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September 9, 1899


Author Affiliations

Surgeon to Presbyterian Hospital; Fellow of American Proctological Society. PITTSBURG, PA.

JAMA. 1899;XXXIII(11):632-633. doi:10.1001/jama.1899.92450630008001c

To sacrifice the minimum tissue and preserve the perfect function of an organ is the highest art in an operation for the eradication of disease. This proposition is especially germane to operative measures involving the anorectal region, for the reason that the mutilation of a single anatomic structure may determine disastrous sequences in the health and comfort of the patient. The notion is wide-spread in the profession, and taught by proctologic writers, that bold incisions and dissections of this region entail no permanent loss of function, trusting to the reparative processes of Nature to restore perfect order out of chaos.

Legitimate surgery of the anus and rectum involves the consideration of certain anatomic landmarks that must not be disregarded. Martin writes: "The three typical visible topographic features of the anal rectum are the white line of Hilton, the pecten of Stroud, or anal pilasters and the linea dentata." The integumentary

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