Abstract
To the Editor:— In our comment ( 205 :469, 1968) we attempted to make the following three points: (1) the responsibility to employ all available diagnostic modalities to rule out a cause of bleeding proximal to internal hemorrhoids; (2) that hemorrhoidectomy can be performed in such a way that it is not extremely unpleasant; and (3) that ligation of internal hemorrhoids is an adjunct rather than a panacea. Blaisdell ( 206 :1793, 1968) commented on our few months experience and his 18 years thereof. It is true that we have used office ligation techniques for only 4 1/2 years. We believe the time sufficient to enable an objective evaluation of a procedure. Blaisdell maintains that our evaluation of the symptoms of anorectal disease and pathology (based on anatomic principles and acknowledged concepts of anorectal innervation) is just not so. As justification for this he offers his clinical evaluation of the results obtained
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