No matter what the disease is to do a good examination, because only a good examination to know what kind of symptoms they are, and the first step of our anorectal examination, it starts from the anal visualization, so what can we see from the appearance of the chrysanthemum? 1, the location of the anus Note whether the anus is at the midpoint of the line between the two sciatic tuberosities, whether it is ectopic anus, anal atresia, etc. 2.Around the anus Pay attention to the skin around the anus and the hairy distribution area to see if there is eczema, scratch marks, erosion white spots and surgical removal marks, etc. 3.Feces, secretions, blood stains Feces: common in anal incontinence, anorectal stenosis, anal canal skin, skin defects. Secretions: common in perianal abscess, anal fistula. Mucus: colitis, rectal prolapse, polyps, etc. should be considered when attached. Blood: internal hemorrhoids, anal fissures, tumors, etc. should be considered. 4.perianal swelling and superfluous organisms If the swelling is located at the anal verge, is smooth and oval, and a dark purple mass is seen in the center, it is mostly thrombosed external hemorrhoid. If there is an uneven surface, clear but irregular swelling on the anal side or perianal skin, anal skin cancer should be considered. Observe the location and number of external orifices and the distance from the anal verge. 6.Caution when there is no obvious lesion in appearance Pay attention to whether the anus is loose, whether there is anal fissure, and if necessary, ask the patient to adopt a squatting position to check whether there are internal hemorrhoids, polyps or prolapsed rectal mucosa, etc. The following three positions are usually adopted by the examined person according to the specific situation. (1) The anterior prone position allows the patient to stand with his back to the light and his upper body bent forward to the side of the bed, so that the hip is bent to a 90-degree position, and the doctor stands to the side of the patient and uses both thumbs to gently separate the buttock muscles to expose the anus. This position is suitable for outpatients or patients with mild disease. (2) Left lateral position patient lying on his side with his back to the light, lower leg straight, upper leg flexed toward the abdomen, and the doctor standing behind for examination is suitable for critically ill patients. (3) Knee-to-thorax position with the patient’s back to the light, kneeling on the examination table with both knees, bending the upper body so that the forehead and one side are close to the examination table surface, and the doctor standing at the side. This position is suitable for sigmoidoscopy. So simply from the appearance of the chrysalis, it is still possible to roughly determine the type of disease, pediatric rectal prolapse, internal hemorrhoids, perianal eczema, pinworms, simple vulvodynia, malignant melanoma of the anorectum, anal sinusitis and anal papillitis, perianal rectal abscess, anal ectopia, rectal prolapse, etc.