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doubted if the suprapubic route would have been bet- ter, as Differin Gel Buy the hemorrhage could not have been checked. The literature .shows nineteen cases of primary sarcoma of the prostate, not including the one now reported. There was no Differin And Acne Scars record Buy Differin Gel Online of a permanent cure. Prostatectomy. — Dr. .^RciiuiALD MacLaren. of St. I'aul, Minn., said that two books recently published, one by Yoimg and the other by Deaver, were excel- lent contributions to this subject, but each advised a ilifferent method. Murphy decided that both routes August 24, 1907.] BOOK NOTICES. Z77 were applicable in selected cases. Dr. MacLaren had used the suprapubic^ for years, and in Epiduo Vs Differin few cases had there been so much bleeding that packing had been necessary. The bad cases were best treated with a perineal drain, and he had made nied an perineal in- cisions recently. He found he could Buy Differin Gel 0.3 remove almost all in that manner. The difficult ones are Coupon For Differin Gel the hard, fibrous prostates. The enucleation had to be Differin Gel Generic done by the sense of touch alone. The greatest care was needed to prevent injury to the rectum, but by working from the inside of the capsule through the incision of the urethra the danger was slight. Rectal fistula was said to occur in eight per cent, of the cases. The mortal. ty Differin Xp Gel is said to be three to five per cent. Rectal incontinence was present in a small percentage. It was generally stated that the mortality of the suprapubic operation was twice as high Generic Differin Gel as that of the perineal, but Murphy said the mortality was the same. Young said an oper- ation for cancer of the prostate w'as undoubtedly the best thing to do. The neurotics needed careful treat- ment, and pure neurotics should not be operated upon. Gonorrhcea was not an important causative agent, as stricture was present in only eight of the 145 cases. Dr. C. L. GiBSO.v, of New York, had had one case of sarcoma of the prostate which had never been pub- lished. He removed the prostate jh toto. The patient died in Buy Differin Cream three weeks. When he first adopted Differin Adapalene Cream 0.1 this oper- ation he Where To Buy Differin Gel did elaborate d ssections, but now confined himself to perineal sections without suprapubic section. The operation lasted only a few minutes, and in his recent cases the average age Differin Oily Skin has been seventy-two Differin Lotion Coupon years, with no deaths. He had his patient up on the second day and out in a week. The operation required ten minutes or less. The Surgical Treatment of Cancer of the Head and Neck. — Dr. (Ieokc.e W. C'rii.e, of (.ileveland, Oliio, said that we could, by tubing the throat for anaesthesia, eliminate pneumonia and operate on a patient in any .position, and thereby prevent gravity abscess in the mediast num. There might be an immunity reaction in sarcoma, Differin Gel Online and animals bled had the least resistance, and therefore the less blood lost the best chance of recoverj'. He had practised transfusion of blood after operations to increase resistance and hasten convales- cence. He had seen no good results from the x ray in deep seated tumors, but had in superficial ones, and, acting upon this, he had left the wound wide open, that the x ray m ght be used in this way. The naked wound might be exposed each day until a reaction was shown, and then skin grafting employed. Perhaps the x ray had played an important part. High mortality followed the loss of the carotid ar- tery. Ligature of the external carotid increased the risk of cerebral embolsm two i)er cent. The jugular veins, one or both, might be excised without fear. The growth rather returned in the sheath of the artery. The sternoniastoid might be removed on one or both sides, and its loss is well compensated for and need not be seriously considered. The scar was little source of concern. Unilateral division of the vagus was attended only with hoarse- ness. Death followed double division. Unilateral ex- cision of the phrenic nerve produced loss of the power of Differin Canada less than one half of the diaphragm. Section of the hypoglossal on one side was safe, but on both sides was fatal. In 1900 he reached the conclusion that ojier- ations for cancer should be less frequent or far more radical. He had operated thirty t'nics since then, Order Differin Online and thirty-nine per cent, of Differin Vs Epiduo the patients had passed the three limit, while only fifteen per Differin For Acne Scars cent, passed that limit befr)rc i<)oo. The operative tcchiiicuie hati en- abled (he surgeon to reacii every part without loss of blood. The x ray was useful. The only tissue to be respected was the common or internal caret d, while the sternoniastoid might be disregarded. Unilateral incision of the phrenic, hypoglossal, or pneumogastric

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