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Still further condensed the results were as fol- lows : Of 6 cases : i died after first stage of opera- tion ; 2 recovered after removal of tumor ; i relieved February i8, 1905.] FRAZIER: TUMORS OF CEREBELLUM. 333 after evacuation of cyst, no Buy Cheap Oxybutynin recurrence more Cheap Ditropan than a year after Oxybutynin Online operation ; i considerably improved after palliative operation; i no improvement ; Buy Ditropan Online tumor not found. My personal experience with this series of cases leads me to believe that the dangers attending cere- bellar operations have been somewhat exaggerated. The present generation of surgeons has inherited the traditional fear of operations within the cranial cavity. It was not very long ago that operations upon the Gasserian ganglion were regarded Purchase Oxybutynin as desperate undertakings, when it was a case of kill or cure, whereas at the present time the operation is under- taken with no especial concern except upon individ- uals, who on account of their advanced years might be unfavorable subjects Buy Oxybutynin for any major operation. And so it is with tumors of the brain generally and especially with regard to tumors of the cerebellum. Physicians put off the question of operation until the patient's condition becomes critical and the surgeon undertakes the operation with Generic Ditropan fear and reluctance. It was not so long ago that Oppenheim classed all tumors of the cerebellum as inoperable, but in the last editions of his book (1902) he frank- ly confesses that his opinion on this point is in need of revision. The dangers and risk peculiar to this operation lie in the proximity of the medulla and pons to the Generic Oxybutynin field of operation and the traumatism to which they may be subjected in the course of the operation. It is on this account that stress has been laid upon the advisability of approaching the cerebellopontile angle from the lateral aspect in order not to injure these structures. In a case of Woolsey's previously referred to, the Order Oxybutynin Online autopsy Purchase Oxybutynin Online revealed a haemorrhage in the pons which the operator attributed to the trau- matism to which it was subjected while he was re- moving piecemeal Order Ditropan a tumor of the auditory nerve. If in the fatal cases a careful examination of pons and medulla had been made we believe that in a majority some evidence of traumatism would have been found. It is only Buy Ditropan in the avoidance of every possible source or degree of traumatism to these vital structures that surgeons can hope to obtain better results. In this connection we refer again to the impunity with which a considerable portion of one cerebellar hemisphere can be removed, since by so doing the operator Order Oxybutynin not only can explore, and expose the tumor, but also remove it without the necessity of exerting undue traction or pressure directly or indirectly upon the pons. This of course applies especially to tumors that were not within the hemisphere. Order Ditropan Online We have been struck Buy Oxybutynin Online especially with the com- paratively slight depression attending operations upon the cerebellum ' and with the rapidity with which reaction ensues. In one of our cases the pa- tient lost a large quantity of blood in a very Purchase Ditropan Online short time, but recovered promptly from the effects, after the administration of appropriate remedies. This patient died twelve hours after the operation sud- denly and Buy Cheap Ditropan unexpectedly, but ten minutes before he died his general condition was reported as excellent. Our experiences, however, we believe to be excep- tional, as there are recorded in literature many cases in which the patients died on the table or a few hours after the operation. We have noted, however, that the gravity of the operation does not seem to have been affected by the act of removing the tumor ; whether the opera- tion was solely exploratory or palliative, or whether a tumor was removed, the Ditropan Online effect upon the patient was the same. STATISTICAL STUDY OF 1 16 CASES OF OPERATION UPON THE CEREBELLUM, Purchase Ditropan COLLECTED BY FRAZIER. The following statistics were compiled from the 116 cases of cerebellar tumors found in the ap- pended table, pp. 334 to 337: Per cent. Tumors found 45

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