e finding an
outlet. There will be pain in the muscles of the buttocks, called
myalgia; and pain at the end of the spine, called coccygodynia. For
this latter pain do not, I pray you, as is so often done, have your
spine removed by the too ready surgeon. No need of it at all. You might
just as sensibly have the muscles cut out for myalgia. Pus in fistulous
channels may burrow for several years through the muscular and
connective tissue structures before finally forming an external opening
through the integument; although its nearness to the surface is
frequently marked by a localized puffiness and inflammation, which,
however, may disappear for a time without forming an external opening.
This condition of affairs results in periodical attacks of
coccygodynia, myalgia and neuralgia of the buttocks and lower
extremities.

The important question with the victim of abscess and fistula is, "How
did I get it? I don't care for the various and numerous names you give
to these fistulas: what I should like to know is, How does it come
about that I, an apparently healthy person, have such a nasty disease?"
Simply years of neglect, is my answer. Neglect is due sometimes, and
perhaps generally, to ignorance of the thing neglected. The laity can
in large measure blame the medical profession for it, and especially
those surgeons who have long made a specialty of the treatment of anal
and rectal diseases.

CHAPTER XXII.

THE ORIGIN AND USE OF THE ENEMA.

Pliny recorded the fact that "the use of clysters or enemata was first
taught by the stork, which may be observed to inject water into its
bowels by means of its long beak." The _British Medical Journal_,
reviewing the newly published _Storia della Farmacia_, says that
Frederigo Kernot describes in it the invention of the enema apparatus,
which he looks upon as an epoch in pharmacy as important as the
discovery of America in the history of human civilization. The glory of
the invention of this instrument, so beneficial to suffering mankind,
belongs to an Italian, Gatenaria, whose name ought to find a modest
place together with Columbus, Galileo, Gioja and other eminent and
illustrious Italians. He was a compatriot of Columbus and professor at
Pavia, where he died in 1496, after having spent several years in
perfecting his instrument. The enema apparatus may be justly named the
queen of the world, as it has reigned without a rival for three hundred
years over the whole con