Fistulas in the anus

These fistulas are sometimes formed due to wounds and perforation of the anus, and sometimes they arise due to the erosion of kidney cones. Fistulas in the anus are not through, in which case they are safer, but also through, more malignant. Fistulas located near the recess and entrance to the intestine are safer, because when perforated, the damage does not affect the entire muscle, but only a section of it, while the rest of the muscle performs its locking effect. As for fistulas remote from the anus, when they are cut, and this is a method of treatment, the entire obturator muscle or most of it is cut, and the ability to lock is lost completely, which leads to involuntary excretion of feces. Sometimes fistulas come into contact with blood vessels and nerves, which is very dangerous.

Through and non-through fistulas are distinguished by inserting a probe into the fistula and a finger into the anus. With a finger they feel the place where the probe has reached, and find out whether the fistula is through or not; A through fistula is sometimes also indicated by the exit of feces through it. Whether the perforation affected the entire muscle or part of it is determined in a way that one of the first ancient doctors spoke about, but it was appropriated by one of the subsequent ones. Namely: a finger is inserted into the anus, a probe is inserted into the swish, the patient is told to squeeze the intestine and pull it upward, and determine by touch which part of the muscle is compressed and which protrudes, what is the width of the damaged part of the muscle running along the body, what is the distance in length body from the end of the probe to the upper edge - whether it is small or large.

A through fistula occurs with one hole, and sometimes with many holes. Treatment. As for non-through fistulas, if they do not cause suffering due to heavy bleeding and excessive stench, they can be left as they are without fear; when they cause suffering, they try to treat them with candles with willow oil and similar remedies for fistulas; if they cure them or reduce the harm from them, good, but if not, then sharp medicine should be used in order to destroy the outer surface of the fistula, that is, the dead meat, and expose the healthy place. The pain is relieved by applying ghee to the fistula, as well as rose oil. The wound is then healed with healing plasters, especially the "messenger patch". This plaster heals even those fistulas that have not yet been treated with anything cutting or piercing, and, moreover, it heals little by little and over a long time. The “black plaster” also heals fistulas. Through fistulas are treated by excision; when excision, one should keep in mind what we said above. Fistulas are well excised using twisted hair, which should be thin, or twisted silk thread, with which the fistula is tightly pulled and left tight. If this causes severe pain and there is a fear that spasms or other bad phenomena will occur, then the thread is removed and pain-soothing agents are used, and then the fistula is tightened again.