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Of the utmost importance to a human being is the
selection of his ancestry. This is delegated to his
parents, and if they fail in observing natural laws
that in a measure give them option in the matter,
they are responsible for the result.
As to consanguinity, it seems that the character
of the stock is the important factor. The presence
of neuropathic tendencies in one or both parents,
especially if there is similarity in the character of
the neurosis, means almost invariably neurosis in
the offspring in definite measure. Even a consan-
guineous marriage between those of good stock re-
sults as a rule in high class offspring. But when
neurosis is introduced, the progeny suffers far more
than in indifferent mating. There is in this a logi-
cal suggestion of high prophylactic value.
I do not agree with the learned New York jurist,
Judge Foster, who asserts that sterilization of the
criminal — he might better have said the unfit — is
the cure for crime. In my opinion, you must go
far back of the individual who is already afflicted.
Individual conscience must awaken, and public
sentiment crystallize so that general laws of men-
tal hygiene will be enacted and carried out under
the supervision of competent scientists, and then we
may eventually hope to be relieved of the awful
burden of caring for Buy Maxolon the mental and physical
anomalies.
34 West Eighty-seventh Street.
HEMORRHOID OPERATIONS.
A Local Anesthesia Technic.
By Leigh Watson, M. D.,
Oklahoma City, Okfa.
I am describing a case of internal varicose hem-
orrhoids of ten years' duration. There is an ex-
ternal connective tissue pile, Tuttle's skin tab, on
the left side. The patient is a printer, thirty years
of Maxolon 10mg age. The hemorrhoids frequently protrude and
the patient is often annoyed by bleeding and tenes-
mus. The patient is lying on his left side in the
Sims position. The internal hemorrhoids are Maxolon Tablets above
the sphincteric ring and are not visible (Fig. i).
A small pledget of cotton saturated with a one
fifth per cent, cocaine solution is introduced into
the anus as the patient strains, as he relaxes the
pledget is drawn up within the sphincteric ring.
The local applications are repeated with pledgets
of increasing size, until the mucosa is completely
anesthetized and the sphincter sufficiently relaxed to
admit the index finger without pain.
The needle is now introduced through the anes-
thetized mucosa and the mucocutaneous margin is
carefully infiltrated with a one tenth per cent, co-
caine solution. The needle should be very superfi-
cial and always in sight beneath the epidermis. The
infiltration is made into the deep lasers of the der-
mis, and not under the skin. .-Vfter each injection
the needle is reinserted well within the anesthetized
area.
The skin infiltration is now complete, a series of
small tense wheals encircling the margin of the
anus. This is all that is required for external hem-
orrhoids when it is not necessary to dilate the
sphincter. Note the small amount of infiltration
necessary when it is properly placed in the deep lay-
ers of the dermis. Massive infiltration distorts or
obliterates the hemorrhoids and is a frequent cause
of failure when physicians neglect to remove all the
pile tumors when using local anesthesia (Fig. 2).
-Hemorrhoids before local .iiiestlie
Fig. 2.— .^11
amount of solutio

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