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TRANSACTIONS OF FOREIGN SOCIETIES. 567 have recently appeared. phenergan online Professor Sonnenberg's article in Communications from the Borderland of Surgery and Medicine (ibe last number) contains an interesting dis- cussion of certain points in the etiology and pathology of the disease. It forms an additional chapter to his book on the subject which appeared at the end of the year. Professor Kiimmers article in the Berliner Klinische Wockenschrift % April nth, is of phenergan syrup more practical import. Kummell's statistics of the mortality from appendicitis, according to the period of the phenergan buy disease at which treatment is begun, are interesting. In 1 order phenergan 5 cases in which treatment was begun on the first day, there were no deaths ; of 44 on the second day, there were two deaths; phenergan cream 76 on the third and fourth days, with 4 deaths ; 4 on the fifth day, with 2 deaths; 102 between the sixth and tenth days, with 9 deaths; 54 between the eleventh and fifteen days, with 4 deaths. Treatment does not necessarily mean radical surgical intervention, but coming under medical care in such a way that the cheap phenergan course of the disease may be carefully observed, and unhampered judgment as to the best method to purchase phenergan be followed in the case can then be made. TRANSACTIONS OF FORE I ON SOCI ETI £S. London. CHRONIC GASTRIC ULCER AND ACUTE PERFORATING ULCER — AGE CHANGES IN PLACENTA AND MEM- BRANES — PERFORATING WOUNDS OF THE KNEE- JOINT — AMMONIUM-CHLORID TEST FOR URIC ACID — NATURE OF KALA-AZAR — ASEPTIC OPHTHALMIC SURGERY — GASTRIC DILATION. At a meeting of the Medical Society, March 14th, Taylor read a paper on "Gastric Ulcer." He said he believed that chronic and perforating ulcer and acute ulcer are two different and distinct diseases. The former attacks males in seventy-two per cent, of the cases, and usually subjects between forty-five and sixty years or age. It occurs in those persons who live busy, energetic lives. It is irregular in outline, situated near the pylorus, and the proliferation of tissue which it produces usually prevents perforation before there has been formed an adhesion to some solid viscus. There is little doubt that such ulcers are chronic from the first. The patients are extremely prone to errors in diet. A clean punched-out ulcer is very rare in phenergan and codeine males, and in females it occurs almost exclu- sively, between the ages of sixteen and thirty years. The frequent association of chlorosis and ulcer is 25 mg phenergan more than ac- cidental, for in almost every acute ulcer there is a previous history of chlorosis. These ulcers have no proliferative zone, as do the chronic ones in men. He suggested that the lesion is of the phenergan 25 nature of a neurotic dystrophy. Other theories which have been advanced are: (1) mechanical, which has not clinical evidence to support it ; (2) vascular, which does not explain the occurrence of a single ulcer in- stead of many; (3) glandular, which does not explain the fact that these ulcers occur in women alone. In favor of the local neurosis theory is to be mentioned the fact that these ulcers occur in young women ; that in appear- ance they resemble perforating ulcers of phenergan vc the foot, and that they are undoubtedly associated with chlorosis. Williams said that the association between chlorosis and ulcer is not a very close one, since ulcer occurs in only a small proportion of chlorotic patients. In the treatment of these patients he prefers to feed by rectum, though that sometimes occasions biliousness, due appar- ently to the lack of the normal stimulus to the flow of bile which the presence of food affords. Bowles said that phenergan iv many of the patients are hard- worked servants, who did not get sufficient rest. Rest of mind and body and good hygienic surroundings are the essentials of treatment. He had observed good results from the use of bismuth and hydrocyanic acid, with or without small doses of opium. At the Pathological Society, March 1 5th*, Eden read a paper on ' 'Age Changes in the Placenta and Membranes. " The life of the placenta is a short one. It grows rapidly, and as rapidly grows old, and is then shed like a withered leaf. The ripe placenta is a worn-out organ, and shows changes of senile degeneration which must be dis- tinguished from real pathologic changes. It is because these alterations have often been mistaken for pathologic ones, and also because the placentas of macerated fetuses have been used for purposes of study that there is so much confusion about this subject. The following senile changes can be detected in the placenta at term: (1) Endarteritis obliterans affecting considerable tracts of the middle- sized umbilical phenergan mg arteries ; (2) degenerative changes in the chorionic epithelium and phenergan dm in the decidual cells of the sero- tina; (3) phenergan use the formation of "white infarcts"; (4) throm- bosis of a certain number of the subplacental sinuses and serotinal vessels. The presence of these changes in pla- cental tissue suffices to indicate that it belongs to the end of the gestation period. At the Clinical Society, March nth, Wallis detailed three cases in which the knee-joint had been perforated. In one, seen twenty-four hours after the injury, the joint contained only blood. In two others, seen two and fourteen days respectively after the accident, there was already suppuration in phenergan dm syrup the joint-cavity. In all of the cases phenergan codeine syrup the joints were washed out phenergan with codeine with a dilute solution of bichlorid of mercury and then sewed up. In the first, healing oc- curred without trouble ; the continued suppuration in the phenergan codeine other two required further incision and drainage, and in the last case excision of the knee was finally required. Though in the two cases of suppuration mentioned it had been necessary to reopen the joints for drainage, the speaker thought it belter to attempt a cure without drain- age, as this treatment is sometimes followed by success. Barker agreed with Wallis that drainage of the knee- joint is often overdone, though in septic cases it is some- times unavoidable. He objected to the use of irritating antiseptics for irrigation. Those germs which are too deeply seated to be mechanically flushed out, can only be

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