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375 and require treatment. 3. If there is enlargement and tenderness of the uterus, and difficulty in immediate replacement, treatment for the purpose of reducing con- gestion should be instituted. Similar treatment should be Cytoxan Oral adopted in cases in which there is prolapse of the ovaries. 4. If there are well marked symptoms of neurosis the case should be carefully Taxotere And Cytoxan considered to de- termine the influence of the local condition in produc- ing them. The treatment of such cases is more or less experimental. 5. If the uterus is bound down by ad- hesions persistence of symptoms will justify an opdta- tion for their removal, and for the release of the uterus. 6. Ventral fixation of the uterus and similar operations are indicated in only a minority of cases. The risks Cytoxan And Taxotere cases in which Adriamycin And Cytoxan the organ has left its normal site, has become attached by adhesions in some other loca- tion, Cytoxan And Adriamycin and has again lost its mobility. The most im- portant changes in the organ from an setiological standpoint are enlargement, relaxation of the splenic ligaments, and trauma. A movable spleen is some- times mistaken for hydronephrosis, or for a tumor of Cytoxan And the pelvic organs, and must be carefully dififerentiated from Cyclophosphamide Cytoxan these. The treatment may be splenectomy or splenopexy. The former yields a permanent cure, the latter is subiect to recurrence, which has been re- corded in a number of instances. 7. Fons et Origo Mali Maris. — Lund, after review- ing the various causes of sea sickness, concludes that : I. The vomiting is not due to the unusual Taxotere Cytoxan impression of vision, for it may occur on land, when the eyes arc closed, and even to the blind. 2. It is not due to smell. Any_ unpleasant odor may cause vomiting, and may oc- cur on land, and to any, including deaf mutes, who have sensitive /lasal organs. 3. It is not due to momen- tary displacement of viscera, for it occurs in swinging, or in descending Buy Cytoxan Online upon an elevator. The sensation is present whether the eyes are open or closed, but it (\rin^ not occur in deaf mutes. 4. There is some mech- anism in the auditory organ, perhaps the .system of Cytoxan Cyclophosphamide semicircular canals, which is directly affected by the oscillations of a vessel at sea, which acts as a stimulant to the vomiting centre. The sensation in the ears is synchronous with that in the epigastrium and may be due to change in Cytoxan Generic the Order Cytoxan equilibrium Cytoxan Adriamycin of the endo- lymph in the semicircular canals. The treatment con- sists mainly in lowering the sensibility or conductivity of the different Cytoxan Tablets nerves or Oral Cytoxan in benumbing the vomiting centre by narcotic drugs. 9. Treatment of Suppurative Peritonitis. — Upcott thinks the consensus of opinion nt the present time favors the early removal of the cause of peri- toneal inflammation with as little injury and handling of the tissues as possible, and with no attempt to cleanse the peritoneal cavity. The operative procedure, with especial reference to peritonitis associated with acute appendicitis, consists in removal of the appendix, cleansing of the appendiceal site, and irrigation of the pelvis and lower abdomen by means of a return flow caninila. The pcriton.Tum may usually be closed with- out complete removal of the valine irrigation fluid. The external wound to the pcriton.x'uni should usually he drained, as it is usually infected, flastric lavage is often desirable before the patient is removed from the operating table, .^n ounce or two of a caturnted .solu- tion of F.psom salts may be introduccrl through the stomach tube, and left in the stomach. Morphine should he avoided if possible. Rectal saline irrigation mav be used Cytoxan Taxotere every six or eight hours for two days. Fowler's position does not greatly influence the drain- age of peritoneal secretions. Uroceetrhtgs ai Sanctics. AMERICAN SURGICAL ASSOCIATION. Tzventy-eighth Annual Meeting, held in IVashingtonj on May 7, 8, and 9, 1907. The President, Dr. Dudley P. Allan, of Cleveland, OJiio, in the Chair. (Continued from page Iv Cytoxan 330.) Rupture of the Spleen. — Dr. Ellsworth Elliot, Jr., of New York, reported three cases. He said that the treatment by splenectomy was the best A lacera- tion might be overlooked. Packing did not always check bleeding, especially where the vessels! were torn. Where the diagnosis was clear the incision should be made along the right rectus muscle, from which a transverse one was carried along the left costal border.

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