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Dr. J. R. (JoFinc, who had assisted in benicar hct cost tho o|)eration, re- marked on the slight liiemorrhago which followed division of tho stump. Submucous fibroids caused great discomfort to the patient, yet wore easily removed; and their removal was fol- lowed by full relief, making it perhaps the most satisfactory sim|)le operation in gyniecology. He had oi)erated oidy where the tumors were [ledunculated. Dr. W. C*. remarked that notall uterine fibroids were so easily removed as when attached benicar hct tablets by pedicles. Where they were dee|)ly seated and not encapsulated, even if the os was widely dilated, it was easy to penetrate the uterine wall in at- tempting to free them by benicar htc the spoon saw, as had happened sev- eral times. Here twisting and snipping with the scissors was a better method. When the capsule was distinct they came benicar savings card out completely. But otherwise there was much danger that a por- tion remaining after partial removal should suppurate, its vital- ity being just enough lowered to allow of this. Many patients had been lost thus. In reply to a question from the president as to what he did with the capsule, when there was one. Dr. Wylie added that after the tumor had been removed he pulled down the capsule and lied off all he could of it. He douched the cavity with very hot water, and allowed the remainder to stay. He had been compelled to use forceps to extract two benicar hct prices or three very large fibroids, and once had been obliged to cut the perinseura. Some Unusual Complications in opening Pelvic Ab- benicar canada scesses through the Vagina.— Dr. J. R. Nilsen read a paper with this benicar generic name title, the discussion of which was postponed till after the reading of the following paper. The Treatment of Suppurative Disease of the Uterine Ap- pendages. — Dr. cost of benicar hct II. J. BoLDT read a paper thus entitled, in which he endeavored to show that operative interference was posi- tively indicated in certain cases of pyosalpinx about which there was apt to be too much difference of professional opinion as to the treatment called for. He remarked that, while many women had been deprived of their tubes and ovaries without the least benefit, and had had reason to regret having consented to being operated on, there buy cheap benicar was also a tendency to go to an extreme in the other direction. Cases were not selected with proper care which deserved general instead of operative treatment. Dis- eases of benicar generic alternative the uterine annexa might be roughly divided into three groups: 1. Those in which an operation was altogether unjusti- fiable. 2. Those where the effect of general treatment was to be watched for a time before an operation was considered. 3. Those where delay was not only inadvisable but dangerous. He wished to present buy generic benicar several cases that had occurred in his own practice which had Tindoubtedly belonged to the third group. 1. A long-standing case of metritis and local peritonitis fol- lowing confinement, with radiating pains, headache, cardiac palpitation, and dyspnoea ; also, within five years previous, syph- ilitic infection had been superadded. Micturition had been fre- ^arcb 9, 1889.] PROCEEDINQS OF SOCIETIES. 275 luent, menstruation very profuse, pains very severe before the iow began, and some leucorrboea after it bad stopped. Exanii- lation bad sbown an indurated cervix tender to tbe toucb, the iterus somewhat enlarged and sensitive, botli tubes and ovaries Quch enlarged and prolapsed, and the surrounding structures very ensltive. A diagnosis of double salpingo-oophoritis syphilitica vitb endometritis had been made and an operation advised, un- ess treatment was benicar discount card soon followed by improvement. A little later 1 physical exertion had benicar equivalent been followed after a few order benicar online hours by vio- ent pain in the epigastrium, accompanied by a fresh attack benicar alternatives of lelvic peritonitis. Five days later general peritonitis had de- eloped, the tubes had lost their full contour, and, instead, afull- less with excessive painfulness had been found on either side of he uterus. Although rupture of the tubes had evidently oc- urred, he had, unfortunately, not made up bis mind to operate ill the evening of the next day. The patient had survived the iparotomy only sixty hours; it had been deferred too long. 2. A case of catarrhal salpingitis of long standing in a ?oman of twenty-nine years, a sequel to scarlet fever at the hirteenth year. Severe pain had been suddenly developed in he lower part of the abdomen, had increased for a time, then ubsided for several days, only to return accompanied by a amperature of 104° F., and a general peritonitis with chills and raaciation. Examination had been exceedingly painful, but ad shown fullness and fluctuation to the right of the uterus, lupture of a tube distended by pus being evident, laparotomy ad been performed on the next day, generic name for benicar the abdominal cavity had een washed, and dense adhesions removed. The haemorrhage :om the latter proving uncontrollable, and the author being :)rced to cut short the operation owing to the state of benicar uk the patient, e had tamponed the pelvis with iodoform gauze. This had acted s both a drain and a hfemostatic. Thirty-six hours later he had n wisely replaced the gauze benicar hcl by adouble-current rubber drainage- ibe, and had washed out the abdominal cavity again through ;. If he had closed it at once the patient would probably have scovered. There had been no odor. After some hours the ulse had become very feeble, but had been restored by raising lie foot of the bed and irrigating the abdominal cavity with a 'arm solution of chloride of sodium (1 benicar generic equivalent percent.). On the third

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