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by irrigation iu the treatment of blennorrhoeal vaginitis and endometritis twice daily, being continued during the menstrual period. About ten irrigations are usually required. If the disease has extended to buy cheap tadacip the cervical tadacip (generic cialis) canal, the mucous membrane of the uterus, and the tubes, the discharge will soon recur. In such cases the uterine cavity should be cauterized with concentrated solutions of chloride of zinc, tadacip erectalis 20 mg and a pencil of iodoform should be introduced at suitable intervals within the cavity. Bandl's method of treatment is the following: The speculum having been introduced, a fenestrated cannula is passed within the cervical canal as far as the os internum ; then a ten-per-cent. solution of sulphate of copper is passed within the cannula, the latter being rotated so that all portions of the mucous membrane shall receive the copper solution through the fenestra. After the cannula has remained in position a few minutes it is to be removed and tadalafil tadacip 20 mg a tampon introduced within the cervix. Such applications should be made every three or four days, irri- gations of a very weak tadacip price in india solution of sulphate of zinc being used during the intervals. Chronic Endometritis (Cornil and tadacip by cipla Brault, ibid., April 25, 1888). — Inflammation and hypertrophy of the mucous membrane of the body of the uterus are frequently seen as the result of frequent and severe par- turitions, as accompaniments of ovaritis, salpingitis, peritonitis, and parametritis, and associated with fibroid or cancerous tumors. The statement that the lesion of endometritis consists in the conversion of the ciliated epithelium of the mucous membrane into pavement epithe- lium is erroneous. De Sinety describes three varieties of vegetations which are to be found in this disease : cialis generico tadacip 1, Glandular, which are develop- ments of the hypertrophied glands ; 2, embryonal, formed from embryo- nal tissue, and containing small vessels and traces of glands ; 3, vascu- lar, formed by dilated vessels tadacip 20 price india and analogous to blood tumors. The modifications of the stroma of the mucous membrane have been well described cialis generika tadacip by Schroder and Ruge. The authors of this paper made their investigations upon fresh uteri removed by Pean from living sub- jects, two cases being illustrations of simple metritis, three of fibroid tumors, and three of cancer of the cervix. These specimens enabled them to see not only the mucous membrane under conditions favorable for study, but also the entire wall of the uterus. The uterus being divided longitudinally, the mucous membrane was found of a grayish or reddish color, and in some cases of a bright-red color ; it was usually buy tadacip uk smooth at the surface, sometimes corrugated, and could be easily scraped ofiF with a scalpel. When scraped with a sharp spoon it was found difficult to distinguish and separate the mucous membrane from the uterine muscle. In most cases it was found that the inflammatory process did not amount to more than a hypertrophy of the glands. In endometritis following epithelioma of the cervix the inflammatory lesions are contiguous to the cancerous zone of the cervix. In metritis, which follows other inflammations of the genital apparatus, the tadacip pille 20mg cialis generika lesions of the mucous membrane are not uniform. In those cases in which the sur- face has a fungous appearance there are eminences and depressions tadacip 20 mg uk which constitute the condition variously known as endometritis villosa, or fungosa, or granulosa, or vegetans, and which has been described by Sinety and Slavjanski. These vegetations represent, in some cases, true pedunculated tumors. Less frequently the papillomatous prolonga- tions, or hypertrophic glandular development, contain small cysts which have the appearance of Nabothian follicles. The glandular ducts are usually lined with a single layer of cylindrical epithelial cells, the vibra- tile processes of which can only be seen in very fresh preparations. The lumen of these glandular processes is usually empty, but sometimes it is filled with epithelial or lymphatic cells in process of tadacip 5 mg degeneration. The lesions of the superficial layer of the mucous membrane are more important than exist in those more deej)ly situated. The elements of this layer may become necrosed and disintegrated after having under- gone a true maceration. The interglandular cellular tissue is normally present in very small quantity, but when inflamed its nuclei increase in size, many new cells appear in the interstices of the glandules, and the vessels increase in number and in size. There may be a general infil- tration by lymphatic elements ; ordinarily the glandules seem distributed in a stroma of young embryonal cellular tissue. Change in the stroma of the mucosa and new formation in the glands appear to be related phenomena. If we compare the changes, in the shape of glandular hypertrophy, which occur tadacip 5mg online in chronic metritis with those which some- times occur in the intestine, we find the mucous membrane of the tadacip 20mg generic cialis latter above a delicate layer of smooth muscular tissue, but in no cases in which there is glandular hypertropliy of this mucous membrane is the muscular layer invaded except in cases of cancer. There is great diffi- culty in the anatomical diagnosis between glandular hypertrophy and epithelioma tadacip online kaufen of the neck buy tadacip canada of the uterus in many cases, but in the major- ity of cases the distinction can be drawn. In simple glandular hyper- trophy there is generally a layer of cells between the bottom of the fol- licles and the connective tissue, which serves as a foundation for the implantation of the ciliated epithelium lining the follicles, and the cili- 474 liKPOHTS ON THE riiOUliESS OF MEDIVINE. iN. Y. Mcu. Jouu., my proccsHCH project Into tadacip erectalis 20 mg tabletten the luincn of the folHcles. generika-apotheke tadacip Tlic intorglniulii. Iiii' tiHHiii' Ims u l«'HH iiiiii'kcd iiiflltnitioii oT lyniplmtki' t'lt'iiiciitN than is thi' faso ill cpitholioiiiii, iiiul the hiycrs of voiinj; coiwu'clivt' tissiii' iirc HiiimUcil ill lilies piuullfl to tlic (liifi-tioii of the iliictM of tho fdiliiics. Ill (■pilliciioinii, on ttic ooiifrarv, tlicrc is not only hvpcrtropliic ciilur^^c- iiiciit of the i^iiiniluif.s, luit an almiKiaiit iiiiiltiplicatioii of ccIIh also wliii'h i|ui('kly los'> tlic tvpical ciiarai'ti'i'isticH of ciliiitcd cpitliciiiiiii, tlio proliferation caiisiii^ i-oiiiplctt' olislnu-lioii of the (liict« of the ^'IhikIiiIcs. Tlif rolls, after their ori^^iiial form has been ehiinged, may present a polyhedral or a eul>ieal form. When the walls of the glandule are lirokeii, the eharat-lers and eonditioiis of epil)i(>li(>ma appear. In fjen-

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