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fit, and the conclusion was reached, in February last, that oophorectomy offered the only means of giving relief The operation was rendered difficult by the shortness of the pedicle. The left Fallopian tube was removed with the ovary ; the Fallopian tube on the right side was allowed to remain. The patient recov- ered, all pain was relieved, and she had gained nineteen pounds in weight in two months. One of the cysts of the right ovary burst during its removal. Dr. Bal- leray was unable to explain the connection between the symptoms and the con- dition of the ovaries. In no one of the several cases at which he had assisted in removing the ovaries had pain been so severe a symptom as in this one. Dr. MuNcfi also presented for Dr. Balleray a specimen of polypus of the blad- der from a child two years of age. Elephantiasis of the Vulva. — This specimen was presented by Dr. MuNnf;, who had removed it from a cheap zithromax online colored woman at Mt. Sinai Hospital ten days be- fore. She was twenty-four years of age, had been married seven years, and had had four children and one miscarriage. Six years and a half ago, when about four months pregnant with her first child, she first noticed an enlargement of the whole supra-vulvar region. It increased in size until confinement, after which it disappeared gradually but entirely. After two years it returned, while she was carrying order zithromax online uk her second child, this time remaining until it was removed. It annoyed her chiefly because of two ulcerations which formed upon it, and made her anxious to have it removed. Her physician suspected epithelioma, but the patient's history and general condition did not sustain this opinion. Feeling certain that it was an elephantiasis of the vulva. Dr. order zithromax online no prescription Munde recommended its removal, which was done by first passing three long needles underneath the growth, and drawing au elastic ligature tightly under them, encircling the tu- mor. By this means hsemorrhage was controlled while the tumor was removed. About a dozen arteries spurted and were tied, some of the ligatures being turned downward, and others upward, thus avoiding a large canal in the center, and obtaining better union by first intention. When the elastic ligature was loosened the first gush of blood was considerable, especially from a large artery order zithromax over the counter and vein near the clitoris. Union seemed to have taken place throughout by first inten- tion, but as the ligatures generic zithromax cheap had been passed deep they had not yet come away- Ee had not seen this method of operating with a view to the prevention of loss of generic zithromax z pack blood mentioned in the literature of the subject. The usual method of oper- ating was by the cautery wire, but the healing i)rocees afterward was very tedious. Schroder some years ago operated in a manner somewliat similar, passing deep sutures from below upward as the operation was proceeded with, and thus arresting hajmorrhage. Union, however, did not take place by first intention, and for the reason, probably, that the tumors were of a syphilitic NEW YORK OBSTETRICAL SOCIETY. 523 nature, which was not true in this case. He understood Dr. Foster had em- ployed Schroder's method with success. An interesting feature of this case was the over-excitement of the sexual passion, which made the patient's hus- band also desirous of having something done for her relief. Dr. Foster stated that in the case referred, to by Dr. Mund6 he tried Schro- der's method, but found it impracticable to introduce the sutures on account of the great gaping of the wound from tension. Dr. T, A. Emmet remarked that he had removed such a tumor, weighing over two pounds, by first passing silver-wire sutures entirely behind it, and twisting them as fast as the incisions were made, thus controlling hajmorrhage. Dr. M. A. Fallen said that he had removed a large thrombus, which had existed sixteen months, by passing a double silk suture, or safe order zithromax online cobbler's stitch, deep behind the growth, and afterward dissecting the generic zithromax 250mg tumor buy cheap zithromax online off, without occa- sioning any hfemorrhage. He recommended it in a paper, at the time, as the best means of dealing with such tumors when they interfered with the expulsion of the child, or obstructed the order zithromax canada orifice of the vulva. The President remarked that in certain cases of very large condylomatous masses on the vulva, in patients at Charity Hospital, the haemorrhage, on remov- ing them with the scissors, was very great, in one instance nearly proving fatal. To avoid this trouble the elastic ligature had been used a few times, and the re- sult had been all that could be desired. The Relation of the Pelvic Viscera at the Full Term of Preonanct. — Dr. W. M. Polk presented a specimen illustrating certain investigations which he had been making with regard to the operation of gastro-elytrotomy. It had been removed from a woman who had died recently at full term from placenta prasvia, and consisted of the pelvis and its contents, arranged as they were when he performed gaetro-elytrotomy upon the dead subject. His principal object was to show that the peritonfBum at this time did not dip so low down into the pelvis as in the non-pregnant state, but was lifted up by the development of the gravid uterus, so that it scarcely descended below the pelvic brim in any degree, and could easily be raised so as to allow of the extraction of the child below it. It was also order zithromax for chlamydia shown that the generic zithromax z pak ovarian vessels and the round ligament could be pushed aside out of the operator's way without injury. Indeed, if the round ligament were divided, it would probably be of but little consequence. The ureter was not in the way, being below the pelvic brim at the side. He was also able to demonstrate the complete manner in which a thorough vaginal tam- pon would control hasmorrhago in cases of placenta pnevia. Operation for Procidentia generic zithromax 500mg Uteri. — The question of the treatment of pro- lapsus of the uterus by Le Fort's method having been discussed at the last meet- ing. Dr. Fallen wished to demonstrate by drawings his method of operating for the relief of this condition, and also of all degrees of laceration of the perinieura. He had employed it with success during the past nine years in sixty cases of laceration down to the sphincter, in three of rupture through the sphincter into the rectum, and in nine of complete procidentia of the uterus. Of two patients belonging to the latter class, one was sixty-three and the other seventy-four years of age, and the operations generic zithromax no prescription were done under unfavorable circumstances, in the amphitheatre of the university, whence the patients were removed to cheap zithromax their homes in the city, but the results were eminently successful. On eitlicr side of the vulva a flap incision was made, embracing the transverse generic zithromax (azithromycin) perineal skin, wiiich was dissected up ; and, instead of being entirely removed, as in the common 524 PROCEEDINGS OF SOCIETIES. operation, the flaps were so folded, raw surface to raw surface, as to make a shelf on the anterior wall of tlje vagina, upon which the uterus rested, and at the same can you order zithromax online time serving the purpose of thickening and strengthening the perineal body. Fine silk sutures were generic zithromax price used for the flap, which cut out upon the vaginal

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