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urethrotomy, had, in his experience, every advantage over the other methods. He had seen the temperature fall at once to normal when such an opening had been made. He therefore never omitted to make it. A Large Bursa over an Exostosis. — Dr. MoBurney pre- sented a specimen of exostosis removed from the outer aspect of the right femur of a young woman over which a large bursa, holding three ounces of bloody serum, had been Tofranil 50 Mg formed. Dr. Weir had removed such a bursa, and the minute ex- ostosis which had caused it, from a woman who had traveled all over Europe for the relief of what had Order Tofranil been supposed to be a hysterical joint affection. Dislocations of the Astragalus — Buy Cheap Tofranil The President showed two plaster casts of the deformity produced by the Purchase Tofranil Online dislocation of the astragalus forward and outward, and also the fractured astragalus removed from one of the patients. The first patient, a stout woman, forty-one years old, had been admitted to the Chambers Street Hospital in December, having just fallen from a step-ladder to the floor, about eight feet, striking upon her left foot. The sole had been slightly inverted and the toes ad- ducted, and an abrasion had been found over the external mal- leolus. Close below and in front of the external malleolus there could be felt a small, sharp edge of bone which could be moved Tofranil Mg slightly, with crepitus; an inch in front of this there had been a rounded mass of bone just under the skin, apparently Buy Imipramine Online the head of the astragalus. In front of this the parts had been deeply depressible, and the fingers had come upon the resistance of the tarsus and metatarsus. On the inner side the change of direction made by the inversion of the foot had begun an inch or more above the tip of the malleolus, the Buy Tofranil latter being masked by the swelling, but palpable on deep pressure and apparently- uninjured. The bony prominences along the inner and outer borders of the foot had been recognizable in their normal rela- tions. The prominence of the heel had appeared a little in- Cheap Tofranil creased. Ether Purchase Tofranil had Tofranil Uses been given and, reduction failing, longi- tudinal incision had been made in front corresponding to the interspace between the tibia and fibula, and prolonged upon the dorsum of the foot so as to expose the head of the astragalus. The astragalus had lain upon its inner side, almost wholly dis- placed from the tibio-fibular mortise, its head directed forward and slightly outward, its inferior surface looking outward and slightly backward. Its attachments had been completely sev- ered except at the postero-external angle ; at the postero- internal angle a small piece had been broken off and had re- mained attached to the capsule. The astragalus and its fragment had been removed, and the wound had been closed. The pa- tient had made a good recovery, but was not as yet able to bear her weight upon the foot. The second patient, a spare man, forty-four years old, had been admitted to the Chambers Street Hospital in January, having just fallen from a ladder, ten feet, striking on Generic Tofranil his left foot. As shown by the cast, the foot was inverted 30°, ad- ducted 45°, and in plantar flexion 20°. About two inches for- ward and inward from the external malleolus there iiad been a hard, rounded prominence, evidently the head of the astragalus. Midway between this and the external malleolus a sharp edge of bone could be felt, slightly movable with the head of the as- tragalus. This had been thought to be either the upper or the lower outer border of the body of the astragalus. The result showed that it must have been the upper one. Tofranil Cost The internal malleolus had been completely masked by the swelling, but could be made out on deep pressure. Ether had been given, and reduction easily made by traction upon the foot in the axis of the leg, and pressure with the thumb upon the head of the as- tragalus; the bone had slipped into place with a distinct snap. The foot and leg had been dressed with gypsum bandages, re- newed on the eleventh day and removed on the twenty-third There was free, painless motion at the Tofranil Tablets ankle, and the patient could Tofranil Online walk easily. Linen Thread for Sutures and Ligatures.— Dr. Wflly Meyer reported having found Buy Imipramine a substitute for other kinds Order Tofranil Online of ligatures and sutures in linen thread such as was sold at the regular dry-goods shops. His experience with Buy Tofranil Online its use was only a short one, but confirmed the results obtained with the same article by Trendelenburg. It was serviceable, safe, cheap, and easily prepared. The only preparation necessary was to wind it on a glass rod and soak it for twelve hours in a solution of corrosive sublimate fone per cent.) and then preserve it, wound on a glass spool, in a one-to-one-thousand solution of the same. It was not necessary to boil it first in a five-per-cent. solution of carbolic acid and then preserve it in alcohol, as had once been done with silk. By soaking the thread in a ten-per-cent. solu- tion of iodoform in ether, shortly before using it, iodoform linen thread could easily be prepared. The thread made by Marshall «fe Co. Tofranil Price was sold in various sizes. No. 40 answered well for sutures and ordinary ligatures, and No. 25 for tying arteries of a larger caliber. A smaller size (about No. 50 or 60) should be used for plastic operations. Linen healed Tofranil Pm well in the wound, but should be used only where primary union was to be expected. In comparison with catgut, its only disadvantage was that it was not so slippery and therefore had to be pulled more. When moist it was stronger than when dry. Of course, catgut was the ideal article for the purposes under discussion, but its aseptic condition, even after a thorough primary disinfection was often untrustworthy, especially in the case of a thick thread which had been preserved for some time. Linen thread was especially adapted for use in large institutions and dispensa- ries on account of its easy preparation and its extremely low price. Dr. Weir remarked that he had been using silk in all his operations of late, and had never got better results, except from the old-style carbolic catgut, which was now called unscien- tific.

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