This well-illustrated, clearly written volume portrays the author's concepts and practice from the standpoint of the general surgeon who has had special training in proctology. The drawings and the photographs are by the author, and the drawings are especially excellent. From a teaching standpoint, however, this work fails to clarify the problems relative to the origin and development of anal abscess and anal fistula, which are confusing to the student and to many practitioners. The author describes and diagrams anal glands, yet states that in most cases there is no obvious cause of anorectal suppuration. He then adds to the reader's confusion by describing, at one point, a fistulous tract passing from the anal canal to the perianal skin, while at another point he indicates that the tract passes from the perianal skin to the anal canal. The surgeon must, however, understand thoroughly the pathogenesis of a fistula in order
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A 1957 study studied this question.