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was seen March 10th, with Dr. Charles Milne. ■ The fourth case also was one of placenta prsevia centralis, and a dead child was extracted by version. Coupon For Alli One week after delivery, March 19th, the patient was seen with Dr. Ilerschel, of Harlem. The uterine mucous membrane was immensely hypertrophied, there was Alli Canada a very foul discharge, the temperature was 104-5°, and the pulse Avas 140. Death took place forty-eight Alli In Canada hours later, of septic hyperplastic endometritis. z==T\\Q fifth case, also seen Avith Dr. Ilorton, occurred three weeks ago. Before Dr. Mund6's arrival Dr. Thomas was sent for, but Dr. Mund6 reached the patient first. This was on Monday, March 27th, at 11.30 a. m. She had mis- iWS'TF YORK OBSTETRICAL SOCIETY. 281 carried forty hours before, and tlie placenta had not come away. Twenty-four hours after the miscarriage she had a marked chill, and twelve hours later an- other, much more severe, which lasted an hour. She then passed into a state Alli On Sale of almost complete coma. In this cdndition Dr. Munde found her, with a tempera- ture of 105"25° in the vagina, and the pulse 150. There was no oftensive dis- charge whatever from the vagina, and he thought it too early Alli Price for septicfemia to have been developed, although possibly it might have been the case. She had been in a malarial district, had been feeling poorly, and had received anti-ma- larial treatment. lie gave her twenty grains of quinine, intending to return and remove the placenta in the afternoon, but Dr. Thomas, coming in in the mean time, pronounced the case one of acute septicemia, and advised the immediate removal of the placenta. This was done, and the uterus was washed out Coupon Alli with a Alli Shop carbolized sohition. In the afternoon the temperature went down to 102-5°, and the pulse also fell. Considerable quinine was given, but the temperature con- tinued high, and", after twenty-four hours, salicylate of sodium was substituted, to the extent of eighty grains in eighteen hours, after which she began to improve. On the second day after the removal of the placenta the right hand and wrist began to swell, precisely as in the second case, and were very painful. Dr. Munde considered this to be evidence of septic absorption. The patient was very much collapsed, and at times seemed delirious. Dr. Barker then saw her, and, as she had redness, swelling, and pain about the wrist, thought her symp- toms due to rheumatism and to malarial fever in connection with the puerperal state, but detected no evidence of septicaamia. He suggested the use of bromide of potassium, with a continuance of the salicylate of sodium. The patient con- tinued to improve, and was now rapidly recovering. About ten days after the swelling appeared in the wrist, it was opened, and pus escaped. Di*. Munde asked : Was this a case of puerperal septictemia, or one of malarial fever occur- ring after a miscarriage? He inclined to the former view, although admitting the possibility of malarial complication. Alli On Line =^ The sixth case was seen March 31st with Dr. Eodenstein, who had attended the Alli Uk patient in labor the day before. Her temperature was 105*25° in the vagina, and her pulse 120 to 130. Her gen- eral appearance was very good, but, as she had lived where there Alli Prices was malaria, she was given twenty grains of quinine, with the understanding that, if she were not benefited, salicylate of Alli Coupon sodium should be tried the next day. On the follow- ing day the fever had entirely subsided, and she made a good recovery. Evi- dently tliis was a case of puerperal malarial fever. Henet J. Gaeeigdes, M. D., B. F. Dawson, M. D., Feank p. Fostee, M. D., ex-officio, Committee on Puhlkation. A stated meeting was Coupons For Alli held May 2, 1882, Dr. Craeles C. Lee, President, in the chair. Modification of Goocii's Cannula. — The instrument, presented by Dr. A. J. C. Skene, was larger than the original, curved, and adapted to the api)licatiou of the ligature, wire, or chain. Elliot's Repositoe combined with a Cijeette. — This instrument was also presented by Dr. Skene. By turning a screw at the external end the Alli Ireland uterine curve could be made groat or small, or be reversed, and adapted Price Of Alli to curetting every part of the canal without withdrawing or turning the instrument. Being 282 PROCEEDINGS OF SOCIETIES. quite flexible, no injury could result. Dr. Skene wished again to state Alli Cost his pref- erence for the 6craseur in the Alli Sale removal of uterine polypi. It had been objected that it was more likely to include a portion of the uterine wall than the galvanic- cautery wire was. He considered this idea contrary to experience and to the laws of mechanics. The danger of hemorrhage was trifling ; the wounded sur- face healed readily. Alli Coupons Dr. M. A. Fallen remarked that he had assisted in removing a polypus from the uterus with the 6craseur, and with it came a portion of the uterine wall as large as a half-dollar, as was proved by a post-mortem examination at which the late Dr. Hodgen was present. Dr. Skexe thought the same accident would have occurred in that case, what- ever instrument had been employed, for doubtless there was partial inversion of the uterus at the attachment of the tumor. Ctsto-Saecoma of the Uterus (?). — Dr. H. J. Gaebigxtes presented the specimen, accompanied by a written history. [See the August number of the journal, p. 139.] Dr. C. S. Ward thought the question Alli 120 of diagnosis in this case was an interest- ing one. One would hardly expect so great depth of the uterine canal in Alli For Sale a case of purely ovarian sarcoma ; would this not suggest that the growth began in the uterus ? Dr. "W. M. Polk asked what the usual depth of the uterine canal was in cases of ovarian sarcoma. It measured between three and three quarters and four inches in a'case in which he had recently made an autopsy. The growth did not involve the uterus in the least. Dr. P. r. MxTNot had read an article which stated that in tumors of the ovary with short pedicles the uterus (and, of course, its cavity) might be found elon- gated. As a rule, however, elongation of this canal indicated a tumor of the uterus itself.

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