We have already seen how fissures and ulcers of the fundament were a
not unusual consequence of the vice of the pathic, yet not the faintest
indication of the fact is to be found in the medical Writers. The
knowledge possessed by the Ancients as to affections of the fundament
have been collected with a very considerable degree of completeness by
_Aëtius_,[400] especially as copying Galen; the remaining authorities
treat them as a rule in conjunction with the corresponding affections
of the genitals, and mostly recommend the same remedies for them. So
far therefore as they are concerned we refer back to the information
given in connection with the latter. At the same time the remark may
be permitted that this juxtaposition of the two seems to point to the
Ancients having held, as we maintain they did, the view that affections
of the genitals and affections of the anus arose from like causes and
were of like character, as is shown by their dealing with the one and
the other class of diseases on the same general lines.
_Ardentes dolores_ (burning pains)[401] and _pruritus_ (itching)[402]
of the anus are not uncommon. _Inflammations_[403] often supervene as a
consequence of fissures, morbid growths and ulcers. _Rhagades_ (cracks)
and _fissures_[404] are found either in the sphincter muscle or in the
rectum, and are an accompaniment of condylomata, whenever the latter
become inflamed and spread, causing the surrounding tissue to rupture;
the edges frequently assume a callous condition, and then require to be
broken down and thus transformed into a simple ulcer. Often abscesses
are set up[405] as a result of the inflammation, and these are liable
to lead to fistulas. The ulcers[406] on occasion assume the character
of the νομὴ φαγέδαινα (eating and spreading ulcer). Supposing them
situated on the sphincter ani, they must neither be cut nor cauterized,
as severance of the muscle makes it impossible for the patient to
retain the faeces. This loss of retentive power may also occur apart
from any operation, if the νομη (spreading ulcer) destroy the muscle.
Supposing on the contrary the νομὴ to be below the sphincter, knife or
cauterizing iron may either of them be employed. In some instances
ulcers lead to a morbid growth at the orificium ani, that must be
obviated by means of pipettes of lead.[407] In other cases _rhagades_
(cracks) and ulcers lead eventually to morbid outgrowths.