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the gynaecologist can correct tendencies toward this un- fitness and thereby avoid abdominal section, is not this non-surgical function as important as that of the sur- geon who can only repair by mutilation? Increased Venous Pressure and the Special Organ. — For example, the return blood current in the nose is hampered and we have a rhinitis; in the larynx, and we have laryngitis; in the bronchial tubes, broncliitis; in the spleen, spleenitis; in the liver, hepatitis; in the appendix by the indirect pressure of a misplaced kid- ney on the superior mesenteric vein, and we have ap- pendicitis. The infection follows the congestion, as a rule. Now, is it far-fetched to call a rhinitis Generic Indocin in part an aggregate Indocin Generic phlebitis, in that innumerable small veins become engorged and inflamed? Is not the same con- dition to be found in the veins and their vasa vasorum, down the leg, in the rectum, up the sides of the pelvis, and around the appendix itself? The relation between a debility of some sort and this hampered return blood current is evident. It is well known that increased blood pressure impairs the resistance of cellular life. The whole subject of lithoemia, renal and cardiac — and, indeed, bronchial and laryngeal — involvement in passive congestion is simply named in passing. Advancing Gyncecological Views. — But I nrge Indocin 25mg spe- cial attention to the steadily advancing conception of the gynaecologists Indocin Tablets from (1) the idea that pelvic soreness was a cellulitis, (2) to the idea that Buy Indocin it was almost exclusively an infection through the womb along the tubes, (3) to this new and truer idea that the congestion often comes first, and then follows an infection from the " resident germ Indocin 25 Mg " ; and that this congestion is not limited to organs in the pelvis only, but extends from the plantar arch to the veins of the diploe. Recall for a moment puerperal eclampsia, puerperal insanity, the insanity of the menopause, the insanity in some post- operative cases, and the fact that the majority of hys- terical and neurological cases are feminine. Conges- tion is the one known underlying fact in these cases. (Of course, infection precedes congestion in all cases of contagion or inoculation.) Some Spectacular Effects. — When these poor women return, aching after pelvic operations, one can frequent- ly be as spectacular as the charlatan by calling their at- tention to their sore veins at the ankle, behind the Imee, in the groin, in the rectum, up the sides of the pelvis, Indocin For Pda in the Indocin Injection region of the appendix and over the liver and Jnne 10, 1899.) THERAPEUTICAL NOTES. 82S spleen, Order Indocin or at one or more of these points. They draw im- mediate inference: Indocin Pda they were operated upon unneces- sarily. This should make a conscientious man — know- ing how gyna;cology has felt its way along, step by step Indocin Iv — hasten to defend the operation. I have toned up the veins of many a post-operative case, but have never al- lowed such an inference to be uttered before me without earnest protest. But if, by repeated success in ailing cases that have already been operated upon, and cases that have only contemplated operation, one has found that trouble in specific organs is often but part of a general condition, he is perfectly justified in saj'ing to patients who dread abdominal surgery, " That is not alone your trouble ; but here and here and here." Even those who must do surgery to live will admit that if a tendency toward a deplorable condition can be recognized before an operation is justifiable, it is our duty to save the patient from the surgical cataract roar- ing in the distance. Great Benefit from the Rest in Bed. — I debate whether much of the benefit from surgery — bear in mind all through this discussion the restricted class of cases — is not due to the rest in bed and the special care Indocin Suppositories 100mg given an invalid after an operation, especially in cases of retro- deviation of the womb. I cite in support the many successes of the Weir- Mitchell rest-cure regime. What can be done without the Knife. — When by regime — but not by " local treatment " — you can take off fifty pounds in weight or put on forty; when you can decrease the Indocin High size of a dilated Indocin Sr 75 heart, as proved by the skiagraph ; when you can make the flabby solid of flesh, increase Indocin And Ibuprofen chest expansion, clear up brick- dust urine, stop palpitation, quiet borborygmus; change the color of the skin, the lustre of the eye, the strength of the heart's impulse; tone up various varieties of ptosi.'*, remove the symptoms of retrodeviation, and ease the aching Indocin Vs Ibuprofen venous system — when all this can be done without the knife (remember again the class of cases), you are justified in protesting that there is an impor- tant nu'dicnl siflo to gynipcolopy. And especinlly when all this has frequently to be done after women have Indocin Headache been as completely eviscerated as Indocin Suppositories possible. What Women did before (hjnaTology. — When, Indocin Suppository there- fore, one wonders what women did Ix'foro the speeinlty In-gnn its evolution, one can consider that the require- luents of modern life have entailed upon women tenden- cies that have made the specialty necessary. Former generations, living more in the open air, hail greater inusoulnr power and prnbalily required less abdominal iirgery. Discussions upon this new step in g^'nirrology are valuable even if some of us are on the wrong side, for "truth comes innrp remlilv fnmi ernir Hi. in fri)m ^btrapfutiral Botfs.

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