ANAL FISTULA, IL-EMORRHOIDS. 9 1 



Other discharging sinuses in this region are not uncommonly 

 confounded with it. Foreign bodies, such as needles and pieces 

 of sharp bone, are the usual cause. Careful examination should 

 always be made by passing a blunt pointed probe up the 

 suspected fistula, and at the same time feeling for the internal 

 orifice with one finger in the rectum. The probe must be 

 passed very carefully, and not in any way forced, as there 

 may be several sinuses, some of them being blind ones. Treat- 

 ment consists in opening up each sinus freely, carefully curet- 

 ting the walls or treating them cautiously with some caustic 

 to destroy their indurated lining, and afterwards applying anti- 

 septics in the same way as to an open wound. In cases where 

 ulceration of the bowel has not taken place the wound generally 

 heals up and brings about a satisfactory termination, although 

 progress may be slow. 



Operation for Hsemorrhoids. — A dilated and very trouble- 

 some knotty condition of the veins around and just within the 

 anus is not infrequent in fat old dogs, especially pugs, and 

 gives rise to a good deal of pain and irritation, especially when 

 faeces are passed, and when the animal is at all constipated. 



The enlarged veins should be picked up with forceps, and 

 either ligatured, by passing a curved needle and silk around 

 them, the intervening portion being excised, or clamped and 

 removed with the actual cautery. 



