EXTRACT XLV. 



ON COCCYDYNIA OR COCCYGODYNIA AND HEMOR- 

 RHOIDS, IN RELATION TO THE FILUM TERMINALE 

 OF THE CORD, AND THE COCCYGEAL GLAND. 



THE former of these morbid conditions seems to us to be 

 so intimately related to that gland as to be dependent for 

 its causation on a condition or conditions of its structure 

 and function, and, consequently, that we must look to it 

 (the gland) to indicate and determine the line of treatment 

 to be pursued in its abatement or removal. The situation 

 of the affection is entirely determined by that of the gland, 

 and would seem to be due to glandular conditions prim- 

 arily, and secondarily to the implication of its proper 

 nervature and blood-vessel arrangements. Being, accord- 

 ing to our contention, a bladder or cystic structure 

 developed in or surviving from the metamorphic and 

 differentiating embryonic elements of the neurenteric 

 canal wall, for the drainage and collection of the residual 

 thecal cerebro-spinal lymph finding its way through the 

 porous or patent lumen of the filum terminale or residual 

 canal texture, it is liable to all the vicissitudes of a cystic 

 organ, as, for instance, retention, suppression, or mal- 

 composition of its contents, and, therefore, to the incidence 

 of a wide range of morbid conditions, determined by its 

 structural and functional relationships to the cerebro-spinal 

 and alimentary canals respectively, as well as to those 

 arising from its own intrinsic and immediate condition and 

 surroundings. Haemorrhoids may also directly and in- 

 directly be largely influenced by conditions affecting the 

 excretory mechanism of the coccygeal gland, their etiology 



