The zealous purpose of mastering the relationship of proctorial to the many ailments commonly treated by the general practitioner has been my aim during a long and varied practice. In this text I have attempted to simplify the descriptions of the common diseases of the colon, sigmoid flexible, rectum and anus, and to present them in the plainest and most direct language. Thousands of cases have been studied and the results of my observations and experience are here presented in an endeavor to draw attention to the frequent association of diseases of the rectum with faulty physiological conditions in the upper digestive tract, and to point out that gastric or intestinal disturbances are. in many instances, the direct predisposing causes.

Plate I. The Rectum And Pelvic Colon

Plate I. The Rectum And Pelvic Colon.

The subject of hemorrhoids is considered as a gradual evolution of time-honored methods to those of the present day in which progressive ideas are linked in a practical manner with modern mechanical devices. A new theory as to the origin of hemorrhoids from a catarrh inflammation of the rectum is also tentatively advanced for scientific consideration, and. if sustained, may give rise to a more careful analysis of intestinal disorders in an effort to find an acceptable etiological factor.

The chapter on "The Relation of Rectal Diseases to Gynecology" is one of the many special features of this work and I trust will be of interest and value. The importance of inquiring into these subjects is emphasized and it is pointed out that the diagnosis of rectal diseases in general does not present any greater difficulties to the average physician than other diseases, when a proper procedure is followed.

Periodontists and sigmoid are given prominence with the object of describing the pathological conditions which commonly affect the sigmoid, and also assisting in the differential diagnosis of the diseases found in the adjacent organs.

In the diagnoses and treatments given, I have included the views of the most eminent specialists as well as treating the subject from the standpoint of the general practitioner. The most modern operative technique is outlined, while obsolete treatments and operations are only referred to when necessary to show the progress made in the practice of proctorial. A detailed description of the modified Cuttle abdominal operation for the removal of cancer of the rectum, and "The Cuttle three-step operation in tumors of the sigmoid colon" are included for the first time in any medical book.

It has been my purpose not to burden the reader with an exhaustive and unnecessarily technical treatise on this subject. but to condense the results of my practice, and the labors of other specialists in this branch of medicine into a book which covers the entire field in the most practical and comprehensive manner.

I am pleased to acknowledge my indebtedness to the many excellent books on the subject, including those written by Cuttle, Ant, Earle, Mathews, Ball, Goodall and Miles, Wallis, Kelsey, Appalling, Churchman and Hertz; also to several excellent articles which have been presented in our medical journals. In illustrating the text, Mr. Francis A. Deck has added to its practical value by his general knowledge of medical work.

Martin L. Bodkin, M.D.

290 Clinton Ave., Brooklyn, N. Y. April 17, 1913.

DISEASES OF THE RECTUM AND PELVIC COLON