M CECUM THE CECU HING THE REACHING REAC By Robert E. Kravetz, MD, MACG Scottsdale, AZ
A LOOK BACK
RECTAL DILATORS
This archival reflection originally appeared in The American Journal of Gastroenterology in September 2001.
R
ectal diseases have plagued mankind for millennia. The earliest mention of them is found in the Code of Hammurabi, about 2200 BC. Instructions for the patient state “pay the doctor five shekels for curing a diseased bowel.” The famous Egyptian “Ebers Papyrus,” about 1500 BC, mentions hemorrhoids. Hippocrates, 400 BC, used a rectal speculum. For the next 1500 years, rectal diseases, hemorrhoids, fistulae, prolapse, etc. were treated with cautery, ligatures and caustics. Aside from rectal strictures related to disease, these therapies resulted in additional structures. Many were
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treated with a variety of rectal dilators, which was preferable to surgical intervention. Various forms of instrumentation were used. It is surprising to note that the opening of a stricture, although extremely small, could maintain adequate bowel function. Graded dilators of various sizes have been used for the past 100 years with great success. This set of Dr. Young’s Improved Rectal Dilators was sold by prescription in drugstores for $3.75 in the 1920s. They are no different from current dilators and would be equally effective today.
