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drainage on the sixth day. The patient was about the ward on the fourteenth day, and on the twentieth day left the hospital with the wound entirely closed except for superficial granulations. On September loth the patient returned to his work as a master plumber and had not missed a day since. He was now perfectly well, with heart sounds normal and regular. Although the wound healed by granulation, there was never any pus and the patient's temperature after the second day was practically normal. Dr. Gibhon believed that this was the fifth success- ful case reported in this country. Although the first successful operation was done in i8g6, since then about 100 operations for stab wound of the heart hail been reported, with a recovery of from thirty-five to forty per cent. He urged that in the event Famvir 500 of question of injury of the heart an exploration should be made just as in questionable wounds of the abdominal wall. In future cases he would close the pericardium and only drain the external wound. Extensive osteoplastic re- sections for exposure of the heart were not approved of, unless the pleura was shown to be injured. In this case he had ample room for manipulation after the sub- periosteal resection of the cartilage and a portion of the rib. This was Dr. Gibbon's second case of suture of a heart wound. The first patient died on the table after tiie introduction of one suture. Dr. Francis T. Stew.^rt said it was not an easy mat- ter to tell the character of the wound from the heart beat. Famciclovir Famvir He referred to a case presented to the college a Order Famvir year ago by himself, and since that time he had seen three cases of wounds in the vicinity of the heart. The Famvir 500mg safest plan with wounds in the neighborhood of the heart was exploration. If necessary there should be resection of the rib above and below. There had been cases in which the operator had opened the pericar- Buy Famvir Online dium, but, failing to find the wound in Purchase Famvir the heart, closed the chest, with death as a result. He considered infec- tion as a large factor in delaying convalescence and causing fatal results. One of the greatest objections to the introduction of gauze or a tube Famvir Online into the pericar- dium was the possibility of adhesions. Dr. James Tyson referred to a case of resection of the rib in which the proximity of the heart to the pos- terior chest wall seemed immediate. Dr. James C. Wilson thought the possibility of ad- hesions not of sufficient importance to deter the sur- geon from draining. He referred to the fact that more or less extensive pericardial adhesions occurred after various kinds of pericarditis without much modifica- tion of the physical signs in the precordial area or in the circulatory signs. Dr. J. Allison Scott Famvir Price referred to a paper presented about a year before by Dr. LeConte and Buy Famvir himself, upon the medical and surgical aspects of pyopericarditis, in which were cited four cases. Three of the patients were operated on and recovered. All had been drained. From his observations of the precordial area since the operation he was not convinced that the heart really became adherent, and he agreed with Dr. Wilson that drainage should Order Famvir Online be instituted Buy Cheap Famvir if indicated. Dr. Joseph Sailer thought the safest treatment in these cases was invariably surgical. This was the re- sult of his experience with two cases. He thought that the formation of a blood clot offered more injury to the patient than an exploratory operation Famvir Buy and drain- age of the pericardial cavity after repair of the heart wound. Dr. Gibbon thought that if drainage of Famvir 500 Mg the pericar- dium could be avoided, it should be. Unless infection was pretty surely indicated, Purchase Famvir Online he would not drain, not for fear of Famvir 250 Mg adhesions, but because of the greater risk offered than by closing the pericardium and draining • only the external wound. ^0oh Uotixfs. On the Nature, Causes, Cheap Famvir Variety, and Treatment Famvir Famciclovir of Bodily Deformities, in a Series of Lectures Deliv- ered at the City Orthop.xdic Hospital in the Year 1852 and Subsequently. By the Late E. J. Chance, F. R. C. S., Eng., Surgeon to the City Orthopaedic Hospital, etc. With Illustrations Drawn on Wood by the Author from Cases in His Own Practice and Many Additional Drawings and Copious Notes from Cases in the Editor's Practice. Edited by John Poland, F. R. C. S., Eng., Surgeon to the City Orthopedic Hospital, etc. Second Edition, Famvir Purchase in Two ■Volumes. Vol. I. London: Smith, Elder, & Co., 1905, Pp. xlviii-3is. It is certainly a hazardous experiment, from the point of view of popular interest, to republish lectures on any medical topic delivered over fifty years ago. The six lectures in the present volume are concerned almost Famvir Cost entirely with the classification and a;tioIogy of deform- ity. While historically interesting and valuable, they can hardly be said, even with Mr. Poland's notes, to reflect the present state of our knowledge. Mr. Chance was evidently an excellent observer, and made good use of his exceptional opportunities for noting cases of interest, but the book will give little satisfaction on the

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