Medicine today has come to accept as rational therapeutics the surgical treatment of anorectal disease. This common acceptance of the application of local removal and drainage of diseased tissues in or adjacent to the bowel outlet is not limited to infective processes. One of the common rectal problems from the standpoint of diagnosis and treatment is fistula in ano. Fistulas occur in the various age periods with an increased incidence in adult life. The fact that it is always associated with some degree of abscess formation predicates the infective nature of this disease process. The tendency of this infective lesion to tunnel through the anorectal tissues, involving adjacent structures and following a multiplicity of patterns with more or less self-limited regional manifestations, but not always communicating with the bowel, stimulated our interest to make a further study of the anatomic background of this problem.
It has been surmised that the