. Les maladies du rectum et anus : conçu pour les étudiants et les praticiens de la médecine. être reconnus comme la maladie, et non pas thenarrowing qu'elle engendre. Spasme permanent d'Europ-muscle volontaire je considère comme une impossibilité. Il dit encore : ni dans ni imaginaire dans le strict réelle-ure est un spasme musculaire un élément d'une importance pratique. Leichtenstern dit : l'existence d'un tel plus affectionno appelle à une discussion sérieuse. M. Harrison Cripps, après avoir convenu avec Van Burenand d'autres écrivains ce permanent spasme de l'involuntarymuscular les fibres sont une impossibilité physiologique, s

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. Diseases of the rectum and anus: designed for students and practitioners of medicine. be recognized as the disease, and not thenarrowing to which it gives rise. Permanent spasm of invol-untary muscle I regard as an impossibility. Again he says: Neither in imaginary nor in actual strict-ure is muscular spasm an element of any practical importance. Leichtenstern says: The existence of such an affectionno longer calls for serious discussion. Mr. Harrison Cripps, after agreeing with Van Burenand other writers that permanent spasm of the involuntarymuscular fiber is a physiologic impossibility, says: Thereis a condition of temporary—followed by permanent—short-ening to which muscles, frequently stimulated by reflexirritation, are liable. In proof of this statement, he cites un-treated cases of chronic knee-joint disease. He argues thatany irritation, as an ulcer, inducing continual reflex contractionin any muscular canal, might terminate in permanent shorten-ing of its fibrous elements, thus producing an annular stricture, and in these views Mr. Ball, of Dublin, concurs.. PLATE XX.—DIAGRAMMATIC DRAWING OF RECTALSTRICTURE DUE TO ULCERATION. A, Dilated rectum above stricture. B, Thickened walls neoA- constriction. C, Ulceration at and above the stricture. NON-MALIGNANT STRICTURE 357 • The author has treated many cases of hypertrophy of thesphincter-muscle the result of spasmodic contraction. In everycase he has been able to trace the cause to irritation inducedby a fissure or other disease about the rectum or anus, or toreflex disturbances from neighboring organs. He has alsoseen the levatores ani so hypertrophied from similar causes thatthey could be distinctly outlined and felt to contract by thefinger in the rectum, especially when the patient was requestedto draw the anus upward. He has never seen spasmodic con-traction above the levatores ani, and he does not believe thatany such condition as phantom stricture exists. On the con-trary, he is of the opinion th

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