A skilful physician is the choicest gem of civilization, and an intelligent patient its worthy setting. Surely it is a moral crime, an inexcusable folly to tolerate a disease with its inevitable train of dire consequences, up to the point when the discomfort compels one to seek treatment. There are patients, of course, who have good and sufficient excuses for their painful predicament; they have, for example, tried persistently for relief and cure, but have failed to find a physician competent to treat their particular case. How many unskilled prescribers there are, and how glaring their shortcomings! Some hold out taking inducements to sufferers; their one object being to transfer their patients' cash to their own pocket. 'Twere charitable to consider these ignorant; but alas! many of them are poisoned by the "fakir" germ. Stuff is sold by the conscienceless, claiming to cure "piles," to "give instant relief," and promising "a complete cure in a few days"; and as to itching piles, why! "only a few applications are necessary for a cure; six boxes for five dollars"! etc. No remedy that sufferers apply themselves can be more than a temporary relief: it cannot really cure piles, polypus, fistula, tabs, pruritus (itching)--all of them consequences of proctitis. Of course one should be thankful for the little relief to be got temporarily from advertised and drug-store drugs; nothing more than relief can be expected of them. There are indeed times when a palliative treatment will serve to tide the sufferer over a few days until he is able to consult a competent physician. But how strange it is that so many sufferers regard their anatomy and physiology so lightly as to think of using remedies, even for relief, without first undergoing a thorough examination by a competent physician. In troubles of a rectal character it is exceedingly foolhardy to allow any one to prescribe without insisting upon a thorough examination to ascertain whether there be any disease of a cancerous nature present, or what the trouble actually is, and its progress. To expect one remedy or prescription to meet all the requirements for the cure of a chronic disease of the anus and rectum and of the many complications accompanying it is hardly sensible, but that is just what a great many do expect. No one remedy in the market, or any number of them combined can effect a cure, for the simple reason that proper local treatment by a physician is of paramount importance. Unless of a traumatic (externally produced wound) origin, diseases of the anal and rectal canals are usually of fifteen, twenty or more years' incubation before the annoying symptoms become apparent. This accounts for the slight attention to the maturing trouble and for the fact that such attention can afford nothing more than a palliation or postponement. A real cure requires a combination of means, all working harmoniously for the proper length of time. Proper treatment and the