The position here taken by the writer was assumed by him first in an article published in the New York Medical Record. On that occasion he expressed the opinion that the "great majority of observers had been led to consider syphilis the causative factor in the production of rectal stricture by the fact that this condition has most frequently been observed in syphilitic subjects." Since that time he has become more thoroughly convinced of the correctness of this view, and he still believes that it is much more rational to assume that syphilis is not immediately responsible for such lesions. The following reasons appear to him to justify the stand he has taken:
Endarteritis is a well-recognized state in syphilis. This change in the vascular system, combined with the resultant low state of nutrition, renders the mucosa of the rectum less resistant to irritants and trauma. Under these circumstances small
BULLARD WD. ACQUIRED NON-MALIGNANT STRICTURE OF THE RECTUM.—CAUSES, SYMPTOMS AND TREATMENT.. JAMA. 1902;XXXIX(14):817–820. doi:10.1001/jama.1902.52480400011001c
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