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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 [p. 336]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.

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