With these stubborn and uncompromising facts confronting us on the one hand, and a full appreciation of the superiority, the simplicity, the safety and certainty of the operation by carbolic acid injection on the other, the writer has no alternative other than to espouse, and proclaim his honest conviction and hearty support in favor of the latter method of cure; and essays to point out in this little publication, in a plain, comprehensive and a practical way, what has been acquired by personal observations and experiences, and all in all, believed to be the best manner of applying this truly scientific and greatly superior method. A method, the discovery of which, I feel prepared to say, marks an epoch in the history of medicine, unrivaled in advancement by the treatment of any other disease or class of diseases to which the human family is subject. “There is no organ that is so prone to become diseased as the rectum. There is no class of cases so little understood and treated as rectal diseases. There are no diseases so annoying and painful, and at the same time producing such dire results on the general system, directly and reflexly, as rectal diseases. For years Rectal Surgery has been principally in the hands of itinerants, whose remorseless greed for money has caused them to treat for revenue only, and to play the vampire on all that fall into their clutches. It is high time for the general practitioner to gather up all the information possible, in order to be able to treat all patients suffering from rectal disease, and thereby drive the itinerants back to their previous occupation of tilling the soil.”—(Yount.) Nowhere in medical lore do we find suitable instructions whereby the beginner may knowingly and intelligently engage in a rectal examination—what to expect, where and how to find it, and how to pursue each succeeding step in applying the treatment. Writers either presume too much on the part of those who have not had experiences, or, are so habituated to the use of general anæsthesia in accomplishing the objects sought, that milder means have been seriously neglected. Finding many, otherwise well informed practitioners, at a great disadvantage in this respect, was a leading incentive to the hurried preparation of the following few pages. HEMORRHOIDS. The division of piles into internal and external, is naturally suggested by their observation and study, and clearly defined by designating all hemorrhoidal tumors originating above and within the grasp of the external sphincter as internal, while those situated external to or outside of the external sphincter, when the latter muscle is closed and the bowel not protruded, are external.