FISTULA IN ANO -J C BURNETT-HOMEOPATHIC MEDICAL TREATMENT:

" 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."

" Mere, Sulph,, Silic 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, 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 (Med. 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, Med. 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:-

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