226 DISEASES Clafs II. r. 4. *iv 



aflertcd, in his lectures, that he had known a fiftula in ano cured 

 by injecting firft a mixture of rectified fpirit of wine and water 5 

 and, by gradually increafing the ftrength of it, till' the patient 

 could bear rectified fpirit alone ; by the daily ufe of which, at 

 length, the fides of the fiftula oecame callous, and ceafed to dis- 

 charge, though the cavity was left. A French furgeon has 

 lately affirmed, that a wire of lead put in at the external open- 

 ing of the ulcer, and brought through the rectum, and twifted 

 together, will gradually wear itfeif through the gut, and thus ef- 

 fect a cure without much pain. The ends of the leaden wire 

 mult be twifted more and more as it becomes loofe. Or, laftly, 

 it mult be laid open by the knife. 



1 1 . Fijlula urethra. Where a flricture of the urethra exifls, 

 from whatever caufe, the patient, in forcing the ftream of urine 

 through the flricture, diftends the urethra behind it ; which, 

 after a time, is liable to burft, and to become perforated ; and 

 fome of the urine is pufned into the cellular membrane, occa- 

 fioning fiitulas, which fometimes have large furfaces producing 

 much matter, which is prefted out at the time of making water, 

 and has been mistaken- for a catarrh of the bladder ; thefe fiftu- 

 las fometimes acquire an external opening in the perinxum, and 

 part of the urine is difcharged that way. 



Can this matter be diflinguifhed from mucus of the bladder by 

 the criterion delivered in Clafs II. iv 6. 6. ? 



M. M"i The perpetual ufe of bougies, either of catgut or of 

 caoutchouc. The latter may be had at No. 37, Red-lion-ftreet, 

 Holborn, London. The former are eafily made, by moiitening. 

 the catgut, and keeping it ftretched till dry, and then rounding 

 one end with a pen-knife. The ufe of a warm bath every day 

 for near an hour, at the heat of 94 or 96 degrees, for two or 

 three months, I knew to be uncommonly fuccefsful in one cafe l 

 the extenfive fiftulas completely healing. The patient mould 

 introduce a bougie always before he makes water, and endeavour 

 to make it as flowly as polfible. See Clafs I. 2. 3. 2$* 



1 2. Hepatitis chronica. Chronical inflammation of the liver. 

 A collection of matter in the liver has frequently been found 011 

 direction, which was not fufpected in the living fubject. Though 

 there may have been no certain figns of fuch a collection of 

 matter, owing to the infenfibility of the internal parts of this 

 vifcus ; which has thus neither been attended with pain, nor in- 

 duced any fever ; yet there may be in fome cafes reafon to fuf- 

 pect the exiftence of fuch an abfcefs ; either from a fenfe of ful- 

 ntU in the right hypochondre, or from tranfient pains fometimes 

 felt there, or from pain on prellure/or from lying on the left fide, 

 and fometimes from a degree of fenfitive fever attending it. 



Dr. Saunder* 



