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5i3 of catheteiizinf: tlie Falloppian tubes, as so many gyuiecologists have, upon various occasions, accidentally passed a sound into one or the other tube. It must be admitted, he says, that in pome cases the tubes can be catheterized or sounded, but those eases are rare. The most interesting points to him in this con- nection are, first, the determination of what cases are suitable (or the operation ; secondly, what, if any, dangers attend it; and. thirdly, what benefits may be expected from it in such cases. In order to pass a sound into the tube it is evident that the tube must be large enough to admit the sound without the use of force; and no sound or probe less than an Purchase Zaditor eighth of an inch in diameter at the point should under any circumstances be used, as the danger of passing it tlirough the uterine wall would be too great. We never know, says the author, the condition ot Cheap Zaditor the Zaditor Price tube we are operating upon, and, unless the operation is done always as if we were dealing with a softened and convoluted tube, it is too dangerous to be tolerated. The tube, then, must be large enough to admit a probe an eighth ot an inch in diameter — a thing that Zaditor Cost rarely occurs in health. Is it possible, asks Dr. Carr, that disease may enlarge the caliber!' Not only must there he a large, patulous tube for sounding, but there mu>t be a proper curve to the uterine canal so that a curved sound may be introduced. There must be. then, a com- liiiiation of ati abnormally large tube, a normally curved uterus, and a normally curved or free tube, or a tube distended with tluiil near its uterine extremity, in order to make the operation possi- ble within the limit of safety. How often, asks the author, can we liope to find those conditions fulfilled Purchase Zaditor Online i Not once in a hun- dreil times, assuredly; not once Buy Zaditor Online in Alaway Or Zaditor five hundred, he believes. In chronic disease of the tubes they are always contorteil and adherent, and usually contain simdl collections of pus stmt otf by constriction or frei|uontly by entire obliteration of the lumen of the tube. It is, then, the acute cases, with collections of Huid or pus in the uterine end of a tube of abnormally large caliber, and held there by recent adhesions or some plui: of mucuH or ins|iis'-ated pus, that are the only suitable ones I'or catheterism. Of course, says Dr. ("arr, it can not be determined Generic Zaditor beforehand whether all these conditions are fulfilled or not ; hut. if a possible case presents itself, there can he no objection to trying to introduce the sound or catheter belVire resorting to more radical methods, provided it is properly done. If the operntioii is done in Order Zaditor Online the following manner, it is in itself devoid of danger : Thoroughly cleanse the vagina with n Zaditor Eye Drop bichloride douche, ami have Buy Zaditor the liand-> and instrumentn aseptic. Introduce the Hpcculum — either Sims's or a valve speciMum — and sponge I lie vagina nnrine cavity will guide it ilire<'tly to the opening of tlio tube. Thin must lie done with great care. iliul if the '•ound fnilii to enter tho tube willioul the use of force, the attempt mUMt bu aliandonud. No ana-slhetie slionlil Ihful, the pUN or Zaditor Coupons lllliit will Mow through thi- catheter, or ewape benide the miiind, or follow it" remuval. We are told, *ns% the author, that this liiix been done and Hint a cure Inn re»tiUed In «everal limtances. Ordinarily, however, we liiil«l expert to have to keep the luba open by re penird «oundlMg«, nml oven wnnli nut the pu« cnvtty gently through n eatheler, or apply itiedicninvlit* lliroilgli it. In the majority of cases there would probably be a condition similar to that resulting from the oi.ening of a tubal abscess through the vagina, and that, as is well known, is far from satisfactory. Tubal cathetcrism sbotd 1 Eye Drops Zaditor never be attempted by any one un- familiar with the pathological anatomy of tnb.'d disease as learned from Zaditor Drops post-tnortems and operations. With all these Order Zaditor restrictions and limitations, says Dr. Carr, a brilliant future can hardly be predicted for the operation, and yet, if, once or twice in a lifetime of practice, we Jire enabled by its use to delay an abdominal operations until the conditions are more Zaditor Coupon favorable, or possibly to cure a patient without the operation, it is well worth bearing in mind, and no harm can come from making the Zaditor Tablets attempt, before resorting to laparotomy, in iMses of tubal abscess or bydrosalpingitis. Auscultation of the Second Sounds of the Heart.— The Lancet for October Gth publishes an article by Dr. William Ewart, of London, who remarks that the important pajier pub- lished in the preceding issue of that journal by Dr. Sydney Kinger and Dr. Arthur G. Phear, on the clinical significance of an accentuated second sound, ends with a conclusion which to all clinical workers can not fail to be discouraging. Zaditor Eye Drops To this conclusion, says Dr. Ewart, they seem to have been led by too keen and gloomy a sense of a real difficulty — that of distin- uuishing and separately tracing the two second sounds. Sev- eral of the points raised by the Buy Cheap Zaditor authors were considered in Dr. Ewart's lecture On the Heart Sounds and on Accuracy in Car- diac Auscultation, published in the Ijinctt of May 27, 1803. Long before its publication he had satisfied himself that the right side of the heart did not conduct the pulmonary second

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