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Swollen Sores

Swollen Sores in Classical Greek Medicine

Hippocratic doctors were quite familiar with painful, red swellings filled with pus. They called these inflammations ulcers. The Hippocratic corpus contains an extensive text dealing with the proper treatment of ulcers.

The primary treatment for ulcers was "a spare diet and water" (1). The doctor would ask how recently the ulcer had appeared. For recent ulcers, Hippocrates recommends:

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 (2).

In addition to a cataplasm (also known as a poultice or plaster), the doctor might offer a drug or herbal concoction that acted as a mild purgative of the bowels.

In keeping with the importance of weather, climate and other aspects of the environment, the season was also relevant for the treatment of 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 (3).

An impression of the Greek materia medica emerges from Hippocrates' recipes for proper cataplasms for ulcers.

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 (4).

Hippocratic poultice recipes could be quite complicated, requiring many ingredients, both common and difficult to obtain. Different poultices were considered appropriate for ulcers in different locations.

Notes

1. Adams, Francis (translator), The Genuine Works of Hippocrates. New York: William Wood and Company, 1886. Volume 2, p. 293.

2. ibid, p 294.

3. ibid, p. 295

4. ibid, p. 297

 

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