Excerpt from The Diagnosis and Treatment of H?morrhoids: With General Rules as to the Examination of Rectal Diseases
Generally, to one unaccustomed to the examination of patients suffering with disease of the lower bowel, the diagnosis is surrounded by many purely imaginary difficulties. This is shown by the fact that the first inquiry of almost all such practitioners is "What speculum do you use?" as though there must be some mechanical contrivance by which the senses of touch and vision can be so improved upon as to render the discovery of obscure troubles much simpler than it otherwise would be.
The same idea is well fixed in the minds of patients who, under the false idea that an examination and diagnosis necessarily mean a painful use of instruments, will defer treatment until disease has made irreparable progress. The surprise of such patients when a diagnosis is made by mere sight, or at most by a painless digital examination, is only equalled by that of the young practitioner when he is told that only in exceptional cases is it necessary to use any instrument whatever.
The secret of successful diagnosis of these diseases consists in taking nothing for granted.
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