THE TITLE of this paper may be somewhat misleading. No attempt is made here to suggest that total colectomy is the final word on treatment for ulcerative colitis, nor even to insinuate that it is the right treatment for the majority of patients suffering from this disease. However, when a ship is foundering, a life boat, though neither pleasant nor agreeable, may be the only hope. Similarly, when a life is threatened by severe intractable or fulminating ulcerative colitis, it has been found that it may be saved by the performance of a procedure which at first sight seems so radical as to make the bravest heart pause.
As in the case of most ailments, the ultimate treatment of ulcerative colitis will probably be determined only after the discovery of its primary cause. We may guess, but we cannot know, that this disease is a local manifestation of the failure