When called upon some months ago by our energetic Secretary for the subject of my presidential address, I thought the matter over for a few days and then sent him the title which helps to adorn the excellent program we have this year. With the conforting assurance that I had a good title, which would be the main consideration, and that many admirable reasons why proctology has been made a specialty could be easily and readily got together, the matter was allowed to drop until quite recently. However, my consternation was very real when in preparation for this effort, I proceeded to read the addresses that have been published in our Transactions since 1909. In them was found nearly every idea I had in mind to utilize, ably presented by my predecessors in office.

Inasmuch, however, as our specialty is, relatively speaking, a new one, and as there are certain problems which we should all keep in mind for the future welfare of proctology, I shall call your attention to some of them in this paper. For this informal presentation I sincerely apologize and ask your indulgence.

In answering the question, "Why Proctology has been made a specialty," I believe we could stop with the one word Fistula. Sufferers from this disease never have-and I started to say never will-receive skillful, or even adequate, treatment at the hands of the general surgeon. He has never taken pains to learn the underlying principles of a fistula operation nor has he the requisite skill, experience or inclination to carry out the necessary steps in the post-operative treatment of these cases, to bring them to a successful conclusion.