PROLAPSUS AND THREATENED FISTULA.
A gentleman consulted me last summer in a very agitated frame of mind for fistula. An examination of the parts disclosed slight rectal prolapse, and a certain amount of inflammation of the projecting folds of the mucous membrane lining the rectum, in which the haemorrhoidal vessels were very prominent. He had been operated on for fistula, and also for piles and prolapse; but notwithstanding all this beautiful rectal surgery, the unfortunate patient is never comfortable at the seat, nor do I think he ever will be, as the anal region is puckered with the crookedly healed tissue, and a blind funnel has been produced more than half an inch deep; this funnel is lined with common integument, and would otherwise be an incomplete fistula.
There was blood at the anus almost every day. His nerves had received a grave shock from the operations, for notwithstanding the ten years that had elapsed since they were performed he still suffers from the effects. I have often been struck with the grave head symptoms that occur at the same time as rectal troubles, and these former are made much worse by all surgical interference. Thus this gentleman lives in a constant state of daze and fright lest a further operation should be needful for piles, prolapse, or fistula; his so-called nervous headaches are at times so bad that he thinks he will go out of his mind. The very mention of the words “fistula” or prolapse quite horrifies him.
A close examination showed so little to account for his state, that I was led to conclude that his very numerous vaccinations might have caused his trouble : he had been vaccinated five times.
Remedies greatly improved his condition, and so far that there was no further fear of fistula : Thuja was the principal remedy; infrequent doses of the thirtieth dilution administered during two months.
He is not comfortable at the seat, nor do I think he ever will be,- a fact due, I think to the bungling way in which he had been operated on. I see evidences of bungling after operations in this region so very seldom that I am constrained to admit this much in common fairness to the surgeons, that they believe in the operations I do not doubt; that they do their work well I can testify; but that their views are erroneous and their practice bad I am certain.