With reference to the presence of ascites, which existed in the cases men-
tioned by Dr. Garrigues and Dr. Polk, starting allopurinol Dr. Pallex said he had seen one case of
epithelioma and another of sarcoma of both ovaries in which it was absent. In
the latter case, he at first diagnosticated marked general chronic pelvic cellulitis,
there being very considerable induration ; his opinion was not changed even
when cancer of the stomach apparently developed. Dr. Thomas and Dr. Sands
then saw the patient again, and diagnosticated carcinoma of the uterus, with gen-
eral infiltration. The patient was under observation thirteen months, and died.
Dr. "Welch made the post-mortem, when the disease was found to be sarcoma ot
the ovaries, which were excessively hard, and crowded the healthy uterus firmly
down into the pelvic cavity ; hence the error in diagnosis. The other patient
was under observation five or six years, and was finally persuaded to be operated
upon for cyst of the left ovary. The cyst was removed by Dr. Fallen, but there
were also epitheliomatous disease of this ovary and a cysto-sarcoma of the right
one. In cost of allopurinol neither case, as stated, was there ascites.
The President remarked that elongation of the uterus as a diagnostic sign in
certain cases of pelvic tumors was found practically to allopurinol brand name be of little value.
Dr. Mund6 remarked, with regard to the relative position of the uterus in
cases of large abdominal tumor, that, if it was posterior to the tumor he believed
the growth was usually ovarian allopurinol online ; otherwise, a tumor springing from the uterus.
Dr. GAEEiauES had seen a number of cases of ovarian tumors in which the
uterus was enlarged. It was true that usually sarcoma of the ovary developed
iV^TT YORK OBSTETRICAL SOCIETY. 283
so rapidly that there was no time for increase in the size of the uterus. But it
must not be forgotten that the disease not infrequently originated in a fibroma,
which, as was well known, was of slow growth. lie thought the patient whose
case he had narrated might have recovered had she been operated upon seven
The TopoGEAPny of the Vesico-uterixe Peritoneal Reflexion. — Dr.
Polk said we were taught in the text-books that allopurinol tablets 100mg the peritonasum did not de-
scend below the internal os upon the anterior surface of the uterus. This was
true in the ordinary position of the pelvic viscera, but, as shown by a specimen
that he now presented, if the bladder were empty, and the uterus displaced up-
ward, as occurred in certain normal and abnormal conditions, the peritoneal fold
dipped lower upon the cervix, and might be injured in incisions below the in-
Henry J. Gaeeigites, M. D.,
B. F. Dawson, M. D.,
Feank p. Foster, M. D., ex-officio..
Committee on Piiblication.
A STATED meeting was held May 16, 1882, Dr. Charles C. Lee, President, in
Battet's Opeeation. — The case was related by Dr. B.Mo E. Emmet. The
patient was forty-six years of age, and had been under his observation four years.
From the time of her marriage, at the age of seventeen years, there had been a
constant metrorrhagia. Once a uterine polypus allopurinol 150 mg was removed, but the symptoms
continued. She had consulted a number of physicians, but they refused to oper-
ate, although it was evident they suspected the presence of some uterine tumor.
Constant expulsive pains, which caused much allopurinol iv suflfering, seemed to have no effect
upon the growth. When Dr. Emmet saw her allopurinol 20 mg he discovered, on dilating the
canal, a neoplasm spread generally over the fundus. The treatment allopurinol uk could only
be palliative. After a year she returned, but the tumor, though it had assumed
more definite shape, could not yet be removed. She returned again, suffering
greatly. The tumor was now on the anterior wall, near the internal os. As she
had not borne children, the cervix was small, so Dr. Emmet divided it posteri-
orly, hoping thereby to allopurinol brand names render the expulsive pains more effectual, and to be
enabled to seize the growth with allopurinol pharmacology an instrument and extract it. This also was
unsuccessful, and considerable hssmorrhage took place, which was checked with
a silver-wire stitch passed around the divided vessel. Peritonitis developed, and
ran allopurinol cost a severe course, but was finally controlled by the cold douche, on Kibbie's
cot. She returned again, to submit to the operation of oophorectomy, by which
it was hoped to end her troubles by bringing on the menopause. On Thursday
last the operation was performed, both ovaries with brand name for allopurinol the tubes being removed.
The abdominal walls were very thick, and considerable difficulty was encoun-
tered in placing the ligatures. Violent peritonitis ensued, the temperature rose
to 104-4° F., but was reduced and kept down to 100°-101° by means of ice-cold
water passed through the coiled rubber tubing. The fifth day had now passed,
and the patient's chances of recovery were very good. There had been no flow
whatever since the operation. Dr. Emmet would call special attention to the
use of what is allopurinol 300 mg the rubber coil in reducing temperature, as being very effectual and con-
venient, and not depreciating the vitality of the patient by unnecessarily chilling
the surface without lowering order allopurinol the temperature, as occurred in some degree in the
284 PROCEEDINGS OF SOCIETIES.
use of the douche. The tubing might be applied to any part — the head, the ab-
domen, or the thighs.
The President remarked that a European modification of Dr. Cliamberlain's
method of controlling the temperature by means of coiled tubing had, incorpo-
rated with it, two thermometers — one in the vessel containing the fluid, the other
to come in contact with the surface of the body, from which the temperature
could be read at any moment.
Dr. W. M. Polk had obtained very satisfactory results from the tubing coiled
round the patient's body during the first stage of pneumonia.
Dr. P. buy allopurinol online F. MuNDE had been accustomed to apply cold in the first stage of
peritonitis, and heat allopurinol generic name in the latter (when exudation had taken place), but it allopurinol 50 mg was
difScult to tell when the cold applications should cease and the hot ones be
begun. He would say that generally after forty-eight hours it was proper to
make a allopurinol rxlist change from cold to hot.
Dr. Emmet remarked that he applied cold in this case not as a curative agent
for the peritonitis, but to control excessive temperature, by which the patient's
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