The majority of Writers however are agreed that among other occasioning causes ulcers hold the first place,[412] though none of them speak expressly of ulcers of the genitals, unless indeed we see good to make the passage of Hippocrates discussed a little above refer to these. No doubt in this passage the words ἑλκώματα, φύματα ἔξωθεν ἔσωθεν τὰ περὶ βουβῶνας (ulcerations, tumours external and internal in the inguinal region) might admit of such an explanation, in which case the words must be taken not as referring to each single patient, but rather held to mean that ulcers and glandular swellings with a tendency to suppuration were set up, the latter occurring in some patients in the urethra, in others in the groin. Such an interpretation is favoured by the case of the Eunuch discussed in § 20, for there can be no doubt the metathesis of buboes into fistulous ulcers was noted by Celsus and other observers. Still it is highly improbable that ulcers on the feet should have afforded the sole and only cause of buboes; it is much more natural to suppose that this, as being the more rare case, was for that very reason brought into special prominence by the ancient Physicians. Besides we have seen above that the old Physicians seldom or never really had an opportunity of seeing the sympathetic buboes, as patients treated the ulcers themselves, and the buboes then disappeared spontaneously. Oribasius no less than other Writers holds buboes following on an ulcer to be without danger. Lastly the cases are very rare in which secondary buboes under the prevailing tendency and course of the disease are thrown out on the skin, and if they do arise, the ulcer as a rule heals up. This being so, the Physician is consulted, only supposing the buboes refused to disappear. On the contrary if the ulcer was still there, the Physician sought actually to stimulate it to enhanced activity, as is distinctly implied by what _Galen_ says (loco citato). Lint smeared with _tetrapharmacum_ (compound of wax, tallow, pitch and resin), liquified by the addition of _oleum rosaceum_ (oil of roses) was applied and warm poultices over that; while on the actual bubo was laid in the first instance wool moistened with oil, to which when the pain and swelling of the part were relieved, was added an admixture of salt. Plethoric or cacochymic (generating evil humours) subjects are to be bled or cupped. If the bubo is inflamed and inclined to suppurate, it must be scarified, the patient having first been purged. Dispersion is then attempted, in this case by means of pulp and honey poultices, but not by plasters, as these are apt to provoke inflammation. If pus appears, recourse must not be had at once, as some advise, to opening with the knife; rather the poultices should be persevered with till the inflammation is relieved. Acrid poultices are suitable only when the metathesis to induration has already begun.