, a reluctant
permission for the passage of the feces; and this inhibition results,
consequently, in some degree of constipation. And this constipation
reacts more or less on the peristaltic action of the bowels and in time
defeats the function of peristalsis. All this will react on the
inflammatory processes at the anus, which originally engendered the
constipation. The narrow and contracted strait or canal through which
the feces must pass, gives a tape-like shape to the stools.

The anal and rectal mucous membrane is of a firm and tough structure,
similar to the integument at the bottom of a boy's heel. After many
years' observation of diseases of the anus and rectum I am forced to
conclude that as a rule inflammation exists in the tissues twenty or
more years before the severe symptoms, such as piles, fissure, anal
pockets, pruritus, hypertrophy, atrophy, tabs, abscesses, and fistula,
are sufficiently annoying to compel the sufferer to seek medical aid. I
believe it to be of as much importance to give early attention to
disease of the anus and rectum as to teeth and eyes, or even more.

CHAPTER XV.

BALLOONING OF THE RECTUM--Continued.

In the last chapter a description was given of the anatomy of the anus
and rectum; and it was shown how a chronic inflammatory process
involving these organs develops stricture in the parts invaded; and it
was shown how a partial stricture of the anal canal results in
ballooning or dilatation of the lower part of the rectum. The primary
cause of all the symptoms of rectal disease is chronic inflammation
(proctitis) involving the whole structure of the anal tubes and in a
few cases the sigmoid flexure as well.

Perhaps the first marked symptom of disease of the rectum is
constipation, semi-constipation or of chronic character. The function
of the anus and rectum being disturbed by the inflammation, the fecal
mass is unduly retained and its moisture is absorbed by the system.
This accounts for the condensed and hardened fecal mass in isolated
lumps of various proportions. A hard-formed stool is abnormal, and is
evidence of auto-infection. When three-fourths of the normal fecal mass
has been re-absorbed by the system, does it not stand to reason that
the blood and tissues have been poisoned by their own waste products
(auto-intoxication) and that anemia, emaciation and local disturbances
of other organs of the body are symptoms of such intoxication?

The loading and block