adjoining to an ulcer 
are inflamed, the ulcer is not disposed to heal until the inflammation 
subside, nor when the surrounding parts are blackened by mortification, 
nor when a varix occasions an overflow of blood in the part, is the 
ulcer disposed to heal, unless you bring the surrounding parts into 
a healthy condition. 



PART 3 

Circular ulcers, if somewhat hollow, you must scarify all along their 
edges, or to the extent of half the circle, according to the natural 
stature of the man. When erysipelas supervenes upon any sore, you 
must purge the body, in the way most suitable to the ulcer, either 
upward or downward. When swelling arises around an. ulcer, and if 
the ulcer remain free from inflammation, there will be a deposit of 
matter in process of time. And whatever ulcer gets swelled along with 
inflammation and does not subside as the other parts subside which 
became inflamed and swelled at the same time, there is a danger that 
such an ulcer may not unite. When from a fall, or in any other way, 
a part has been torn or bruised, and the parts surrounding the ulcer 
have become swelled, and, having suppurated, matter flows from the 
swelling by the ulcer, if in such cases a cataplasm be required, it 
should not be applied to the sore itself, but to the surrounding parts, 
so that the pus may have free exit, and the indurated parts may be 
softened. But when the parts are softened as the inflammation ceases, 
then the parts which are separated are to be brought toward one another, 
binding on sponges and applying them, beginning from the sound parts 
and advancing to the ulcer by degrees. But plenty of leaves are to 
be bound above the sponge. When the parts are prevented from coming 
together by a piece of flesh full of humors, it is to be removed. 
When the ulcer is deep seated in the flesh, it is swelled up, both 
from the bandaging and the compression. Such an ulcer should be cut 
up upon a director (specillum) if possible, at the proper time, so 
as to admit a free discharge of the matter, and then the proper treatment 
is to be applied as may be needed. For the most part, in every hollow 
ulcer which can be seen into which can be seen into direct without 
being any swelling present, if there be putrefaction in it, or if 
the flesh be flabby and putrid, such an ulcer, and the parts which 
surround it, will be seen to be black and somewhat livid. And of corroding 
ulcers, those which are phagedaenic, spread and corrode most powerfully, 
and, in this case, the parts surrounding the sore will have a black 



and sub-livid appearance. 



PART 4 

Cataplasms for swellings and inflammation in the surrounding parts. 
Boiled mullein, the raw leaves of the trefoil, and the boiled leaves 
of the epipetrum, and the poley, and if the ulcer stand in need of 
cleansing, all these things also cleanse; and likewise the leaves 
of the fig-tree, and of the olive, and the horehound, all these are 
to be boiled; and more especially the chaste-tree, and the fig, and 
the olive, and the leaves of the pomegranate are to be boiled in like 
manner. These are to be used raw: and the leaves of the mallow pounded 
with wine, and the leaves of rue, and those of the green origany. 
With all these, linseed is to be boiled up and mixed by pounding it 
as a very fine powder. When there is danger of erysipelas seizing 
the ulcers, the leaves of woad are to be pounded and applied raw in 
a cataplasm along with linseed, or the linseed is to be moistened 
with the juice of strychnos or of woad, and applied as a cataplasm. 
When the ulcer is clean, but both it and the surrounding parts are 
inflamed, lentil is to be boiled in wine and finely triturated, and, 
being mixed with a little oil, it is to be applied as a cataplasm; 
and the leaves of the hip-tree are to be boiled in water and pounded 
in a fine powder and made into a cataplasm; and apply below a thin, 
clean piece of cloth wetted in wine and oil; and when you wish to 
produce contraction, prepare the leaves of the hip-tree like the lentil, 
and the cress; wine and finely-powdered linseed are to be mixed together. 
And this is proper: linseed, and raw chaste-tree, and Melian alum, 
all these things being macerated in vinegar. 



PART 5 

Having pounded the white unripe grape in a mortar of red bronze, and 
passed it through the strainer, expose it to the sun during the day, 
but remove it during the night, that it may not suffer from the dew; 
rub it constantly during the day, so that it may dry equally, and 
may contract as much virtue as possible from the bronze: let it be 
exposed to the sun for as great a length of time as till it acquire 
the thickness of honey; then put it into a bronze pot with the fresh 
honey and sweet wine, in which turpentine resin has been previously 
boiled, boil the resin in the wine until it become hard like boiled 
honey; then take out the resin and pour off the wine: there should 
be the greatest proportion of the juice of unripe grape, next of the 
wine, and third of the honey and myrrh, either the liquid (stacte) 
or otherwise. The finest kind is to be levigated and moistened by 
having a small quantity of the same wine poured on it; and then the 
myrrh is to be boiled by itself, stirring it in the wine; and when 
it appears to have attained the proper degree of thickness, it is 
to be poured into the juice of the unripe grape; and the finest natron 
is to be toasted, and gently added to the medicine, along with a smaller 
quantity of the flowers of copper (flos aeris) than of the natron. 
When you have mixed these things, boil for not less than three days, 
on a gentle fire made with fuel of the fig-tree or with coals, lest 
it catch fire. The applications should all be free from moisture, 
and the sores should not be wetted when this medicine is applied in 
the form of liniment. This medicine is to be used for old ulcers, 
and also for recent wounds of the glans penis, and ulcers on the head 
and ears. Another medicine for the same ulcers: -The dried gall of 
an ox, the finest honey, white wine, in which the shavings of the 
lotus have been boiled, frankincense, of myrrh an equal part, of saffron 
an equal part, the flowers of copper, in like manner of liquids, the 



greatest proportion of wine, next of honey, and least of the gall. 
Another : -Wine, a little cedar honey, of dried things, the flowers 
of copper, myrrh, dried pomegranate rind. Another: -Of the roasted 
flower of copper half a drachm, of myrrh two half-drachms, of saffron 
three drachms, of honey a small quantity, to be boiled with wine. 
Another: -Of frankincense a drachm, of gall a drachm, of saffron three 
drachms; let each of these be dried and finely levigated, then, having 
mixed, triturate in a very strong sun, pouring in the juice of an 
unripe grape, until it become of a gelatinous consistence, for three 
days; then let them be allowed to macerate in an austere, dark-colored, 
fragrant wine, which is gradually poured upon them. Another : -Boil 
the roots of the holmoak in sweet white wine; and when it appears 
to be properly done, having poured off two parts of the wine, and 
of the lees of wine as free of water as possible one part; then boil, 
stirring it, so that it may not be burnt, at a gentle fire, until 
it appear to have attained the proper consistence. Another: -The other 
things are to be the same; but, not withstanding, instead of the wine, 
use the strongest white vinegar, and dip into it wool as greasy as 
can be procured, and then, moistening it with the lees of oil, boil, 
and pour in the juice of the wild fig-tree, and add Melian alum, and 
natron, and the flowers of copper, both toasted. This cleanses the 
ulcers better than the former, but the other is no less desiccant. 
Another: -Dip the wool in a very little water; and then, having added 
a third part of wine, boil until it attain the proper consistence. 
By these, recent ulcers are most speedily prevented from getting into 
a state of suppuration. 



PART 6 

Another : -Sprinkle on it dried wakerobin, and add the green bark of 
the fig-tree, pounding it in the juice: do this with or without wine, 
and along with honey. Another : -Boiling the shavings of lotus with 
vinegar (the vinegar should be white) ; then mix the lees of oil and 
raw tar-water, and use it as a liniment or wash, and bandage above. 
These things in powder prevent recent wounds from suppurating, or 
they may be used for cleansing the sore along with vinegar, or for 
sponging with wine. 



PART 7 

Another : -Sprinkle (on the sore?) lead finely triturated with the recrement 
of copper; and sprinkle on it, also, the shavings of lotus, and the 
scales of copper, and alum, and chalcitis, with copper, both alone, 
and with the shavings of lotus. And otherwise, when it is wanted to 
use these in a dry state, do it with the Illyrian spodos triturated 
with the shavings, and with the shavings alone. And the flowers of 
silver alone, in the finest powder; and birthwort, when scraped and 
finely pounded, may be sprinkled on the part. Another, for bloody 
sores myrrh, frankincense, galls, verdigris the roasted flower of 
copper, Egyptian alum roasted, vine flowers, grease of wool, plumbago, 
each of these things is to be diluted, in equal proportions, with 
wine like the former. And there is another preparation of the same: -The 
strongest vinegar of a white color, honey, Egyptian alum, the finest 
natron; having toasted these things gently, pour in a little gall; 
this cleanses fungous ulcers, renders them hollow, and is not pungent. 
Another: -The herb with the small leaves, which gets the name of Parthenium 
parviflorum, and is used for removing thymia (warts?) from the glans 
penis, alum, chalcitis, a little crude Melian alum (?); sprinkle a 
little dried elaterium, and a little dried pomegranate rind in like 
manner . 



PART 8 

The herb which has got the name of lagopyrus, fills up hollow and 
clean ulcers; (when dried it resembles wheat; it has a small leaf 
like that of the olive, and more long;) and the leaf of horehound, 
with oil. Another: -The internal fatty part, resembling honey, of a 
fig much dried, of water two parts, of linseed not much toasted and 
finely levigated, one part. Another: -Of the dried fig, of the flower 
of copper levigated a little, and the juice of the fig. The preparation 
from dried fig:-The black chamaeleon, the dried gall of an ox, the 
other things the same. Of the powders: -Of the slender cress in a raw 
state, of horehound, of each equal parts; of the dried fig, two parts; 
of linseed, two parts; the juice of the fig. When you use any of these 
medicines, apply above it compresses wetted in vinegar, apply a sponge 
about the compresses and make a If the surrounding parts be in an 
inflamed state, apply to them any medicine which may appear suitable. 



PART 9 

If you wish to use a liquid application, the medicine called caricum 
may be rubbed in, and the bandages may be applied as formerly described 
upon the same principle. The medicine is prepared of the following 
ingredients : -Of black hellebore, of sandarach, of the flakes of copper, 
of lead washed, with much sulphur, arsenic, and cantharides . This 
may be compounded so as may be judged most proper, and it is to be 
diluted with oil of juniper. When enough has been rubbed in, lay aside 
the medicine, and apply boiled wakerobin in a soft state, either rubbing 
it in dry, or moistening it with honey. But if you use the caricum 
in a dry state, you must abstain from these things, and sprinkle the 
medicine on the sore. The powder from hellebore and sandarach alone 
answers. Another liquid medicine : -The herb, the leaf of which resembles 
the arum (wakerobin) in nature, but is white, downy, of the size of 
the ivy-leaf: this herb is applied with wine, or the substance which 
forms upon the branches of the ilex, when pounded with wine, is to 
be applied. Another: -The juice of the grape, the strongest vinegar, 
the flower of copper, natron, the juice of the wild fig-tree. Alum, 
the most finely levigated, is to be put into the juice of the wild 
grape, and it is to be put into a red bronze mortar and stirred in 
the sun, and removed when it appears to have attained proper consistence. 



PART 10 

These are other powders : -Black hellebore, as finely levigated as possible, 
is to be sprinkled on the sore while any humidity remains about it, 
and while it continues to spread. The bandaging is the same as when 
plasters are used. Another, in like manner: -The driest lumps of salt 
are to be put into a copper, or earthen pot, of equal size, as much 
as possible, and not large, and the finest honey, of double the size 
of the salt, as far as can be guessed, is to be poured upon the lumps 
of salt, then the vessel is to be put upon coals and allowed to sit 
there until the whole is consumed. Then, having sponged the ulcer 
and cleansed it, bandage it as before, and compress it a little more. 
Next day, wherever the medicine has not been taken in, sprinkle it 
on, press it down, and bandage. But when you wish to remove the medicine, 
pour in hot vinegar until it separate, and again do the same things, 
sponging it away, if necessary. Another corrosive powder: -Of the most 
finely-levigated misy, sprinkle upon the moist and gangrenous parts, 



and a little of the flower of copper, not altogether levigated. Another 
powder equally corrosive : -Having sponged the ulcer, burn the most 
greasy wool upon a shell placed on the fire until the whole be consumed; 
having reduced this to a fine powder, and sprinkled it on the sore, 
apply the bandage in the same manner. Another powder for the same 
ulcers: -The black chamaeleon, when prepared with the juice of the 
fig. It is to be prepared roasted, and alkanet mixed with it. Or, 
pimpernel, and Egyptian alum roasted, and sprinkle on them the Orchomenian 
powder. For spreading ulcers : -Alum, both the Egyptian roasted, and 
the Melian; but the part is to be first cleansed with roasted natron 
and sponged; and the species of alum called chalcitis roasted. It 
is to be roasted until it catch fire. 



PART 11 

For old ulcers which occur on the fore part of the legs; they become 
bloody and black : -Having pounded the flower of the melilot and mixed 
it with honey, use as a plaster. For nerves (tendons?) which have 
been cut asunder : -Having pounded, sifted, and mixed with oil the roots 
of the wild myrtle, bind on the part; and the herb cinquefoil (it 
is white and downy, and more raised above the ground than the black 
cinquefoil), having pounded this herb in oil bind it on the part, 
and then remove it on the third day. 



PART 12 

Emollients (?) :-These medicines are to be used in winter rather than 

in summer. Emollient medicines which make the cicatrices fair: -Pound 

the inner mucous part of the squill and pitch, with fresh swine's 

seam, and a little oil, and a little resin, and ceruse. And the grease 

of a goose, fresh swine's seam, and squill, and a little oil. The 

whitest wax, fresh clean grease, or squill and white oil, and a little 

resin. Wax, swine's seam (old and fresh), and oil, and verdigris, 

and squill and resin. Let there be two parts of the old grease to 

the fresh, and of the other things, q. s. Having melted the grease 

that is fresh, pour it into another pot; having levigated plumbago 

finely and sifted it, and mixed them together, boil and stir at first; 

boil until when poured upon the ground it concretes; then taking it 

off the fire, pour it all into another vessel, with the exception 

of the stony sediment, and add resin and stir, and mix a little oil 

of juniper, and what has been taken off. In all the emollient medicines 

to which you add the resin, when you remove the medicine from the 

fire, pour in and mix the resin while it is still warm. Another: -Old 

swine's seam, wax, and oil, the dried shavings of the lotus, frankincense, 

plumbago, -namely, of the frankincense one part, and of the other one 

part, and of the shavings of the lotus one part; but let there be 

two parts of the old grease, one of wax, and of fresh swine's seam 

one part. Another: -Or old swine's seam along with the fresh grease 

of a goat; when cleaned, let it retain as little as possible of its 

membrane: having triturated or pounded it smooth, pour in oil, and 

sprinkle the lead with the spodium and half the shavings of the lotus. 

Another : -Swine ' s seam, spodium, blue chalcitis, oil. 



PART 13 

For Burns: -You must boil the tender roots of the ilex, and if their 
bark be very thick and green, it must be cut into small parts, and 
having poured in white wine, boil upon a gentle fire, until it appear 



to you to be of the proper consistence, so as to be used for a liniment. 
And it may be prepared in water after the same manner. Another, not 
corrosive : -Old swine's seam is to be rubbed in by itself, and it is 
to be melted along with squill, the root of which is to be divided 
and applied with a bandage. Next day it is to be fomented; and having 
melted old swine's seam and wax, and mixed with them oil, frankincense, 
and the shavings of lotus and vermilion, this is to be used as a liniment. 
Having boiled the leaves of the wakerobin in wine and oil, apply a 
bandage. Another : -When you have smeared the parts with old swine's 
seam let the roots of asphodel be pounded in wine and triturated, 
and rubbed in. Another : -Having melted old swine's seam, and mixed 
with resin and bitumen, and having spread it on a piece of cloth and 
warmed it at the fire, apply a bandage. When an ulcer has formed on 
the back from stripes or otherwise, let squill, twice boiled, be pounded 
and spread upon a linen cloth and bound on the place. Afterward the 
grease of a goat, and fresh swine's seam, spodium, oil, and frankincense 
are to be rubbed in. 



PART 14 

Swellings which arise on the feet, either spontaneously or otherwise, 

when neither the swellings nor the inflammation subside under the 

use of cataplasms, and although sponges or wool, or anything else 

be bound upon the sound part; but the swelling and inflammation return 

of themselves again, an influx of blood into the veins is the cause, 

when not occasioned by a bruise. And the same story applies if this 

happen in any other part of the body. But blood is to be abstracted, 

especially the from the veins, which are the seat of the influx, if 

they be conspicuous; but if not, deeper and more numerous scarifications 

are to be made in the swellings; and whatever part you scarify, this 

is to be done with the sharpest and most slender instruments of iron. 

When you have removed the blood, you must not press hard upon the 

part with the specillum, lest you produce contusion. Bathe with vinegar, 

and do not allow a clot of blood to remain between the lips of the 

wounds, and having spread greasy wool with a medicine for bloody wounds, 

and having carded the woof and made it soft, bind it on, having wetted 

it with wine and oil. And let the scarified part be so placed that 

the determination of the blood may be upward and not downward; and 

do not wet the part at all, and let the patient be put upon a restricted 

diet and drink water. If upon loosing the bandages you find the scarifications 

inflamed, apply a cataplasm of the fruit of the chaste-tree and linseed. 

But if the scarifications become ulcerated and break into one another, 

we must be regulated by circumstances, and otherwise apply whatever 

else appears to be proper. 



PART 15 

When a varix is on the fore part of the leg, and is very superficial, 

or below the flesh, and the leg is black, and seems to stand in need 

of having the blood evacuated from it, such swellings are not, by 

any means, to be cut open; for, generally, large ulcers are the consequence 

of the incisions, owing to the influx from the varix. But the varix 

itself is to be punctured in many places, as circumstances may indicate. 



PART 16 

When you have opened a vein and abstracted blood, and although the 
fillet be loosed the bleeding does not stop, the member, whether the 



arm or leg, is to be put into the reverse position to that from which 
the blood flows; so that the blood may flow backward, and it is to 
be allowed to remain in this position for a greater or less space 
of time. Then bind up the part while matters are so, no clots of blood 
being allowed to remain in the opening. Then having applied a double 
compress, and wetted it with wine, apply above it clean wool which 
has been smeared with oil. For, although the flow of blood be violent, 
it will be stopped in this way. If a thrombus be formed in the opening, 
it will inflame and suppurate. Venesection is to be practiced when 
the person has dined more or less freely and drunk, and when somewhat 
heated, and rather in hot weather than in cold. 



PART 17 

When in cupping, the blood continues to flow after the cupping-instrument 

has been removed, and if the flow of blood, or serum be copious, the 

instrument is to be applied again before the part is healed up, so 

as to abstract what is left behind. Otherwise coagula of blood will 

be retained in the incisions and inflammatory ulcers will arise from 

them. In all such cases the parts are to be bathed with vinegar, after 

which they are not to be wetted; neither must the person lie upon 

the scarifications, but they are to be anointed with some of the medicines 

for bloody wounds. When the cupping instrument is to be applied below 

the knee, or at the knee, it should be done, if possible, while the 

man stands erect. 

THE END