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July 15, 1933


Author Affiliations

From the City of Chicago Municipal Tuberculosis Sanitarium and the Loyola University School of Medicine.

JAMA. 1933;101(3):201-204. doi:10.1001/jama.1933.02740280021010

For years it has been taught by various clinicians and writers on tuberculosis that a tuberculous fistula should not be operated on, that, after operation, it is more apt than not to recur, and that if it remains healed the pulmonary disease, if latent, is often activated and, if active, is frequently made worse. Although proctologists for a number of years have operated on tuberculous anal fistulas and obtained favorable results, the beliefs enumerated are widely held and perpetuated in recent publications. It is the repetition of traditional error. One might almost suspect some of the ideas of having survived the era of the humeral theory, when it was feared to stop a discharge in one place lest this dam back the humors, which would break out anew elsewhere.

Tuberculous fistulas will heal after adequate operation if reasonable care is given to the pulmonary disease. For several years I have