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is the only way by which the inflammatory element is transmitted from the uterus to the neighboring organs. Septic infection after having tenormin iv been located in the endometrium is propagated principally by the lymphatic vessels. Pelvic cellulitis, phlegmasia alba dolens, and the great majority of puerperal accidents are caused by the absorption of septic germs. Contagion is acquired rapidly, on account of the existence of trau- matic lesions caused by parturition or abortion. While buy tenormin online the so-called puerperal septicemia can be transmitted directly by the uterine parenchyma, the lymphatics, or the veins, the same con- dition is not propagated apart from the puerperal condition. Catar- rhal inflammation and gonorrhneal infection tenormin 50mg have a tendency to invade the uterine raucous membrane. After having produced the lesions of the womb, there is extension to the tubes, salpingitis being first pro- duced and then perimetritis. The foregoing statements explain the views of Schroder and others that pelvic peritonitis is very frequent, tenormin syrup and pelvic cellulitis, apart from the puerperal state, very rare. The initiatory agent of inflammations of the mucous tenormin tablet membrane is alwavs a microbe. This micrococcus, whether septogenic, pyogenic, puerperal, or blennorrhoeal, located in the folds of the mucous mem- brane, gives rise to symptoms of endometrial inflammation, which in- dicate active treatment for their relief. To cure this inflammation and avoid subsequent pelvic peritonitis, dilatation, curetting, and antiseptic precautions are indicated. The fol- lowing conclusions result from the author's experience : April 27, 1889. REPORTS ON THE PROGRESS OF MEDICINE. 475 1 . In non-exudative pelvic peritonitis the pain which is the princi- pal symptom may be relieved by dilatation. 2. In the exudative variety forcible dilatation by facilitating the re- turn circulation may check the tenormin online progress of peritoneal infarctions and assist the absorption of exudates. 3. In tenormin 25mg circumuterine or pelvic abscesses, which are usually nothing more than cysts of the tubes, purchase tenormin it is possible, by dilating the womb, to evacuate the cysts by way of the uterine canal. 4. In cases of puerperal septicaimia the septic tenormin 25 mg symptoms will dis- appear under this treatment. No other is so efficient for the disinfec- tion of the cavity of the tenormin atenolol uterus and disposing of the products of infec- tion. 5. Reflex symptoms, such as vomiting, are immediately relieved by forcible dilatation. The Pathogeny and Treatment of the Diseases of the Cervix Uteri (Doleris, ibid.). — The best way to understand the diseases of the cervix uteri should consist in observing and carefully following the course of their pathogenesis. Obstetric traumatisms, natural or artificial, open the door to pathogenetic order tenormin online agents of tenormin 25 inflammation. Inflammation impedes the spontaneous repair of the lesions. The nature of the tissues and the condition of the glandular acini insure the persistency of the changes. The changes in the form of the cervix are caused by uni- lateral or bilateral traumatisms, or by muscular spasm. Nervous de- rangement and repeated congestions establish and increase the deformi- ties. The following deductions are based upon the study of more than a hundred clinical cases and the microscopical examination of sixty fresh anatomical specimens obtained from operations practiced upon the cervix uteri : 1. A general condition which is below the normal causes in the raucous membrane of the female genital apparatus, whether in the virgin or not, a predisposition to inflammation by encouraging passive congestion, and thus favoring excessive secretions. This condition is commonly called cheapest tenormin simple catarrh. In this catarrh there is no a priori inflammation. 2. Inflammation of the cervix uteri follows the introduction of buy cheap tenormin and contact with phlogogenetic agents. Traumatism by means of operations and the parturient state, inflammations of the vagina, etc., prepare the way for these agents. 3. Aseptic traumatisms of the cervix are repaired without the occur- order tenormin rence of inflammation, whether the traumatism consists of a simple erosion or a removal of tissue. 4. Septic traumatisms do not undergo repair, but give place to per- sistent deformity, with inflammation, painful cicatrices, repeated at- tacks of perimetritis, etc. 5. Erosions, with reference to their progress, may be primary or secondary, the former being immediately related to the pathogenetic cause. They may consist cheap tenormin of destruction of continuity purchase tenormin online in the tissue of the cervix with inflammation in the parturient woman, or they may be due to a buy tenormin recent inflammation in the virgin or the nullipara. The sec- ondary erosions are those which appear upon a surface which is already diseased — that is, upon everted and cicatricial portions of the cervix. 6. Cicatrization of cervical generic tenormin ectropion with erosion can not take place as long as the tissues remain in a morbid condition. The cervix

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