Viagra Pill Bangalore | Generic Viagra Is | Best Pharmacy













































mal condition it would not bear high pressure. But it was frequently diseased, and weaker in some places than in others. Therefore he had long ago given up using the whole length of the fountain syringe, but used viagra pill bangalore pressure of only afoot or two fall. With the baby on its belly, the hips raised, chloroform anaesthesia, that amount of pressure would suffice. He had always ad \ ised the use of opiates immediately after reduction in order to keep the bowel absolutely quiet and pre- vent recurrence. Improved Statistics Due to Earlier Interference. Dr. B. F. Curtis said that according to some sta- tistics which he had collected in 1887 he had found the mortality-rate from operations in intussusception on both infants and adults to be seventy-six per cent. These statistics, with some which he had collected since, gave a mortality-rate of fifty-eight per cent., which showed a very great improvement. He sup- posed there had been still further improvement, but he doubted whether viagra pill bangalore the generic viagra is mortality-rate had yet fallen as low as twenty-two per cent, as stated by Dr. Wig- gin. Probably few of us would be able to save more than one child in three in view of the late hour at which we were usually called to the case. He thought the improvement noted was due to operating at an earlier period more than to any improvement in oper- ative technique during the past few years, for abdom- inal surgery had now been at a high standard for some time. Dr. Wiggin's comparison of the cases to those generic viagra is ol hernia was a just one. the lighter or reducible cases being likened to cases of reducible hernia, the worst cases to those of strangulated hernia. The general practitioner should not be refused the privilege of early reducing a hernia, but in doing so he should remember that he was dealing with a viagra pill bangalore surgical case. In generic viagra is intussusception, as in appendicitis, the physician and surgeon should generic viagra is come together as early as possible, for if the surgeon were viagra pill bangalore permitted to see the generic viagra is case in the beginning he would be able to form a better judgment as to an operation. It might be possible at the begin- generic viagra is ning to determine whether the case were reducible or irreducible. Where there was acute collapse, there should be no viagra pill bangalore delay in operating. On the other hand, if the case developed slowly, rectal injections might be tried. Regarding relapses, even operative interference did not insure against this, for a number of cases were on record where relapse had occurred after laparotomy, in some within a few hours. Hence Dr. Senn had sug- gested stitching the folds of the mesentery together in such a way as to prevent intussusception of this por- tion of the bowel. Dr. Curtis thought that if injec- tions would succeed at all, they would succeed early. If they had generic viagra is to be repeated, it was an indication for operation. He thought a fountain syringe ought to be used, and with an elevation of water of generic viagra is not more than three feet, which was two viagra pill bangalore feet less than what he had formerly thought was permissible. The operation should be clone as speedily as possi- ble. A large opening was not necessary. One suffi- cient to admit two fingers, generic viagra is or three at most, would enable the operator to make reduction within the ab- dominal cavity. All unnecessary interference should be avoided. He would advise against resection, espe- cially that by use of suture. Intussusception generic viagra is Becoming Less Fatal. Dr. J. Lewis Smith thought that during the past twelve years intestinal intussusception had become less fatal than formerly. Twenty-five years ago it was unusual to be called to a case which had not been rendered worse by administration of purgatives at the hands of the par- ents and physician. He mentioned a case in which a distinguished physician had given half an ounce of quicksilver to a child with a foot of the bowel protrud- ing from the anus. An early diagnosis was extremely important and could usually be made. One ought to be able to dif- ferentiate between dysentery and intussusception with- in two days at most. In intussusception, after a few hours there was no discharge of fecal matter, but of mucus and blood, with tenesmus. Earlier diagnosis and omission of purgatives would account for the diminished mortality in the last few years. For dis- tention, water was to be preferred to gases. Where peritonitis had spread from the region of the tumor, operation offered little hope. Does Colicky Pain Mean Intussusception? Dr. Richard Van Santvoorp remarked that any one who had made many autopsies on infants must know how frequently small invaginations of the intestine were present. It had been the custom to attribute these to the death agony, but on what ground was not plain. Perhaps it was Treves who had suggested that ordi- nary colicky pains were due to intussusceptions of the small intestine which came and went. While this was difficult to prove, it had the practical bearing that when one met a case of diarrhoea with colic it was de- sirable to control it. Dr. Wiggin closed the discussion. His objection to the use of opium was that if the intussusception had not been entirely reduced it would cover up the symp- toms for a number of hours. If it were given in small doses it would, according to Nothnagel, increase the intestinal peristalsis and thus do harm. The cases cited in his paper had shown the importance of early treatment, for the mortality both from enemata and January 18, 1896] MEDICAL RECORD. 101 from laparotomy had been much higher when there had been procrastination beyond the forty-fourth hour.