The anal region does not long suffer in silence, and its many difficulties are soon called to our attention by pain, often of severe degree. Most of us know very little about the anal region, and the idea of hemorrhoids, fistula or fissure, brings to mind only a vague picture.

Piles. This term signifies rectal disease to most people and usually means any kind of protrusion about the anus, the most


Fig. 122. Hemorrhoids are only enlarged blood vessels. Inside the rectum, they are called internal and are painless. On the outside, they are called external and may be very painful.

common of which is the skin tab. It is usually only an extra fold of skin about the anus which no longer contracts to a smooth skin surface after it is stretched. It means only that this individual has seen younger years.