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tail of the pancreas were Buy Acticin Online similarly treated. The use of the clamp in this way has Acticin Price long been prac- ticed in vaginal hysterectomy, and similar treat- ment of the splenic pedicle seems justifiable, for the artery, near its termination, is practically without collateral branches, and the resulting thrombus should be as secure as that which forms after the application of the usual ligature. The fact that the clamp or clamps may become accidentally unlocked, especially during an attack of postoperative vomit- ing and lead to a fatal Buy Acticin renewal of the haemorrhage is the only valid objection to their use, but this ac- cident can scarcely happen if the clamps are careful- ly selected. That some form of drainage should Acticin Permethrin Cream be employed seems rational if for no other reason than to pro- vide for the possible contingency of damage to the adjacent pancreas. The tail of that organ is in close proximity Acticin Cream to the spleen and may simultane- ously be injured by the force of the trauma. Under such circumstances a drain for several days or longer would prove desirable especially if a pancre- atic fistula seemed inevitable. Such a complication was observed in the cases of Fontoynont and Bardenheuer and Boger. In the former, a woman of twenty-eight, splenectomy was done two hours after the accident. The adjacent tail of the pancreas was also torn. The clamps on the splenic pedicle were left in situ and were re- moved on the third day. A tampon was also intro- duced, a pancreatic fistula forming, which eventual- ly closed spontaneously. In the latter case a tear in the tail of the pancreas was sutured after the spleen was removed Generic Acticin for rupture. The patient re- covered. A successful case of splenectomy for rupture is also reported by Morison, in whicli Order Acticin there was dam- age to the tail of the pancreas. This case was drained through a stab puncture in the left loin, the abdominal wound being closed completely. Pri- mary union was secured, but there is no mention of a .subsequent pancreatic fistula through the counter- opening. The only Purchase Acticin Online possible objection to si)lencctnmy for rupture of the spleen consists in the fact that, in the al)scnce of accessory spleens which by their hy- pertrophy could easily and satisfactorily contiime the splenic functions, it necessitates the sacrifice of an organ which unquestionably is important to the body economy. That its preservation is not essen- tial, however, to a condition of perfect health, is of course proved by the numerous cases of complete recovery after its removal. That, on the other hand, some temporary constitutional disturbance may follow splenectomy is Order Acticin Online clearly shown by the cases in which a long persistent anaemia with gen- eral emaciation has Acticin Cream 5 been observed, as well as occa- sional instances of delay in the repair of associated lesions, particularly in the long bones. Thus, in Notzel's case, there was no evidence of callus for- mation in a fracture of the shaft of the humerus three months after the accident, and an operation done at that time for nonunion proved a total fail- ure. Six months later union was secured by a sec- ond operation of an osteoplastic character. In the first case reported by the writer a simple fracture of the shaft of the femur united with no special de- lay, although with rather more shortening than usual. The following instances may be cited in illustra- tion of the disturbances of the body economy that sometimes follow splenectomy. Ballance reports a case of a female of forty-five who made good progress during the first week after a splenectomy. Then the pulse became 120 to 130, the temperature 100° to 101° F. There was threat- ened anorexia, pain in the Buy Cheap Acticin limbs, especially along the tibia and little urine. The patient showed a tenden- cy to sleep all day. She fainted on changing her position, in bed. The patient was fed on grilled spleen and on extract of spleen, with ultimate re- covery. The same observer also reports a second case in a man of thirty-six. Two weeks after the operation this patient became cachectic with loss of flesh and sunken face. There was weakness and thirst, and Purchase Acticin the patient continued to lose ground for four weeks. He was given cod liver oil and mar- row on toast, but finally improved and ultimately recovered on the use of arsenic. At the end of four months, slight enlargement of the lymphatic glands could be detected. \'on Beck reports a case of slow recovery from an acute anremia following splenectomy without any appreciable enlargement of the lymphatic glands or thyreoid. Heaton reports a case in a boy in which anaemia persisted for six months after operation. Lewerenz reports a case of a man, twenty-seven years of age, in whom some psychic disturbance

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