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in prophylactic measures, remedial and dietetic, when the urine and other facts pointed to deficient elimina- id threatening eclampsia, but when these meas- ures tailed to produce a response free online roulette games for fun he emptied the uterus, and preferred to empty it too early rather than take the chances involved in allowing the symptoms ■ On. The viability of the child was worth little prior to the ninth month, in the uremic mothei I 01 dilatation the water bag was, all things worth more than the hand, but there were cases which yielded so readily to the hand that it constituted the more rapid and satisfactory means. For the control of eclampsia in download roulette games for free labor, chloroform was very valuable, but it added danger if its use had to be continued long. Yeratrum viride was the most valuable of the drugs. Diihrssen's in< isions should be reserved for emergency. He believed venesection would come into more gen- eral faVor, especially when the attack was attended by a good deal of cyanosis. Saline injections had been of great value in his hands. He had relied largely on casino roulette games for free water as a diuretic in prophylactic treatment. While milk diet was of value, yet in his experience it had not been sufficient without other food to support the patient more than two weeks. His experience had not been so favorable with trinitroglycerin as with veratrum. Surgical Methods in Obstetrics Dr. Elbert H. Grandin thought there was little ground for difference of opinion with regard to the prophylactic treatment of eclampsia. He was satisfied that Dr. Davis did not make use of too strong a statement when he said that eclampsia was a preventable disease. A preg- nant woman duly watched by her attendant ought not to have eclampsia, or. if premonitory symptoms de- veloped, she ought not to die. In the past we had been casino roulette strategy win taught too much to watch for albumin and too little to watch for urea. Toxaemia and not albumi- nuria was the term which should be employed. The term urina mia and not eclampsia should be drilled into the mind of the student. The speaker said he now came to the question which interested him most, and yet he approached it with diffidence, since quite lately in this city a leader in the obstetrical world had referred rather sneeringly to the surgical tendency of the younger obstetricians. It was the surgical tendencies, together with the asep- tic tendencies, which free online slots roulette had mr^e the lying-in room to-day as different from that of the past as the heavens were above the earth. It was the distinctly surgical tendencies (if the younger gynecologists and obstetri- cians which were robbing labor of its roulette slot machine online dangers. As he stood prepared again to advocate the surgical ten- dencies, it was with the diffidence which the pupil should always yield to the master. The following statements were based on russian roulette android app free download his per- sonal experience: (;i\en a woman with impending eclampsia, and the rule of action should russian roulette game board be surgical as speeclilv as the surgu ,il instrument which the Almighty had given us, the best of all. the hand, could do it.- There was no time roulette slots online for Barnes' bags, nor for other dilating-bags. Vfter the seventh month and a half of utero-gestation, in primiparae as well as in multipara, the hand, and the hand alone, barring exceptional cases, could, in a shorter time than any drug could possibly do, place the woman in such a position that the mortality rate, as pointed out by Dr. Kdgar. was reduced to seven per tent. He was. however, in full d with all that the reader had said in depic of the irrational use of the hand. He also objected to in the game of roulette a player can place a 8 the use of that old and abominable term, accouche- ment shot glass roulette game rules forei, which apparently had been the cause at the late Geneva conference of scarcely a voice being raised in favor of rapidly emptying the uterus. The pro- cedure which he advocated, and which had been casino roulette machine cheats de- scribed by Dr. F.dgar. was not accouchement forte'. There was nothing forcible about it. It was simply a muscle yielding to applied pressure. The uterine muscle would yield to the applied pressure of finger after fing( 1 Id the sphincter ani, only it took a -little longer. When time was not a factor, the gauze tamponade should always be used for six or eight hours to si, n preliminary softening of the cer- vix and lower uterine segment. In every case in which urgency did not allow of this preliminary tarn- January 2, 1 897] MEDICAL RECORD. ponade, any man who casino roulette strategy red black could not dilate the cervix and empty it within thirty minutes, in ninety-eight and a half per cent, of cases, did not know how. And abso- lutely no force should be used at all. Due care should be taken entirely to paralyze the cervix and lower uterine segment before any attempt was made to extract the child, which should always be done by version when there was sufficient liquor amnii present to allow it. Delivery must be effected rapidly, else the cervix would recontract. Then the colon should be washed out with gallons of water, as much as six- teen to twenty gallons. This would also cause a more russian roulette game play free \ profuse diuresis than a Turkish bath. - With such r treatment one would find even the mortality of seven ' per cent, in eclampsia disappearing. He was opposed to Cesarean roulette casino game free play section, and had made deep incisions into the cervix but once. He believed in the use of drugs after the uterus had been emptied, but he did not believe in waiting before this how to win at roulette slots for their slow ac- how to play russian roulette card game tion, when the uterus could be emptied within thirty minutes by the hand and the eclamptic seizures re- duced thereby to one-sixth in frequency. If one was not afraid of the surgical tendency in obstetrics and would leave ruts, he would rarely lose a woman in eclampsia, and he might save a third of the children. Dr. Lusk's Reply. — Dr. William 1. Lusk was the next speaker. In replv to his interrogatory, he was informed by Dr. Grandin that it was to a stenog- rapher's report of some remarks which he had made that Dr. Grandin had referred. Dr. Lusk then said he presumed that nobody had been more consistent than he had been from the time of his first essay at teaching, in maintaining that the proper treatment of eclampsia was. whenever the symptoms were sufficiently threatening, or whenever they were threatening at all during pregnancy or labor, to empty the uterus. He was glad to learn that the younger men were keen in mind in that respect. But surgical evacuation of the uterus, or call it by any other name, was abortion, and we did not want to practise abortion unless we had reason for doing so. We did not want to empty the uterus unless there were some symptoms. He pre- sumed Dr. Grandin would agree with him on that point. Vet within twelve months a woman had been brought to him for consultation as to emptying the uterus when there was not how to play shot roulette drinking game a single symptom, but only a trace of albumin in the urine. All knew that during the second half of pregnancy a large proportion of normal women had a slight trace of albumin in the urine. This called, perhaps, for watchfulness and diuretic treatment, but it did not call for surgical treatment. With regard to prophylaxis, one of the speakers had said, and correctly said, that it was not alone the albumin which should be considered, but all the con- stituents of the urine. But mention was made of a fall in the amount of urea, while the fact was ignored that urea was not poisonous at all, and the amount of urine was not considered. In some older works on physiology four hundred grains were laid down as an average amount of urea passed daily, yet a woman had been brought to him for consultation as to emptying the uterus because she was passing only two hundred grains of urea a day. The amount of urine was from fifty-two to sixty ounces, and there was not a casino roulette wheel layout single symptom. The family was anxious, but he advised waiting, and said that if she reached the thirty-sixth

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