Book 5
28
Ignis sacer should be counted also among the bad ulcerations. Of this there are two kinds; one is reddish or partly red, partly pale and roughened by a chronic pustulation, the pustules all of about equal size, but mostly very small: in them there is nearly always pus and often there is redness with heat. And sometimes the disease spreads while the first part attacked is healing; sometimes even after this is ulcerated, when the pustules have ruptured and the ulcer continues and a humour is discharged which appears to be continuing between sanies and pus. It attacks chiefly the chest or flanks or extremities, particularly the soles of the feet. The second form, again, consists of a superficial ulceration, not going deep, but wide, somewhat livid, yet patchy; while it heals at the centre, it extends at the margins. And often the part which apparently had healed again ulcerates. But the skin around, which is about to be invaded by the disease, becomes more swollen and harder and of a dusky red colour. And it is the aged who are mostly afflicted by this malady too or those with a bad habit of body, but chiefly in the legs. Now all cases of erysipelas, although the least dangerous of the ulcerations which spread, are the most difficult to relieve. A chance remedy for it is a one-day fever which carries off noxious humour. The thicker and the whiter the pus, the less the danger. It is also beneficial to make incisions below the opneings of the sores, to let a larger amount of pus escape, and to extract it because the body there is corrupt. If, however, slight fever supervenes, abstinence, rest in bed and a clyster are needed. In erysipelas of all kinds, neither mild and glutinous nor salted and acrid foods should be used, but material of the middle class, such as unleavened bread, fish, kid, poultry and all kinds of game, except wild boar's meat. When there is no feverishness, both rocking and walking are of service, and dry wine and the bath. And in this class of cases drink should be taken more freely than food. gut if the ulceration spreads slowly it should be fomented with hot water; if rapidly, with hot wine; then whatever pustules there are must be opened with a needle; afterwards applications are to be made which corrodeputrid flesh. When the inflammation is relieved and the ulcer cleaned, soothing ointment should be applied. But in the former kind, quinces, boiled in wine and pounded, may prove beneficial, as also a plaster, either that of Heras or the tetrapharmacum, with a fifth part of frankincense added, or black ivy boiled in dry wine; and if the disease is spreading rapidly there is nothing better. When the ulceration has been cleaned, the same soothing remedies which I prescribed above for the superficial variety are sufficient to induce healing.
