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Related post: out opening the peritoneal cavity, vijs., ( i ) Shall we leave the ovaries and tubes intact and merely separate adhesions, replace the organs, etc? (2) Shall we Finax Online remove the diseased portion of the ovaries and leave the best part of them, open up and clean out closed tubes, etc., and thus get rid of the diseased tissue without abolishing func- tion? Or (3) shall we remove the diseased ad- nexa so completely as to bring on the menopause and prevent the Finax Tablet monthly hyperemia ? There are imdoubtedly cases in which the con- ditions require the complete abolishment of the monthly hyperemia of the sexual organs. Dr Reddy Finax Of these I will not speak. There are other cases in which separation of adhesions and suturing of the parts on a higher level may be all that is in- dicated. These I will also pass by. It is the second class of Order Finax Online cases that I wish to consider, viz., those in which the diseased portions of the ovary must be excised, the tubes made previous, and the patient left unaltered as far as her sexual func- Finax Tablets tions are concerned. Since peritoneal sections have become com- paratively safe, it is not such a terrible misfor- tune if the patient should be obliged to submit to a second operation, and we are sometimes justi- fied in reconmiending and performing conserva- tive operations even when there is no certainty of a cure. We have also learned that purulent sactosalpinx is not Finax 1mg a contra-indication to con- servatism, for Order Finax the pus in most cases has become sterile or is but Finax Dr Reddy feebly septic, and the communica- tion of the tubes with peritoneal cavity and thus its usefulness as a transmitter of the ovum can be restored without danger or bad effects. Severe septic cases of disease of the uterine appendages with habitual elevation of the body temperature, frequent acute attacks, large accu- mulation of pus, and complete disorganization of the tubal walls and ovarian structures should not as a rule be treated in a conservative manner. Eliminating the septic cases just mentioned we have a very large majority left in which we can assure the patient Buy Finax that the diseased tissue can be removed or treated without interfering with her sexual functions or vigor. This I consider one of the chief advances made in modem gyneco- logical surgery. When there is for any good reason an objec- tion to an abdominal incision, the same work can often be done by the vaginal route, although the abdominal operation more often gives good re- sults. The only argument which I care to advance in this short study is that we are doing such opera- tions and that the immediate as well as remote results are good. Before abdominal sections were performed for adherent appendages, gyn- ecologists recorded a large percentage of symp- tomatic cures without any operation, and now that we are operating in a conservative way we are likewise observing a large percentage of cures without complete removal. In other words, we are becoming more and more convinced that cor^plete castration Buy Cheap Finax is to be reserved only for ex- treme cases. 1 will only take up your time with two cases representative of many others which I am con- stantly performing. Dr. A. Palmer Dudley of New York has also reported a number of Finax Price opera- tions for pyosalpinx. It was his pioneer work that encouraged me to extend my conservative operations to adherent and occluded tubes. I was called to see Miss H. in April, 1898, and found her Purchase Finax in bed. She had been broken down in health for a year or more, and had taken local treatment and the rest cure without benefit. Her local symptoms were dysmenorrhea and pelvic pain. A consulting gynecologist of wide experi- ence had recommended removal of the ovaries and uterus as the only means of getting Buy Finax Online her out of her deplorable condition. I found double oophoritis, a small cervix and moderate uterine hyperplasia. I dilated the cervix, curetted the uterus, made a peritoneal incision Purchase Finax Online through the posterior vaginal fornix, and removed about two- thirds of each ovary, leaving only what seemed to be healthy tissue. The patient recovered promptly, married in a year, and has been well and hearty since. In another case, that of Mrs. J. S. S., on Feb- ruary 15, 1901, I did an abdominal section and found both tubes occluded. The right tube con- tained cheesy matter and its walls were thickened and hardened from interstitial inflammation. The left tube contained a little turbid mucus. The left ovary contained a hematoma the size of a walnut. The appendages of both sides were extensively adherent. I separated the adhesions, removed a large part of the right ovary, opened the fimbriated extremity of both tubes by inci- sions, and sutured the mucous to the peritoneal coat in order to insure permanent patency. The contents of the tubes were pressed out, and the cavities Dr Reddy S Finax syringed with sterile water. The peri- toneal cavity was closed without drainage. The patient walked about the room at the end of three weeks. Her immediate recovery was about as rapid and complete as in those cases in which the ovaries and tubes are removed in toto, she con- tinues well, and complains of no symptoms what- ever. 100'State Street, 538 COHEN : EDEMA OF UVULA.
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