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outer side of the ascending colon, which in each in- stance was drained through the ileocostal space. In one case the distended paretic bowel necessitated opening Pentoxifylline Trental it, and the establishment Purchase Trental of an artificial anus. Three of the patients thus treated had died, one after an illness of nearly five months, during which time death on three or four occasions was threatened by intestinal obstruction, while a number of abscesses in the abdominal wall Trental Tablets Buy Trental followed. Death resulted from exhaustion incident to Trental Mg the prolonged suppuration. In the second Trental Online fatal case death took place ten days after the operation, due to toxaemia. Gastric Dyspepsias Amenable to Surgical Treatment. — Dr. William E. Ground, of Superior, Wis., said in this paper that it was now recognized that many forms of digestive disturbance were dependent upon conditions entirely outside the stomach, and involved Trental Injection this organ Trental Cost either by direct extension of the patholog- ical process or indirectly by nerve influence. Among Trental Generic these might be mentioned inflammatory or Purchase Trental Online irritative conditions in the biliary apparatus, pancreas, duod- enum, or appendix and adhesions of the Trental 400 stomach to the surrounding viscera. Within the stomach con- ditions remediable by surgical means were chronic gastric ulcer, hemorrhage, pyloric obstruction, gastric dilatation with stasis, hyperchlorhydria, and cancer. The question of operative intervention in some of these conditions was still in dispute, but the wisdom of referring cases of perforating gastric ulcer, with or without adhesions, cicatricial stenosis of the pylorus, adhesions of the stomach to any of the sur- rounding structures, and perhaps chronic gastric ulcer, to the surgeon was now pretty firmly settled. Closely associated with ulcer was the sequence of cicatrization and contraction, and when thiS process involved the pylorus, it led to stenosis and obstruction, and later, if this was prolonged, gastric dilatation and atony would result. Whether the pylorus was ob- structed by spasm due to the presence of the ulcer or to hyperchlorhydria, which almost always accompanied nonmalignant ulcer, or to the cicatricial contraction following the healing of an ulcer, the pylorus was rendered incapable of readily transmitting its con- tents, the stomach became distended, and its muscular walls were weakened, leading ultimately to permanent atonia gastrica. Stomach dilatation might be due to atony alone, but it was much more frequently due to mechanical obstruction at the pylorus. In this con- dition of gastric stasis food might remain in the stomach a day or more. In fairly advanced cases, when the obstruction had given rise to a compensa- 322 BOOK NOTICES. [New Yoek Medical .Iodbnai.. tory hypertrophy of the stomach, the peristaltic move- ments might be seen and felt through the abdominal walls, usually accompanied by pain and vomiting. Later, when the stomach began to dilate and assumed a more passive state, the patient complained of fulness and epigastric pains after meals. Fermentation took place, causing eructations and heartburn and frequent vo.miting. Vomiting was a most prominent symptom when gastrectasia Buy Trental Online and fermentation were well estab- lished. When this sequence of events was set up, there was but one remedy, and that was in surgical intervention. The curative effects of an operation could not be attributed alone to drainage of the stomach or to short circuiting of the food current, as was so often contended, for unless the pylorus was closed food would pass through it. The explanation the writer had arrived at was to the effect that the cutting of the circular fibres in the pyloric end of the Trental 100 Mg stomach did away to a Order Trental Online considerable extent with the muscular unrest accompanying gastric digestion, es- pecially where ulceration was present. To the author's way of thinking, gastroenterostomy acted much the same as Trental Price cutting the Order Trental fibres of the sphincter ani in anal fissure. In this latter condition the fieces continued to pass over the ulcer, but the paralyzed sphincter prevented friction, and it healed readily. Restoration of the Perinaeum. Buy Cheap Trental — Dr. Howard Hill, of Kansas City, read a paper on this subject (to be published). Gluteal Cavernous Angeioma. — Dr. J. E. Summers, Jr., of Omaha, reported a case, and said that cavernous angeiombata of voluntary muscles were comparatively rare, and in the case of this report the size of the growth was exceptional. It was Generic Trental excised while the circulation was controlled by direct digital pressure on the com- mon iliac artery through an abdominal incision. Preoperative Thrombi in the Region of the Field of Operation as a Cause of Postoperative Complicationa and Death. — Dr. A. W. Abbott, of Minneapolis, in a paper with this title, said Trental Indications that thrombosis, especially

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