*5tf DISEASES Clafs It i. 4. if} 



sflerted, in his le&ures, that he had known a fiftula in ano cured 

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

 and, by gradually increafmg 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 became callous, and ceafed to dif- 

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

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

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

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

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

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

 it muft be laid open by the knife. 



1 1 . Fiftula urethra. Where a ftrieture of the urethra exifts, 

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

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

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

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

 fioning fiftulas, which fometimes have large furfaces producing 

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

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

 las fometimes acquire an external opening in the perinaeum, and 

 part of the urine is difcharged that way. 



Can this matter be diftinguifhed from mucus of the bladder by 

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



M. M. 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 moiftening 

 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 luccefsful in one cafe ; 

 the extenfive fiftulas completely healing. The patient fhould 

 introduce a bougie always before he makes water, and endeavour 

 to make it as flowly as poflible. See Clafs I. 2. 3. 24* 



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

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

 diflecftion, which was not fufpecled in the living fubjecl:. Though 

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

 matter, owing to the infeniibility 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- 

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

 iiefs in the right hypochondre, or from tranfient pains fometimes 

 felt there, or from pain on preiTure,'or from lying on the left fide, 

 and iometimes from a degree of fenfitive fever attending it. 



Dr. Baunders- 



