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
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
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
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