y a nice surgical operation a new aperture is to be made from the
internal corner of the eye into the nostril, and a silver tube introduced,
which supplies the defect by admitting the tears to pass again into the
nostril. See Melanges de Chirurgie par M. Pouteau; who thinks he has
improved this operation.

10. _Fistula in ano._ A mucous discharge from the anus, called by some
white piles, or matter from a suppurated pile, has been mistaken for the
matter from a concealed fistula. A bit of cotton wool applied to the
fundament to receive the matter, and renewed twice a day for a week or two,
should always be used before examination with the probe. The probe of an
unskilful empyric sometimes does more harm in the loose cellular membrane
of these parts than the original ulcer, by making a fistula he did not
find. The cure of a fistula in ano of those, who have been much addicted to
drinking spirituous liquor, or who have a tendency to pulmonary
consumption, is frequently of dangerous consequence, and is succeeded by
ulcers of the lungs, and death.

M. M. Ward's paste, or 20 black pepper-corns taken after each meal twice a
day; the pepper-corns should be cut each into two or three pieces. The late
Dr. Monro of Edinburgh asserted in his lectures, that he had known a
fistula in ano cured by injecting first a mixture of rectified spirit of
wine and water; and by gradually increasing the strength of it, till the
patient could bear rectified spirit alone; by the daily use of which at
length the sides of the fistula became callous, and ceased to discharge,
though the cavity was left. A French surgeon has lately affirmed, that a
wire of lead put in at the external opening of the ulcer, and brought
through the rectum, and twisted together, will gradually wear itself
through the gut, and thus effect a cure without much pain. The ends of the
leaden wire must be twisted more and more as it becomes loose. Or, lastly,
it must be laid open by the knife.

11. _Fistula urethrae._ Where a stricture of the urethra exists, from
whatever cause, the patient, in forcing the stream of urine through the
structure, distends the urethra behind it; which after a time is liable to
burst, and to become perforated; and some of the urine is pushed into the
cellular membrane, occasioning fistulas, which sometimes have large
surfaces producing much matter, which is pressed out at the time of making
water, and has been mistaken for a catarrh of the bladder;