Dudley Smith

1938 to 1939

Gentlemen of the American Proctologic Society and Guests:

The American Proctologic Society in the years since it was established under the leadership of the Father of Proctology, Dr. Mathews, has gained an enviable position among special medical societies and has succeeded in establishing proctology as a recognized specialty.

The presidency of this organization is an honor I deeply appreciate and am especially grateful to be able to preside at this meeting because of the fact that I was prevented by illness from presiding at the Philadelphia session in 1931. Thus your kindness and fine courtesy has assuaged my disappointment of eight years ago.

Much of this address may be, and probably is, old stuff to many of you; but I hope that some of it may filter out into the practice of the occasional proctologist, the general surgeon and the general practitioner.

Neglect of details is a prime cause of poor results in medical and surgical practice, but especially in proctology because few general surgeons and general practitioners have had adequate training in this specialty.

Unnecessary pain in examination, treatment and postoperative care has convinced the public that it is hell to have anything done in this region, whereas the contrary is true, and practically all pain can be eliminated by attention to detail. The chief cause of delay in diagnosis of cancer of the rectum is this fear of examination. In my series of 420 cases it accounts for six of the eleven and a half months average delay after the appearance of symptoms before diagnosis is made. The balance of this delay is caused by several factors, among which are suppositories and lack of attention to the details of efficient examination when the patient consults the doctor.