. Diseases of the rectum and anus: designed for students and practitioners of medicine. empted to classify these neoplasms, and topoint out the various methods used to destroy them. Holmes,in a practical paper written in 1867, called attention to this classof tumors and the satisfactory results to be had from theirtotal extirpation. Tumors of this region, except dermoid cysts described elsewhere (page 491), are of rare occurrence, and are met 11 163 DISEASES OF THE RECTUM AND ANUS with more frequently by the obstetrician than the surgeon, be-cause they are congenital and noticeable at birth. T
. Diseases of the rectum and anus: designed for students and practitioners of medicine. empted to classify these neoplasms, and topoint out the various methods used to destroy them. Holmes,in a practical paper written in 1867, called attention to this classof tumors and the satisfactory results to be had from theirtotal extirpation. Tumors of this region, except dermoid cysts described elsewhere (page 491), are of rare occurrence, and are met 11 163 DISEASES OF THE RECTUM AND ANUS with more frequently by the obstetrician than the surgeon, be-cause they are congenital and noticeable at birth. They belongplainly in the domain of rectal surgery, for the reason thatthey displace the rectum and anus (see Dr. Lords case. and 52), interfering with the performance of their divided them into the following varieties:— 1. Coccygeal tumors in the proper sense. 2. Sacral hygromata. 3. Tail-like formations and lipomatous appendages. 4. Tumors in the adult, the congenital nature of which isnot clearly proven. Holmes suggests the following arrangement of these. Fig. 51.—Sacro-coccygeal Tumor (Front View). growths: (a) tumors assuming the forms of supernumerarylimbs, the result of double fetation; (b) tumors with fibro-fatty(Hpomata) constituents where congenital duration is not ap-parent; (c) congenital tumors which enter the pelvis, not offetal origin. In recent years many cases of sacro-coccygeal tumors havebeen reported, some of which do not seem to fall within theclassifications of either Braune or Holmes. Because of theirvariety, difference in shape, consistence, contents, and eti-ology, a grouping of these neoplasms is extremely , it is frequently impossible to make a positive diagnosisin these cases except by operation or autopsy. For the reasons DISEASES, INJURIES, AND TUMORS OF COCCYX 16i named, the author will not attempt a rearrangement of thesetumors, but will simply point out their principal manifestations,which, after all, a
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