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By H. Stevenson.
8. Ascans Lumbricoides as a Cause of Appendicitis,
By A. Castellani.
1. Treatment of Uterine Fibromyomata. — Haultain
states that the treatment of uterine fihromvomata may
be divided into electrical and surgical. Medicinal means
are obsolete. Electrical treatment has fallen into un-
deserved disuse. Many cases are not only temporarilv
benefited and thus tided over till the menopause, but
also are completely cured. A current of less than
eighty milliamperes cannot 1)e expected to have efifect
on a fibroid growth, and anything between that and
one hundred and twenty milliamperes may be given
with_ the utmost safety. The surgical treatment' mav
be divided into: i. Removal of the uterine appendages.
This has had its day, and was only valuable before
the more radical operative measures were perfected.
2. Removal of the tumor; and 3, removal of the uterus
and tumor. These now hold Ciprofloxacin Buy the field as practicaliv
the only surgical procedure. They may be done cither
abdominally or vaginally. The former is much more
dangerous. The author uses the supravaginal method
and has a record of two hundred and three cases, with
two deaths ; a consecutive series of one hundred and
nine cases were successful. One death was due to
embolism, and the other occurred in a patient suffering
from marked anaemia. Panhysterectomy has little to
recommend it, except that it is an efficient bar to sub-
sequent cervical cancer. Instead of condemning ninety
per cent, of women suffering from uterine fibromyo-
mata to a life of semiinvalidism till the climacteric
arrives only partly to relieve their sufferings, we are
now able to offer a certain prospect of cure to at least
ninety-five per cent.
2. Dysmenorrhoea.— Routh states that dysmenor-
rhrea is a symptom, not a disease ; its cause must be
ascertained and treated. The various types of pain are
classified as follows : I. Painful uterine Where Can I Buy Ciprofloxacin contractions.
(a) Obstructive dysmenorrhoea ; this may be : (l) Abso-
lute; this is a very rare condition, whether congenital
or acquired. (2) Partial: due to a partially occluded
cervix, the result of a faulty operation, or to cauteriza-
tion. (3) Relative; due to the presence of clots in
cases of subinvolution and retroversion, where there
is a bulky, feebly contractile uterine body, (b) Spas-
modic dysmenorrhoea. Here the pain comes on before
the flow, and is intermittent in type. It is probably due
to spasm of the cervical sphincter, caused in turn by
persistent infantile characteristics, the presence of a
small fibroid, an overloaded rectum, etc. II. Conges-
tive dysmenorrhoea. (a) True pelvic congestion. This
may be due to displacement of the pelvic viscera, to
tumors of the uterus, ovaries, or tubes, or to venous
engorgement of cardiac, pulmonary (or hepatic)
origin. As a result there is an increase of the normal
vascular tension during menstruation. The patients
are usually heavy dull women of lethargic habits, (b)
Pelvic inflammation. Here there has been preceding
pelvic inflammation as a result of which either the
venous return of the blood is Buy Ciprofloxacin 500mg interfered with by means
of adhesions, or the uterus is displaced or rendered im-
mobile by cicatricial bands. III. Ovarian dysmenor-
rhoea. Occasionally the maturation and escape of the
ripened ovum from the ovar\- is accompanied with diffi-
culty and pain, due to thickening of the capsule or ad-
herence of the ovary. If ovulation should not occur
concomitantly with the menstrual cycle, this ovarian
dysmenorrhoea causes an intermenstrual dysmenor-
rhoea called " Mittelschmerz," with which there
is usuallv a more or less profuse mucopurulent or
watery discharge. Treatment. True obstructive cases
must be treated by temporary relief of the symp-
toms. Complete obstruction calls for incision, par-
tial or relative obstruction for dilatation. In the
spasmodic form, general medicinal treatment is called
for, the bowels and skin must be attended to, and
iron given in the anaemic cases. .Mcohol, opium, or
chloral should never be given. Dilatation of the cer-
vix may eventually be called for. In congestive dys-
menorrhoea cannabis indica often works well. Efforts
should be directed towards encouragement of the flow,
and to relieve the congestion by acting on the other
cxcretorv organs. Any uterine displacement must be
manually rectified, and a pessary inserted if necessary.
AX'hen the pain is due to old inflanmiation operation may
become necessary. Ovarian dysmenorrhoea is treateil
by means of sedatives (especially bromides) and the
relief of congestion. Operative treatment is unsatis-
3. Abdominal Buy Ciprofloxacin Uk Section. — I.yle's paper is based on a
series of fifty consecutive cases of abdominal section.
.\ttention to the following points is necessary to secure
good results: i. A correct preliminary Ciprofloxacin Online Pharmacy diagnosis. 2.
Simplicity in operative technique. 3. The simplest anti-
septic preparations combined with asepsis. 4. The use
of few surgical instruments and appliances. 5. Limited
August 25, 1906.]
abdominal incisions. 6. The correct adjustment of all
cut peritoneal surfaces. 7. The complete closure of
the abdominal cavity without drainage of any kind. 8.
The free use of normal saline solution in cases where
purulent material gets accidentally spilled in the pel-
vis or abdomen during the performance of an oper»
August 4, ipo6.
1. The Pathology — Past and Present — of Skin Diseases,
2. Removal of a Cerebral Tumor (Endothelioma) Which

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