Presumably the earliest treatment for anal ulcer consisted of the local application of various caustics, stimulants and sedatives; it is a rather interesting observation that most of the treatment prescribed by other than proctologists today consists of the same early methods. The next step in advance, namely, dilation of the sphincter, was a marked step forward toward securing rapid recovery, but has within the last few years been supplanted among the more experienced by the actual open incision into the sphincter muscle to put it at rest. This method has proved satisfactory both in the immediate relief of pain and in the more certain healing of the ulcer. It has, however, one definite objection—the open incision at times has been rather prolonged in final healing, especially at the anal margin.
In the effort to avoid this open incision and its subsequent infection, I have attempted what I have chosen to
Martin EG. SUBMUCOUS SPHINCTOTOMY: PRELIMINARY REPORT. JAMA. 1922;79(26):2160–2161. doi:10.1001/jama.1922.26420260001013
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