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January 26, 1918


Author Affiliations

House Physician, New York Hospital NEW YORK

JAMA. 1918;70(4):222. doi:10.1001/jama.1918.02600040020006

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The grave complications frequently arising from seemingly simple methods employed in the treatment of dispensary patients leads to the presentation of one such treatment and its undesirable result.

The rectal mucosa cannot be effectively freed from pathogenic organisms, which may be carried deeper by a hypodermic needle. The liquid injected reduces tissue resistance, and furnishes a good medium for the growth of organisms. If an anesthetic agent is injected, pain and the defensive reflexes it arouses are abolished. Hence, the mechanical spread of the infection is unretarded. The patient's walking, jolting in cars and sitting in chairs all aid in spreading the infection. Dispensary patients, therefore, are subjected to a double risk.


History.  —For ten years, a chauffeur, aged 38, had had external and internal hemorrhoids, which had bled six years. He was constipated. January 31, in a dispensary, three large internal hemorrhoids were injected with quinin

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