concerned. The urethra admitted a No. 30 French sound. The
urine had to be drawn every twenty or thirty minutes with a
catheter. The capacity of the bladder without an aneesthetic
was buy femara two ounces and a half. Urine sediment, cheap femara 75 per cent, mucus.
Constant vesical tenesmus. The patient was in the habit of
taking ten grains of morphine daily, hypodermatically.
When the speaker had first seen tlie patient he had a tem-
[)erature of 104° F., his pulse was 140, and his general aspect
was that of a man rapidly sinking. His extremities had been
literally covered with abscesses, due to repeated hypodermatic
injections of morphine. Epicy.stotomy order femara online liad been advised by the
speaker with the promise of a permanent epicystic fistula for
constant and permanent drainage. He had operated February
13, 1889, in presence of femara online Dr. W. E. B. Davis, Dr. Ransom, Dr.
Brown, Dr. Pouncy, Dr. Abenathy, and Dr. Dougla.ss, by per-
pendicular incision as in the case of Mr. H. Intravesical explo-
ration through the opening had buy femara online revealed a small abscess in the
trigonum, which had been opened and the pus evacuated. The
bladder had been washed out with sterilized water, and the
wound closed and dressed as described in the previous case.
The patient had experienced immediate and complete relief
from the day of the operation. The bladder had been washed
out daily with sterilized water by means of a fountain syringe
with the nozzle in the urethra and femara price the water escaping through
the fistula. No more abscesses, fever, or tenesmus had occurred,
and the bladder capacity was now twelve ounces. The amount
of morphine taken had been reduced to a quarter of a grain
every four to seven hours.
This case illustrated what drainage would do in an inflamed
paretic bladder when the urethra was in itself complete.
Dr. CnKw said that this was the first operation of the kind
he had ever seen. The question had arisen in his mind as to
whether or not this had been a purchase femara prostatic stone, owing to its
large size. He had also noticed, from rubbing a portion of this
stone between his fingers, that it was principally viineral mat-
ter^ when it seemed to him that such stones should be animal
matter. He thought thorough drainage a most scientific pro-
cedure. He agreed with Dr. Davis that the suprapubic was the
Dr. Griggs asked Dr. Davis if he would perform the high
operation for stone or cystitis in a woman.
The Chairmax said he thought the operation the ideal one
for thorough drainage of the bladder, and that, aside from the
formation of a permanent fistula, he thought in a few years
suprapubic lithotomy would be the accepted operation. He
had seen the suprapubic operation done several times, had per-
formed it himself, and considered it simple in execution and
almost devoid of danger.
Dr. Davis said, in reply to Dr. Parke, that he would always
perform the medio-lateral operation for stone in the bladder
when there was but little catarrh and no paresis. In reply to
Dr. Chew, he said it was a fact that analysis of the stone had
April 13, 1889.]
revealed its true nature, as described. The stone was secondary
phosphate of lime, the result, no doubt, of a preceding pros-
tatic fissure femara mg or abscess. In reply to Dr. Griggs, he said he would
not perform suprapubic cystotomy for stone in women, as the
vagina afforded every advantage. In reply to the chairman, he
said he did not agree with him as to the final and early adoption
of the high operation for stone. It was not the ideal operation
for stone in the bladder where permanent after-drainage was
unnecessary, but only in cases where intravesical treatment and
drainage were necessary to complete comfort and relief.
The dangers of the operation, with ordinary care, were nil.
It provided an opening into the bladder for cystoscopic explora-
tion in after ti-oubles. With the endoscope through the epi-
cystic fistula, the surgical electric light could be made to illu-
minate the entire intravesical wall while a current of clear fluid
might be passing through. It secured permanent drainage in
prostatic hypertrophy, as shown by Dr. Hunter McGuire. in
serious vesical catarrh, in vesical resection, and in malignant
tumors, and, in fact, was the best method of draining the bladder
for any cause. He had made frequent incisions into the bladder
for drainage of the prostate and bladder, but in no instance had
he been rewarded with such good results as he had attained by
the epicystic surgical femara cost fistula. There was no doubt, in his opin-
ion, that epicystic surgical fistula had a great future for cysto-
scopic explorations, intravesical treatment, and drainage.
Idiopathic Erysipelas. — The Chairman reported the his-
tory of generic femara a case occurring in femara tablets a woman ten days after the removal
of an ovarian tumor. The patient was forty-eight years of age,
and had been operated upon in the pay wards of buy cheap femara the order femara Birming-
ham Hospital soon after the opening of the hospital, and before
there had been any cases of contagious disease in the wards.
The inflammation had begun in the face and had extended over
the entire body, the wound in the abdomen being the last part
involved. The operation had been purchase femara online done antiseptically, and a
dressing of iodoform, boric acid, and absorbent cotton applied.
The patient had given a history of having had five or six attacks