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eclamptic seizures. It could be given in doses of india viagra 100mg from ric t0 sir f a g ralrl every two or three hours through- out pregnancy, if necessary. In the case of a phy- sician's wife they had given seven hundred grains of nitroglycerin during the course of pregnancy, and she gave birth to her child without an eclamptic seizure, which she had not done in a former pregnancy. Her condition was one of chronic nephritis. It was their custom to let these patients bleed freely after the sec- ond stage of labor. Speaking of the next class, the mere presence of al- bumin and casts, india viagra 100mg or occurrence of constitutional symp- toms during the course of. pregnancy, should lead the physician to put the patient to bed at once and stimu- late every emunctory to action and rid the system of poisonous substances supposed to be circulating in the blood. Catharsis should be produced with calomel and jalap, followed by a saline; or a satur- ated solution of salines might be given per rectum, or even hypodermically. A hot bath, the tub covered with a blanket may be followed with sweet spirits of nitre. They were absolutely opposed to jaborandi and pilocarpine. A milk diet should be generic viagra asia given, and as much water as the generic viagra asia patient would drink. They ab- stained from the use of potash salts because they were cardiac depressants. Digitalis was objected to in acute but not in chronic kidney cases. They objected to the use of the tincture of chloride of iron. Of value india viagra 100mg were caffeine, one to five grains; nitroglycerin, sul- phate of sparteine, nitrites, chloral. They questioned the value of veratrum viride in cases in which it had been supposed to be of use. Under those conditions surgical measures would answer better. After labor, however, if the pulse were full and bounding, they ad- ministered veratrum. It should not be used in valvu- lar lesion, weak, dilated, or fatty heart. As to vene- section, if it were indicated, let it be from the uterus by emptying that organ. In acute toxaemia, where albumin and casts ap- peared in the urine, a true uraemia, nearly all malig- nant cases died. It was good treatment to empty the uterus at once. The Surgical Treatment of Eclampsia Dr. Eg- bert H. Grandin read this paper. Surgical treat- ment of eclampsia began where judicious medical treatment had been tested and failed to control the premonitory symptoms, or where the urgency of the symptoms did not admit of the institution of medical treatment. The indications for drugs had been pointed out in the previous paper. The aim of surgical treat- ment was to empty the uterus. Dr. Grandin impressed the point that one should give attention to the daily secretion of urine, the relative proportion of solids, even though albumin were absent. It was toxaemia which we should endeavor to forestall. When the patient had shown any of the classical symptoms of eclampsia, the uterus should be emptied. If already in the throes of india viagra 100mg eclampsia when seen, meas- ures of the most active type should be employed for emptying the uterus. Fortunately cases were seldom so urgent as to preclude sufficient preparatory meas- ures, for in emptying the uterus it should always be done with the care of a major surgical operation. The only method which he would resort to in non- urgent cases, because he considered it safe, effective, and aseptic, generic viagra asia was the following: The external genitalia and vagina having been rendered aseptic, the cervix was dilated sufficiently with steel dilators to permit of being packed with gauze up to the internal os. The upper vagina was filled firmly with gauze. After twenty-four or india viagra 100mg thirty-six hours the gauze was removed. Prior to the sixth month he found it preferable to in- troduce a second packing under absolute asepsis, for rarely after the first one was the cervix sufficiently softened to enable the finger to be utilized in conjunc- tion with the dull curette in bringing out the foetus. Under the third month, at the end of twenty-four hours, in the absence of pathological change in the cervix, under anasthesia, the finger aided by the dull india viagra 100mg curette could now absolutely india viagra 100mg empty the uterus. He did not consider the procedure properly performed un- less the finger was inserted to the fundus and the organ was completely emptied. After the third month and up to the sixth, dilatation was more difficult. The only risk was from hemorrhage, and this was fore- stalled by use of the uterine tamponade. Forceps above the brim should never be used unless version was contraindicated ; if used, it should be axis-traction forceps. The uterus being emptied the tamponade might be employed after sufficient bleeding had taken place. Many patients were benefited by this loss of blood to an extent which we little appreciated. If in- fection took place, the operator or attendant was to blame. In eclampsia, if there was no pathological obstruc- tion, it was generic viagra asia usually possible under surgical anaesthesia to empty india viagra 100mg the uterus by the method of manual dilata- tion alone within the space of forty-five minutes. In the mean india viagra 100mg time such remedies as the operator had faith in could be given -hypodermically, and, if needed, venesection by the uterine route could be resorted to. The only risk which rapid dilatation subjected the woman to was sepsis. There was no danger from hemorrhage, as experience had shown. Should rup- ture occur it india viagra 100mg could easily be repaired. In Dr. Grandin's experience, the symptoms abated after the uterus had been generic viagra asia emptied, except in fulminant cases, in which neither drugs nor surgical interference availed. Here, slow preliminary dilatation could india viagra 100mg not for a moment be thought of, but such cases were ex- tremely rare, and Diihrssen's incisions could be re- sorted to. The criticisms upon this formerly made by him he now considered not well founded, but the in- dications for Diihrssen's incisions, as stated, were rare. A third group of cases was that in which there was obstruction to the india viagra 100mg parturient tract by tumors, etc. Here the only course was by Ca-sarean section. 916