Cantharides in the Treatment of Fistula.
DAVID WARK, M. D., NEW YORK, N. Y.
About three years ago, when in charge of a Sanitarium in Colorado for the treatment of pulmonary tuberculosis, a lad of sixteen years was sent to me from Ohio, with the following history:
About eighteen months before, a large abscess, said to be tubercular, formed in his right hip. This, when opened, left a large sinus about nine inches in length, extending from near the edge of the sacrum to that of the ilium. In the center the sinus passed deep into the muscle.
The boy's health had failed notably and his parents feared the occurrence of pulmonary tuberculosis. His lungs, however, were quite sound. When he reached the Sanitarium and under the treatment which was advised, his physical condition improved rapidly. There had been previous injections of iodine, which were continued over a period of many months. These had failed to be of any service.
I triturated the cerate of cantharides with the tincture of cantharides to the consistency of cream and with it filled the fistula full. In ten hours a copius discharge of pus occurred. A thick tuft of pyogenic membrane which lined the whole fistula from end to end was blistered off, and I washed it out with peroxid of hydrogen, half strength. I used this solution also to keep the wound clean, and perfect healing took place in about three weeks. This was about as soon as a simple wound of the same extent would cicatrize.
This is the first case in which I have ever used cantharides or ever thought of doing so, in the treatment of fistula. Hitherto I have used the knife, but in this case the disease lay too deep for surgical operation. I have looked up the literature of the past sixty years, in all accessible works, and find no mention of vesication for the cure of fistula.
There is possibly, therefore, some claim to novelty on my part, but whether new or old, I believe this course would obviate the use of the knife in some severe cases.