This historic book may have numerous typos and missing text. Purchasers can usually download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1865 edition. Excerpt: ... The symptoms of fistula in ano are not always very acute: occasionally there is great pain, but more frequently a feeling of uneasiness only about the anus is complained of, with more or less tenesmus at stool, and difficulty in the evacuation, particularly if the bowels are costive, or the function of the digestive organs deranged: in complete fistula in ano, and in the blind internal form of the complaint, the evacuations are smeared with pus and mucus, perhaps also slightly with blood. One, and sometimes the chief, source of annoyance to a patient with fistula is the discharge, in a greater or less quantity, of purulent or muco-purulent matter, soiling the linen, making it wet and uncomfortable, and producing excoriation of the nates. In complete fistula, the escape of flatus and mucus from the intestine is a further source of annoyance, and should the fistulous channel be very free, feculent matter will also be expelled. Besides these symptoms, the minds of many people are affected with an impression of physical imperfection and weakness in their organization, rendering them miserable and unhappy. As in other diseases affecting the rectum, various sympathetic pains are experienced: they are referred to the back, the loins, and the bottom of the abdomen; pain extends down the leg and to the foot, which is not unlikely to be attributed to sciatica, unless the history of the case is carefully inquired into. The external and internal openings difier in character according to the duration of the disease, and the cause that has given rise to it. In some cases, especially in phthisical patients, the opening will be prominent, and the edges hard and round. In others the aperture will be indicated by a crop of pale and flabby granulations, ..

1865年のトマス・ジョン・アシュトンによる本作は、単なる医学書を超えた、ヴィクトリア朝時代の執拗なまでの観察眼と人間への深い共鳴が息づく記録です。肉体の苦痛のみならず、病が患者の精神に落とす「自己の不完全さ」という影をも克明に描き出す筆致は、肉体と精神の不可分な脆さを浮き彫りにし、読者の胸を打ちます。 臨床的な細部を追う文体には、現代の合理主義では零れ落ちてしまう、物語としての豊穣さが宿っています。暗部の疾患を光の下に晒し、救済を試みる著者の情熱は、まるで魂を癒やす文学のような崇高さを湛えています。150年の時を超え、生身の人間が抱える根源的な苦悩と対峙する、知的好奇心を激しく揺さぶる名著です。