PILES, PERINEAL ABSCESSES, AND FISTULA
One certainly meets with a goodly number of cases of fistula in portly men about forty years of age. Such a one, a dark gentleman, forty-one years of age, came under my observation on November 26, 1887, complaining of his liver and perineal abscess, and also haemorrhoids.
Patient suffered also from pains in the stomach, coming on in the early morning about six or seven o’clock. Both liver and spleen were swelled; tongue and fingers gouty; slight eczema of anal regional and there was much depression of spirits, attributed to business worries.
Rx Nux vomica 1x, five drops in water night and morning.
February 4, 1888.- Much better in almost all respect; only had the stomachic pains once lately. Complains of anal irritation on getting warm in bed at night. Sleeps badly: has much business worry, and is in consequence depressed; weight on the top of the head.
Rx Sulphur 30.
May 5.- Not very materially improved; has indigestion, anal irritation, insomnia, depression of spirits, some uncomfortable feelings about the heart, and he has grown very short of late.
Rx Tc. Vanad ammon. 12.
Feb. 16, 1889.- Has had another perineal abscess, and there is now an incomplete external fistula with much mattery discharge.
Two months of Phytolaccin 3x, six grains at bed-time, cured him of the fistula, and he was otherwise so far well that he did not want any further treatment.