IN THE FIRST edition of his authoritative text on diseases of the colon (1923), Lockhart-Mummery1 stated that "... while a history of a slight amount of (rectal) bleeding is common in cancer, it is usually absent in diverticulitis." This was the standard teaching at that time, and a history of bleeding, certainly in the presence of an obstructive lesion of the distal colon, was believed to be more strongly in favor of carcinoma than of diverticulitis. Further, diverticulitis did not readily come to mind as a likely diagnosis when a patient presented with unheralded hemorrhage in the absence of any obstructive symptoms.
How very different are the views current today. Noer and his colleagues (1962),2 in an analysis of 245 patients who presented with rectal bleeding, decided that in 62 of these patients the cause was diverticulitis. Fallis and Marshall (1950)3 went so far as to say that