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May 24, 1913


Author Affiliations

Omaha, Neb.

JAMA. 1913;60(21):1619-1620. doi:10.1001/jama.1913.04340210029014

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While serving as intern in Immanuel Hospital, I was called to see a patient 74 years old, who had been operated on four days previously for very large thrombotic hemorrhoids, which had become gangrenous. He was quite exsanguinated; the dressings were soaked, and a small stream of blood was flowing from the rectum.

The patient was removed to the operating-room and I soon ascertained that the hemorrhage was taking place inside the sphincter, considerable quantities of blood being expelled periodically, after the "whistle tube" was withdrawn.

I packed the rectum with cotton saturated with epinephrin (adrenalin chlorid), as the surgeon in charge telephoned me to do, but without giving relief. I then packed with gauze, but this too failed. I then resorted to the following method: Taking a piece of gauze about 18 inches square, I spread it in a single layer over a Kelly proctoscope, rubbed petrolatum into it

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