The profuse serous exudation resulting from proctitis and sigmoiditis makes its way from the diseased area into the neighboring regions like lava from an active volcano, carrying with it an intense burning inflammation, destroying normal fatty tissue as it advances, owing to its extremely acrid character. Is it any wonder that we find dilated veins and arteries in the lower rectal and ano-rectal canal and around the anus where stasis of the blood has existed for a great many years? The real wonder is that thrombus in the veins around the anus does not occur more frequently than it does. What is the necessity of calling such a pathological change in the caliber of a vein and the weakening of its walls “thrombotic pile”? Thrombus is a clot of blood in a vein, and there is no use in adding the word “pile.” The aggravated character of the inflammation accounts for the hypertrophied and the cicatricial tissue so often found around the anal vent of proctitis cases. The Biblical suggestion that sacculated mucosa, commonly termed piles or hemorrhoids, is a disease, accounts for the numerous names used to designate the particular variety of the disease--whether it be an internal or an external pile tumor. It is very wrong to so mislead “scientific” medical men. Had they only known that the numerous sacs, bags, prolapsed pouches, longitudinal and transverse folds of the ano-rectal mucous membrane, and the ragged, jagged, prolapsed, pouched muco-cutaneous tissue around the anus, as well as the fissure-in-ano, pruritus ani, fistula, are only symptoms of a disease, all of the many abnormal changes and the other symptoms could have been prevented many generations ago by simply treating their exciting cause. But it is never too late to learn things that will benefit mankind. Don’t for a moment think that all of the structural changes on the mucous membrane and about the anus mentioned above indicate an affliction only skin deep, or even the depth of the mucous membrane. They are far worse than that. You will find all the muscular structure of the anal organ and that of the rectum sigmoid flexure severely invaded by the inflammatory process and its fibrinous exudation, and also the external tissues that surround and support the organs. We have circular and longitudinal muscular tissue entering into the structure of the anus and rectum. The sphincter muscles are two large and strong muscles that close the anal orifice and guard its vent very effectually if they are not destroyed by a surgeon’s knife.