THE RADICAL CURE OF FISTULA BY MEDICINES.
There are various kinds of cure in practical medical life; given a case of fistula that is treated by applying healing remedies to the same, it may thus be brought to heal up. This healing up is commonly designated as cure. In the sense of curare, this is of course, correct; but I hardly think it is so in the true meaning of our English word to cure. But to obviate any misapprehension. I mean in this little treatise by cure a radical proceeding aimed at the constitutional cause or root of the complaint, and not a forcible healing up, by medicines applied to the suffering part. The word fistula means in Latin a pipe, such as a water-pipe or wind-pipe. In medical language it signifies a really or assumedly pipe-shaped canal in the living tissue, and may occur in various region of the body. We are here principally concerned with fistula as it is found near the anus- fistula-in-ano,-one case only, and that a very remarkable one, of urinary fistula being narrated. ( In the Second Part, however, other cases are now added – AUTHOR.)
In common medicosurgical practice, it is held and taught that the fistula canal cannot heal, either because- the fistula being internal (complete or incomplete)-flatus and faecal matter constantly irritate it, and thus prevent the healing process or else because of the lining of the fistula itself becoming a secreting membrane-pyogenic or otherwise. Hence it is useful to slit open the fistula, and thus turn it into a wound, which is then cleansed and dressed with some antiseptic or vulnerary, to the that the same may heal up. At first sight this seem the only rational mode of treating fistula, so that the individual may not be debilitated by the discharge and local misery.
It has, however, long been contended by able medical thinker that the fistula process is the local expression of a constitutional cause, and that the true philosophical and scientific way of treating fistula is to remove the said constitutional cause, and then the fistula will heal of itself with little or no local aid at all.
We will call these two theories respectively that of the localists and that of the constitutionalists. I take the stand of those who hold that fistula is most commonly a constitutional affection, and must therefore be treated by the physician. I go further and maintain that the local treatment of dyscratic fistula is not only wrong, but irrational and harmful. In many cases it is better to leave such a fistula alone that causes it is heal by operation and antiseptic (or other) dressings. Theories to be of any service must be workable in practice. The localists- the surgeon operate upon their fistula patients, and publish their results. I treat my fistula patients with medicines, and here given some results. Let these respective result be compared. But this comparison of results should take into account the future life and health-history of the patient. On this part of the question hinges the whole things. I do not deny that fistula can often be successfully operated upon and made to close up, but what of the future health of the individual? there the rub.
But whatever view may be held of the true nature of fistula (using the word as commonly employed), I shall in the following pages prove that fistula can be radically cured by medicines, and that is all I claim for merit of these pages.
Incidentally the remedies found useful are given, so that the competent may judge for themselves and the inexperienced learn how to do it if they so elect. The key to the use of the remedies is the law of similars; the guide to their choice, the patient’s symptoms, subjective and objective.
As before remarked, fistula in the anal region and piles are not always duly differentiated from one another by suffer, and hence it happens that those practitioner who see a good deal of one compliant are pretty sure to see a good deal of other. Myself, I have had a rather wide experience in the medicinal treatment of haemorrhoids, ( See my “Diseases of the Veins”. ) and inter-currently a certain number of fistula have passed under my observation and professional care, and from the experience thus acquired, i can say that fistula-in-ano may usually be completely cured by medicines. And I think that there can hardly be any two opinions as to the superiority of the cure of fistula by remedies over its operative treatment.
I say operative treatment, for in operative cure I do dot indeed believe; you may slit open a fistula and causes it to heal up, but the fistula patient (though well quoad the fistula as fistula) is constitutionally precisely where he was before. That surely every thoughtful person, whether patient or even surgeon, must concede. There are, no doubt, certain cases of fistula in which we are obliged to have recourse to the knife or other surgical operation but I am firmly convinced this need not often be the case, indeed, hardly ever; provided the right medicinal treatment be begun early enough and persevered in long enough. Even those only means of treating fistula is surgery have, nevertheless, to admit their utter and absolute powerlessness in a very large number of cases of this most distressing complaints, and, unfortunately for the poor suffers, the cases in which the surgeons dare not operate, on account of contingent poitrinary explosions or exacerbations, or because the fistula will not heal, even thought they were operated upon, just these very cases are the worst and most serious. In fact, in really dyscratic cases of fistula, the surgeon’s knife is of no more than the north wind.
And indeed how should it be possible for local work to cure a constitutional ailment, which fistula undoubtedly is nine times out of every ten? It is not possible. The diathesis must be mended and then the fistula heals, and after certain flickerings comes no more; the patient gets a healthier colour and takes on flesh, and with it comes health and strength. Of course, I do not advocate the medicinal treatment of traumatic fistula from fish bones imbeded in passing down athwart the gut, lacerating it, and then then faeces irritate, set up inflammation, which together burrow into the tissues, from sinuses and fistulae; nor do I advocate leaving bags of scrofulous pus pent up; not at all here let surgery step in and that promptly. But these cases are not the most common by any means Nor would I for one moment be understood to deny that the poor person suffering from fistula living under unhygienic conditions, ill-fed and badly cared for, I say I would not for an instant be understood to say that such patients are not much improved, and perhaps even cured, when brought into a nice clean hospital, well-fed, dosed with cod- liver-oil and tonics, and their fistulae operated upon.
Common sense and actual facts forbid. I am thinking of the clean living, well fed sufferers from fistula, who still suffer notwith-standing easy circumstances, faultless hygiene, and every attention to their physical well-being. These are the cases I am familiar with, and of these I write I will now close in a little upon my task and proceed to show the way in which anal fistula may be medicinally treated without any operation or local messing and pottering at all, and not only medicinally treated, but also medicinally radically cured. The following series of detailed cases will also prove that the right remedies will help where surgery has failed, for the very best surgical treatment fails much more frequently than surgeons. I know of, are willing to confess. Not that I impute bad faith to them, but it takes a good deal to convince even the most honest against their will. I think I could hardly do better than beings with a case of recurrent fistula, because it seems to me that if a complaint recur over and over again at any given spot, there must need be an internal causes for such recurrence; if not, whence does the prefistular abscess come.