Fistulae are produced by contusions and tubercles, and they are also
occasioned by rowing, on horseback, when blood accumulates in the
nates near the anus. For, having become putrid, it spreads to the
soft parts (the breech being of a humid nature, and the flesh in which
it spreads being soft), until the tubercle break and corrupt below
at the anus. When this happens, a fistula is formed, having an ichorous
discharge, and faeces pass by it, with flatus and much and abomination.
It is produced, then, by contusions when any of the parts about the
anus are bruised by a blow, or a fall, or a wound, or by riding, or
rowing, or any such cause. For blood is collected, and it, becoming
corrupted, suppurates; and the from the the same accidents happen,
as have been described in the case of tubercles.
In the first place, then, when you see any such tubercle formed, you
must cut it open while still unripe, before it suppurate and burst
into the rectum. But if a fistula be already formed when you undertake
the case, take a stalk of fresh garlic, and having laid the man on
his back, and separated his thighs on both sides, push down the stalk
as far as it will go, and thereby measure the depth of the fistula.
Then, having bruised the root of seseli to a very fine powder, and
poured in some water, let it macerate for four days, and, mixing the
water with honey, let the patient drink it, fasting, to the amount
of three cyathi, and at the same time purge away the ascarides. Those
who are left without treatment die.
In the next place, having moistened the strip of cotton cloth,