Sylphium as injection and charpie impregnated therewith, locally applied; internally, sulphur 30. and 200, each remedy given successively for eight consecutive days, resulted in a cure in a few month. To this I would say; why the Sylphium? it probably did no radical good, and yet serve to vitiate one’s therapeutic conclusions. However, it is pleasing to note that hack the poor sufferers about.
The more one’s mind dwells upon the subject of fistula the less justifiable, nay how utterly unsound does its surgical treatment appear; I used to have some valued friends among the surgeons, but I have long since offended them all with my outspokenness in regard to the comparatively humble handworker’s sphere to which I would relegate what they are pleased to call the “science of surgery”.
I lost all my allopathic friends when I threw in my lot with the peculiar therapeutic people called homoeopaths, and have learned to do without them in my strong consciousness of right. Now I am beginning to do without my chirurgical friend just because I can do without them and so they cease to love me as of yore. Well, well, the pretty elastic ligature if my friend for fistula-in-ano is no more a cure for the fistular disease than is a catheter for the urethra, which we commonly call stricture.
Berberis vulgaris, a remedy very like Hydrastis canadensis, has also cured fistula. Dr. Schuessler, of Oldenburg, before he hatched his new duodecimal therapeusis, once wrote – Ich habe Mastdarmfistel mehrere Mal durch Berberis geheilt,” but I suppose the tissue remedies have rendered Berberis obsolete, if not inoperative, at least at Oldenburg.
I find a note on a fly-leaf of a book in my own handwriting, to the effect the Dr. Adams cured fistula with Berberis 30.
Even old-school-surgeons are compelled to admit the amenability of fistula to medicinal and general treatment, thought they make the admission rather shame facedly, and as if yielding to vulgar prejudice.
Thus the Messrs Allingham in “Diagnosis and Treatment of Diseases of the Rectum” (a sound practical work from the merely mechanical standpoint). mention the subject of “cases cured by Treatment”with a contempt that I hardly think they can really feel. To speak of those who object to having their flesh cut about for fistula as “wonderfully cowardly’ is arrant nonsense. People with fistula are not well, else they would not have fistula, and own idea is that having one’s cut for fistula is not a sign of courage, and still less of intelligence.
And I say this not with standing the dicta of all the great surgeons, special and general surgeons, special and general, including my very distinguished friend Prof. Tod Helmuth, of New York. I tell them all even where it is unavoidable it is no cure Of course, here and there a complete fistula with an opening allows for the passage of feculent matter at frequent internal;in such a case naturally, the operation becomes unavoidable, but how often how often is that the case?Not at all often.
Allingham says (P.19):- When the fistula is complete wind may through it and also faces if the bowels are relaxed; as a rule, however, this symptom does not occur, in consequence of the smallness of the internal aperture, its situation, or its valvular form. It follows that, though the passage of wind is a certain indication of a complete fistula, the absence of this symptom should not induce the belief that there is no internal opening.”
Myself I think the reason why there is not usually any faecal discharge though a complete fistula, lies in the fact that the defecatory act twists and bends the fistula canal. and so occludes it more less completely for the time being. Prof. Tod Helmuth (“system of surgery “p.779) thus treat of fistula from the standpoint of the physician;-
” When the inflammation is erysipelatous and spread rapidly, bell or Rhus may be prescribed. Silica is a very important medicines, not only in the commencement of the affection, but also when the fistula is fully established. In the former case, if the abscess has not discharged, and the cellular membrane is found in a sloughy state, a free, incision should be made to permit the escape of the purulent secretion. If healthy action does not display itself, Ars and China must be prescribed.”
” Merc, Sulph, Silica, Hepar or Calc Carb must be exhibited if incarnation proceed imperfectly, If the constitution of the patient is impaired before operation is thought of, appropriate medicines must be administered to eradicate any disease that may be present. In cases where the fistula has not been subjected to homoeopathic treatment from the commencement, Merc or Silica may be given Hepar may be required after Merc when the fistula is extensive; and Phosph, after Silic where is complication with disease of the lungs. When the digestives apparatus is impaired, Calc, Nux vomica, Merc, and silic will prove valuable medicines.”
Caust is very important in cases of long-standing, and in alteration with Silica.I have known a fistula-in-ano to be healed for a time.
“DR. Eggert of Indianapolis, and Dr. Grasmuck of Kansas both report cases of fistula cured by internal medication, the latter gentleman using AEsculus cerate in connection with Nux vomica and sulphur. My friend, Dr.Scriven, of Dublin also related to me a successfully treated case.”
Then Dr. Helmuth decided against the adequacy of remedies, and says surgical means must be resorted to as general rule. On this point I very much question his power to speak with authority. for the very reason that he is such a splendid surgeon. I well remember, some nine or ten years.Prof Helmuth honouring me with a visit here, and showing me the then little- know elastic ligature of Dittel, and so infection was his enthusiasm for the thing that I really thought for a time medicines were nowhere, But some experience and mature reflection teach me that fistula cannot be really cured by any mechanical mean whatsoever Still certain cases do need surgical aid and then I cordially join Prof. Helmuth in his praise of the elastic ligature of Dittel. I say medicines first, and afterwards surgery if, unhappily, be There is a good practical work by Prof. J.S.Gilchrist (surgical Diseases and their Homoeopathic Therapeutics, Chicago, 1880 third edition), from which I call the following practice cases, placed under the heard of the remedies used;-
” Aloes.- A case is reported cured by Dr. Boyd (Medorrhinum Invest, vol. vi. p. 122), complicated with piles, in which the fistula was found cured when the piles had disappeared.”
” Berberis vulgaris.- This remedy I have already referred to as curative of as certain kind of fistula, Dr. Adams (N.Y.State Socy. Train,1868, p. 378) gives a case cured with the following symptoms :- Great soreness and pain thought the entire back, from the sacrum to the shoulder, greatly increased from exercise. The fistula would close up, and inflammation and suppuration follow. Acrid leucorrhoeal discharge very prostrating.
” Lachesis.- A case was cured in which, with other symptoms of the remedy, there was a full feeling of the rectum, and a sensation of little beating ‘(Eggert, Medorrhinum Invest.,’ vol, vi p, 143
” Thuja- Eggert also report a case cured (with Thuja occidentalis), in which the condylomatous condition was present.
” Arsenic.- Dr. Mera (N.Y.Tran,’1871, p. 617) cured with Arsenicum a case of fistula of ten years’ standing in which the symptoms were great despondency, chill running up and down the back, relief from heat, large purple swelling in the right gluteal region.”
Causticum.- Gilchrist himself report case of one year’s standing in an old man, very corpulent the discharge being acrid, and accompanied with intense pruritus ani. The cure was speedy and radical.
Eggert’s Thuja case is rather better report by Hoyle (Clinical Therapeutics,” vol ii), or rather Hoyle mention two cases of fistula of the anus as having been cured by Eggert thus:-
CASE 406-Two case of blind external fistula with the symptoms- at the verge of the anus cauli-flower excrescence of the size of a quarter of a dollar and offensive. Thuja 200, two doses, cured in ten weeks. Thus put, we understand the case better.
Eggert’s lachesis case also requires a little more elucidation than Gilchrist vouchsafes, viz, that the case was one of a lady at the climacteric. Put into the ordinary language of every-day clinical work, Thuja case was prescribed for on Hahnemann’s recommendation as an anti-sycotic; the Lachesis, because of the Climacteric symptoms.
Both successful cases, and both treated according to the doctrines of Hahnemann in the Coethen phase of homoeopathy. The Aloes case was cured. The known effect of Aloes in haemorrhoids lead to its being prescribed. That is quite intelligible.
The indication in the Berberis case was evidently the yellow leucorrhoeal discharge.In fact, primarily, from the time -old signatura rerum naturalium. And the like may be said of Thuja in sycosis.
Schuessler’s use of berberis in fistula I have already mentioned.