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hours. She was twenty-two years of age, had always Cheap Bupropion been healthy, was mar- ried at seventeen. One year later she was normally delivered of a healthy child, and she was now pregnant for the second time. Five hours after la- bor began the waters had come away, two hours later the head presented, and 314 MONTHLY REPORT ON then tlie pains became less frequent and of shorter duration. The abdomen was greatly Purchase Bupropion Online distended, and the slightest touch caused severe pain. The fundus uteri was felt just below the epigastrium, upon the right side. Just above the re- gion of the OS internum was a pro- jection — apparently the child's head. Upon the left lateral wall of the uterus a depression could be felt, and at this point the pain was very severe. No heart sounds could be detected. A dark-blue, blood-stained upper extrem- ity projected as far as the elbow joint from the vulva. The shoulder of the child was so firmly wedged into the pelvic outlet that the author could not pass his hand into the uterus. The woman bled freely at every attempt to move the foetus. The decision to turn and extract was made, as being safer than decapitation. The patient was Generic Bupropion anaBSthetized, and the foetus was re- moved without much difficulty, but the operation was followed by free haemor- Buy Bupron Sr rhage. The placenta was adherent over a portion of its area, but it was entirely removed. The rupture was found at the point indicated by the external examination, and was large enough to admit three fingers. A two- branched drainage-tube was placed in this rent, and a lukewarm one-per-ceut. solution of carbolic acid was injected into the uterus, until it came away only slightly tinged with blood. Oarbolized cotton was placed over the external genitals, and a bandage was applied, to be kept cool with applications of ice. The ordinary antiseptic precautions were carried out, and in thirty days the patient was able to sit up, and to have the drainage-tube removed. A month later she was quite well, the uterus had undergone involution, the OS was closed, and menstruation had taken place. The author praises the drainage theory as the cause of Order Bupropion the suc- cessful issue in this case, and advises in all similar cases turning and extrac- tion, to be followed by drainage, irri- gation, ice applications, and bandages to the genitals. 16. i)r. Hart recently read before the Edinburgh Obstetrical Society a note on a unique cause of delay in the third stage of labor. The author was called to assist at a case of labor delayed by hydrocephalus. U[)on arriving Bupropion Online at the patient's bedside, he found the body of the fcetus, Buy Bupropion Online a small one, born, and the arms down. The head was arrested at the brim. After perforation it was easily extracted. Shortly afterward the vagina was examined, but no placenta was found. Pressure upon the uterus failed to bring it forth. The patient was chloroformed, and the author passed his finger within the cervix. Guided by the navel-string, his fingers passed into a flaccid Buy Cheap Bupropion bag, upon the left side of the cervix, in which the placenta lay, and from which it was easily removed. The cause of this fiaccidity was attrib- uted Purchase Bupropion primarily to the right obliquity of the uterus, then to the uterine contrac- tions, which carried the enlarged head forcibly to the left, where it had lodged. 17. Dr. Wolczynski writes concern- ing adhesions of the placenta and Buy Bupropion mem- hranes. He says that Bupron Sr Tablets firm union of the membranes to the uterine walls is quite an extraordinary occurrence. He quotes Scanzoni as saying that he knows of no case of union by inflammatory adhesion of the membranes and uterus throughout. The author has seen a case where Order Bupropion Online such a condition of affairs

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