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However, the probabilities are that the adenomata were then present. The finger was used to free the rectum from its nor- mal attachments and the scissors to free the adherent mass overlying the prostate, so that about generic of flomax four laches of the entire lower rectal wall was removed. The sphincter ani was not lemoved, but sutured. flomax cr The flomax alternative end of the remaining gut was flomax tamsulosin sutured at a point immediately below the lower end of the sacrum, and drainage provided for through the anal opening. The operation, requir'ng but price of flomax forty minutes, was uneventful and the loss of blood insignificant. .Mthough the bow- els had moved freely during the flomax price previous twenty-four hours, f?ecal discharges were several times thrown into the field of operation. Patient died seventy-two hours after operation, ap- parcntlv from exhaustion, probably the result of flomax generic infec- tion. Temperature remained normal after operation, bowels moved freely, but nourishment could not be re- tained. It has been stated that adenoinata may become vil- lous to such a degree that they resemble villous papil- loma, but no sucii case has been recorded, nor has it been shown that villous papilloma becomes adenoma- tous. It being impossible to identify either of these neoplasms without the use of the microscope would August 31, 1907.] BUCHANAN: GLAUCOMA. 389 indicate their intimate relationship. There is some doubt as to the two existing independently at the same time in a given case, but so long as the difficulty to distinguish them what is flomax exists flomax online even with the use of the micro- scope, such a doubt cannot be cfispelled. Coiicliisions. 1. The insertion of the pedicle into the rectal wall without induration with preservation generic for flomax of supliness and normal constituency to such a degree as to per- mit the mass to present itself at the anorectal mar- gin (Tuttle) with cost of flomax the villous character described indicates villous papilloma in the first instance. 2. The failure of its recurrence indicates that it was benign. 3. Adenomata were not found on October 25, 1906, probably because the examination and flomax in women opera- tion only flomax cost pertained flomax 0.4 mg to the mass presenting and be- cause of ths desperate condition of the patient. 4. The large size and number of the adenomata, together with the absence of pedicle and the slow growth which is ascribed to them, would indicate that they were present on October 25, 1906. 5. The relationship of villous flomax prices papilloma and ade- noma of the rectum being so intimate and difficult to determine is greatly in favor of the two existing at the same time in a given case. I am indebted to Dr. M. L. Heidensfeld for the most excellent microphotographs, reproduced in this article. Corner of Fourth and Bro.\dway. References. Quain. Diseases of the Rectum, Second Edition, New York, 1855. Holmes, Transactions of the Pathological Society of London, xii, pp. 120-121. flomax for women 1860-61. Marshall. Medical Times and Gazette, i, p. 714, London, 1871. Curling. Diseases of the Rectum, Fourth edition, Phila- delphia, 1876. Vance. Lancet and Ohservator, x\. flomax women p. 543, Cincinnati, 1877. Goodsall. Lancet. flomax 0.4 1881. i, p. 828. Cook. Medical Record, xxxvi, p. 38, 1889. Bowlby. Transactions of the Pathological Society of London, xlii, p. 136, 1891. Paul. Medical Press and Circular, p. 446, alternative to flomax London, 1895. Mummery. Lancet, 1905. ii, pp. 88*^-889.

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