This condition ordinarily indicates an affection of the rectum in the form of pain or muscular contraction, the cause of which is not understood and no pathological lesions have been discovered to account for the symptoms. It is probable that, in our ignorance as to the nature of hysteria, the term is used for the simple reason that we cannot supply a better one.

Etiology. Constipation seems to be a common cause in the production of anesthesia of the rectum, particularly in people who live a sedentary, inactive life associated with neurotic tendencies. Sometimes, there will be well-marked hypersensitive areas about one-half to one inch in diameter which do not exhibit any visible evidence of disease.

The terminal nerve filaments are probably affected from either a mechanical, chemical or pathological disturbance. In some instances a disease of the central or peripheral nervous system seems the only explicable cause of the insane or hysterical rectum. Disease or displacement of the coccyx may originate the neuralgic pain commonly known as congeniality, but this is easily discerned and remedied by treatment.

Catarrh Diseases and Reflex Irritations from neighboring organs, nervous diseases, rheumatism and gout are probably the sole causes of this condition of irritability and muscular spasm. In another class of patients, we have the condition known as the insensitive rectum, in which the normal sensibility of the rectum is deficient, permitting retention of enormous quantities of fecal matter. This latter condition, presenting an entirely different symptomatic from the forum, is classified under the same list of diseases not clearly understood.

Treatment. The treatment of these conditions will be dependent upon the possibility of discovering the true origin of the trouble. Where there is an hypertrophy of the sphincter muscles and no fissure or other discoverable cause can be made out, irrigation with Kramer or other soothing remedies will prove of much comfort. Dilatation or incision of the sphincter will put the muscle at rest. Ulceration or any abrasions of the mucous membrane should be treated with nitrate of silver or ichthyology as is indicated. Cauterization with the Jacqueline cattery in one instance exaggerated the pain and muscular spasm. Irrigation of the rectum with alternating hot and cold water will be found of great benefit in some cases. Diseases of the neighboring organs, such as retro version, prolapse of the uterus and ovaries, should also receive treatment. Tonics directed to the improvement of the general health, combined with improved environments and habits will, as a rule, improve these patients. The administration of cocaine, opium and sedatives in general are con-contraindicated, as their use. either locally or internally, almost invariably produce disturbances which later aggravate the disease.