This historic book may have numerous typos and missing text. Purchasers can usually download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1876 edition. Excerpt: ... les enfants. Gaz. des hop. 1852. British Med. Journ. 1868. avirch. Arch. Bd. XXIII. 1862. 'Archiv f. klin. Chir. von Langenbeck. 15. Bd. 1873. S. 122. subordinate one.' Most stenoses of the rectum can be reached with one or two fingers. But when the obstruction is seated higher up, in the region of the sphincter tertius or the sigmoid flexure, it cannot usually be determined, when the sound is arrested by some insurmountable obstacle, whether it has reached the physiological limit of its advance, or whether it has been stopped by a pathological or accidental obstruction. Only repeated examinations, always yielding the same result, and the sense of touch which often allows us to recognize that the sound is passing with difficulty through a constriction, and that, on being withdrawn, it suddenly slips out with a jerk, occasionally furnish valuable infomiation. Recently the upper portions of the rectum, and even part of the rectal end of the sigmoid flcxurc, have become accessible to direct palpation by the method of introducing the whole hand through the anus into the rectuln. To Simon, ' of Heidelberg, belongs the credit of having methodically described and confirmed and perfected by numerous investigations, this mode of examination which I saw Nussbaum employ in his Clinic, about the year 1865, and which Maunderfi in 1868, used for the diagnosis of rectal stenosis. The bloodless method of this manual exploration consists in the introduction of the whole hand through the gradually distended anus during deep chloroform narcosis. Great narrowness of the outlet of the pelvis, especially in men, or an unusually large hand on the part of the examiner, may interfere with the practicability of this mode of exploration. In other...