byHippocratestranslatedbyFrancisAdamsFistulaeareproducedbycontusionsandtubercles，andtheyarealsooccasionedbyrowing，onhorseback，whenbloodaccumulatesinthenatesneartheanus。For，havingbecomeputrid，itspreadstothesoftparts（thebreechbeingofahumidnature，andthefleshinwhichitspreadsbeingsoft），untilthetuberclebreakandcorruptbelowattheanus。Whenthishappens，afistulaisformed，havinganichorousdischarge，andfaecespassbyit，withflatusandmuchandabomination。Itisproduced，then，bycontusionswhenanyofthepartsabouttheanusarebruisedbyablow，orafall，orawound，orbyriding，orrowing，oranysuchcause。Forbloodiscollected，andit，becomingcorrupted，suppurates；andthefromthethesameaccidentshappen，ashavebeendescribedinthecaseoftubercles。
　　2。Inthefirstplace，then，whenyouseeanysuchtubercleformed，youmustcutitopenwhilestillunripe，beforeitsuppurateandburstintotherectum。Butifafistulabealreadyformedwhenyouundertakethecase，takeastalkoffreshgarlic，andhavinglaidthemanonhisback，andseparatedhisthighsonbothsides，pushdownthestalkasfarasitwillgo，andtherebymeasurethedepthofthefistula。Then，havingbruisedtherootofseselitoaveryfinepowder，andpouredinsomewater，letitmacerateforfourdays，and，mixingthewaterwithhoney，letthepatientdrinkit，fasting，totheamountofthreecyathi，andatthesametimepurgeawaytheascarides。Thosewhoareleftwithouttreatmentdie。
　　3。Inthenextplace，havingmoistenedthestripofcottoncloth，withthejuiceofthegreattithymallus，andsprinklingonittheflosaeris，roastedandtriturated，andhavingmadeitintoatentequalinlengthtothefistula，andhavingpassedathreadthroughtheendsofthetentagainthroughthestalk，andhavingplacedthepatientinarecliningposition，andhavingexaminedtheulceratedpartsoftherectumwithaspeculum，passthestalkbyit，andwhenitreachestherectum，takeholdofitanddrawitoutuntilthetentbepushedthrough，andbebroughtonalevelaboveandbelow。Whenit（thetent？）hasbeenpushedinward，introduceaballofhornintotherectum（therectumhavingbeenpreviouslysmearedwithCimolianchalk），andleaveitthere，andwhenthepatientwantstogotostool，letitbetakenoutandagainreplaced，andletthispracticebecontinuedforfivedays。Onthesixthdayletitberemoved，anddrawingthetentoutoftheflesh，andafterwardspoundingalumandfillingtheball（pessary）andintroducingitintotherectum，leaveituntilthealummelts。Anointtherectumwithmyrrhuntilthepartsappeartobeunited。
　　4。Anothermethodofcure：Takingaveryslenderthreadofrawlint，andunitingitintofivefoldsofthelengthofaspan，andwrappingthemroundwithahorsehair；thenhavingmadeadirector（specillum）oftin，withaneyeatitsextremity，andhavingpassedthroughittheendofrawlintwrappedroundasabovedescribed，introducethedirectorintothefistula，and，atthesametime，introducetheindexfingerofthelefthandperanum；andwhenthedirectortouchesthefinger，bringitoutwiththefinger，bendingtheextremityofthedirectorandtheendofthethreadsinit，andthedirectoristobewithdrawn，buttheendsofthethreadsaretobeknottedtwiceorthrice，andtherestoftherawthreadsistobetwistedaroundandfastenedintoaknot。Thenthepatientistobetoldthathemaygoandattendtohismatters。Therestofthetreatment：Wheneveranypartofthethreadgetslooseowingtothefistulabecomingputrid，itistobetightenedandtwistedeveryday；andshouldtherawthreadrotbeforethefistulaiseatenthrough，youmustattachanotherpieceofrawthreadtothehair，passitthrough，andtieit，foritwasforthispurposethatthehairwasrolledroundtherawlint，asitisnotliabletorot。Whenthefistulahassloughedthrough，asoftspongeistobecutintoveryslenderpiecesandapplied，andthentheflowersofcopper，roasted，aretobefrequentlyappliedwithadirector；andthespongesmearedwithhoneyistobeintroducedwiththeindexfingerofthelefthand，andpushedforward；andanotherbitofadded，itistobeboundoninthesamemannerasintheoperationforhemorrhoids。Nextday，havingloosedthebandages，thefistulaistobewashedwithhotwater，andcleansed，asfaraspossible，withthefingerofthelefthandbymeansofthesponge，andagaintheflosaerisistobeapplied。Thisistobedoneforsevendays，forgenerallythecoatofthefistulatakesthattimetofistulatakesthattimetoslouchthrough。Thesamemodeofbandagingistobeperseveredinafterwards，untilthecurebecompleted。Forinthisway，thefistulabeingforciblyexpandedbythespongewillnotfillupandhealunequally，butitwillallbecomewholetogether。Duringthetreatment，thepartshouldbebathedwithplentyofwarmwater，andthepatientkeptonasparediet。
　　5。Whenthefistuladoesnotgeteatenthrough，havingfirstexamineditwithasound，cutdownasfarasitpasses，andsprinklewiththeflosaeris，andletitremainforfivedays。Thenpourwarmwateruponit，andabovelayflourmixedwithwater，andbindonittheleavesofbeet。Whentheflosaeriscomesaway，andthefistuloussorebecomesclean，cureitasbeforedescribed。Butifthefistulabeinapartwhichdoesnotadmitofthistreatment，andifitbedeep，syringeitwiththeflowersofcopper，andmyrrh，andnatron，dilutedwithurine，andintroduceapieceofleadintotheorificeofthefistulasothatitmaynotclose。Syringethefistulabymeansofaquillattachedtoabladder，sothattheinjectionmaydistendthefistula。Butitdoesnothealunlessitbecutopen。