TREATMENT OF FISTULA. 
443 
feelings of those who have, since such occurrences, established 
a name for themselves? It would, indeed, be a study, more 
especially for those anticipating the right to subscribe V.S. 
to their names, if the thoughts of all the members of the art, 
under such trying circumstances, were chronicled. 
These comments, I hope, will impress on the students 
mind the really short time he has to acquire that knowledge 
so essential in buffeting the world in his professional capacity ; 
and warn him of the very many variations he must adopt in 
his future practice to combat disease successfully. This 
variation of treatment, probably a departure from all the 
prescribed rules of the college, he will often find necessary; 
and this is the time too that he tests the truth of his acquired 
theory ; and he is lucky indeed who can pass through the 
ordeal without wishing for a helping hand. 
The foregoing were somewhat my thoughts, when I met 
with some of the worst cases of fistula I ever saw, and had 
occasion to be very severe in the treatment of them. Many 
years ago, I had recourse to the usual routine of dressing these 
lesions in the authorised way, but not with the anticipated 
result. As a last resort, in a case of fistula of the withers, I 
used the knife most unmercifully, removing about three 
pounds of organized fibrine, afterwards applying the hot iron 
to the indolent parts ; repeating the cautery about every fourth 
day, and dressing the wound in the intermediate days with 
digestives. It was certainly astonishing how quickly the 
parts healed thus treated. The iron has now usurped all 
other modes of cure in such cases ; and even in quittor I 
have found it particularly efficacious, applying it on every 
appearance of an unhealthy discharge. The probe will 
denote the improvement that is taking place, and also the depth 
of the sinuses. The wound must always be cleansed by in- 
jecting water into it prior to the application of the iron, 
which will be required about every third day. On the sub- 
sequent days an injection of a solution of the acetate of zinc, 
twice in the twenty-four hours, will be found beneficial, first 
cleansing the sinuses with warm water. I have found this 
mode of treatment answer all my expectations. The iron at 
the first may be applied pretty freely, but afterwards more 
cautiously. 
