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PITH OF CURRENT online elavil LITERATURE. 83 jpitb ai Current ^xltralurt. THE BOSTON MEDICAL ANO SURGICAL JOURNAL. July ./, iQor. 1. Retroversion and Its Treatment: An Analysis of Five Hundred Consecutive Cases at the Free Hospital for cheap elavil Women, By \V. P. Gr-W'es. 2. Neuralgia of the Superior Alaxillary Nerve. By Howard A. Lothrop. 3. " Organism X." elavil 50 mg Probably of the Coryne-Bacterium Gror.p : Its Differentiation from B. Diphtheriae and Allied Organisms. Its Pathogenicity in Man, Espe- cially in Bronchopneumonia and Its Relation to Gen- . eral Paralysis of the Insane. By Louis Ho.\G. 4. Painless Labor. Report of a Case Due to a Destructive Lesion of the Spinal Cord, By E. W. Taylor. 1. Retroversion and Its Treatment. — Graves has sent out letters to patients operated upon for retrover- sion of the uterus, inquiring after their health after operation. Two hundred and sixty-three patients an- swered the circular letter in a satisfactory manner. Of this number 86 per cent, stated that they elavil amitriptyline were either completely cured or much relieved b)' the oper- ation. Considering the numerous additional opera- tions, many of them serious ones, which complicated the operation for retroversion, this percentage must be regarded a satisfactor\- one. elavil buy It is interesting to note that those who elavil for anxiety were entirely cured or much relieved of elavil 25mg the symptoili of backache amounted to 85 per cent., in comparison with 86 per cent, of those cured or much relieved by the operation. This would tend to show that in the great majority of these cases, though com- plicated as many of them were, the retroversion was the chief cause for suffering on the part of the patient. It is also interesting to note in this connection that the anatomical recurrences of retroversion after the oper- ation, elavil for which is approximated at 15 per cent., corre- sponds closely to the proportion of patients who stated that they received slight or no relief from the opera- tion. Seventy per cent, of those having ovarian pain, elavil 25 and buy elavil online 70 per cent, of those sufYering from some disturb- elavil 10mg ance of menstruation, were either cured or relieved. Forty-eight per cent, were cured or relieved of con- stipation. The author thinks that with these figures in view and in consideration of the fact that the great majority of retroversion cases are complicated by other surgical diseases any argument as to the comparative merits of treatment by pessaries or tampons is prac- tically out of the question excepting in a few selected cases. 2. Neuralgia of the Superior Maxillary Nerve.- Lothrop describes his method, which has been devised for relief when the dental branches are the seat of pain. First, the teeth should be examined by a com- petent dentist, and if foimd to be sound they should not be extracted. .^ hotizontal or somewhat oblique incision about one inch long should he made over the exit- of the nerve from the infraorbital foramen and carried down to the bone. The nerve should be ex- posed at the foramen ;.nd with care the vessels may be spared injury, elavil 50 for a time at least, so as to avoid obscur- ing the field by ha;morrhage. elavil mg Free the cutaneous branches elavil 10 for a distance elavil 50mg and carefully isolate the main trunk. With elavil uses a small chisel remove the bridge of bone whicii completes the foramen above and also chisel awav a considcrnble portion of bone elavil 10 mg below the fora- men without injuring the nerve. Elevate the perios- tciun from the facial surface of the maxilla ilownward and outward towards its malar process and then con- tinue unelavil used for in front With rongeur forceps a channel should be made in the facial wall of the maxilla extending downward and outward to a point just under the malar process, and thence as far as possible on the zj-gomatic surface. By means of suitable retractors and properly curved rongeur forceps this procedure offers no difficulties. This channel should be from three eighths to one half inch wide. Thereby all dental branches are inter- cepted. The bony support of the alveolus is not ma- terially weakened, the teeth are not injured, nor is any harm done the antrum. Finally the main nerve trunk should be carefully isolated to the sphenomaxillary fissure elavil 25 mg where it is severed and then as much as possi- ble of the cutaneous distribution teased out. All haem-

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