FISTULA, in general, denotes any ulcerated and sinuous cavity, with callous and elevated edges, which extends to a carious bone.
This formidable disease is, according to the parts which it attacks, called either fistula lachrymalis, that is, a sinuous ulcer of the lachrymal sac or duct, beginning with a tumor between the inner cornea of the eye, and the side of the nose; or a fistula in perinæo, namely, an ulcer communicating with the urinary canal, but sometimes opening into the bladder; or fistula in ano, when the ulcer is in the vicinity of the rectum or straight-gut.—The first generally appears in ricketty children, or such as are subject to glandular obstructions; the second may arise from wounds in the bladder and of the urethra, from external violence, &c. but is most frequently occasioned by certain diseases with which voluptuaries are punished; and the last is produced by whatever tends to form matter about the anus, by piles, soft tumors, hardened feces, or in consequence of irritation and inflammation, terminating in suppuration.
It would be needless to enlarge upon the treatment of this complaint, the cure of which cannot be entrusted to unskilful hands; nay, medical and surgical advice are often inadequate to relieve the unhappy sufferer, especially from the last species of fistula, after an operation has been ineffectually performed. Indeed, the frequent unsuccessful attempts of the most experienced operators, have encouraged a degree of quackery in this malignant disease, which ought never to be submitted to dabblers; as the delay of proper advice cannot fail to be attended with fatal effects. Hence we think it necessary to caution the unwary against the insidious attempts of those eccentric impostors (particularly in the west end of the metropolis) who extort large sums of money from the unhappy patients, under the specious promise of curing a fistula, without cutting.
After the disorder has been suffered to prey upon the internal parts, and the bones in the vicinity have become affected, or carious, we venture to pronounce that it is incurable. But, if the patient be of a sound constitution, and has not neglected himself at the commencement of the malady, he may doubtless be cured by professional treatment, an appropriate diet, consisting of light and nutritive food, and abandoning every kind of stimulating and heating aliment, both in a liquid and solid state. Hence game, pork, wine, spirits, coffee, and spices, are here equally improper.—Lastly, we are inclined to believe, that the external use of living snails, or at least the expressed juice of them frequently applied to fistulous ulcers at their commencement (especially after completely laying open the sinus), will have an excellent effect in stopping the progress of the disease; and, by sufficient perservance, probably accomplish a cure. There are several well-attested cases, that this simple remedy has recently been found of excellent service in removing scrophulous ulcers, which had resisted every other mode of treatment.