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again in consultation ; to my surprise the enormous tumor had so much disappeared that the uterus now was not larger than at about the fourth or fifth month of pregnancv. There existed still a very offensive discharge, which, however, ceased very promptly after I had extracted from the uterine cavity the re- mainder of an entirely separated mass of tumor. The offensive smell of this sloughed tissue was beyond description. The uterine cavity was disinfected as thoroughly as possible, and disinfecting irrigations were kept up for some time after. The patient, though very much run down, made a rather rapid recovery, and was able, four months later, to see Dr. Schaie at liis ofiice. The latter has had the kindness to inform me that she is now in perfect health. About a year ago her menses — which had become quite normal — ceased. There is no recurrence of the tumor, and the parts seem to be in an almost normal condition. As far as I remember, Buying Levitra Online Safe the mass of the tumor at the first visit must have weighed at least from fifteen to twenty pounds. Case II. — Buying Levitra Online Safe Mrs. II., forty-six years of age, who had never been pregnant, consulted me in October last. Though otherwise in good health, she had suffered for the last two years from pro- fuse and prolonged menstruation, now and then associated with severe pain in her back and vomiting. Within the last month, a few days before and after menstruation, a white dis- charge had appeared. There was no doubt that her trouble was due to a Buying Levitra Online Safe fibro-myomatous tumor of such size that the uterus, on examination, reached within about two fingers' breadth of the umbilicus. From the 12th of October to the 6th of November about eighteen hypodermic injecti(ms of Squibb's fluid extract of ergot were administered in the hypogastric region. They caused a good deal of pain and inflammatory irritation, which were relieved by cold applications, so that no abscesses occurred ; small indurations, however, remained at the points of injection. During the menstrual periods the patient rested at home, tak- ing ergot internally, fifteen- to twenty- drop doses twice a day. On the 14th of December I was called to see her at her house. Buying Levitra Online Safe She had a bloody, Buying Levitra Online Safe somewhat offensive discharge from the vagi- na, and suffered from great restlessness and pain of labor-like character; the vaginal portion of the uterus was softened and dilated, and a soft mass could be felt within it. On the follow- ing day, under chloroform, a considerable mass — about a pound 20 PROCEEDINGS OF SOCIETIES. [N. ^ . Mki>. Jijijii.> and a half — of sloughed fibroinatous tumor was removed from the uterine cavity after lateral incisions into the vaginal portion had been made. On account of the narrowness of the sexual pas- sages and the impossibility of pulling the uterus down, I could not pass ray finger high into the uterine cavity, hut 1 was able to ascertain that a good Buying Levitra Online Safe many irregular necrotic pieces of tissue remained undetached as yet. Two drainage-tubes were intro- duced into the uterus, and repeated irrigations were made with a warm solution of salicylic and boracic acid, and, once or twice a day, with a corrosive-sublimate solution, 1 to 5,000. But, in spite of my endeavors, I did not succeed in preventing further decomposition ; the drainage-tubes were so often blocked up by small particles of necrotic tissue that they did not act satisfactori- ly ; besides that, their presence in the internal orifice seemed to be the source of constant irritation. I therefore removed tliem, and applied irrigations several times a day by passing a Fritsch's uterine irrigator high into the uterine cavity, usually inject- ing first a l-to-2,000 solution of corrosive sublimate, followed by an Buying Levitra Online Safe injection of boro-salicylic acid, according to Thiersch's prescription. Very soon, with Buying Levitra Online Safe repeated chills and high fever, the palpable symptoms of peri- aud parametritis set in, espe- cially in the cul-de-sac of Douglas, where a fibroma, inserted at the supra-vaginal portion of the cervix, had been felt be- fore; a dift'use infiltration and exudation could be made out pushing the lower portion of the uterus toward Buying Levitra Online Safe the symphysis. Dr. Noeggerath was called in consultation, and was likewise convinced of the extremely precarious condition of the patient. It was then decided to renew the attempt to remove the source of infection from the uterine cavity, and, on September 23d, with the assistance of Dr. Noeggerath, sloughed masses were again removed. It was discovered that, from the anterior as well as from the posterior aspect, tumor-like prominences pro- truded toward the uterine cavity, and that the process of sloughing was particularly seated posteriorly and toward the fundus. The uterus by this time had already become con- siderably reduced in size. On January Buying Levitra Online Safe 5th I made a deep in- cision into the exudation through the posterior cul-de-sac, evacuating pus mixed with small pieces of necrotic tissue, Buying Levitra Online Safe as I suppose, from the center of a fibroma which had undergone suppuration, and from that time, while the discharge from the uterus became gradually less, and almost daily small pieces of necrotic tissue were expelled, the patient's condition became decidedly better. Several times slight hemorrhages accom- panied the expulsion of sloughs. At present, for more than a month, the discharge has entirely ceased ; the uterus is very little Buying Levitra Online Safe larger than its normal size; but there is still a decided induration at the .seat of the para- and perimetritic inflamma- tion, which, however, is gradually diminishing. Her general condition is very good, and twice already, if I am not mistaken, the menstrual flow has appeared again, normal iu quantity and duration. The patient is now forty-seven years of age, and certainly very near the end of her menstrual Buying Levitra Online Safe life. I think there is very little probability that a new formation of fibro-myomata will occur. I am under the impression that in this case the whole of the tumor has not sloughed, but that, with the gradual contraction of the uterus, several lumps have disappeared either by atrophy or by fatty degeneration. It seems, further, that iu this case the administration of the ergot had a causal rela- tion to the necrosis and elimination of the main part of the tu- mor. Case III. — Miss B. L., twenty-eight years of ago, was in good health until four years ago, when she began to sutler from profuse menstrual hiemorrhage and pain in the back, which were ascribed by a physician to the presence of a uterine tumor. For about three mouths she was treated with hypo- dermic injections of ergot, altogether about thirty in number, but without success. Three years ago, in making a forced at- tempt to prevent herself from falling down by throwing her- self backward, she felt a severe pain in her abdomen and had a sensation as if something had been torn; the pain in her abdomen persisted during the summer; erirot internally was used again, but gave her no relief. In September, 1883, I saw the patient in consultation Buying Levitra Online Safe with Dr. Dieffenbach, when she pre- sented a deep-seated phlegmon of the abdominal wall in the retro-peritoneal space below the umbilicus. On the 15th of September, through an incision in Buying Levitra Online Safe the linea alba, a great quantity of pus was discharged; a drainage tube was passed at one point to such a depth into a rather small ap-