RECENT concern over gonococcal proctitis has not extended to interest in rectal infections caused byTreponema pallidum. Detection of rectal syphilis depends on maintaining a high index of suspicion and looking carefully for anal or rectal chancres. This is particularly important because the incidence of venereal disease has increased substantially in recent years and because early diagnosis and treatment prevent dissemination ofT pallidumand the late complications of syphilis. We describe a patient who was hospitalized for treatment of "internal hemorrhoids" but who, in fact, had syphilitic proctitis. Report of a Case A 28-year-old, unmarried, homosexual man had rectal pain on defecation and mucoid, blood-streaked stool for the week before admission to the surgical service of the Veterans Administration Hospital in Houston. He had received intermittent treatment for rectal pain and bleeding resulting from hemorrhoids for the preceding few years but had been relatively free of complaints until the