URINARY FISTULA – A REMARKABLE CASE.
Some seven years since, a London professional man came under my observation for an ordinary gonorrhoea. He is otherwise a good, conscientious fellow, but harvested the wages of sin at the very start, and was in a great state of mental perturbation. I was, after careful examination, enabled to assure him that he had a gonorrhoeal urethritis, and noting else; there was absolutely no sign or suspicion of anything beyond that. Aconite; Hepar, Hydrastis, and Cynosbati were administered, and in some six or seven weeks I thought were out of the wood, there only a little urethral sediment left. But one day, without any concern whatever, he told me he thought he had caught a cold, and was getting a boil in the fork, that he also had some lumps in the groin, and nettle rash on the body.
The experienced may judge of my utter amazement when I discovered a typical roseola syphilitica all over his body, notably on the chest and abdomen, and all the superficial glands of the body enlarged and indurated! Moreover, on the under surface of the member, some two inches or more from its extremity, and just on front of the prostate, there was in the very deed a “boil” of the size of a gooseberry, and very hard. I set to work vigorously with antisyphilitic treatment, and in a few weeks the roseola and other prominent symptoms had much abated, but his hair came out, and the nuchal glands were very prominently enlarged. During all this time the urethral discharge, which had returned, persisted. Just as I thought I was mastering both the gonorrhoea and the syphilis, he called one day and informed me that he had a “leak’ in the region of the “boil.” a said boil had burst. Horrible dictu. I found a fully established urethral fistula, with a thick hard wall surrounding and lining it. Several further months of persistent treatment finally resulted in a cure of the gonorrhoea, and of most of the manifestations of syphilis, but the terrible fistula persisted, notwithstanding Mercurius, Aurum, Acid. nit., Stillingia, Iodatum, and Silicea, and some other seemingly likely remedies.
I do not easily despair of a case, but when distinct consumptive symptoms began to show themselves, I certainly felt very anxious indeed, an I deemed it my duty to tell my poor patient that I feared he would have to undergo an operation for the urinary fistula, as it seemed to be wearing him out. However, I thought the matter over a few days, and finally came to the conclusion that the fistula was not only syphilitic, but also tuberculous, though how the infection could have been communicated within the urethra some three inches from the orifice I cannot even now understand. I then alternated Mercurius solubilis Hahnemanni 3x with very infrequent doses of Bacillinum c. (six grains of the former, and as many globules of the latter to the dose). At the same time I put him on very full diet with a generous wine.
Result.- In a few months the patient was quiet well in every respect; the indurated glands all returned to the normal, the hair grew again, the night-sweats ceased, the fistula completely healed up, the sclerosis around it disappeared, and patient put on flesh and reassumed his old healthy appearance.
I will finish this long story by remarking that the amelioration, that set in as soon as he was put on the last- mentioned double prescription, was truly remarkable, and for weeks and weeks whenever it was discontinued for other remedies, the amelioration at once ceased, so that I had to recur to it over and over again. The Bacillinum was, however, never given more than one dose in four days. The Mercurius sol. three times a day. To look at this gentleman now no one would suspect what he has gone through. Aux grands maux les grands remedes, they say over in France. This case forcibly reminds one of Hunter’s famous experiment on himself. We have here a case of urinary fistula, a very bad one too, and its having been perfectly and permanently cured with medicines, should encourage us all to treat urinary fistulas also with medicines only-a thing I believe never been attempted. Perhaps I had better add, to prevent mistakes or misapprehension, that absolutely no local applications were used, not even a bit of lint or charpie.
I do not think it would serve any useful end were I to detail any more cases of fistula, as I think I have proved my point : fistula can be cured medicinally.