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chloride dressing applied. On the operating table this dressing was women viagra pills in india removed by a sterile assistant, the parts rescrubbed for one minute, douched with ether, alco- hol, and 1-5U00 solution of sublimate. The wound area was surrounded by sterile towels and the entire body covered by sterile sheets. Sterile caps, gowns and gloves were worn by all participating in the operation. The tow'els around the wound area were flanged as often as soiled, and always before the insertion of the cutaneous sutures. Their method of sterilizing their materials did not differ in any material way from that employed in any modern surgical clinic. Frequent bacteriological examinations demonstrated that their materials were sterile. They did not wear face masks because they had a system of signals by which they were enabled to avoid talking during operations. The tables submitted gave their results in the clean cases, and would show the number of infected cases rendered sterile by their operative treatment. It- would be seen that for the first six months in 1912, the percentage of infection occurring women viagra pills in india in clean operative wounds was 2.4 per cent. This was larger than they had anticipated and certain additional precautions were instituted. For the second six months of 1912 the percentage of infec- tion was 1.2 per cent. For the first six months of 1913 the percentage was 1.8 per cent, and for the last half of 1913 l.(i per cent, if they included three eases in which infection occurred as a result of using an un- sterile solution of novocaine for local anesthesia, for women viagra pills in india which none of the women viagra pills in india operative room staff was in any way responsible. For the six months ending July 1, 1914, no infections occurred in the 273 clean cases. From Juh 1, 1913 to July 1, 1914, only one infection occurred in 516 cases women viagra pills in india for which the operating staff could genericos viagra india be held responsible, a little less than 0.2 per cent. Dr. Fenton B. Turck said that the condition of the patient that favored autoinfection was quite as im- portant as the care in the prevention of infection from extrinsic sources. In 189(5, 1900 and 1903, he genericos viagra india carried out a series of experiments on animals, genericos viagra india which were pub- lished at the time, and compared them with studies in cases operated on by Drs. Senn, Murphy and others. It was found that shock or marked splanchnic conges- tion precipitated by genericos viagra india trauma, anesthesia, etc., lowered the resistance so that even saprophytes such as staphylo- coccus albus from the skin and colon bacillus caiised post-operative women viagra pills in india infection equally as fatal as the more virulent groups from extrinsic sources. Normal ani- mals used as controls gave negative results. The es- sential things, which he had women viagra pills in india previously presented, and treatment outlined, were the prevention of shock and prompt reduction of splanchnic congestion and increase of the resistance — the antibodies — on the part of the patient. New Points in the Handling of Recent Fractures of the Femoral Neck. — Dr. R. H. M. Dawbaen presented this communication, which he prefaced by referring to the use of mnemonic keys as a help to memory, women viagra pills in india and sug- gested "Pine Branches" as naturally associated with the brittleness of old bones. The chief signs of fracture of the femoral neck were as follows: Pain and tenderness, inability (disability), neck shortening (noticed upon ro- tation), external rotation of limb. The signs associated with shortening were: Bryant's triangle, Roentgen rays, Allis's sign, Nelaton's line, Chiene's lines, Hennequin's test, ecchymosis. genericos viagra india sound. It would lie noticed that there were just twelve of them, and the thirteenth (ahvays unlucky) was crepitus. This emphasized the danger "of using this sign as an intentional attempt at diagnosis, which often did harm rather than good by breaking up a kindly impaction. As to the inability, preventing the patient from lifting the foot from the bed. which had been considered pathognomonic of femoral fracture, re- cent experience, confirmed by the .r-ray, showed that they must add acetabular women viagra pills in india fracture to that of the femur as causing this curious sign. RpErardincr rotation of the limb outward. Dr. Dnwbarn said that just women viagra pills in india once he had seen the opposite condition, and then it was carried to a degree of inversion which was deceptive. Whenever 592 .\li;i31C.\l. RECOKU. [Oct. 2, 1915 this break occurred and the foot remained with the toes forward, or but little rotated outward, one was fairly certain to be right in assuming impaction to be present and the prognosis exceptionally good from simple im- rnobilization, preferably of Whitman's method. The va- rious aids to diagnosis named after their famous invent- ors should be verified whenever possible by the roent- genograph. The writer protested against the custom of measuring for shortening from the anterio-superior iliac spine to one of the malleoli. It was always easy to feel the upper edge of the tibia just at the inner side of the patella, and this should be the lower limit as it was the limit of the bone one was measuring. As a method women viagra pills in india of measuring the degree of shortening, Dr. Dawbarn sug- gested that the patient be laid flat on his back on the floor, with a pillow and blanket, his legs semi-flexed, keeping the knees together. Thus his legs would be horizontal and his thighs vertical. Now the difference in height of the two patella;, as indicated by a ruler or book laid flat upon genericos viagra india the uppermost one, showed at a glance the degree of shortening, if any. Sound as a means of diagnosis had been badly neglected. He had been teaching it, however, for twenty-odd years under the name of "osteophonic percussion." There was no sign, except the roentgen ray, w-hose guidance should be placed before this in reliability to the experienced ear in most instances. Tliis method indicated the presence of a layer of muscle, however thin, crushed between the fragments, preventing bony union, whereas if bones were in good apposition there was scarcely any change in the conductivity. In suspected neck fracture the stethoscope was placed over the great trochanter while percussion was firmly and repeately made by an assist- ant upon the anterio-superior iliac spine, until the lis- tener was quite familiar to the pitch and intensity of the note produced; then this was repeated on the oppo- genericos viagra india site limb and the sounds compared mentally. If it was