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GENERAL SURGERY. By M. L. foster, M. D. TJlcers of the Legs. — Finzi (Lancet, June 11, 1892) makes some very good sufrgestions regarding the treatment of buy tadacip canada ulcers of the leg when the patient can not be confined to bed. In most cases of ulcers of an indolent nature a persistent course of an astringent iron tonic, with total abstinence from alcoholic stimulints, is of great benefit. Bandaging should not be left to cialis generico tadacip the patient or friends, but should be done daily, every other day, or every third day, by the physician himself. Rest and elevation of the leg are useful adjuncts to treatment, and some- times essential, but many ulcers can be cured without interfer- ing with the usual vocations of the patients, and some seem to progress more rapidly then than when completely at rest. In most, if not in all, cases of indolent or callous ulcer an acute in- flammatory condition of the ulcer and of the skin immediately surrounding it should be produced, to induce the absorption of the products of tlie chronic inflammation, and then it should be treated by sedative applications. Local applications are con- sidered under three heads: those in which tlie medicament to be applied is dissolved in water, those in which it is applied dry, and those in which it is mixed with, dissolved in, or emul- sified with oil. When water is used as a menstruum frequent dressing is required, and the method can not be carried out sat- isfactorily without rest in bed. tadalafil tadacip 20 mg When the water is allowed to evaporate, the dressing becomes practically a dry one. Some- times this will give a brilliant result. Covering the application with an tadacip 5mg online impermeable fabric or poulticing is sometimes sooth- ing; in other cases it produces eczema, and in others oedema- tous granulations when continued too long. Under this heading the author considers the application of rubber tadacip 20 price india bandages, which he condemns, as they keep the whole limb in a sodden and re- laxed condition. The dry and the oleaginous dressings he considers the most useful when it is necessary for the patient to be tadacip 5 mg about. Fore- most among the dry applications he places iodoform, especially when the ulcers are sloughing or spreading, and frequently when they are indolent. In many oases iodoform causes, after one or cialis generika tadacip more applications, eczema of the skin, irritation, burning pain, and pi-ofuse watery discharge, the condition required to start healing in callous and indolent ulcers. The oleaginous preparations may be divided into the stimu- lating and the sedative; the former for the indolent, the latter for the healing, inflamed, or eczematous condition. Of the foiTner, the blister is one of the most ])owerfiil and rapid ; then come tadacip erectalis 20 mg a strong iodoform (lintiiient, carbolic oil, emulsion of coal tar in oil, and the official ointments of tar, resin, eucalyptus, salicylic and carbolic acids, and red and white precipitate. buy cheap tadacip Among the sedatives are emulsions of lime water, a sainrated solution of borax in olive oil or linseed oil, an emulsion of liquor tadacip 20 mg uk plumbi subacetatis with oils, the ointments of zinc, oleate of zinc, calamine, boric acid, acetate and carbonate of lead, and bismuth. The ointment made of equal parts of oleate of bis- muth and soft paraflin is particularly recommended. Congenital Contraction of the Ascending and Transverse Colon. — tadacip pille 20mg cialis generika Dodd (il/id.) reports the case of an infant in which be found post mortem a congenital contraction of the ascending and transverse colon, which was throughout but little larger than an ordinary lead-pencil. The head of the caecum was nor- mal ; the vermiform appendix about two inches and a half long ; the descending colon, the sigmoid flexure, and the rectum dis- tended, but normal with the exception of a partial annular con- traction at the sigmoid flexure ; the small intestine very nar- row ; the ileum for a few inches before its junction with the C83cum much contracted ; and the stomach having an hour- glass-like contraction near the cardiac end. All the other organs were normal. A Lipoma in the Pharyngo-laryngeal Space removed by Subhyoid Pharyngotomy. — Aplavin (Arch. f. klin. C'hir.)Te- ports tbe removal of a large, hard lipoma from the pharyngo- laryngeal cavity by a modification of Langenbeck's operation of pharyngotomy. The longitudinal incision along the anterior border of the sterno-cleido-mastoid, added by Kuster and Iven- son to the transverse incision of Langenbeck, Aplavin does not approve of, because by it both branches of the generika-apotheke tadacip superior laryngeal nerve are divided. He therefore cuts directly upward from the transverse incision, and divides the greater cornu of the hyoid bone with pointed scissors, which is easily done with- out injury to the lingual artery and the superior laryngeal nerve. After these incisions were made the larynx and the lower part of the wound sank down and the hyoid bone rose and was drawn backward, so that the field of operation came into easy view. Inspection was also facilitated by the fact that the larynx could be shifted from its normal position and placed obliquely, so that the entrance into the larynx, its cavity as far as the tadacip erectalis 20 mg tabletten vocal tadacip 20mg generic cialis bands, and the anterior wall of the pharynx were easily seen and of easy access. Through this opening he re- moved a polypoid growth as large as .i ben's egg, attached by a broad base to the hack jiart of the cricoid cartilage. An Osteoplastic Operation for Spina Bifida.— BosrotT (Ctrlbl.f. Chir., June 4, 1892) reports the following case: A boy, eight years old, had suffered from myelo-meningocele in the sacral region and from incontinence of urine and fasces since birth, and this operation was undertaken for his relief. A por- tion of the skin covering the tumor was removed, the whole of the sac was excised, and then the cleft in the bone, which corre- sponded to the third piece of the sacrum, was closed by a piece of bone taken from the crest of the right ilium, an inch and a quar- ter long, three fourths of an inch wide, and nearly buy tadacip uk half an inch thick. The bony margins of the vertebral cleft were cut away and the tadacip (generic cialis) displaced portion of bone was sutured in its new posi- tion, the part covered with periosteum being directed toward the interior of the spinal canal, and tbe cut, spongy surface back- ward toward the external wound. A profuse discharge of cere- bro-spinal fluid persisted for several days, but the patient made a good recovery. At the end of tbe second month the tadacip price in india trans- planted fragment of bone had consolidated with the sacrum. After three months the boy had complete control over the rec- tum and no longer had nocturnal incontinence of urine, but was still unable to restrain the flow of urine tadacip by cipla when he was in the erect posture. Sept. 17, 1892.] tadacip online kaufen EEPORTS ON THE PROGRESS OF MEDICINE. 335

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