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she desired the extrusion to be effected ; then she should be aided. If, on the other hand, bad symptoms under these circumstances at any time showed them- selves, laparotomy, under strict antiseptic precautions, should be promptly re- sorted to. Fifth. Should rupture of the foetal nidus have occurred before a diagnosis had been fully made, the practitioner should wait and see whether Nature was power- ful enough to overcome the shock and control haemorrhage, then, further, if the patient was going to escape the dangers of peritonitis and septicaemia. If these favorable results did not occur, if haemorrhage was about to destroy the patient immediately, or if septicasmia attacked her, laparotomy, followed by antiseptic cleansing, should be promptly adopted. Of his twenty-one cases, rupture of the sac occurred in five, and, of these, four of the patients died and one recovered, none being operated upon ; seven were interfered with by surgical means, and, of these, three of the patients died and four recovered; two were treated by vaginal tapping with a very small tro- car, and both patients died; six were treated with electricity, and all of the patients recovered ; spontaneous death of the foetus occurred in three, with ex- pulsion of the foetal bones through the rectum, and, of these, two patients recov- ered and one died. Dr. H. Flonase Acne J. Gaerigxies, of New York, then read Alternative To Flonase a paper on Electricity in ExTRA-TJTERiNE Peegnanoy. It was prepared with special reference to treat- ment. Five methods had been suggested for killing the child. These could be conveniently grouped under two heads: first, sharp instruments, introduced through the roof of the vagina or through Flonase Generic Cost the abdominal wall, including punc- ture, injection, elytrotomy, and laparotomy; second, dilatation and electricity. Of tliese, electricity was the best, was really the only measure to be employed, and it was the duty of the physician to give the patient the benefit of its appli- cation. It had been objected to, first, because it was unreliable, and, second, because it was apt to cause rupture of the cyst. The second objection was re- garded by Dr. Garrigues as purely theoretical. With reference to Flonase Rxlist the first, elec- tricity had been successful, up to the middle of the fourth month, in Purchase Flonase Online every case Generic Flonase Nasal Spray in which it had been employed. The conclusions which the author of the paper reached were, that experience had proved electricity to be an eflicacious Flonase Canada and safe agent for arresting extra-uterine pregnancy during the first three months, and perhaps in some cases wiiero the pregnancy had even advanced more or less into tlie fourth month ; that it seemed likely the same agent might be [jrofitably used at any period of fa*tal life. The clinical history of a case was given in which he used a one-celled French electrical apparatus successfully. The appli- cations, ten in all, were made daily, each sitting occupying ten minutes, and 513 PROCEEDINGS OF SOCIETIES. during the time Flonase 0.05 the woman was able to attend to the duties of her small house- hold. Dr. H. F. Campbell, of Augusta, Ga., referred to one case in which, at the autopsy, extra-uterine pregnancy of the tubo-ovarian variety was found. The mother had gone beyond the full term, and the child was fully developed with- out rupture of the sac. The patient died of exhaustion soon after reaching the hospital, and without a diagnosis. Dr. H. P. C. "WiLsox, of Baltimore, referred to cases, seen in consultation, where the -women had died suddenly, death being due probably to rupture of the cyst. He had had two cases of extra-uterine pregnancy under his own care. The first was a case Flonase Generic Price of twin pregnancy in which one of the children Cheap Flonase was born in the natural way, and the other he removed through an abdominal incision, and it lived two months. The mother recovered. In the second case he de- stroyed the life of Flonase Nasal Spray Generic the foetus by electricity, placing one pole upon the tumor in the vaginal cul-de-sac and the other above the pubes. The woman made a good recovery. There was nothing especially noticeable in the clinical history. Bal- lottement was absent. Dr. William Goodell, of Philadelphia, said, with reference to diagnosis, that he would suspect extra-uterine pregnancy when pregnancy occurred after a long cessation of fruitfulness or a long-continued sterility. Extra-uterine pregnancy Flonase Generic Name was also occasionally supposed to be retroflexion of a pregnant uterus. The occur- rence of paroxysmal pains associated with symptoms of pregnancy be regarded as a very valuable symptom ; also the fact that the size of the cyst was not equal to that which the uterus would have attained at a corresponding period of utero- gestation. He had seen thirteen cases, and the histories of these were given briefly. Death took place in all except those in which Nature interfered. Dr. Albert H. Smith, of Philadelphia, referred to the thermometric test as an aid in determining the existence of pregnancy. The temperature of the cer- vical canal in pregnancy varied from three fourths to one and a half degree higher Flonase Ns than the Buy Generic Flonase normal, and it had been established that where the foetus died the temperature fell proportionately lower within thirty-six hours after its death Iiad occurred. Dr. G. H. Lyman, of Boston, thought that at the time when electricity would be of the greatest service — that is, in early pregnancy — the diagnosis was not so easy. Tlie suspicion of extra-uterine pregnancy was not, at that time, very strong, Flonase Generic Equivalent and frequently cases progressed until rupture of the cyst took place be- fore diagnosis was made. Early diagnosis, therefore, became a question of spe- cial importance. He then quoted from the paper read by Dr. Eeeve, of Dayton, Ohio, and published in the fourth volume of the " Transactions " of the society, in which the author referred to a statement made by Dr. Stephen Rogers as far back as 1867 — namely, that "attacks of colicky pain accompanied by a sanguin- eous difccharge, the symptoms of pregnancy being present, were almost certainly indicative of extra-uterine pregnancy." Dr. Howard, of Baltimore, thought that Order Flonase Online a diagnosis could be reached in most cases without very great difficulty. He had seen three cases, to which he re- ferred briefly. With regard to diagnosis, he thought it important to bear in mind Dr. Barnes's statement that Flonase Coupons Printable the placental souffle was absent in abdominal pregnancy. In any case of suspected abdominal pregnancy a distinct foetal-heart sound and absence of placental souffle would go far toward settling the diagnosis. Mr. Knowsley Thornton, of London, Eng., said that, Avhereas he had been AMERICAN GYNECOLOGICAL SOCIETY. g^g an Flonase Alternatives advocate of surgical interference in cases of extra-uterine pregnancy, he should return home determined Flonase Discount to use electricity. He referred to a case confirmatory

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