FISTULA, in former times, was applied, in its etymological meaning of a pipe, to such abscesses (q.v.) as had contracted to narrow, hard, open passages in the soft tex ture of the body (see TISSUE), lined by a kind of false membrane, giving rise to a thin discharge. At the present time, however, the term F. is generally giving to the opening of such a passage when in close contact with a mucous membrane. Thus it is common to speak of salivary, urinary F., etc.; and the most common and trouble some kind of all the F. in ano; in connection with the" lower bowel, or rectum (q.v.). The treatment of F. should only be intrusted to experienced surgeons; but there are always quacks in abundance willing to undertake it, and hold out flattering hopes of an early cure without proper. surgical procedure.
For the cure of salivary or urinary F., all that is generally necessary is to restore the patency of the ducts, which is done by passing instruments along them. Should a F., however, be situated where it is surrounded by muscular fibers, as at the orifice of the lower bowel, it is necessary to divide these muscular fibers, so as to leave the part at rest while nature repairs it. As the sinus, which is the continuation inwards of the F., is lined with imperfectly organized lymph, it is generally necessary to stimulam the, part by the introduction of lint, either alone or saturated with some irritant, such as the sulphate of zinc, which,- when mixed in the proportion of 1 to 3 grains to each ounce of water, and colored with lavender, makes the famous red lotion of the shops.
At times, however, fistulm require more elaborate treatment, and are extremely difficult to close, especially those which result from loss of tissue between two adjacent mucous canals; fortunately, however, modern surgery is able to remedy these also. It is neces sary to make the edges of the orifice 'once more raw, and to bring them in contact, but formerly the wound used rarely to unite, as the stitches produced such an amount of irritation. NoW, however, by the use of silver or iron wire, according to the taste of the surgeon, the parts can be kept together long enough to insure union; and thus, by the ingenuity of American surgeons, especially Marion Sims of New York, and others in this country, certain diseases of women, arising from protracted labors, and formerly rendering the unfortunate subjects of them miserable and unfitted for any of the duties of life, may be now remedied by a skillfully performed but almost painless proceeding.