1919 Journal of the American Medical Association  
Case 2.-C. J. O'N., a man, aged 40, an executive, married, with negative family and previous history, was taken ill one year ago with pain and swelling about the rectum, accom¬ panied by constipation and general symptoms lasting several days. A diagnosis of ischiorectal abscess and fistula was made, and he was treated surgically ; the wound showed no disposition to heal, and he was referred to the junior author, who found the opening of a small tract on the skin, 5 cm. from the anal rim, and to
more » ... he anal rim, and to the left of it, which opened inter¬ nally on the corresponding rectal wall, and showed no evi¬ dence, either in its physical condition or in its clinical char¬ acters, of signs other than those one would expect to find in a simple, nonspecific fistula. Neither was there a history of cough, loss of weight, or any abnormal findings in the chest. The patient was treated surgically and his wound improved for a time, but nine months after the onset of his trouble it is still unhealed,
doi:10.1001/jama.1919.02610120023011 fatcat:hezbucmluvbyfdd6zor7zahd3y