558 
FISTULA OF THE WITHERS. 
where a dose of aloes has been administered and has not 
operated in about thirty hours afterwards. I then give, without 
fear, half a pint to a pint and a half, depending on circum- 
stances. I much prefer this plan to that of waiting a week 
and then exhibiting a second dose of physic. Of course, no 
one would think of giving a second dose of aloes quickly 
upon the first, unless it were wished to induce superpurga- 
tion ; and who could wish to see this in the horse ? 
ON FISTULA OF THE WITHERS. 
By the Same. 
In the August number also of your journal is an article 
headed f Past and Present Treatment of Fistula/ by Actaeon, 
who says that, “ 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 interme- 
diate days with digestives.” Further on he remarks, that 
“ the iron has now usurped all other modes of cure in such 
cases.” 
This treatment is doubtless very efficacious, but I think 
that fistulous wounds are often to be cured without the use 
of the actual cautery. To speak at once to the point; if you 
can bring — and which is the great secret in curing fistula — 
your remedial agents in direct contact with the diseased parts, 
you can cure any fistula without the actual cautery. The way 
to do this is, not by merely syringeing the parts, but by tho- 
roughly cleaning away the secreted matter from the sinuses 
before injecting the fluid. If you have a straight sinus to 
deal with, a probe with a piece of tow at its end will suffice ; 
but if the sinus is curved, and some parts of it are out of 
reach, you must then use the knife to enable you to pass the 
probe to the bottom of it. 
Some practitioners will doubtless say, why should we dis- 
agree about the treatment of a disease when the object can be 
obtained in either way? My reason for taking notice of 
“ Actaeon’s” communication is, that I think the treatment of a 
wound appears in the eye of the public to be more scientifically 
and professionally managed, and certainly more humanety, 
when milder measures are employed. We should avoid, as a 
