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May 7, 1898, AMERICAN SURGICAL ASSOCIATION. 607 of-Paris jacket brought about an excellent recovery. While in the second case presenting practically the same symptoms the same method of treatment was of no avail ; the patient died in three days. He did not think surgeons were at present in a position to formulate any rules for the treatment of these injuries. Dr. Burrell also continued the discussion by com- menting on the cases reported by Drs. Carson and Car- malt* and stated that no doubt a reunion of the fibers of the cord by the formation of connective tissues often took place in cases of these injuries, this connective tissue sub- sequently undergoing absorption. Dr. Halsted reported having had one successful case of purchase atarax online this kind in his experience. He agreed, however, in the main with what had already been said on this subject. Dr. Prewitt said that fractures of the kind referred to by Dr. Carson atarax cost should be called simple fractures in the speaker's opinion especially as they oft times resulted from a displacement of the body of the vertebra itself. Pressure upon the cord can as well be caused by a dislo- cation as by a fracture and this is particularly true if there be a fracture of the lamina. He believed that gunshot wounds should always be considered as compound and atarax tablets 25mg local and considered that the inability to determine the method of procedure in these order atarax cases was due principally to the fact that one was not able to judge, from the symp- toms present, what the exact condition of the cord was, thus making an operation necessary to determine this point No harm could be done by opening up and disin- fecting the wound, particularly when it atarax price has been proven that most of the cases die anyway. He was strongly in favor of giving the patient the benefit of whatever doubt might exist, especially as one might at least reduce the likelihood of meningitis, even though life might not be spared very long. He drew especial attention to a case reported by Haw- ley of gunshot injury of the spine where the cause of death, which occurred 5 % years later, was due to irrita- tion caused by a fragment of bone. He was confident of the opinion that this man's life could have been spared many years had an buy atarax online operation been performed at the time of the accident and the fragments removed. With regard to the use of plaster-of-Paris jacket the author had been quite favorably impressed with the re- sults obtained, and called attention to the statistics of Dr. Burrell. If, in cases of gunshot injury, one had good reason to believe that there was no pressure upon the cord, he would not urge immediate operative interference but he was of the opinion that in all these cases pressure, symptoms would be noted from the presence of spicules of bone and pieces of lead long after the accident. As stated by where to buy atarax Erichsen, since little harm could be done by operation and a few order atarax online cases would be rescued, the speaker believed operation advisable. Dr. James E. Moore of Minneapolis read a paper, entitled HYSTERIA FROM A SURGICAL STANDPOINT. Hysteria is so frequently met with in surgical cases that it is something one must always be looking for or grave er- rors in diagnosis and prognosis will result. Hysterical symptoms not infrequently occur as a complication of operation, while a atarax online rise of temperature after an operation may also be neurotic. To illustrate this fact, and also that persistent hiccough, cough, and emesis following an- esthesia may be hysterical, a number of cases were cited in detail. The author then referred to the peculiarities of some cases of phantom tumors and to one of hysterical aphonia following an operation on an adult male. He urged great care in operating, or even advising operation, upon neurotic females in whom the subjective symptoms are often out of all proportion to the objective, especially as these women not only are often willing to submit to grave surgical operations when their sufferings are entirely im- aginary, but because they not infrequently derive consid- erable morbid pleasure from the procedure. In his opin- ion the osteopaths and Christian scientists rather buy cheap atarax than a surgeon should undertake the treatment of these cases. The most skilled diagnosticians will often be misled by the mingling of real diseases with generic atarax hysterical hyperes- thesia, anesthesia, paresis, and atarax 10mg seemingly complete par-, alysia. As a atarax 50 mg valuable aid to diagnosis the author referred to Patrick's method of diagnosticating hysterical hyperes- thesia or anesthesia by means of the shifting border of the affected area. The surgeon most frequently meets with hysteria atarax mg in joint and spinal ailments and a surgeon should always remember to avoid mistakes in diagnosis and prognosis in the case of hysterical joints, as they bear such a close resemblance to joints, cheap atarax the seat of disease. These hysterical joints often follow an injury and there will be slight atrophy but no local rise of tem- perature, in fact the temperature may be subnormal, no marked purchase atarax swelling buy atarax but slight puffiness may be noted. There is usually marked restriction of motion which is voluntary in character however, and readily overcome when the patient's attention is directed to something else. The mus- cular spasm in these cases is more pronounced and differ- ent in character from that in tuberculosis and the deform- ty is often exaggerated and differs considerably from that which is present in disease. Hysterical joints are o * course most prominent in hysterical persons, but have been observed in atarax tablets persons not in any way hysterical. The prog- nosis in the case of a hysterical joint is good and it is very rare that organic changes occur. The author then dwelt at great length upon various valuable means of treating these conditions, among other correction under anesthesia, atarax 25 mg but did not consider any

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