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1. Galen details the principles of treating a wound, ulcer, or sore - that is, a dissolution of continuity - identifying the key components as conglutination, enfleshing, reduction of excess flesh, and cicatrization. Which is to be used depends on the exact circumstances and the part of the body involved. It is also important to deal with any general 'dyskrasia' if it exists and any causative factors still operative. Drying agents are the most important medications. 2. Galen describes dissolution of continuity as affecting both 'homoiomeres' and organic parts. Treatment depends, to some extent, on which of the two is involved - something lost on the followers of Erasistratus, who recognize organic parts only. He then deals with dissolution of continuity in blood vessels - both arteries and veins - beginning by identifying the various causative factors. 3. In treatment the immediate necessity is to stop the bleeding from the injured vessel. There are two options: close the opening and redirect the flow. The former is achieved by compression (manual, various tamponading devices, and bandaging), ligatures, eschar formation, positioning the wounded part, hemostatic (blood-stanching) medications, and cutting through the vessel completely. The latter may occur naturally or may be helped by appropriate application of cupping glasses. |
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