182 
S. MYLNE. 
I 
Incomplete or blind, with but one opening, which may be 
either external or internal. 
External incomplete fistula is kept up by caries or necrosis 
of bones, by extraneous bodies in any of the living textures, or 
by purulent cavities, the walls of which have not become 
united. 
The great object of treatment in fistulous sores is to bring on 
an altered condition of the parieties of the canal by astringent 
or stimulating injections, the knife, pressure, etc.; in those de¬ 
pendent on diseased bone, by exfoliation of the morbid part. 
Distribution -—Caries of teeth—shot, the parotid duct, 
lachrymal fistula, ear, poll evil, withers, quittor, scrotum, fis¬ 
tula in ano (dog), fistula in teat, vesico-vaginal fistula, fistu¬ 
lous umbilical hernia. 
A fistula is liable to be produced in any part of the body 
from numerous causes such as, “ blows and injuries to bones, 
entrance of extraneous bodies, formation of pus.”—(Williams). 
When pus is seated in parts, the action of which is defec¬ 
tive owing to local or general causes, or when it cannot be 
completely evacuated, the cavity that remains does not con¬ 
tract completely, and the wound is called a sinus or fistula. 
Fistula , of whatever kind, presents to the young practi¬ 
tioner or, for that matter, the veteran, a case which in the 
majority of instances tendeth to give him ample field for ply¬ 
ing his experience, his knowledge, and too frequently a thank¬ 
less and expensive operation. 
In all cases have your patient under personal observation, 
where you can note the changes which take place towards a 
successful termination or vice versa. This is most imperative, 
else you become disheartened, disgusted, and your client 
wavers in his estimation of your ability to cope with the 
trouble. In all cases state‘exactly length of time necessary to 
a complete cure, more or less, circumstances altering cases. 
The cost should be so much per day, with medicine extra, or 
so much for curing, etc. 
The great advantage of surgery over other modes of treat¬ 
ment are these: 
i. If a pus cavity is readily evacuated by aspirator, tro¬ 
car and canula or knife. 
