That migratory pain, headaches, dyspepsia, sleeplessness, palpitations, sexual weakness, nervousness, despondency, irritability, and a general breaking down of the system, may all be caused by a small ulcer or other irritation of the rectum, which has passed unnoticed by either physician or patient. Nearly every physician is familiar with the white ring around the mouth extending up the sides of the nose, produced by the presence of pin worms in the rectum, or a fatal lock-jaw caused by a broken off needle or rusty nail in the foot. Such illustrations alone, are sufficient to demonstrate conclusively the power of this dynamical disturbance called reflex action. While there is doubtless unwarrantable exaggeration concerning rectal reflexes by some, there are many unpardonable oversights by others. A case was reported in the _Medical Record_ where all preparations were made to operate for organic stricture of the urethra, which, perchance, proved to be a reflex from a small rectal fissure. When the fissure was cured the spasm ceased. A case of roaring in the right ear was relieved by the cure of a fistula, says Dr. Rorick, who also speaks of two other similar cases. A very remarkable case occurred in my own practice, where the right testicle had been enlarged to the ordinary size of a well developed case of orchitis for some years, and had resisted all manner of treatment, completely disappeared after the removal of hemorrhoids. The case of hemorrhoids, which was one of the worst I ever saw, is represented in Fig. 2. Another case was that of a merchant, who suffered frequently from a sensation of drawing and weight in the back of the head and neck. When these attacks came on, his memory became so badly impaired that he was rendered unfit for the transaction of business. He noticed during the attacks that there was a feeling of heaviness in the rectum, swelling and tightness of the sphincters, and a lack of expulsive power at stool. Examination revealed several pockets and papillæ of the variety shown in Fig. 23, which was taken from this case. Have not been apprised of any return of the trouble since an operation for the removal of these abnormalities. As evidence that physicians should be a little more vigilant in the observation and study of rectal reflexes, the case of a very talented and influential lady of this State might be appropriately instanced. Her general health had been greatly impaired for a long time, with unexplained and repeated outbursts of sickness. Several prominent physicians were consulted, to whom she called attention to a little uneasiness, at times, in the rectum with an irritable bladder. They all examined the rectum, in their way, and ridiculed the idea of local disease, but went on treating the reflex symptoms, with nothing more than temporary relief.