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is worn for a considerable period of time involution of the vaginal walls always takes place and buy trazodone online no prescription pro- buy trazodone sleep gressive reduction in the size of the implement, therefore, becomes absolutely imperative. After wearing the instrument for six months or a year, the patient may be allowed to discard it for a period of two or three months at a time ; indeed, in some instances recovery is so marked that one buy trazodone could almost term it complete. SUMMARY. 1. Therapeutically there is a distinct need for a specific line of division between medical and surg- ical malpositions. 2. The symiitomatology of uterine displacements, in general, as taught today is erroneous. This is confirmed by the small percentage of socalled cures buy trazodone hcl following operation. ?<. Uncomplicated malpositions should be treated by generic trazodone cost medical and mechanical means. Operative meas- ures should be applied to those associated with dis- tinct surgical complications. 4. Operative intervention should not be utilized in the simple malpositions of virgins or young mar- ried women. 5. The infantile uterus never requires, nor is the condition benefited by surgerj'. Endocrine dysfunc- tion as an buy trazodone uk etiological factor should be remembered. This condition should be treated and not the uterus. 6. Nerve and muscle relaxation (backache) should be regarded as a causative factor and not the result of generic trazodone online uterine malposition. 7. Restoration of nerve and muscle power should be restored in buy trazodone 50 mg all cases and is best accomplished by rest and generous feeding. 8. In no case of retroflexion or retroversion will the patient recover in the trazodone cost without insurance presence of obstinate con- stipation or bladder overdistention. Overcome con- stipation and malpositions will largely disappear. 9. The prolapsus of old women with low surgical resistance is best treated mechanically by the Menge pessary. 1621 Spruce Street. DISEASES OF THE CERVIX UTERI.* By Alfred Heineberg, P. D., M. D., Philadelphia, Associate in Gynecology, Jefferson Medical College; Obstetrician to the Jewish Maternity; Assistant Gynecologist, St. Agnes Hospital. The ease with which the cervix may be amputated has, I am how much do trazodone cost convinced, frequently led to its removal without due consideration of other possible means generic trazodone 50 mg of restoring it to a healthy condition. A careful study of the aftereffects of amputation of the cervix, as ordinarily performed, must reveal that frequently the immediate result and at times the influence upon subsequent pregnancy leave much to buy trazodone hydrochloride be desired. In most instances the amputation is done to remove a cervix which has undergone hypertrophy cheap trazodone no prescription and ero- sion. Such conditions result from laceration and eversion with exposure of the mucous lining of the cervical canal to infection, trauma and irritation of the acid vaginal secretion. To insure complete generic trazodone hcl re- moval of the diseased cervical mucosa and eroded area, the internal incision in the formation of the flaps must be made so high across the mucous mem- brane of the cervical canal in most cases that the canal or buy trazodone generic internal os may be impaired. The latter may be left in a state of wide dilatation ; the for- mer may be tightly constricted by a ring trazodone discount coupon of cicatrix perpendicular to the long axis of the cervix cheap trazodone formed at the edges of the apposed flaps. A permanently dilated internal os favors infection of the uterine cavity, with the production of a leucorrheal dis- charge how much does trazodone cost which is much more difficult to cure than that which resulted from the preexisting cervical disease. More important than the annoyance of the discharge is the influence of the infected uterine mucosa and widely patulous os upon subsequent pregnancy. Both produce unfavorable conditions for the retention of the impregnated ovum in the uterine cavity. Several cases of inevitable abortion have come under iny observation in women who, before amputation of the cervix, had had no diffi- culty whatsoever in carrying a fetus to full term. I recall especially one buy trazodone online uk patient from whom I had to remove retained products of conception as a Medical Association of Philadelphia, November 6. 1920.]

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