DISEASES CLASS II. 1. 4. 11. 



asserted, in his lectures, that he had known a fistula in ano cured 

 by injecting first a mixture of rectified spirit of wine and water; 

 and, by gradually increasing the strength of it, till the patient 

 could bear rectified spirit alone; by the daily use of which, at 

 length, the sides of the fistula became callous, and ceased to dis- 

 charge though the cavity was left. A French surgeon has 

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

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

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

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

 must be twisted more and more as it becomes loose. Or, lastly, 

 it must be laid open by the knife. 



11. Fistula urethrw. Where a stricture of the urethra exists, 

 from whatever cause, the patient, in forcing the stream of urine 

 through the stricture, distends the urethra behind it; which, 

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

 some of the urine is pushed into the cellular membrane, occa- 

 sioning fistulas, which sometimes have large surfaces producing 

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

 and has been mistaken for a catarrh of the bladder; these fistu- 

 las sometimes acquire an external opening in the perinaeum, and 

 part of the urine is discharged that way. 



Can this matter be distinguished from mucus of the bladder by 

 the criterion delivered in Class II. 1. 6. 6.? 



M. M. The perpetual use of bougies, either of catgut or of 

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

 Holborn, London. The former are easily made, by moistening 

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

 one end with a pen-knife. The use 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 successful in one case; 

 the extensive fistulas completely healing. The patient should 

 introduce a bougie always before he makes water, and endeavour 

 to make it as slowly as possible. See Class I. 2. 3. 24. 



12. Hepatitis chronica. Chronical inflammation of the liver. 

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

 dissection, which was not suspected in the living subject. Though 

 there may have been no certain signs of such a collection of 

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

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

 duced any fever; yet there may be in some cases reason to sus- 

 pect the existence of such an abscess; either from a sense of ful- 

 ness in the right hypochondre, or from transient pains sometimes 

 felt there, or from pain on pressure, or from lying on the left side, 

 and sometimes from a degree of sensitive fever attending it. 



