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be generic diflucan cost of interest to the readers of the Medical News, the operation was never reported. However, a short time ago, generic diflucan over counter in looking over •• Pepper's System of Medicine," vol. v, Edit, 1886, it was noted that only twenty-three cases of excision, with separate suture of the sac (the operation we did), with sixteen successful results, had generic diflucan 150 mg been reported. This encouraged diflucan costo me to report my own case, discount diflucan which, if it gives no other information, will show what we country fellows sometimes do. The patient was first seen when tie was about five or six hours old, and was found to be a healthy- generic diflucan no prescription looking child, with the exception of a large tumor over the spine at the diflucan gel costo lumbosacral junction, diflucan compresse costo and a most remarkable absence of bone in the composition of the cranium, the anterior and posterior fontanels being very large, and the sutures plainly demonstrable. Noting that the child kicked in a lively manner, which was taken as a criterion favorable to treatment, the parents diflucan cost with insurance were advised of possibilities and an operation recom- mended. They consented, and Mayo-Robson's oper- ation was decided upon. Delay was deemed advisable, that the child might become accustomed to being outside the uterus, so we costo del diflucan did not operate until he was seven weeks old. The tumor was pedunculated, round, tense, slightly flattened, slightly transparent, and fluctuated. It was i3# inches in circumference at the largest part, and was covered by thin skin. diflucan cost There was a peculiar, reddish, crusty spot, about the size of a half-dollar, near the fundus of the tumor, from the center of which leaked a few drops of serum. Continuous pressure would cause the growth to relax, and would produce stupor of the child. We made injections of a two-per-cent. solution of co- cain about every half inch around the base of the tumor, on one side of the spine, then, making an incision, we worked a grooved director along and divided the pfizer diflucan costo integument. A copper uterine sound was pushed between the sac and the skin, and bent from one angle of the incision out at the other. Looping on a ligature, it was drawn around the tumor and tied. A cannula was now introduced, and and about half the fluid allowed to flow out. We found it very difficult to separate the flap from the sac, and the child began to show symptoms of shock. Dr. Davis ad- vised and gave a hypodermic injection of diluted whisky. After the patient revived we finished separating the adhe- sions and laid open the sac. I now discovered that I had failed to draw the ligature sufficiently tight to constrict the pedicle, and that a cord- like process, about three lines in diameter, came through the aperture in the spinal column and attached itself to the reddish spot above mentioned. This was later found to be a bundle of nerves, vessels, and connective 1 issue. Another ligature was placed on the pedicle and tied, after which the sac and cord were cut away. Almost at once the ligature slipped and a hemorrhage generic diflucan fluconazole occurred from the stump of the cord, which was controlled by pressure with the finger. The bony ring was #-inch in diameter. Thanks to my assistant the spinal fluid did not pour out. The sac was brought together transversely with a con- tinuous silk suture. The periosteum should have now been grafted, but the patient being again in a condition of shock, we thought best to at once close the wound. The flap reached well around the internal wound. Dr. Davis suggested that it would not be well for the child to nurse from his mother's breast because of her undue excitement, so a neighbor kindly consented to act as wet-nurse. There is only one point in the dressing which should be mentioned, viz., an improvised truss, consisting of a disk of Digitized by Google 536 OUR BERLIN LETTER. [Medical News lead about two inches in diameter, backed with a ball of cotton, and a pad of the same material in front. Four days after the operation the dressing was changed and the wound was found to be doing well. By the eighth day two- thirds of the wound had healed ; diflucan cost without insurance and at this time the external stitches were removed. The diflucan 150 costo temperature was not at any time over 101. 5 ° F. The patient continued to do well about four weeks, when a generic diflucan online fistulous opening formed and the internal suture made its way out. The use of the truss was continued until about three months ago, when the bones were seem- ingly in such close proximity as to make diflucan 150 mg costo its use no longer necessary. In May, 1897, buy generic diflucan online the child had hydrocephalus. For this the usual treatment was instituted. The circumference of the head was 20X inches. The patient was recently again seen, and at this time, the last visit, the vertebra seemed to have approximated. how much diflucan cost The circumference of the head (with long hair) was twenty-one inches. The anterior fontanel still remained large. The patient does not use his left leg as well as the right. A. Dan Morgan, M.D. Witt's Mills, Aiken County, S. C. March 22, 1898. OUR BERLIN LETTER. [From oar Special Correspondent]

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