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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., 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 best operation. 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.] BOOK NOTICES. 417 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

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