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December 18, 1926


JAMA. 1926;87(25):2064-2071. doi:10.1001/jama.1926.02680250022008

At the Ohio Valley Medical Association, just ten years ago, I1 proposed a new classification of hemorrhoids into infective and noninfective groups, based, of course, on the relative virulence of the infection in the pile tumor. Since all examples are actually or potentially infective, I shall limit my remarks to this type, premising that it is essential that the focus be extirpated.

The section reproduced in figure 1 is from the stump of a hemorrhoidectomy done by one of the "closed" methods; bacteria and a round-cell infiltration can be seen in the field. This patient was supposed to have "ulcer of the stomach," and was to have a gastroenterostomy performed; but the gastric symptoms promptly subsided after removal of the pathologic condition and provision of free drainage. A crater-like opening can be seen in the apex of the field, evidently nature's mode of permitting the excess products of infection