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Arch Surg. 1939;38(4):617-624. doi:10.1001/archsurg.1939.01200100020002.
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It is generally conceded that the large majority of nonmalignant and nontraumatic strictures involving the rectum, especially those occurring in Negro women, are caused by lymphogranuloma venereum. Many articles have appeared in the medical literature describing this condition since Frei1 introduced his intracutaneous test in 1925.

The causative agent is thought to be an ultramicroscopic virus transmitted during coitus, which after an incubation period of one week causes a transient, painless ulcerative lesion on the genitals. Two weeks later there is edema of the lymph nodes draining the initial lesion, associated with hyperplasia of the lymphoid tissues, fibrosis and abscess formation. These secondary manifestations vary with the sex of the patient and the location of the primary lesion. Martin and Bacon2 in their detailed report of this condition stated:

There exists a dense network of lymphatics in the external genitalia and anorectal region of both the male and


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