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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.
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
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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