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lief of social distress and disease was not less im- portant than the cure of physical ailments and dis- cipro price eases. For the happiness buy cipro and wellbeing which could be brought to the individual mother and those asso- ciated with her by intelligent guidance, sympathy and help were nnmeasurable. The Importance of a FoUowup System. — Dr. George W. Kos.mak, of New York, asked whether a recently delivered mother in either private or hos- pital practice was accorded as much attention in a followup sense as a patient recovering from medical or surgical illness. During the past decade the de- velopment of prenatal care might be regarded as one of the most important advances in obstetrics. In view of the tendency to injuries resulting in invalid- ism remaining unrecognized in the usual postpartum examination, a discharge of the patient should not be made for at cipro 500mg least three months after the birth of the child. During this interval at least two or three ex- aminations of the patient should be made. It was possible to treat minor traumatic and other lesions during this period and avoid later complicating con- ditions resulting in invalidism. A survey of forty-eight American maternity hos- pitals showed that thirty-six of this number main- tained some sort of followup system but in the majority of the latter the patients returned only if purchase cipro abnormalities developed. The admission was made by practically all observers that a followup system for obstetrical patients was not only desirable but necessary. Certain difficulties must be acknowledged in instituting such a system but with the better edu- cation of the patient the realization of the need would become apparent to her and her family. A regularly organized postpartum clinic should be part of the equipment of every maternity hospital and in con- nection with the same an organization of social serv- ice workers or followup nurses to visit the patients in buy cipro online their homes was essential. The necessity of more prolonged postpartum obser\-ation shoidd be includ- ed in every scheme of hospital standardization and the' shortcomings of institutional work in this field applied with equal buy cheap cipro force to cipro 250mg private patients. The advisability of some form of maternity insurance might do a great deal cipro cost to obviate some of the diffi- culties connected with the scheme of more prolonged | postpartum care of obstertical patients. I An Analysis of the Failures in Radium Treat- ment of Cervical Cancer. — Dr. F'rederick J. Taussig, of St. Loui.-., stated that radium treat- ment of uterine cancer should be kept cipro online in the hands of cost of cipro the gynecologist rather than the rontgenologist, but such a gynecologist cipro 250 mg should seek preliminary training in the use of radium and must have con- tinued opportunity for observation and treatment of cancer cases in order to reduce mistakes to a mini- mum. Good permanent results could be obtained in a certain proportion of cervical cancers with cipro 250 amounts of radium not exceeding one hundred to one hundred and fifty mgs. of the element, though the use of large amounts in the form of emanation would doubtless decrease complications and increase the number of cures to some degree. If possible, all necessary treatment should be given within the first six or eight week period before sclerosis had set in and rendered the cancer less accessible and the nor- mal tissues more susceptible to injury. Tumor filtration or light metal filtration together with intracervical application did most good and least damage; twenty-five hundred to thirty-five hundred mgs. buying cipro online were usually enough to give results in the favorable cases. In the absence of the Bailey bomb and large amounts of emanation, purchase cipro online well directed and prolonged x ray from six to eight portals would usually affect the parametrial and glandular involve- ments. Prolonged necrosis and fistulas were due to repeated treatments, to vaginal applications and to heavy gamma radiation or to a combination cipro hc of the three. Rectovaginal fistulas were more frequent and cipro order vesicovaginal fistulas less frequent after radium treatment. Operation was to be preferred in all operable cases where the patient was under thirty- five years and in the early operable cases where the patient was beyond this age. Radium was to be rec- i ommended wherever obesity, lung, heart or kidney I lesions made operation difficult or dangerous, and in advanced operable, borderline and inoperable cases, price of cipro but not in the advanced inoperable group with cipro cheap cach- exia. The advanced inoperable cases had better be treated with acetone, since radium increased the ten- dency to fistulas and pain in most instances. These views were based on an experience extending over two and a half years in the treatment of eighty-six cases of cervical and vaginal cancer and six cases of vulvar cancer, in which radium or a combination of radium with operation was cipro online pharmacy employed. (To be concluded.) (. New York Medical Journal

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