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ries than many men. A comprehensive survey of the subject of ovarian conservatioit is beyond the scope of this paper. However, the wide divergence of opinion elicited b}- the queries of Vineberg in 1915 is voltaren ec 75 mg equally ap- parent in the responses to my questionnaire. Dr. John G. Clark informs me that he has recently been making a careful study of the question with the generic for voltaren hope that definite conclusions may be reached. The personal opinion voltaren ec of Dr. Clark is quoted elsewhere in this paper. SUMMARY. The subject of this report had a forceps delivery in 1901. At intervals of two years she had three -subsequent pregnancies, all of which terminated >|)ontaneously after short labors, two at full term, the third at the eighth month. After the second delivery she noticed a protrusion from the vulva, voltaren in usa which increased after each of two later pregnan- cies. In 1920 she sought surgical voltaren topical relief for the disability resulting from voltaren xr 100mg the cystocele which a pes- sary would no longer support. Examination prior to operation revealed an ex- tensive laceration through the anterior lip and across the cervical canal, due presumably to instru- FiG. 3. — Showing, at the generic name for voltaren right, the long rod in the external os, in the centre voltaren for sale the bulk of the anterior lip and to the left tlie gaping laceration and the remainder of the anterior lip. (Uterine fibromata are apparent in all three views.) mental traimiatism during the first delivery nine- teen years ago. The tear had apparently remained undiagnosed, certainly untreated, during this long period. Examination of the uterus in situ and •16 PARKE: RECTAL EXAMIXATloX IX OBSTETRICS. [New York Medical Journ^ ;ilter removal afforded convincing evidence that the three spontaneous deliveries had taken place through the rent in the anterior lip rather than through the external os. It is remarkable that this extensive laceration produced such a slight patho- logical change in the cervix ; tliat three spontaneous deliveries occurred through it. and finally that sur- gical relief was sought after nineteen years solely for the disability due to the cystocele. CONCLUSIONS. 1. A thorough gynecological examination three months voltaren sr 75 mg tablet after delivery should be routine practice. 2. The disability following cervical lacerations is dependent upon the voltaren sr 100mg degree of subsequent patho- logical condition rather than the tear, per se. 3. Premature or precipitate labors following am- putations of the cervix are probably due to some other factor than the voltaren in canada mere loss of tissue. 4. voltaren 50mg diclofenac Operative morbidity and mortality will be decreased by multiple stage operations in lieu of one prolonged procedure. 5. The advisability voltaren xr 100 of conserving normal ova- ries in hysterectomy is still undetermined. REFERENCES. 1. Fr.^nk, L. : Safety Factors in Surgery with Especial Reference to the Blood, Surgery, Gynecology, and Obstet- rics, 1920, .XXX, 1S2. 2. M.wo, C. H. : Uterine Prolapse with Associated Pelvic Relaxation, Surgery, Gynecology and Obstetrics, 1915, XX, 253. 3. voltaren 100 mg retard GoLDSPOHN, A. : Discussion of Pavlik's paper. 4. Sturmdorf, a.: Tracheloplastic Methods and Re- sults : A Clinical voltaren ec tablets 50mg Study based upon the Physiology of the Mesoraetrium, Surgery, Gynecology and Obstetrics, 1916, xxii, 93. voltaren xr 100 mg 5. EwiNG, J.\MES ; Neoplastic voltaren 75 sr Diseases. 6. voltaren generic name Leoxard, V. N. : voltaren rapid 25mg Postoperative Results of Amputa- tion of the Cervix, Surgery, Gynecology and Obstetrics, 1913, xvi, 390. 7. Pavlik, O. S. : Pregnancy and Labor Following

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