of the
piles," and many other complaints of bowel ailments that are usually
the outcome of that deplorable inflammation.

I have endeavored to make clear the fact that inflammation destroys
normal tissues and blood-vessels, and that the newly formed tissue is
cicatricial in character, that is poor in cells and vessels, with a
tendency to contraction which of course lessens the bore of the gut.
When the hypertrophy or thickening is extensive the appearance of the
mucous membrane suggests the addition of one or more thicknesses of a
chamois skin added to the inner surface of the anal and rectal canals.
The hypertrophied or newly formed tissue may be limited to the rectum,
leaving the anal tissues comparatively exempt from the superabundant
cicatricial formation; or the hypertrophy may involve, to quite a
degree, only the anal tissues and the integument around the anal
orifice. The added connective tissue about the anus forms the skin into
tabs, or into a circle of elongated integument around the orifice, with
a mucous lining. These hypertrophied tabs or folds, like pruritus ani,
are symptoms of proctitis.

Proctitis (the inflammation of the anal and rectal canals) is the most
common and serious disease that afflicts man. The system is not only
poisoned by bacteria and filth through proctitis, but proctitis is also
the cause of the many annoying and painful local symptoms, such as
hypertrophy, piles, abscess, fistula, cancer, polypus, fissure,
pruritus, etc.

When the subject of proctitis is better understood by laymen they will
see to it that the rectums of children receive an examination before
the children are six years old, and thus obviate the necessity of
dosing them with all sorts of medicine that follow improper diagnosis.

CHAPTER XIX.

PROCTITIS AND PILES.

Piles (hemorrhoids) are not the result of either the normal or abnormal
growth of the tissues of the anal and rectal mucous membrane. They are
developed by the combination of pathological and physiological
conditions: (1) chronic inflammation or proctitis; (2) stricture of the
anal canal and lower portion of the rectum, which may be spasmodic, or
more or less permanent, which stricture pinches or constricts the
canal, thereby inhibiting the circulation of the blood; (3) the
pressure or straining effort during the act of defecation, occasioned
by the constricted canal, which effort brings on greater local
congestion and constriction of the tiss