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Percy reports an instance in which semen was found issuing from the os uteri eight and one-half days after the last intercourse; and a microscopic examination of this semen revealed the presence of living as well as dead spermatozoa. We have occasional instances of impregnation by rectal coitus, the semen finding its way into an occluded vaginal canal by a fistulous communication.
Marsden reports a case in which, following secondary papular syphilis and profuse spontaneous ptyalism, there was vicarious secretion of the urinary constituents from the skin. Instances of the anomalous exit of urine caused by congenital malformation or fistulous connections are mentioned in another chapter.
Colostomy, an operation designed to make a fistulous opening in any portion of the rectum, was first practiced by Littre. In early times the mortality of inguinal colostomy was about five per cent, but has been gradually reduced until Konig reports 20 cases with only one death from peritonitis, and Cripps 26 cases with only one death.
The prostate was considerably contused. After two months of suffering the patient recovered, being able to evacuate his urine through a fistulous opening that had formed. In ten weeks cicatrization was perfect. In his "Memoirs of the Campaign of 1811," Larrey describes a soldier who, while standing with his legs apart, was struck from behind by a bullet.
The success of the Lagrange operation, which, like the Elliot operation, aims to produce a fistulous communication between the anterior chamber and the sub-conjunctival area, depends upon securing the removal of a relatively large section of all of the layers of the scleral and corneal lip of the wound, so that a permanent opening, covered by the replaced conjunctival flap, is made.
Bites and bruises to the withers resulting from other horses taking hold of the region with the teeth, or striking the part against a hard surface, are frequent causes. The treatment is both preventive and surgical. All possible causes should be investigated. This is of special importance on premises where several horses develop fistulous withers and poll evil.
From some occasional acrimony of the tears, the lining of this duct may be inflamed and thickened, or some foreign body, or some unctuous matter from the ciliary glands, may insinuate itself into the duct, and the fluid accumulates in the sac and distends it, and it bursts; or the ulcer eats through the integument, and there is a small fistulous opening beneath the inner canthus of the eye, or there is a constant discharge from it.
The disease is characterized by a slowly progressive necrosis and by a destruction of more or less of the cartilage and by the presence of fistulous tracts. Etiology and Occurrence. The disease is due to the introduction of pus producing organisms into the subcoronary region of the foot under conditions which favor the retention of such contagium and extension of infection into contiguous tissues.
This perforation is called "Fistula Lachrymalis." The tears, entering the canal at its punctum, are carried along till they pass out at the fistulous opening. Treatment'. This is a very troublesome affection, and has been pronounced incurable by some writers. However, we would not hesitate making an attempt at relieving a favourite or valuable dog of this disagreeable deformity.
Upon probing through a small fistulous opening just above the superior end of the sternum, the point of the arrow was found resting against the bone, about 1 1/2 inches below, the head lying against the trachea and esophagus, with the carotid artery, jugular vein, and nerves overlying.
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