[Proctological surgery (2). Hemorrhoids, anal fissures].
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In two manuscripts of Galen's De compositione medicamentorum secundum locos, the Marcianus gr. V 7 and the Vaticanus Reginensis gr. 172, Galen's text is interrupted by a brief anthology about aetiology and therapy of prolapses, haemorrhoids and anal inflammations. Both manuscripts present a chapter, titled (see text), which consists of chapters 1-2 (p. 146, 2-12 July) of the Hippocratic On Haemorrhoids. My contribution presents this new document about the knowledge of this Hippocratic work, neglected by modern scholars, but well known by Byzantine medical writers.
After a careful review of the Author's own case list and of the literature on this subject, Milligan-Morgans' technique is assessed and compared with different surgical techniques as far as early and late complications are concerned. The Authors conclude that the Milligan-Morgan technique is to be preferred because of its simplicity, safety and flexibility, particularly if associated with sphincterectomy, with or without rhagade, in order to prevent the cicatricial scars.
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