The greater part of all rectal surgery is done by the general surgeon, and practically all general surgeons do rectal work. At the same time, it is true that most of these men regard rectal work as a subordinate part of their practice. They are not especially interested in it and are not particularly adept at the making of rectal examinations. It is not improbable that a considerable number do not possess a proctoscope and are unskilled in the use of the instrument. Under such circumstances a review of the significance of rectal signs and symptoms would seem worth while. There is nothing of great novelty to be expected in such a discussion, but clarification and emphasis on clinical facts have a value as practical if not as striking as novelty.
The signs and symptoms that accompany rectal disorders may be grouped under comparatively few headings: sensory disturbances, abnormal secretions