Fistula's are callous Ulcers: If one of these happen in the Fundament, and is open on the outside, it may be cur'd thus: After the Patient hath been laid upon his Belly on the side of a Bed, with his Legs asunder, the Surgeon makes a small Incision with his Knife in the Orifice of the _Fistula_, in order to pass therein another small crooked Incision-Knife, at the end of which is a Pointed Stilet with a little Silver Head which covers it, to the end that it may enter without causing Pain. When the Surgeon hath convey'd his Knife into the {246} _Fistula_, having the Fore-finger of his Left-hand in the _Anus_ or Fundament, he pulls off its Head, holding the Handle with one Hand, and the Stilet that pierceth the _Anus_ with the other; and at last draws out the Instrument to cut the _Fistula_ entirely at one Stroke. If the _Fistula_ hath an Opening into the Intestine, an Incision is to be made on the outside at the Bottom thereof, to open it in the Place where a small Tumour or Inflammation usually appears, or else in the Place where the Patient feels a Pain when it is touch'd. If the Tumour be remote from the _Anus_, it may be open'd with the Potential Cautery, to avoid a greater Inconvenience. After having thus laid open the very bottom, the little Incision-Knife and Stilet, with its Head, is to be pass'd therein, the end of the Stilet is to be drawn thro' the _Anus_, and the Flesh is to be cut all at once. But if the _Fistula_ be situated too far forward in the Fundament, the _Sphincter_ of the _Anus_ must not be entirely cut, otherwise the Excrements cannot be any longer retain'd. Lastly, when the _Fistula_ hath been treated after this manner, all its Sinuosities or Winding-Passages ought likewise to be open'd, and the Wound being fill'd with thick Pledgets steept in some Anodyn, is to be cover'd with a Plaister and a Triangular Bolster; as also with the Bandage call'd the T. * * * * * {247} CHAP. XIX. _Of the Suture or Stitching of a _Tendon_._