Clinical Variations in Negro Proctology

Two years ago before this section, 1 I called attention to the role enacted in rectal pathologic changes in the negro by that racial peculiarity which had previously 2 been termed the fibroplastic diathesis, the inherent ethnic predisposition to develop adult connective tissue in excess in response to trauma of any type. From the analysis of cases presented at that time, it was indicated that rectal disease in general is equally prevalent in the Caucasian and in the negro; that cancer, pruritus and fissure are less common in the negro, while the inflammatory lesions, including fistula, are more often found in the black. Benign rectal stricture, accompanied by other manifestations of the fibroplastic diathesis, was eleven times as frequent in the negro, while hemorrhoids occurred only half as often. In addition, microscopic studies of a series of excised hemorrhoids from both races seemed to indicate that fibrosis is the dominant