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under your olmorvatir>n during that time? In the answers to these (piosttons I should like a brief hut complete history of oacli case and an account of the troatinent that has houn pursued. I hope by this means to obtain the e.x- porlonco of n lar((u number of obHcrverrt and to njiich n fiijrly raliAhlu noncluHJon as to the time when wo may safely puriiiit our nyphilitic patients to marry. Kdiinsiok Kostkh, M. I). IProce^trings of Somties. AMERICAN ASSOCIATION OF OBSTETRICIANS AND GYN..«COLOGISTS. Seventh Annual Meeting, held in Toronto, Ontario, September 19, 20, and 21, 1894. The Second Vice-President, Dr. Geohge F. IIulbert, of St. Louis, in the Chair. An Address bactrim 400 mg of Welcome on behalf of the local medical profes.sion was delivered by Dr. James Thorbuen, which was responded to by Dr. Hulbekt. The Incision in Abdominal Surgery— Methods and Re- sults. — A paper thus entitled was read by Dr. J. Henry Caestens, of Detroit. The author summarized as follows : 1. With a small, narrow-bladed, sharp knife make a clean incision through the skin, of the necessary length, and with another sweep or two cut through the linea alba, mus- cle, etc. Lift the peritonfeum with your fingers, open it, and enlarge the incision. The use of the forceps to lift the tis- sues, or the grooved director is unnecessary. 2. In closing the abdominal incision use animal ligature, kangareo tendon, or catgut. First carefully bring together bactrim price the peritoneum in a running stitch, then the transversalis fascia, and the rectui* if the incision is through this muscle. Then carefully bring to- gether, edge to edge, the tendinous insertion of the oblique muscles. The fat and loose cellular tissue above can generic for bactrim be brought together in one or two tiers, according to thickness. Bring the skin together carefully with Marcy's cobbler stitch, thus bury- ing all the sutures. 3. Then seal with collodion, and, if every- thing connected with the operation cost of bactrim has been carefully aseptic, absolute primary union will take place, and the different layers of the abdominal wall will have been brought together as near- ly as possible as they were in the first place, and no hernia will result. 4. In cases of extensive umbilical, ventral, or other hernias, it is best to bring the peritonsBum together with an over-and-over stitch of kangaroo tendon or catgut; to make a flap-splitting operation of the ring, which is brought together with silkworm gut or silver wire, which are buried ; and then to unite the fat and skin with the buried animal sutnrc. Plastic Surgery in Gynaecology.— Dr. .Iosei-h Trice, of Philadelphia, read bactrim bactrim a paper on this subject in which bactrim 800mg he said that the practice of surgery in all its branches required a antibiotics bactrim mechanical trend and an ability to devise moans to accomplish a given end. In order to mend a perinjBum intelligently, the mechanism of labor must be understood. In cases of serious pelvic invasion, with accompanying lacerated cervix, it was often better, or im- perative, first to do the pelvic operation, and to follow this at another time with bactrim cost the cervical repair. The author condemned the plan advised by some of performing internal and external operations purchase bactrim at one sitting. Perineal tears always occurred mrsa bactrim at certain parts bactrim 800 mg of the perineal structure. These tears were either lateral, under the ramus of the ])ubos, or central, extending from vagina toward the rectniii. The tears toward the rectum tended to run around it rather than through it, antibiotic bactrim owing to the dif- ferentiation bactrim and the external or skin operations for perineid lacerations were essentially unscientific procedures. All opera- tions for restoring the integrity of these bactrim prices parts should bactrim for mrsa be done in the lines of their destruction, and therefore from within out- ward and from above downward. When the skin of the pori- niuum was Involved, mending of this was merely a cosmetic Oct. 6, 1894.] BOOK XOTICES. 441 (irocedure. The cosinetic sulfa bactrim element too often predominated in many of the so-called perineal devices. The silkworm gnt with -liot was by far the best material to be ased for sotures. As little tissue as possible was bactrim tablets to be included within the ligature, ,.nd strangulation bactrim and uti was to be avoided. bactrim generic The Care of Pregnant "Women.— Dr. W. B. Dewees, of Salina. Kansas, read a jiapt-r thus entitled. The paramount du- ties of the obstetrician in the study and care of prejrnant women might be classified as follows: 1. To discover if the patient was Actually pregnant. 2. To determine positively if the pregnancy was uterine or normal, as distinguished from extra-uterine preg- nancy. 3 To carefully note the pregnant woman's history, in- «luding lier age, primiparity or multiparity, environments, sta- tion in life, general condition of health, and period of gestation,

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