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Dr. Hunter remarked that, a few months after restoring a lacerated cervix, he could not determine by the touch where the injury had been; the tissue seemed to be no harder than the surrounding tissue. In i*eply to a question by ^38 PROCEEDINGS OF SOCIETIES. Dr. Skene, he said he used silver-wire sutures in repairing the cervix and the perineum ; smaller wire in the former case, larger in the latter. Dr. online propranolol Skexe had operated in three cases on the cervix and perinteum at the same time, but he used Japanese whale-sinew sutures on the cervix, and paid no attention to them afterward, and found that at the end of the month there was no trace of them left, and the results were good. He had never had a case do badly after the use of this suture. With reference to the existence of cicatricial tissue some time after restoring a lacerated cervix, Dr. A. S. Claeke remarked that about five years ago he assisted Dr. Skene in restoring a cervix badly lacerated bilaterally, and he was sent for in June last to deliver the same woman, but when he arrived the child was born, labor having been very rapid. The child weighed ten pounds. There was no laceration. He examined the woman again lately, and no trace of a laceration could be found. He thought that, if any cicatricial tissue from the old operation had been present at this rapid dilatation and delivery, it certainly would have given way. Dr. F. P. FosTEK asked Dr. Skene what ground purchase inderal there was, if any, for sup- posing that cicatricial tissue running lengthwise of the cervix would offer resist- ance to dilatation. Dr. Skene replied that, if the cicatricial tissue were considerable in quantity, it might possibly do so. He said mighty but in fact he believed with regard to this canal and others, the rectum, etc., that no trouble would arise from the presence of cicatricial tissue unless the circle was completed. If, buy cheap inderal for instance, nitric acid or nitrate of silver were propranolol hydrochloride 80 mg for anxiety applied to the wall of the canal, the circle not being complete, but broken by healthy tissue, any tendency to contraction in the scars would be compensated for by the intei'vening healthy tissue. Dr. H. T. Hanks said that, in one of the first cases he ever operated upon for laceration of the cervix uteri, he delivered the patient of a child about eighteen buy inderal months afterward without any injury to the cervix. Since then he had had a similar experience in several cases, one of which he remembered reporting order inderal online when Dr. Emmet read his second paper on this operation. Two years ago the President performed an operation in the Woman's Hos- pital on a patient who had a very extensive double laceration of the cervix, so that very little of the true cervical tissue remained after its repair. An excellent result was obtained. He was particularly interested in the case, as the lacera- tion had been so extensive, and she was a young woman and expected to bear more children. He was engaged purchase inderal online to attend her in confinement last summer, as she feared a recurrence of the laceration. Being unable to attend her himself, his associate. Dr. Swasey, was present, and reported that no laceration whatever liad occurred. The President examined her very carefully afterward himself, drawing down the cervix with the purchase propranolol tenaculum, but he was unable to find any laceration. Regarding the so-called operation for cystocele, devised really not by Dr. Emmet but by Dr. Sims, he believed that Dr. Emmet himself had about abandoned it except it were in extremely marked cases ; that at his clinics he usually did only the operation for restoring the perinaeum. The President remarked that he had certainly inderal cost found the special operations which had been recommended for cystocele of late years of no benefit. In an operation for cystocele, he could well appreciate the difficulty of keeping the edges of the wound inderal tablets approximated, and preventing the sutures purchase propranolol online from cutting through the thinned or extremely attenuated vesico-vaginal tissue, and he had 2^mV YORE OBSTETRICAL SOCIETY. 539 failed to obtain practically the results which wei'e theoretically claimed for the operation ; but he had obtained very good results by closing the lacerated peri- neeum, and extending the operation up the posterior wall, as had been described by Dr. Hunter. Dr. M. A. Pallex said he believed the operation upon the posterior wall of the vagina for the relief of cystocele was original with himself. Some of his views on the subject had been quoted in a recent number of the " British Medical Journal." He would give them more fully at a future meeting of the society^ With regard to subsequent delivery without injury after operation on the cervix, he had met with several such cases — at least half a dozen — in his own experience. Some patients he attended at two subsequent labors, and no laceration took place. Last February he closed a double generic inderal laceration of the cervix, and in July last attended the patient in labor. No laceration occurred either of the cervix or cheap inderal of the perinteum, both of which he had operated upon for laceration. He had also had a number of cases in which no inderal price recurrence of laceration of the perinseum had occurred at subsequent deliveries. With regard to the operation on the perinreum for the relief of inderal online cystocele, the patient whose case he related at the last meeting of the society, while describing his method of operating, had had cystocele and cystitis, but since the operation she had been well. Dr. Hunter said he was very glad to have had an expression of opinion with regard to the non-laceration of buy inderal online the cervix in parturition after an operation had been performed upon it, for he believed it was a very common opinion, not in this city, perhaps, but elsewhere, that an operation was useless if the woman expected to have children afterward. He remembered two cases in which the operation was indicated, but, under the advice of their physicians, the patients declined, saying they would wait until after the time of child-bearing. He be- lieved that the cervix was just as liable to laceration after the operation as be- fore, but no more so. He order inderal inderal mg did not believe that any hardened tissue remained after the lapse of six months or a year. In connection with the question of what suture should be used, the President asked Dr. Hunter at buy propranolol what period he usually removed the silver-wire sutures from the cervix in the number of cases in which he knew him to have operated upon both the perinseum and cervix at the same time. Dr. Hunter replied that he never had had any difficulty from them ; that he usually removed them within three or four weeks. He inserted a small speculum, and had no difficulty in removing the sutures from the cervix, and did no harm

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