JAMA. 1934;102(5):348-353. doi:10.1001/jama.1934.02750050014004.
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The two symptoms that usually first induce the patient to consult his physician are pain and some noticeable departure from normal in his physiologic functions. Pain is usually the symptom that induces this contact in the vast majority of cases, but apprehension and worry caused by any noticeable deviation from the normal is second only to physical suffering in causing an individual to seek medical advice and care.

Pain referred to or originating in the anorectal region usually induces the patient to seek relief promptly on its appearance. Since in most cases pain is aggravated by anorectal function and this perforce cannot be suspended in the average case for a very long period of time, the patient who seeks immediate medical advice as a result of his disability should be the recipient of early and effective therapy.

Unfortunately, in many instances, a large group of persons will defer medical attention


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