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Neither did he think that pleurectomy should be thought of until Schede's operation has been done. Extra-Uterine Pregnancy. Dr. Howard Kellv, of Baltimore, spoke at some length of his new method of treating this affection, and mentioned the excellent results he had obtained. He spoke of several causes for error, not only in the diagnosis but in the treat- ment. Among other experiences he mentioned the fact that he had opened dermoid cysts, pelvic abscess- es, and small ovarian cysts, all of which he had mis- taken for extra-uterine pregnancies. All of these he evacuated through the vagina. If there is a large pel- vic ha-matocele and it is opened from below and then the sac is evacuated, it will very rarely be necessary to open the abdomen. Dr. Ni< hoi \^ Si \\, of Chicago, said that for once hi. Kelly and himself agreed thoroughly. Dr. KELLY, in closing the discussion, advised all to look out for the rectum, and also to be verv careful to keep clear of the uterine artery and the ureters. SECTION ON OBSTETRICS AND DISEASES OF WOMEN. J. Taber Johnson, M.D., of Washington, D. C, Chairman. First Day Tuesday, May jf/i. Address of the Chairman Dr. J. Taber Johnson, of Washington, in buy viagra member his address briefly reviewed the progress of the past year in obstetrics and gynecol He called attention to the fact that the treatment of puerperal infection has become much simplified, and now buy viagra member amounts practically to absolute cleanliness; that as few examinations as possible should be made, and that douches should not be used when there is no- rise of temperature. For the purposes of exploration in buy viagra member suspected retention of morbific material the index buy viagra member finger is the best instrument; the curette is con- demned by many authors. Hysterectomy is val- uable in selected cases, but is useless where the in- fection had spread beyond the uterus. Symphyseotomy, he said, has been revived as a sub- stitute for Cesarean section and craniotomy, but in his experience so much injury to the tissues has often oc- curred and unpleasant sequelaa have followed, that it is a question whether Cesarean section, with the present methods of operation, is not preferable. In regard to placenta praevia nothing new has been brought for- ward except the proposition to do Caesarean section. But the diagnosis is not generally made until hemor- rhage occurs, and then it is buy viagra member the duty of the physi- cian to save the mother. Where the hemorrhage buy viagra member is slight and the os undilated, the tampon can be used. After dilatation of the os, the child's leg can be brought down to act as a tampon and the progress of labor watched. He condemned the rapid extraction of the child. One case of puerperal diphtheria has been re- ported by buy viagra member Nisso and successfully treated by antitoxin. The discussion of the treatment of uterine dis- placements has buy viagra university been quite general, and the advocates of Alexander's operation, ventral and vaginal fixation, have presented their claims, but the question of supe- riority is still unsettled. The same is true in re- gard to the vaginal and abdominal operations for the removal of tumors, etc. Great improvement in the methods buy viagra university for the removal of fibroid tumors has taken place and the mortality has been reduced from eighty per cent, to ten per cent. There has also been great improvement buy viagra university in the buy viagra university technique of operating, and the direct transfusion into the tissues of considerable quantities of the normal saline solution has doubtless saved many lives. He hoped the coming year would see great improve- ments in the administration of anaesthetics, and that the application of the Roentgen rays would clear up many doubtful points of diagnosis. A Note on Cervical Stenosis as a Factor in Pel- vic and Uterine Disease. Dr. Henry P. Newman, of Chicago, said that twenty years ago stenosis of the cervical canal was thought to be very buy viagra university common, and the operations and instruments devised for its relief had made buy viagra university the reputations of the gynecologists of that day. Now it is even denied that such a condition exists. That is going too far, since it is not a rare condition; but it is doubtful if it ever is congenital. In the opinion of the author the buy viagra university condition is genei- ally due to a persistence of the normal natal type, due to improper hygienic condition and management at the time of puberty. He wished, therefore, to put in a plea, not for the treatment of the condition when it exists, but for the prevention of its occurrence and the consequent ster- ility and disorders of menstruation which lead to en- dometritis, metritis, salpingitis, and the nervous phe- nomena associated with these diseases. While there is tendency in some directions to give girls the same opportunity to develop that boys have, yet the condi- tions found in our public schools and in the factories and stores where growing girls are employed all tend to retard the development of the generative organs and produce this condition of stenosis. It is the duty of the profession to recognize this, and labor for the prevention of this trouble buy viagra member by insisting on a better hvgiene. How to Remove Pus Tubes without Rupture. May 1 6, 1S96] MEDICAL RECORD.