A Neglected Form of Cervical order celexa without rx Endometritis.
— Dr. Henry T. Byford, of Chicago, stated that
as a result of acute cervical endometritis a buy celexa canada perma-
nent exudate was sometimes left about the internal celexa price comparison
OS uteri, which for descriptive purposes he called a
constriction ring, although in reality it was merely
a greater thickness of the mucosa at that celexa manufacturer discount program point. This
constriction ring not only produced the characteris-
tics of stenosis in many cases, but gave rise to the
ordinary symptoms that were usually attributed to
endometritis, such as backache, reflex stomach order celexa no prescription dis-
turbances, malaise, dysmenorrhea, intermenstrual
i:^p iiar. >o»e k TJaroat Hoj^piir
Octnber 16. 1920.]
PROCEEDINGS OF NATIONAL AND LOCAL SOCIETIES.
607
pain, menorrhagia and sterility. The number and
severity of the symptoms varied greatly in different
patients, depending in part upon the interference
with the patency of the lumen, the chronicity and
the associated pelvic conditions, and partly upon
the patient's general resisting powers and nervous
habits. The diagnosis was made by means of the
sound which detected a tender area at the internal
OS and which caused more or less bleeding. In the
more chronic cases firm pressure exerted by a
dilating wound produced a slight discharge of -in-
spissated mucus which adhered to the sound. The
treatment called for gradual progressive dilatation
with round dilators under the strictest aseptic and
antiseptic precautions, and later stimulating applica-
tions of iodized phenol. The occasional failure of
an Emmet trachelorrhaphy to cure the symptoms
was laid to a persistence of such an exudate at the buy celexa
internal os.
Hemorrhages Into the Pelvic Cavity Other
Than Those of Ectopic Pregnancy. — Dr. Rich-
ard R. Smith, of Grand Rapids, Mich, stated that
although ectopic pregnancy was by all odds celexa discount card the most
frequent cause of hemorrhage within the pelvic
cavity, it occurred occasionally order celexa line from other causes.
The most frequent source of such hemorrhage was
the ovary. For clinical purposes they might be
conveniently divided into three groups.
1. Caused by a ruptured Graafian buy celexa 40 mg follicle or cor-
pus luteum which occurred order celexa canada most frequently in young
women, and in which celexa prices us the 'symptoms rather closely
resembled an ectopic pregnancy. Many patients had
been operated upon also for supposed appendicitis.
Blood might be found in lesser amounts or in
amounts large enough to cause grave symptoms.
.\ microscopical examination ordinarily showed a
normal Graafian follicle or corpus luteum.
2. The second group was not uncommonly desig-
nated as hematoma ovarii. Here one was dealing
with a distinctly pathological condition, which might
be evidenced with hematomata order celexa online generic celexa vs celexa into the Graafian
follicles, with secondary changes following in the
ovarian structure. This condition was rather fre-
quently associated with fibroids or with some inflam-
matory trouble with the appendages. In other
cases no such association apparently existed nor was
the cause clear. In young women it was sometimes
the cause of severe dysmenorrhea.
3. A group of hemorrhages associated with ova-
rian tumors (cystic or solid) of considerable size, order celexa in
which the bleeding occurred into buy cheap celexa the tumor or from
it into the peritoneal cavity. Such bleeding tumors
were commonly the seat of a twisted pedicle or of
inflammatory adhesions ; also a ruptured pedicle had
been the cause.
Although the tube might on rare occasions give
rise to hemorrhage without the cause being evident,
in most cases the reason for such hemorrhage was
apparent. A ttibe involved in the twisted jiedicle
of an appendage was a good illustration of such discount celexa
hemorrages : . occasionally it was found associated
with the thickened tubes of an old infection. Such
hemorrhages were small in quantity in the reported
cases and the condition order celexa online no prescription should be easily differentiated celexa cost without insurance
from ectopic pregnancy. Intraperitoneal hemor-
rhages from fibroid tumors formed a verv interest-
ing group. celexa generic cost Wallace reported seventeen collected
cases and Gerstenberg one. The hemorrhage was
often severe and the mortality had been very high
(thirty-five per cent.). They occurred from dilated
veins or from a rupture of the tumor itself.
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