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FISTULA IN ANO.

When this disease is ascertained to be present, costiveness shouldbe guarded against chiefly by means of diet, which ought to becooling, and consist of ripe figs, roasted apples, and articles of asimilar nature. Oatmeal porridge eaten with milk or beer, forbreakfast or supper, rarely fails to keep the body regular. Theradical cure of this complaint must depend on the proper applica-tion of topical remedies. Much may be done by strict attentionto personal cleanliness. The parts should be carefully washedwith it sponge and water several times a-day, and regularly aftergoing to stool. Stimulant injections, as for example a solution ofcorrosive sublimate, or of common culinary salt, tincture of can-tharides, or port wine thrown into the fistula by means of a smallsyringe, or elastic gum-bottle, furnished with a conical point, have,when duly persisted in, effected a cure. Or, the orifice of the fis-tula may be kept open, and a free passage given to the containedmatter, by means of a tent or bougie shaped like a cone, and theulcer be thus disposed to heal. This disease has also been at-tempted to be cured by introducing a bougie, or flexible leadenprobe into the fistula, passing it through the orifice that communi-cates with the rectum, and bringing it out at the anus, then twist-ing the two opposite extremities together, and occasionally tight-ening them, till they destroy the interposed substance, when thefistula, being reduced to the state of a simple ulcer, heals.

Drinking any sulphureous mineral water, such as that of Har-rovrgate, improves the constitution in general, and by that meanstends to promote the healing of the ulcer. In cold, languid, andwhat are termed phlegmatic habits, tar-water may be taken withconsiderable advantage. I knew an instance of a fistulous sore,seated near the rectum, being almost healed up by taking regularlyhalf a pint of sea-wafer morning and evening for six weeks togeth-er, and believe it might have been completely cured, had the per-son persisted in this course for a sufficient length of time. It iscertainly worth while to give any of these remedies a fair trialprevious to having recourse to the operation, as even that does notalways succeed.

Ulcerations about the rectum are frequently symptomatic of af-fections of the liver. When that is known to be the case, or whenthey occur about the decline of life, or in persons who have residedlong in warm climates, we should not be too busy with our effortsto heal them up. In such persons they seem frequently to operateas salutary drains to the constitution, and to prevent the access ofother diseases. Many examples have occurred of persons some-what advanced in life being attacked by asthma, spitting ofblood, paralysis, and even insanity, within a short rjeriod of timeafter undergoing the operation for the radical cure of a fistula;while others, of apparently similar constitutions, who have submit-ted to the inconveniency of a discharge, and been attentive to keepthe parts clean and warm, have lived to an advanced period oflife. Individuals past the meridian of life, who determine to un-dergo the operation for fistula, should never omit to have an issueopened in some other part of the body, which may serve as a suc-cedaneum for the natural drain they are about to obliterate.A. P. B.