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1. Gynaecology Among the Other Medical Sciences. By Professor V. N. Massen. 2. On the Treatment of Narrow Pelves. By N. I. Prieuinskv. ,3. The Diagnosis of Gonorrha-a in Women. By G. A. Greiffe. 4. A Case of Cancer of the Ovary in a Girl Aged Four- teen Years. By 1). P. Kouznetskv. 6. On the Technics of Laparotomies. By P. T. Sadovsky. 7. The Hi.story of Puerperal Sepsis. By P. G BONDARIEFF. 4. Early Ovarian Cancer. — Kouznetsky re- ports a rare case of carcinoma of the ovary in a girl who had barely reached puberty. Gussenbauer and Olshausen each have observed similar cases in girls of about eight years of age. and Brown has reportetl an instance of carcinoma' of the ovary in a girl aged nine months. The usual age for this dis- ease is between thirty and fifty years, according to Pfannenstiel. The scirrhous form occurs in old age, but the other forms, especially the medullary, are seen in women during menstrual life or Elimite Price at Elimite Cream Otc the cli- macteric, and grow very ra|)idly. The diagnosis of a primary carcinoma of the ovary in a yoiuig girl is, according to the author, absolutely impossible, al- though the rapiility of the growth may give a hint as to its malignancy. The treatment is, of course, solely operative, but the prognosis is not so bad as might be supposed, Elimite Or Kwell for in Buy Elimite Cream three cases on record Where Can I Buy Elimite there was no recurrence in from seven to eight years, and in another case Elimite Cream Over The Counter over eight years elapsed without recurrence. Papillary carcinomata of the ovary give the worst record for relapses. In the present instance the patient was a girl, aged four- teen years, who entered com])laining of a swelling in the abdomen" which had grown larger during the preceding six months. She noticed the "lump" ac- cidentally, but afterward Elimite Cost shooting pains developed in it, which recurred in paroxysms. She had never menstruated. The Elimite For Lice tumor was of the size of one fist and a half, very movable, and situated at the lower part of the abdomen. It was found to involve the right ovary, and was removed, the pedicle being tied with reindeer tendon. The left ovary was found cnlargefl to the size of a walnut and nodular, and Elimite Lice was tiierefore also removed. On Permethrin 5 Cream Elimite microscopical ex- amination, a medullary carcinoma of both ovaries WM*; fruuid. The patient made a good recovery. 6. The Technics of Laparotomy. — Sadovsky says that the majorit}- of gynaecologists in remov- ing the uterus or annexa ligate the stumps en masse by means of stout ligatures passed with blunt nee- dles. In the after-treatment, there are many cases which show a painful thickened stump on palpation or a stumj) that gives rise to constant and distress- ing pain, which compels the patient to ask for an- other operation Elimite 5 Cream if needed, to relieve the patient of the painful conditions. This pain in the stumps Permethrin Elimite may be explained by the presence Elimite Generic of inflammatory changes Elimite Otc in the ligated structures or by the forma- tion of dense adhesions in the surrounding perl- tonreuiTi. In three cases in which the author has had occasion to Elimite Cream Scabies perform secondary laparotomies for painful stumps, he has found these structures very nuich thickened and surrounded by dense adhesions. In one case the stump after an ovariotomy was found adherent to a loop of small intestine, and the remains of a silk ligature were found on separating the loops. In the other cases no Where Can I Buy Elimite Cream traces of the liga- tures could be found, the ligatures Generic Elimite having been evi- dently absorbed completely The author thinks that the trouble lies with the method of ligature em- ployed, and that the structures of the stump should be tied separately, and the peritoneal stump closed by suture afterward. This method takes more time, but that does not matter under present aseptic con- ditions when we know how to protect the periton- eum by means of sponges. Permethrin 5 Percent Elimite The author applied one or two Permethrin Elimite Cream hysterectomy clamps to the stumps, then dissected the structures, caught the ovarian vessels with artery clamps, and took oflf the hysterectomv clamps. The remaining bleeding points were then caught with artery forceps. All the vessels were now ligated with catgut and the clamps and forceps removed. The peritoneal stump was closed with contiinious or interrupted catgut sutures. In re- moving the tubes the same method was pursued. the tubes being cauglit in separate clamps and tied separately. The advantages of this method are that the peritoneal cavity contains only a continu- ous suture instead of thick ligatures : that the stumps do not project into the peritoneal cavity, and present a smooth surface everywhere • covered bv the peritonaeum : and that the formation of adhe- sions, especially to the small intestines, is avoided. ROUSSKY VRATCH. Saturday,'. .If'ril .'d, 1003. 1. The Rontgen R.iys and Other Methods of Early Diag- nosis in Pulmonary Tuberculosis. By D. I. VlERCZHSKV. 2. The Sensation of Rhythmical Vibrations at the Peri- phery of the Body: significance in Diagnosis. By F. I. IVANOFF. 1198 PITH OF CURRENT LITERATURE.

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