374 SURGICAL APPLIED ANATOMY, ichap. xvin. 



producing a kind of spermatorrhoea. Defecation also 

 often causes much pain in inflammatory affections of 

 the prostate and adjacent parts. 



The anterior surface of the rectum in the female 

 is in relation, so far as the finger can reach, with the 

 vagina, and in examining the lower part of the rectum, 

 it is convenient to protrude its mucous membrane 

 through the anus by means of the finger introduced 

 into the genital passage. 



The rectum is dilated, and is very distensible just 

 above the anus. In fsecal accumulations it may be dis- 

 tended to a considerable size, and strange foreign bodies 

 of large dimensions have been found in the ampulla. 

 Among the latter may be mentioned a bullock's horn, 

 an iron match-box, and a glass tumbler. Experiment 

 has shown that when the rectum is distended in the 

 male, the recto-vesical fold of peritoneum is raised, 

 and the bladder is elevated and pushed forwards. In 

 the female the fundus uteri is raised and pushed 

 towards the symphysis. In connection with the 

 latter effect it has been suggested that the rectum 

 should be artifically distended in some cases of opera- 

 tion on the uterus and ovaries, so that those organs 

 may be placed within easier reach. 



If the sphincter be very gradually dilated, the 

 entire hand, if small, may be introduced into the 

 rectum in both males and females. The circumference 

 of the hand should not exceed eight inches. By a 

 semi-rotary movement, and by alternately flexing and 

 extending the fingers, the hand can be insinuated 

 into the commencement of the sigmoid flexure. 

 ( ) wing to the - mobility of this part of the bowel a 

 large extent of the abdomen may be explored through 

 the bowel wall. The structures that can be readily 

 felt are the kidney, the aorta, the iliac vessels, the 

 uterus and ovaries, the bladder and its surroundings, 

 the pelvic brim, the sacro-sciatic foramina, the ischial 



