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Kraske's methodology was classic: develop the operation in the laboratory, try it initially on patients as a last resort and, if it works, expand its use to patients with less severe disease. His operation immediately gained acceptance and was popular for the next quarter of a century. It was subsequently modified by Hochenagg, Billroth and Rydygier. These men merely altered the amount or manner of sacral removal. The operation was largely abandoned after Miles (3) showed that the lymphatic spread from carcinoma of the rectum is toward the liver. Kraske's procedure, however, stands as a landmark in preantibiotic operations on the colon. Combined with abdominal exploration, this type of procedure can be used to preserve the anus in certain instances of carcinoma of the rectum today.