Journal of the American Medical Association
1927; volume 88, number 24, page 1883
Frank K. Boland
Abstract by Jon Miles
An account is given of a man with pain on sitting. Abscesses were found relating to sinuses in the skin over the coccyx. The coccyx was removed and chronic osteitis diagnosed. The wound did not heal, and later a fistula was found. The surgeon decided to try the old method of passing a ligature through the fistula into the rectum, and tying the two ends together outside the anus. The ligature was tightened every third day. By the tenth day the ligature had cut its way entirely through the sphincter, with practically no pain to the patient. Evidently rapid union of the severed fibers took place behind the ligature, since the control of the sphincter at this time, while not complete, was very satisfactory.