Do you know that this occasional "touch of the piles" over a period of many years, and all that it involves, is a precursor and an invitation to the development of that deadly enemy, Cancer--a worse disaster than financial ruin? It is my duty to utter a warning here. Only one making a specialty of the diseases of the alimentary canal is aware of the frequency of the occurrence of cancer in the lower bowel resulting from chronic inflammatory process, induration, etc. I have been, again and again, shocked and alarmed at the reckless neglect that has brought on this as yet incurable disease--cancer. These remarks apply well to what I have to say on Abscess and Fistula at the terminal portion of the intestinal canal. It is the old, old story of being "touched by the piles for many years," and neglect, ending in dread and despair at the necessity of being bored full of holes by pus seeking an outlet. The victim wonders at the spread of the local trouble, and that an opening for the pus canals has frequently to be made three to sixteen inches away from the seat of the abscess. In a former chapter the subject of proctitis and piles was gone into, and some idea given of the invasion of inflammation in the rectal and anal tissues. In exceptional cases the exciting cause of anal and rectal abscess and fistula, or of abscess and fistula of the buttocks, may be a traumatic injury or accident, produced, say, by a blow or a fall bruising the tissues, or by sharp, hard substances--such as pieces of bone or nutshell--from within the canal, lacerating it. But wounds of this character are very infrequent compared with chronic inflammation (proctitis) as the exciting cause. There are several varieties of proctitis recognized as the exciting cause of abscess and fistula, namely, traumatic, dysenteric, diphtheritic, gonorrheal, catarrhal, etc. The reader should not only pardon me, but should be grateful if by adding another name to the list I point out the most common cause, namely, _diaper-itic proctitis_. As pointed out in the first chapter or two, the improper use of the diaper will evidence its deplorable result when the period of manhood or womanhood is reached, by some of the many symptoms of proctitis. Proctitis may be considered as acute, subacute or chronic according to the duration of the process; or as atrophic or hypertrophic from the structural changes induced. But no matter about the cause and character of the proctitis, the question is, Have you inflamed anal and rectal canals? If you have, then the very annoying symptom, abscess or fistula, is liable to occur any day. Can you afford to take the chances?