. Rectal and anal surgery : with description of the secret methods of the itinerant specialists. Fig. 12.—Kelseys Speoulum. ment, is inserted with the plug iu, aud the feuestruni ouwhatever side it is desired first to examine. The plugIs then withdiawn and the membrane inspected; the plug is then re-insertedand the fenestrumturned in a newdirection, when theplug is again with-drawn. The plugprevents the edgesof the fenestrumfrom scraping themembranes pain-fully, and by severalre-insertions of itthe opening can beturned to every partof the rectal walls. The inner opening shows something ofthe m
. Rectal and anal surgery : with description of the secret methods of the itinerant specialists. Fig. 12.—Kelseys Speoulum. ment, is inserted with the plug iu, aud the feuestruni ouwhatever side it is desired first to examine. The plugIs then withdiawn and the membrane inspected; the plug is then re-insertedand the fenestrumturned in a newdirection, when theplug is again with-drawn. The plugprevents the edgesof the fenestrumfrom scraping themembranes pain-fully, and by severalre-insertions of itthe opening can beturned to every partof the rectal walls. The inner opening shows something ofthe membrane prolapsed over it, but the orifice of the tip istoo small, and the instrument too short for efiiciency in deep jiresent rec-tal itinerantsgenerally use asmall, taperingspeculum, openat the tip, andhaving a plugto facilitate en-trance. LikeAllinghams, itis too short andtoo small fordeep work, but as it has a lateral fenestrum, closed by aremovable slide, most of the objects sought by that ignorantclass can be brought into \dew by means of Fig. 13.—Allinghams Foue-bladed Speculum. METHODS OF EXAMINIXO THE HECTUM. 19 Tubular specula, however, are solely for cannot use them in operating. A pair of Sims speculaset in handles is very convenient in many cases both forexamination and for operations. Dr. Kelsey, of New York, has devised a good bivalvespecuhim, which is, however, not equal for general use tothe four-bladed speculum of Allingham. Sets of Instruments for Rectal Surgery.—The diminu-tive cases of instruments sokl at extravagant prices to itin-erants and some unwary physicians are an illustration of theadage knowledge is power, since the possession of so verylittle knowledge on the part of an ignorant vender enableshim to extract one hundred dollars from tlie pocket of liisstill more ignorant patron for ten or fifteen dollars worth ofvery simple appliances. Of late competition has broughtdown the prices of these sets somewha
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