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4^0 THE MECHANISM OF SPONTAISTEOIIS testimony of Martin and Alt shows tliat motilium imodium it is easier to pene- trate the tissue motilium cost of the uterus than enter the tube. Dr. Tyler Smith was the first to call the attention of the profession to Fallopian-tube catheterization, in 1849, for sterility. The in- strument he used was the Gairal Eustachian catheter and then introduced through it a fine whalebone bougie, to enter motilium mg the tube. Dr. S. M. Cartwright, of ISTew Orleans, has cauterized the motilium domperidone 10mg Fal- lopian tube with nitrate of silver. He has also treated success- fully a case of ovarian tumor in 1851 through the tube. He does not consider it easy in an unimpregnated state of the uterus to catheterize the Fallopian tube, unless the uterus is diseased. It is of course difiicult to decide on the exact status of the uterus wdiere the sound enters to such a length in the unimpregnated state. I conceive, however, that it is a demonstrated fact, and, as I have seen no unfavorable symptoms springing from that mode of motilium tablets 10mg testing the length of the uterus, whether in the newly- confined or unimpregnated state, I must reject the opinions which advocate the perforation of the uterus, or the entrance in a large number of cases into the Fallopian tube ; and recog- nize the soft condition of the uterus, spoken of above as causing the ductility, which, when sounded, gives rise to the different lengths, as stated. In the Atlanta Medical and tSurgioal Journal for December, 1871, before the Atlanta Academy of Medicine, this lengthened state of the uterus for procidentia uteri was under observation and discussion ; and the various opinions expressed on motilium buy this subject, without any reference to the condition of the uterus, I have referred to in this article on the ductility in procidentia uteri. Boyer claims that there must be a certain condition of the uterus in the unimpregnated state before inversion may motilium generic take place. What that motilium online condition is he does not state, but it has no relation to gestation or expansion motilium price of the body of the uterus by any foreign substance. Ashwell hints at it, while he ad- mits inversion may occur in the domperidone motilium non-pregnant uterus. Resting as I have upon the term " squatty uterus " as significant in its characteristics of softness, flabbiness, size, and ductility, as tested in many motilium 10 instances by the sound, or becoming procident by the gravity of its position, my experience would author- ize me to adopt that peculiar or certain condition I have re- ACTIVE UTERINE rNVEESIOjS'. 461 ferred to of the uterus. I frankly admit, that I do not pro- fess to give its true status, unless it is simply buy motilium online what is referred to by some cheap motilium of the older gynaecologists as an intumescence. It is certainly in many purchase motilium cases not a true pathological change of struct- ure such as we notice in the uterus after confinement, and motilium tablets be- fore perfect and natural involution has transpired, whether of recent date or after some years, as we recognize in procidentia uteri. "We must bear in mind the peculiar structure of the ute- rus, isolated as an organ from every other visceral structure in the human frame, springing into existence as a physiological organ at puberty, subject to important physiological and pathological changes or processes dm'ing a thirty-year's life, formed anew again and again, as motilium canada a consequence of gestation, then passing into forgetfulness, and physiologically, virtually dead, but incident to other serious pathological mutations after- ward. During, therefore, this living existence many changes or peculiar conditions of its structure transpire which no gynsecologist has yet recognized and explained, but the facts we notice, and the observations I have made, are founded on the facts under our cognizance. In illustration of the cases I propose presenting for con- sideration, after the general remarks I have made, and to pave the way for further investigation and observation, I shall offer first the case of Mr. "William Lawrence, of London, pub- lished in the London Medical Gazette^ December 5, 1838, in a clinical lecture, and order motilium is styled " Spontaneous Partial motilium uk Inversion of the Uterus." Xo authorities that I have read, except Klob, have made any reference to his case. Klob mentions it only incidentally, and says : " A very remarkable class of cases of inversion are those in which, without efficient cause, an inversion of the cervix into the vagina takes place, drawing the fornix of the latter with it, and thus forming a polypus-like tumor in the cavity of the vagina, which may reach down to the vulva, at the lower part of which the internal orifice is situa- ted." This description of Klob's would answer for Lawrence's case, the recital of which will show a more extensive in- version than he has alluded to. In my monograph, referred to above, I illustrated my views on the subject of the eversion \ 462 THE MECHANISM OF SPONTANEOUS of tlie cervix uteri, and gave cases which measured, motilium pharmacy when com plete, from three to four inches in diameter. In the cases to be related by Lawi'ence and myself of partial inversion of the uterus, tliey are greater in length and differ in appearance entirely from eversion, as the diagram will show. The case of Lawrence appears either to have been overlooked or ig- nored by those wlio have advocated the views as maintained above. It is too much the case with members in our profession to disparage all evidence which has a practical bearing on old and preconceived opinions, and while they have no more van- tage-ground, if as much, from the theories they wish to advocate and circulate, they dismiss the subject by 6im])ly considering it an error of diagnosis, or a mistake entirely. For one, I am dis-

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