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less the condition of the patient is a contraindication, immediate repair of all lacerations should be made within twenty-four hours of delivery. A physician who attends a case of labor is grossly negligent if he fails to make a careful inspection of the pelvic floor as soon after delivery of the child as is con- sistent with the safety of the mother. It is with unrepaired tears of the third variety that this paper is concerned. An operation which has proved satisfactory is Generic Zaditor performed as follows ; A U or V Zaditor Eye Drop shaped or transverse incision is made along the mucocutaneous line. The scar tissue is removed by denudation with the scissors to allow access to the deeper and more important struc- tures. In inserting the scissors care must be exer- cised to Zaditor Tablets keep the points pressed against the Buy Cheap Zaditor vaginal wall. By delicate manipulation with the scissors, or perhaps better with the gauze covered finger, the plane of fascia separating the vaginal and rectal walls is found and the underlying tissues are quickly rolled of? the vaginal wall so as Zaditor Drops to expose the two walls. The tissues are easily and safely separated as Zaditor Coupons far as desired without producing any bleeding. The flap should now be elevated and care should be used to see that the dissection extends sufficiently high on either side to expose the upper border of the levator ani Buy Zaditor muscle. The layer of veins is the guide to safety and Eye Drops Zaditor one should keep within the line Buy Zaditor Online of cleavage so as to avoid injuring the rectum. The method of introducing the sutures is no less important Alaway Or Zaditor than that of denudation. The wound is preferably closed in two layers. The first row of sutures approximates the levator ani muscle and Zaditor Eye Drops fascia in the median line. Each suture should in- clude deep bites of the muscle and fascia on either side. This Zaditor Price puts the muscle and fascia on either side on tension and brings them into view, thus giv- ing a Order Zaditor Online broad surface for approximation by figure of eight sutures. The second row of sutures unites the mucous membrane and skin down into the muscle and fascia. The wound is closed by running sutures, locked at intervals. Twenty-day chromi- cized catgut should be used for approximation. Where this is not available, tension sutures of silk- worm gut should be employed. Care should be taken to keep sutures and scar tissue from the im- mediate vicinity of the vulvovaginal glands. Other- wise a hypersensitive and troublesome scar or cyst formation may result. 235 American National Bank Building. Role of the Ovary in the Female Organism. — Alfred Labhardt {Schzveicerische medizinsche Woclicnschrift, May 6, 1920) uses Zaditor Coupon much space to say that the influence of the ovary on the general condition of the body is much less than that of the other endocrine glands, yet this influence is great, not only on the genital, system, but also on the entire orejanisni. 720 TOVEY: FEMALE PELVIC URETERS. [New York EDiCAL Journal. THE FEMALE PELVIC URETERS * By David W. Tovey, M. D, New York, Adjunct Professor of Gynecology, Polyclinic Medical School and Hospital, Gynecologist to Harlem Dispensary. Palpation Cheap Zaditor of the pelvic ureters should be a part of every vaginal examination. During examination there is nothing between the fingers and the ureter but the vaginal wall. The ureters can be felt from the bladder to the pelvic brim. At the New York Polyclinic Hospital it was easy to teach students to jialpate the ureters, after they had learned their po- sition, by inserting ureteral catheters into them. The ureters are an inch apart in the trigone, about an inch behind the internal urethral opening, and two inches behind tlie external meatus. They are about two inches Purchase Zaditor apart at their entrance into the bladder, where they run through Zaditor Cost the bladder wall for three quarters of an inch. These points are about half an inch in front of the cervix on the anterior vaginal wall, and about an inch from the crossing ofthe ureter by the uterine artery. After Purchase Zaditor Online leaving the bladder the ureters curve over Order Zaditor the anterior va- ginal wall and lateral fornix, to a point half way between the lateral border of the cervix and the

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