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coroner's surgeon, district of COLUMBIA; ATTENDING PHY- SICIAN, WASHINGTON CITY ORPHAN ASYLUM, ETC. On December 19, 1905, at 10 a. m., A. H. H., 14 months of age, while playing with several other children around a room, was noticed by the attend- ant as being ill. The child was markedly cyanotic Order Ditropan Online and was having a severe rigor. She was at once taken from the floor, and it was noted that the child cried with pain on motion. The nurse at once administered ten drops of whiskey in water ; in a few minutes the patient was comfortable, falling off to sleep in the nurse's lap. At that time the child was still pale and was breathing rapidly. The patient was put to bed and rested quietly until 12 Buy Cheap Oxybutynin m. At that hour the child awoke, crying with pain, which appeared to be situated in the lower right chest. Pallor was still marked, with short rapid breathing. At that time the nurse realized that the child was very ill, and suspecting pneumonia, tele- phoned for me. As I was engaged with another case Dr. E. L. Mason was called. He arrived about I p. m. At that time the child was Order Oxybutynin Online in a semicomatose condition, with all the objective symptoms of pneu- monia. I arrived a few minutes later and noted the same general appearance of the patient ; before I was able to examine the patient, the little one died. Upon inspection and percussion I could Ditropan Online make out nothing abnormal. Previous History. — Father and mother appar- ently healthy people ; several other young children. .Six months before Purchase Oxybutynin Online father had died of some acute disease. The mother was unable to care for this Buy Cheap Ditropan young child and secured its admission into the Wash- ington City Orphan Asylum. Upon admission, the child was found to be in a healthy condition, and subsequently showed no ill effects of bottle feeding The mother of the child, since her husband's death, had worn crape. As already stated, Buy Ditropan Online the child thrived upon the change of diet. At times, however, since its admission, it had had attacks of Order Ditropan " wind colic,'' which had promptly responded to ordinary home remedies. My attention had never been called to this patient, until its last illness. A'ccropsy. — December 20, 1904. Rigor mortis slight. General appearance, anaemic. Nutrition fair. Abdomen not distended. As soon as abdomen was opened, my attention was called to the picture that presented itself. The large omentum, fan shaped, was seen to be adherent to the vermiform appendix, midway between the cascum and its tip. This anastomosis was very firm, and appeared to be of several months' duration. As a result of some contraction of the omentum, the appendix had been drawn upwards ; at the apex, the omental adhesion was found. The distal end of the appendix was free and not adherent. The Cheap Ditropan only evidence of ad- hesions was at the omental attachment mentioned. To Purchase Ditropan the left and posterior Purchase Ditropan Online to this point about one drachm of green pus was found, which was escap- ing from a small perforation of the appendix. The * Specimen and paper presented to Buy Oxybutynin the Clinico-Pathological Society. 484 VON RUCK: CLASSIFICATION OF PULMONARY TUBERCULOSIS. MsBurnzyi Purchase Oxybutynin point appendix was then removed with a portion of the fan shaped omentum. The other organs were found to be in a normal Generic Oxybutynin condition ; the lungs in no way involved. The re- Order Oxybutynin moved specimen was then carefully examined. A small round mass, about the size of a number 8 bird shot, and of Buy Oxybutynin Online the same Oxybutynin Online consistence was felt three eighths of an inch above the tip of the appendix. Upon opening the appendix, I found this object to be Buy Ditropan the round head of an ordinary black mourn- ing pin: at the omental attachment, where the rupture had been noted, I found the point of the pin (A). Immediately around the seat of the rup- ture, the parts were gangrenous. The accompany- ing drawing is of about the size of the specimen removed. Besides the interesting features of this unique specimen, there are Generic Ditropan several other points which may be of interest. The mother of the child was disposed to blame the institution for the condition found. Upon in- quin- I found that no attendant at the institution was perrnitted to wear black, and that no black pins were ever used, especially the round head, mourn-

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