months pregnant."
Pavlik emphasizes the importance of determining,
if possible, the role vermox syrup played by the cervix during
pregnancy vermox 100mg and labor, and states his belief that at
all events "the cervix acts as does a puckering string
to a bag, or as a stopper to a bottle, so far as it
relates to the gestating uterus, and its removal sub-
jects the patient to the danger of uterine evacuation
at all stages of pregnancy."
Holmes (8), on the vermox tablets other hand, admits the pos- mebendazole vermox
sibility purchase vermox of premature vermox for worms labor following amputation
of the cervix but not so early that a living child
might not be delivered, because it is very near ter-
mination of labor before the internal os gives way.
Holmes concludes, therefore, that the cervix plays
an unimportant part in gestation. Sturmdorf concurs
with a statement that pregnancy and labor are in-
trinsically corporeal functions. Clinically, Holmes
found, merely, that after amputation of the cervix
the earmarks of labor were lost and the labor was
exceedingly easy and uneventful. Heaney (9) also
has observed easy labors following amputation of vermox for sale
the cervix.
The question of the advisability of conserving
normal ovaries in hysterectomy invites disctission.
Culbertson (10) defines the menopause as a func-
tional derangement on the part of various glands
of the endocrine system subsequent to the cessation
of the ovarian vermox price secretion. During the early vears
.following vermox oral suspension puberty, for example, before glandular
harmony has become established, castration is pro- vermox for children
ductive of but slight disturbance. Later, with some
variations, the longer the gonad has been function-
ally vermox suspension associated with the endocrine group the greater
disturbance there will be when that gonad is with-
drawn, and further, the syndromes following the
cessation of ovarian secretion present familiar pic-
tures of underactivity or overactivity of the vari-
ous order vermox ductless glands. This glandular interrelation
has been discussed, also, by Frank (11), Goetsch
(12), Graves (13), Loeb (14), Marine (15), Rich-
ardson (16), Vincent (17), and others. Culbertson
believes that ovarian tissue should be retained
whenever surgically possible.
Graves states that during maturity until the
menopause the ovary plays a subordinate but not an
insignificant role in the endocrine group. In the
reproductive system, on the other hand, it is a pre-
dominant but not independent factor, since its
proper function depends upon a normal relation vermox online
with the uterus and its endometrium. The break-
ing of this relationship and the consequent upset of
the physiological balance of the endocrine group,
whether by removal of the ovaries or of the uterus,
is of slight difTerence symptomatically. Retention
of the ovaries after hysterectomy or of vermox worms the uterus
after oophorectomy are both potentially trouble-
some.
The investigation of Sampson (18) into the blood
supply vermox otc of the ovary convinces him that the actual
supply is derived from the ovarian and uterine
arteries. The potential supply is found in the com- vermox australia
munications between the vermox tablet arteries of the tube and
of the broad ligament, branches of uterine and
ovarian origin. The blood supply is considerably
jeopardized by salpingectomy. The surgeon should
therefore cut close to the tube and avoid mass
ligatures of the broad ligament. Sampson has fol-
lowed, with satisfaction, the safer plan suggested
by Dickinson (19) of retaining the tubes in hyster-
ectomy when the ovaries are conserved. Dickinson,
in 1912, strongly advocated retention of normal
ovaries.
Polak (20) believes that preservation of the
menstrual function is the important consideration.
To that end, when infected tubes require removal
and one or both ovaries can be conserved, he pro- generic vermox
tects the ovarian blood supply by a technic similar
to that suggested by Dickinson with the addition
714
FOWLER: CERVICAL LACERATION.
of removal of the fundus uteri. Polak (21) states,
ho\ve\er. that in hysterectomy, with ligation buy vermox of the
uterine arteries, the ovarian blood supply is seri-
ously reduced. The ovaries, too, when hysterec-
tomy is indicated, are frequently abnormal. The
life hi.story of the retained ovary is only about two
years. Polak has reoperated upon seventy-three
women for painful and cystic ovaries within five
years of the primary procedure.
VinelxTg (22), in 1915, had reoperated upon two
patients for cystic degeneration of the ovaries fol-
lowing hysterectomy for fibroma. Vineberg con-
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