The Rectal Examination

Abstract

A quotation attributed to one of England’s leading rectal surgeons, fondly known as the “Rear Admiral”, states: “If you do not put your finger in, you will put your foot in it” ; implying that a routine “ physical” is not complete without a competent rectal examination, and failure to acknowledge this fact may lead you and your patient into serious trouble.

Words such as distasteful, repugnant, inaesthetic, are often chosen to describe the “rectal” . Such adjectives in this context stem from a false modesty and the complicated rituals of excretion which afflict a modern
urban civilization. The result is that many people consider a per rectum (P.R.) examination to be an affront to the person or at least “not quite nice”. Negative attitudes of this kind cannot be tolerated within the profession who must accept a P.R. as the routine final act of the complete physical examination.