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February 19, 1887


JAMA. 1887;VIII(8):223. doi:10.1001/jama.1887.02391330027011

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Dear Sir:  —In a recent number of The Journal I described the amusing instrumental outfit of the itinerant practitioners upon piles, fistulæ, and fissures. The following is a condensed statement of the oldest of these secret "systems" so far as it relates to rectal ulcers. The information is from a trustworthy source, but I am not at liberty to use the name at present:Once or twice a month, as the itinerant comes around on his circuit, he inserts his little speculum, cleans out the ulcer, and applies to it a solution of nitrate of silver, 40 grains to the ounce. Between the applications, the patient uses a morning and evening treatment himself. Each morning he is to evacuate the bowels, then inject the rectum with lukewarm water, and finally insert into it a little ointment consisting of 3 grains of carbolic acid and 8 grains of sulphur to the

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