depressed piece of bone, a dislocation, a foreign body, an
abscess, or a tumor, there is good reason to believe that
removal of this pressure will Purchase Artane favor the restoration of the
normal offices of the cord and help the patient to get well.
The bony cavity in which the spinal cord rests is not
difficult of access, nor is the mere opening of it bv surgical
means more serious than opening the cranial cavity.
Dogs and cats tolerate exposure of the spinal dura mater
through a wound in the posterior segment of the vertebra
with almost trilling inconvenience, and on them the sur-
geon Buy Artane can learn more of the handicraft of removal of the
spinous processes and vertebral laminae in a few hours
than can be learned by months of patient study of the
literature of laminectomy or laminotomy.
There are characteristic Order Artane Online difiFerences between the cervical,
dorsal, and lumbar regions which cause corresponding dif-
ferences in the methods of doing these operations ; and it
is an addition to the operation Buy Trihexyphenidyl Online to open the dura mater of
the cord and explore its vascular and serous membranes.
The danger Order Trihexyphenidyl to Buy Trihexyphenidyl life is greatly increased. The most delicate
manipulations must be familiar to the surgeon who would
do this, lie can not be permitted to tear round with his
fingers and instruments as if he were removing an ovary
or Artane Online peeling out a uterus. The godless and indiscriminating
surgeon will never " cut for record " in spinal cases. One
thing will always discourage and deter him — the patients
are always sick, except in the rare cases of railway spine.
The vertebral Artane Tablets canal may lie opened so that the lateral
and posterior aspects of the spinal cord can be ejisily Generic Artane ex-
amined by first making an incision through the integument
and superficial fascia, four inches long, over the spinous
processes nearest to the diseased area of the spinal cord.
Then the muscles and tendons must be cut away from their
attachments to the spinous processes and the laminie. For
this purpose it is well to use a strong knife and [leriosteal
elevator, so that the periosteum may be turned back with
the tendons and muscles, as it subsequently becomes useful
in tilling in flie boneless Artane Price area. A pair of strong retractors
with teeth are commonly needed to Purchase Trihexyphenidyl Online hold back the soft
parts, so that the lamina- can be divideil with a chisel and
bone forceps. After the lamina' Order Trihexyphenidyl Online on each side of the spi-
nous process have been cut llirough, the latter is catight
with a strong forcejis and lifted from it-s bod, oxposiug
the Buy Cheap Artane vertebral cavity and the dura mater. .\ considerable
Hpacc normally exists between the dura mater anil its in-
vcHling wall of bone. Tliroiigli an opening made by lifting
out the spinous process and lamina of one vertebra, the
cord can generally be examineil a distance of an inch above
and below the opening. It is not often necessary to re-
move mole than the posterior MOgiiient of one vertobra. If
the chinel and bone forceps are u.sed cautiously, and no
more bone Im removed thnii is n«'ci's.Hary to overcome the
patliological conditions on which Purchase Trihexyphenidyl the o|icratioii restjt, there
will lie no need of nplint Order Artane or other apparnlus to Artane 1 Mg support the
Hpine during tlir healing of llio wound.
WEISSINOER: STRANGULATED FEMORAL HERNIA.
[N. Y. Mkd. Jour.,
I dress the wound carefuilv with gauze and cotton and
change the dressing as often as it becomes soiled. It is
not a good plan to turn the patient during the dressing of
the wound. It is better to have three or four strong at-
tendants, who can lift him three times a day from his bed
and support him in a horizontal position while the dress-
ings are being applied.
In closing the wound, I take pains to close the perios-
teum and muscles over the boneless area Purchase Artane Online with silk sutures.
Drainage by means of tube or gauzes is rarely needed,
because gravity is competent to do the work.
The internal treatment is generally limited to tonics and
special attention to diet.
The impairment of bowels and bladder incident to para-
plegia makes the after treatment and care of laminectomy
cases particularly Artane 2 Mg important. Bedsores are sure to come
if the patient is not lifted from his bed several times every
twenty-four hours. I have tried many devices for moving
the patient to facilitate keeping him clean, but have suc-
ceeded best when I have summoned a sufficient number of
nurses to lift him bodily as often as required. The drib-
bling urine is apt to get into the bedding and infect the
wound if it is not carefully conducted away. I have had
no trouble from using a sterilized catheter, lubricated with
freslily sterilized oil, three times a day, and in the intervals
a rubber or glass urinal has been constantly in service.
A diet containing well-cooked Indian meal helps to
keep the bowels in a proper state Buy Artane Online of solvency.
A CASE OF