Gynecological diagnosis . , p. 524; Myomatous polyp, p. 525. 2. Malignanttumors, p. 525; Cancer of the rectum, p. 525; Cancer of the anus, p. 526,Pathology, p. 526, Symptoms, p. 527, Diagnosis, p. 528, Differential diag-nosis, p. 528; Sarcoma of the rectum, p. 529, Varieties, p. 529, Diagnosis,p. 530. A short sketch of the chief points in the anatomy and physiologyof the rectum, as well as a description of the methods of examination, 494 ANOMALIES 495 will be found in Chapter IX., page 121. An analysis of the chiefsymptoms of rectal disease is given in Chapter X., page 156. ANOMALIES The diffe
Gynecological diagnosis . , p. 524; Myomatous polyp, p. 525. 2. Malignanttumors, p. 525; Cancer of the rectum, p. 525; Cancer of the anus, p. 526,Pathology, p. 526, Symptoms, p. 527, Diagnosis, p. 528, Differential diag-nosis, p. 528; Sarcoma of the rectum, p. 529, Varieties, p. 529, Diagnosis,p. 530. A short sketch of the chief points in the anatomy and physiologyof the rectum, as well as a description of the methods of examination, 494 ANOMALIES 495 will be found in Chapter IX., page 121. An analysis of the chiefsymptoms of rectal disease is given in Chapter X., page 156. ANOMALIES The different stages of the development of the rectum and anusare shown cliagrammatically in the figures from Schroeder onpage 395, Figs. 158-162, Chapter XXL As it is not the generalcustom for obstetricians to examine carefully the anus and rectumof the new-born infant, many minor malformations pass unob-served. Where a careful examination is made some degree of mal-formation will be found not so infrequently. Starr has estimated. Fig. 191.—The Anal Canal. A, Columns of Morgagni; B, Semilunar valvesor Crypts of Morgagni; C, Dentate Border Marking Upper Limits of Anus andsurmounted by Papillae; D, Hiltons White Line. (Tuttle.) that anal and rectal malformation occurs about once in ten thou-sand births. It is more common in girls than in boys, if weinclude anus vaginalis (see page 393, Chapter XXI.). As shown inthe diagrams on page 395 the rectum and the anus are developedfrom entirely different structures of the blastoderm, the formerfrom the hind-gut, and the latter from the proctodeum, a depressionin the epi-blast opposite the lower end of the hind-gut, thereforemalformation of the one does not necessarily imply abnormalityof the other. As a matter of fact, if the rectum is malformedor displaced the anus is generally normal, and vice versa. Malformation of either of these organs is likely to be associatedwith malformation in other portions of the body that are derived 496 DISEASES O
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