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Richer, etc., all have some defect, and only Ouaine ( ? Quain) gives the proper directions for this in- cision. The chief difficulty in finding the vessel lies in the fact that the insertion of the sartorius, which serves as a landmark, is subject to variations. It is a common error to take the internal head of the quadriceps femoris for hydrochlorothiazide price the sartorius and thus the operator fails to find the artery. The author in- vestigated the anatomical relations of Hunter's canal in sixty cadavers, and came to the conclusion that the best method for this ligation is as follows : After the patient esidrix 25 mg has been placed in the proper position for the exposure of Hunter's canal, first find the sartorius. This is done by measuring a distance of thirteen cm. from the tubercle of the adductor muscle, a point which indicates where the sartorius muscle in the average person crosses the line of in- cision. The incision should be made from four to five cm. in length, on the right side from above downward to the point marked, and on the left side from this point downward. The incision is made along the line indicated by Ouaine, namely, one drawn from the middle point between the anterior superior spine and the symphysis, down to the tubercle of the great adductor muscle. This in- dicates the course of the femoral artery. By meas- uring thirteen cm. along this line we are able to find the sartorius, esidrix or zaroxolyn without which we cannot find the ar- tery. 2. Two Caesarean Sections in a Patient With Narrow Pelvis. — Orloft relates the case of a woman, aged twenty-seven years, who had an ab- solutely contracted pelvis due to rickets, which necessitated a Caesarean section in 1901, from which the patient recovered uneventfully. A second operation was performed in buy esidrix the same woman in 1904. The interesting feature in this case was, that the ovaries and tubes had been left intact during the first operation, at the special generic hydrochlorothiazide request of the pa- tient herself, in spite of the assurance that she could not bear children normally. Although in both operations the uterus was order hydrochlorothiazide online incised during the first stage of labor, there was a prompt and efficient con- traction of the uterine cheap hydrochlorothiazide vessels, and the loss of blood was not greater than during normal labor. The author thinks that the best rule hydrochlorothiazide mg as to the time when such operations should be undertaken is. that if the woman is otherwise healthy and there is no tuber- culosis or other imperative reason for hurrying, the section should be performed when true uterine con- tractions have begun, thus insuring an arrest of haemorrhage without much trouble. He believes that drainage into the vagina by means of a gauze strip is useless in these cases, and that it only fa- cilitates infection. 4. Sepsis in Infants. — Ostroffsky relates the case of an infant, buy hydrochlorothiazide online aged fourteen days, in whom hydrochlorothiazide cost he observed hydrochlorothiazide online the development of a septicaemia at the acme of which streptococci appeared in the blood. At the autopsy no infection was found to have taken place through the umbilicus, and the only possible portal of entry seemed to be a slight injury to the right ankle. The treatment proved ineffectual but the author did not employ antistreptococcus serum. MEDICAL RECORD. December j/, i<)04. r. On What Lines is the order hydrochlorothiazide Treatment of Malignant Disease .Advancing. By Robert Abbe. buy hydrochlorothiazide J. Problems Relating to Simple Ulcer of the Stomach. By BE\'ERLEy Robinson. .V The " Yolk Cure " in the Treatment of the Underfed. By Heinrich Stern. 4. Trachoma. buy cheap hydrochlorothiazide By Albert C. Bardes. 5 The Present Attitude Regarding the Treatment of Pros- tatic Hypertrophy. By Martin W. Ware. 1. Malignant Disease. — Abbe holds that the treatment of malignant disease has made notable advances recently in three directions, viz.. (i) in the recognition of the principle that carcinoma and sarcoma are primarily of local origin. This makes the cure almost certain when very early operation is done. (2) In recognizing the enormous value of increasingly extensive operation in advanced cases — widening the field of skin removal and Ivmphatic dissection. (3) In purchase hydrochlorothiazide establishing the value of radio- therapv. Apart from these we have to record at- tempts to utilize serum therapy — antitoxine — and tissue metabolism by oophorectomy (Beatson's method) and thyreoid extract administration. Serum therapy is still of undetermined value. The author has performed oophorectomy eight times in five vears for malignant disease purchase hydrochlorothiazide online of the breast. In all but one case retrograde changes occurred and life was prolonged. Lltimately all the hydrochlorothiazide tablets patients but one died of cancer. Phototherapy is of no value in malignant disease. There remain for considera- tion the Rontgen rays, the ionized rays, and the

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