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the time. During menstruation she suffers some pain in mic- turition, and walking causes undue fatigue, with abdominal pains and backache. Appetite variable and bowels con.stipated. At this time she complained of pains in Best Price Levitra Online both ovarian regions and back, with almost constant severe headache. Menstruation was rather irregular and paiufid. She was very weak and anaamic, and nervous even to the extent of hysteria, crying on the least provocation. Locally, there was no marked tender- ness about the uterus, nor was there any decided enlargement of that organ. There was a double laceration of the cervix with but slight ectropion, and the whole surface was covered with a smooth epithelium. The fundus uteri was somewhat anteflexed. The laceration of the perinseum had not resulted in any displace- ment of the nterus requiring support. Deep in each angle of the cervical laceration there was exquisite sensitiveness, even slight pressure causing marked suffering, and the same was true of pressure, made with a stiff probe, at corresponding points in the cervical canal. On May 17th I removed a considerable amount of hard, cica- tricial tissue from each angle, completing my excavating only when the last bit of hard tissue had been eradicated, leaving the remaining tissue soft and natural, and then closed the angles with silver-wire sutures. At the same time I closed the peri- nseum, the surfaces denuded being slight in extent. From the day of the operation she expressed herself as feel- ing relief from the old pains and nervousness. Three weeks later she took a considerable walk with greater ease than for many months, and on July 15th, two months from the date of operation, examination showed that there was no tenderness in the cervix, the Best Price Levitra Online old nervous symptoms and pains had entirely disappeared, and the patient had gained much in .strength. Now, here we have a patient who for over a year had had the benefit of hot douches and approved applications to the cervix and vaginal vault, and with evident improvement of the local condition. The laceration of the perinanini was slight, and in the three years since its occurrence had not resulted in any displacement of the uterus. The anteflexion probably antedated her Best Price Levitra Online last confineinent and still exists. There was not enough pelvic cellulitis or engorgement to cause any sensitiveness about the uterus, and the cervix it- self, with but slight ectropion, was covered witii a smooth epithelium. But, in spite of all Best Price Levitra Online this, the headache, pelvic pains, auiiemia, and nervousness had steadily gone on in- creasing. Hard, cicatricial tissue was removed from the angles of the cervical tear, and from the day of operation improvement was noticeable. The neuralgic symptoms dis- appeared at once, Best Price Levitra Online and the nervousness and anjemia steadily improved. In two months there was no tenderness in the line of union, and the patient expressed herself as well, and has remained so up to the present day. Case II. — Mrs. S., aged thirty-eight, Best Price Levitra Online first consulted me Janu- ary 29, 1884. She had been married seventeen years; liad had three children, but no abortions, all the labors, especially the last, being rather rapid. She dates her illness from her last labor, nearly ten years ago, but has been much worse for the past four Best Price Levitra Online years, during which time .she had occasional inenor- rbagia, with dysmenorrhoea, tree cervical leucorrhrea. and at times painful micturition. Her general health has been steadily failing, the anwmia becoming more and more marked, and she has lost much flesh. She is excessively nervous, so much so as to unfit her for her domestic duties or seeing friends. She is naturally a very active, energetic woman, and one who formerly bad her nerves well under control. Seven mouths before, she consulted a physician, who made Best Price Levitra Online some applications and fitted a pessary. Examination showed a double laceration of the cervix, with the lips somewhat granular, and a slight laceration of the peri- nreum. There was no marked tenderness about the uterus or in July 24, 1886. MOSELEY: CICATRICIAL PLUG. 99 the ligaments, but there was great sensitiveness on pressure deep in tlie angles of the cervical laceration, where the tissue was Best Price Levitra Online very hard. I thought it best to remove the pessary which was in her vagina. For nearly four months she was kept on Best Price Levitra Online general tonic treat- ment, with hot vaginal douches twice daily, and applications to tlie cervix and vaginal vault twice each week. During tliis time the granular condition of the cervix entirely disappeared, and there was considerable improvement in her general condi- tion, but her marked gain in health dated from the time of her operation, April 17th, on which day I removed a large amount of cicatricial tissue from both angles in the cervix, and at the same time repaired the comparatively small tear in her peri- nseum. From that time tlie gain was steady and rapid. The nervous symptoms, headache, and dyspepsia disappeared ; her color became good and she gained rapidly in flesh. I have seen her within a few weeks, and she informed me that she was really well. In this case we have a woman who had no cellulitis, no involution, no misplacement, no pelvic engorgement, but in whom there was present a Best Price Levitra Online mass of hard cicatricial tissue deep in the angles of an old laceration, these points being marked by Best Price Levitra Online great sensitiveness to pressure. Although she had improved somewhat under treatment, the change imme- diately following the operation was so marked that I could but believe that the cervix operation was the prime factor in her restoration to health. Case III. — Mrs. M., aged Best Price Levitra Online twenty-nine, consulted me Febru- ary 6, 188i, and was as thoroughly anffimic and run-down a woman as I have often seen, unable to walk two squares with- out great fatigue. She had been married four years and had had two children, the first labor being rapid and the last rather easy. She had been losing ground since her first labor, three years Best Price Levitra Online be- fore. Locomotion caused bearing-down feelings. Her bowels were constipated and her appetite was poor. She complained of almost constant headache, nervousness, and great weakness. Examination showed a uterus two inches and a half deep, lying slightly low in the pelvic cavity ; a double laceration of the cer- vix, deeper on the left side, with marked tenderness deep in the .angles. There was but slight eversion of the lips, which were covered with a smooth epithelium. There was no tenderness in the broad ligaments or in the pelvic tissues about the uterus. Four days later, February 10th, I removed considerable cica- tricial tissue from both angles of the cervical laceration, closing