VALUE OF RECTAL EXAMINATION IN DIAGNOSIS. 
335 
easily. If it is a protracted case when it comes to you, and you 
are not thoroughly satisfied as to the cause and you decide to 
use very active agents (as eserine) from the start, better make 
the examination first. You could have rupture of the intes¬ 
tines where it might have been avoided ; be satisfied that your 
patient is prepared for such treatment. 
Prof. Williams in his “ Principles and Practice of Veterin¬ 
ary Medicine,” page 554, after describing the symptoms of an 
animal suffering with an intestinal concretion weighing about 
ten pounds, which proved fatal, says: “ In one case examina¬ 
tion per rectum enabled me to feel and remove a calculus 
from the rectum, the animal being immediately relieved.” 
He further says : “ This shows the necessity of such an ex¬ 
amination in all cases of abdominal pain.” 
A list of most of the diseases, as a class, brought before 
your minds this evening, in which rectal examination is a sat¬ 
isfying means of the proper diagnosis, might surprise you 
somewhat. 
Constipation from the following causes: 
Paralysis of large intestines, paralysis of rectum, inflam¬ 
mation in other organs adjacent to rectum, producing an ex¬ 
cessive heat in the fasces and also the voidance of passages 
resulting from the pressure on the inflamed organ, thereby 
causing pain and as a result the misplacement of some abdomi¬ 
nal viscera. 
2. Impaction. 
3. Colic, with distended bladder. 
4. Haemorrhoids. 
5. Rectitis from malpractice or other causes. 
6. Pelvic deformities and fractures of certain parts ol it. 
7. Pelvic abscesses. 
8. Deep tumors in the gluteal region. 
9. Intestinal concretions. 
10. Cystitis, 
11. Nephritis. 
12. Calculi of bladder, ureters and urethra. 
13. Hernia and its reduction by manipulation. 
14. Diseased ovaries. 
15. Ridglings. 
