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June 8, 1935


Author Affiliations

From the National Jewish Hospital.

JAMA. 1935;104(23):2067-2072. doi:10.1001/jama.1935.02760230015005

By anorectal tuberculosis is understood a chronic inflammatory process of the terminal region of the bowel, caused by the tubercle bacillus, occurring commonly as a secondary involvement in pulmonary tuberculosis. It is characterized pathologically by swelling, induration, caseation, abscess, sinus and fistula formation, and clinically by a variety of symptoms including itching, sense of irrigation, localized pain, painful defecation and the presence of a purulent discharge.

The literature on anorectal tuberculosis, or tuberculosis fistula in ano, as it is commonly called, is large and voluminous. Up to a few years ago considerable thought was given to the question whether or not all anorectal fistulas were tuberculous in character, and proponents of each view were easily found. Likewise, the questions of incidence, pathology, diagnosis and treatment have been the subject of many an acrimonious discussion. In addition to the modern literature, the ancient writings of Celsus, Hippocrates, the Old Testament, and