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pendix of the cavity as to allow of the conclusion that it must reach sopie distance into the abdominal cavity. After some time, when infiltration and pain had sufficiently ceased, it could be made out that a uterine tumor, originating from the fundus of the uterus, was adherent to the abdominal wall, and that a pus-cavity passed some distance into its mass. Suppuration went on for several months and the tumor gradually decreased in size, having presented originally about the dimen.sions of a small chihl's head. Small, irregular-shaped calcareous masses were repeatedly washed out or extracted from the bottom of the wound. On December 31, 1888, after having enlarged the existing opening, I removed from the narrow cavity, by scraping, elevator, forceps, and finger, quite a considerable quantity of calcareous spiculae, shells, Levitra Generico Prezzo In Farmacia and irregular-.shaped bodies — in all perhaps as much as a tablespoonfiil. Four weeks later cicatrization was complete, and since then the patient ha.s enjoyed perfect health. A hard lump, in conueftion with the soar, of about the size of a duck's egg can still be felt, but docs not cause the slightest inconvenience, while menstruation has at all times been normal. I can not say what connection exists at present between the tumor and the uterus, the patient not hav- ing undergone an examination of suflicient thoroughness. It seems that in this case, through an injury, perhaps by partial rupture of the insertion of the tumor, its nutrition was in- terfered with, until finally central softening with suppuration occurred which gradually led to its diminution and arrest of growth and development. No medicinal treatment was used after the operative interference. Though quite a number of cases are on record in which, after the manner described in the preceding histories, fibroma- tous tumors have disappeared, they are rather exceptional, and, withal, this natural way of healing is not free from danger, no small percentage of cases ending fatally. We are, therefore, in no way entitled to trust to such an exceptional and Levitra Generico Prezzo In Farmacia unreliable course of the disease so far as to give it any important weight in regard to our prognosis of fibro-myomatous tumors of the uterus. We know ouly too well that sometimes these tumors will have an unbounded development, which, after they have attained a certain size, becomes dangerous, and, in au impera- tive way, demands our surgical help, and that so much the more as in just these cases medicinal Levitra Generico Prezzo In Farmacia treatment is usually nothing but loss of time. With reference to the question how far the extirpation of the ovaries may effectually check the development of fibro-myo- matous tumors, I am unable to give a satisfactory answer from my own experience. I have attempted the operation once, but only to find out that in that case the removal of the ovaries would have been Levitra Generico Prezzo In Farmacia a very tedious operation, and probably not much less dangerous than the remov.al of the whole inass. In those five cases in which so far I have seen the necessity of performing supra-vaginal amputation of the uterus for the dis- ease in question, the tumors were of such uncommon size and were mostly so complicated by adhesions, that it would have July 3, IS^ti.J PROCEEDINGS OF SOCIETIES. 21 been no easy thing at all to get at the ovaries, and this, together with the question whether in such cases castration proraises the desired result, led me in all those five cases to frive prefer- ence to the radical method of operating. AD have ended in recovery ; two of them have been reported to this society in previous years, one of them being complicated with pregnancy. The third patient was operated upon about a year and a half ago. Of the last two operations in the course of this year I present before you the tumors removed. With reference to the third of the before-mentioned cases, I should say that it was that of a married lady of about thirty-three years of age, who for several years at every menstrual period had bled so abundantly as to become quite ana?mic, her whole way of living finally being devoted to the purpose of building her- self up to stand the dangers of the next menstruation. She suffered repeatedly from alarming attacks of weakness of the heart, which seemed to be dilated in its right half, and there was no doubt that, every other remedy Levitra Generico Prezzo In Farmacia having proved ineffectual, she would finally have died from the consequences of a fibro- myomatons degeneration of the uterus, whicli, as the specimen afterward proved, consisted of a large number of tumors of ditierent size and location, massed together Levitra Generico Prezzo In Farmacia in tlie different layers of the uterus and forming a tumor of the size of the uterus in its seventh week of pregnancy. The operation was performed in about the same manner I am going to describe in the following cases, and recovery took place without any un- toward symptom, except that about two months after the opera- tion the elastic ligature by which the stump of the uterus had been secured passed away through the external os. The lady is now Levitra Generico Prezzo In Farmacia in flourishing health. About four months ago she lost Levitra Generico Prezzo In Farmacia a considerable quantity of blood witli tier urine for three or four days, with some feeling of pain in her back, and the general sensation as if she had lier periods. The Levitra Generico Prezzo In Farmacia urine afterward be- came quite normal, and, as far as I know, no such hsemorrhage has since occurred. She professes to enjoy sexual intercourse without impairment as compared with her healthy period of married life before the operation. Lately she is becoming rather stout. In January of this year Miss W., thirty-three years of age, consulted me for an abdominal tumor which had been noticed for the past three years, but only lately attention had been called to it by its more rapid growth and large size, having been the source Levitra Generico Prezzo In Farmacia of disturbance. The whole aVjdomen seemed to be occupied by a resistant, rather smooth tumor, reaching from the OS pubis high up to the epigastrium and tlie free border of the ribs. The same was very movable, and allowed of passing the fingers partly under it toward the entrance of the true pelvis, so that on the first examination it did not seem to take its origin from a pelvic organ, though its movements were com- municated to the uterus. A closer examination, however, re- vealed a connection with the fundus uteri, and made the diag- nosis Levitra Generico Prezzo In Farmacia of a pedunculated fibrons tumor the most probable. In this case the operation was comparatively simple. Though it would have been possible to remove the tumor witliout sacri- ficing the internal sexual organs, I still deemed it advisable to perform supra-vaginal amputation for the following reasons : First, I thought of the possibility that, from its rapid growth within the last Levitra Generico Prezzo In Farmacia few months, tlie tumor might have assumed a more malignant character; and, secondly, several small begin- ning fibromata could be distinguished lower down within the walls of the uterus, which, if left, would have developed further and jierhaps more rapidly. Tlie operation was performed in the following manner: Through an incision in the linea alba reaching from the epi- gastrium almost down to the symphysis pubis the tumor was slowly and without difficulty brouglit out through the abdominal walls ; the adhesions were but very slight. Enormously dilated