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Dr. A. P. Di'dlet, of New York, believed firmly that it was important to remove the dense tissue in the cervix. Some of the speakers had mentioned cases in which the operation had failed. He would call attention to a result of this dense tissue or of the laceration which developed before the operation was performed — namely, a fungous condition of the endometrium dependent upon arrest of involution and consequent congestion. If we operated and succeeded even in getting out all the dense tissue, but left the fungous condition of the endometrium, the operation would prove a failure. Dr. Henry C. Coe, of New York, said that he would ven- ture to criticise the expression " cicatricial tissue," which had been so freely employed by the reader and by all but one or two of those who had taken part in the discussion. He had entered his protest against it on several occasions. Many ob- servers had sought in vain for some substantial microscopical evidence of nerves in such masses of condensed tissue. He agreed with Dr. Wylie and Dr. Baker in believing that the so- called "plug" was not really of a cicatricial character, but consisted essentially of cirrhotic or condensed fibrous tissue. He had sought for nerve-filaments within the tissue, but he had not succeeded poker games rules baseball in finding them, either in the plug itself online poker games for ps3 or in free strip poker app iphone the tissue of the cervix immediately beneath the plug. It therefore seemed to him imaginative to compare these fibrous masses to the painful cicatrices free poker games for ps3 which were sometimes met with in gen- eral surgery. It was well known that the normal cervical tis- sue was often quite hard and semi-cartilaginous, especially after it had undergone senile changes, so that in lacerations of the cervix in old subjects it was diflicult to distinguish, either by the touch, by inspection, or by microscopical .appearances, the difference between the normal tissue and that in the angle of the tear. Clinically he had been equally unsuccessful in demon- strating to his own satisfaction that the tissue in the angle of a lacerated cervix ever became so exquisitely sensitive as the pseudo-neuromatous cicatrix of an amputation stump, for exam- ple. He could recall but few instances in his experience in which firm pressure upon the plug had caused marked pain, and none in which extreme agony or reflex phenomena had followed July 24, 1886. REPORTS ON THE PROGRESS OF MEDICINE. 1C9 such pressure. Inflammation of the uterine lining membrane or of the circura-uterine tissues might account for much of poker games to play for free the pain. The cervix any new poker games for ps3 uteri was comparatively insensitive, as was shown by casino arizona poker forum the absence of unusual pain during cutting opera- tions performed without ether. In view of best poker games to play at home this low degree of painful sensation, the cervix could hardly be regarded as such an important center for reflex neuroses. He did not deny the reflex theory in toto, bnt it seemed to him that existing views on this subject must undergo some modifications. Dr. Harrison, referring to Dr. Coe's remarks, said that, while the intra-vaginal portion of the womb was not sensitive in the healthy state, yet when diseased and in a condition of hyperaimia it was exceedingly sensitive. He referred to a case in which every time he had brought his finger in contact with the diseased download game poker offline android apk cervix the woman had vomited. He thought at first that the cause was something else than the diseased cer- vix, but the fact was elicited at three diSerent examinations. In another case the patient made no objection to the examina- tion until his finger came in contact with a ]>oint of hardened tissue in the cervix, when she shrieked with agony. Dr. .James R. Goffe, of New York, thought that there might be cases in which there was great tenderness of the cervix, but he thought that, as a rule, it was not sensitive as compared with other pelvic organs. The statement made by Dr. Coe, that we could dig out the cicatricial plug and close the wound without administering an aneesthetic, he doubted. He had seen but one case in which it was done, and that was at the Woman's Hospital. The operation was poorly performed, and apparently, as the result of the jerking and twitching of the patient and the pulling upon the uterus, there followed a pelvic abscess. He poker games rules home game had met a gentleman from Detroit who had said that he never thought of giving an aneesthetic when operating upon the cervix uteri, but Dr. Goft'e thought that the operation must be diflierent from that performed in New York. Dr. Coe said that, without taking up the subject of operat- ing without an anffisthetic, he wished simply to emphasize the fact that the cervix was not, as some writers had stated, an ex- tremely sensitive organ which responded to trivial irritation. He maintained that it was best free offline poker game for ipad not highly sensitive, but, download game poker offline untuk android of course, there might be peculiar conditions in which it was so. As a rule, he believed it to be about the least sensitive portion of the genital tract. Dr. G. W. Porter, of Providence, thought that the case re- lated by Dr. Townshend offered an excellent opportunity, if carefully watched, for determining whether the symptoms in laceration of the cervix were due to contraction of hyperplastic tissue, as spoken of texas holdem poker android app free download by Dr. Baker, or whether they were due to diseased glands and follicles, as maintained by Dr. Wylie. Dr. Townshend said that in health the cervix was perhaps about poker games rules and strategy the least sensitive portion of the body, but he was sure that in more than half of the cases in which it contained a cica- tricial plug it exhibited niore than an ordinary degree ot sensi- tiveness, and often a high degree. Dr. -J. B. Hunter said that his clinical experience agreed with that of Dr. Moseley. He knew of no operation which had been more satisfactory than that for laceration of the cervix. It made no ditference clinically what we called the diseased tissue ; we were agreed as to the propriety of removing all we could find. With regard to sensitiveness of the cervix, he had operated upon eighteen odds & live betting online casino games och poker or nineteen patients without ether be- cause' there was good reason for not giving it, and in not one of the cases had there been much difficulty in doing the operation. Of course it was not so satisfactory as with an ansesthetic, be- cause there was not so much relaxation, download game poker untuk hp android and the uterus could not be drawn down so well. One patient had said the operation was not more disagreeable than having a tooth plugged. He thought that in Dr. Harrison's case the influence upon the uterus itself, or upon the ovaries, might have had something to do with the pain. Dr. MosELKY, in closing the discussion, said that the nature of the tissue in the lacerated portion of the cervix would casino arizona state poker championship 2012 have to be determined by the pathologists. The four cases which he had selected out of a list of cases had been chosen because in them there had seemed to be absolutely no other cause for the symp- toms. As to sensitiveness of the cervix, he had seen a number of patients operated upon under cocaine, and, although there was no pain during the stage of denudation, yet as soon as the deeper tissues were reached, and sutures were inserted, there was exquisite sensitiveness. That fact, it seemed to him, was an answer to the ordinary theory that the pain new york new york casino poker room was reflex, from pressure on underlying tissue. (To be continued.) Ilcports on tbc llrotjrcss of UletJirmc. MATERIA MEDICA, PHARMACY, AND THERAPEUTICS. Strophanti!!. — Professor T. R. Fraser, of Edinburgh, made public ("Brit. Med. Jour.," Nov. 14, 1886) the results of his studies and ob- servations with this drug in a valuable paper presented at the last annual meeting of the British Medical Association, on July 28, 1885. Strophantin is obtained from the plant Slrophantiis, which belongs to the natural order of Apocynacew, and is widely distributed tlirough- out equatorial Africa. The seeds of the plant are very active, and, when coarsely ground and formed into a paste, they constitute the poison with which arrows are smeared. Strophantiu is obtained from the seeds, though it exists in small quantities in the leaves and bark of the plant. It is a crystalUne body, having a strongly bitter taste, readily soluble in water and in poker games to play online for fun rectified spirit, and practically insoluble in ether, chloro- form, benzole, and petroleum spirit. It is essentially a muscle poison. Introduced into the body, in whatever manner, it increases the contrac- tile power of all striped muscles, and renders the contractions more

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