BEIRUT -- Syrian president Bashar Assad defended his crackdown on opponents yesterday, saying a doctor performing messy emergency surgery does not have blood on his hands if he is trying to save a patient.

In his first speech since January, Assad appeared unmoved by scathing international criticism of his ferocious response to the 15-month-old revolt against his rule, which has killed up to 13,000 people, according to activist groups. He also denied responsibility for the Houla massacre of more than 100 people, saying not even "monsters" would carry out such an ugly crime.

He said terrorists had pushed his country into war.

"When a surgeon in an operating room . . . cuts and cleans and amputates, and the wound bleeds, do we say to him your hands are stained with blood?" Assad said in a televised speech to parliament. "Or do we thank him for saving the patient?" Assad insisted the revolt was the work of foreign-backed extremists, not reformers seeking change.

A massacre May 25 in the central region of Houla has brought fresh urgency to solving the crisis.

The opposition and the government each blames the other for the house-to-house killings in Houla of more than 100 people, many of them small children. UN investigators have said there are strong suspicions that pro-regime gunmen are responsible for at least some of the killings.

Assad denied his forces had anything to do with Houla.

"Not even monsters would carry out [the crimes] that we have seen, especially the Houla massacre . . . There are no Arabic or even human words to describe it," he said in his first public comments about the mass killing.

"Today we are defending a cause and a country," Assad said. "We do not do this because we like blood. A battle has been forced on us, and the result is this bloodshed that we are seeing."

Members of the Syrian opposition brushed off his comments as meaningless.

"It is a desperate and silly speech that does not merit a response," said Adib Shishakly, a Saudi-based member of the main opposition group, the Syrian National Council.

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