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Examination of the rectum and lower sigmoid by some method which permits of visual inspection of their interior is a diagnostic procedure of the first class. Tubular specula have been utilized for such examinations for many years. In the lateral position they permit of the inspection of a limited area of the mucous membrane which presents at the distal end while the instrument is being withdrawn. In a normal case, the tube may usually be introduced for a considerable distance with comparative ease; but the presence of those pathologic conditions most demanding investigation very frequently adds such technical difficulties or even dangers to this procedure as largely to destroy its value.
The introduction of the principle of atmospheric inflation in rectal work by Van Buren and by Kelly was a great advance, and has constituted the essential feature in modern proctoscopy. Under favorable conditions this method allows of very satisfactory
STANTON EM. USE OF THE DIRECT VISION CYSTOSCOPE WITH WATER DILATATION FOR PROCTOSCOPIC EXAMINATIONS. JAMA. 1915;LXIV(14):1154-1155. doi:10.1001/jama.1915.02570400036012