Those who have had the unwelcome duty of caring for any considerable number of patients with chronic ulcerative colitis of the so-called idiopathic form realize that the condition presents many problems. In spite of much conscientious work and many ingenious theories, its cause still eludes discovery. The medical care of these patients is by no means acceptably standardized. Relation to other disorders and to complications is obscure. The prognosis is very uncertain. The clinical course is full of surprises and disappointments. Recurrence after years of apparent cure is well known, and sudden exacerbation of long-standing, mild forms may take place.
It is not with such phases, however, or with the handling of the surgical complications, such as perirectal abscess, fistula or stricture, that this paper is concerned, but rather with the proper place of surgical measures in the treatment of the disease itself. There is wide difference of opinion as