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spleen. Of these five patients recovered. viagram viagram Dr. Charles L. Gibson of New York mentioned five cases of traumatic rupture of the spleen, two cases of splenectomy for acholuric (hematogenous) jaun- dice, two cases of splenectomy viagram for Banti's disease, one case of splenectomy for von Jaksch's anemia, one case of splenectomy for ecchinococcus cyst of the spleen, and one case of attempted splenectomy in splenomvelog- enous leukemia. Three of the traumatic cases, both cases of acholuric jaundice, one case of Banti's disease, and the case of von Jaksch's anemia ended in recovery. September 11, 1915] iMEDICAL RECORD. 459 as did viagra price in bangladesh also the case of ecchinococcus cyst. In viagra price in bangladesh the ca.se of splenomyelogenous leukemia splenectomy was im- possible, due to the enormous size of the spleen, viagra price in bangladesh and the patient died on the tenth day following operation. In this case the operative interference was done at the viagram earnest request of the patient. Dr. W. A. DowNES of New York reported eleven cases of splenectomy performed during the past three years with five deaths. In this viagram series was included one case of spontaneous viagra price in bangladesh viagra price in bangladesh rupture of the spleen in typhoid fever and this was supposed to viagra price in bangladesh be the only one on record which had terminated favorably. Dr. K. A. J. Mackenzie of Portland, Oregon, cited a case of splenomegaly associated with polycythemia and suggested that such a condition might well deserve more serious viagram attention from the surgeon. Dr. E. H. Pool of New York referred to two cases of von Jaksch's anemia occurring in viagra price in bangladesh his practice dur- ing the past year. He advocated in this condition that if persistent and careful medical treatment did not pro- duce satisfactory results, viagra price in bangladesh removal of the spleen should be considered; if the anemia is marked, he stated that a preliminary transfusion should always be done. Dv. Charles H. Peck of New York reported a case somewhat similar to that mentioned by Dr. Mackenzie, a polycythemia associated with splenomegaly; this con- dition was accidentally discovered in a patent admitted for coccygodynia. There was a hemoglobin of 140 per cent, and an viagram erythrocytosis of 8,000,000, with viagra price in bangladesh a much enlarged spleen. He found in the literature that viagra price in bangladesh such a case was considered unsuitable for splenectomy and was to be classed as leukemias. He also referred to a case of hemorrhagic acholuric jaundice, on which he did a splenectomy three years ago with a good recovery. Dr. Fred T. Murphy of St. Louis mentioned a typi- cal case of the Gaucher type in a child of six, in which he had recently operated. Dr. Arpad G. Gerster viagra price in bangladesh of New York discussed the technique of splenectomy. He also reported a hitherto unpublished case of abscess of the spleen. This patient was admitted as an emergency case to the hospital, with high fever and symptoms of perforation ; previous history unknown. Physical examination disclosed an effusion in the left pleural cavity, and a tumor occupy- ing the left subphrenic space. A diagnosis of an acute suppurative process was made (the viagram spleen as such could not viagra price in bangladesh viagra price in bangladesh be made out) and a puncture was made from behind. This proved a very satisfactory procedure, yielding seropus, and he then entered viagram by the posterior route which gave an exceedingly easy access to the spleen. A large abscess was evacuated in viagra price in bangladesh which there were stomach viagra price in bangladesh contents as well as pus; there was a perforation of the stomach into the abscess; whether this perforation viagra price in bangladesh had led to the development of the ab- scess, or viagra price in bangladesh whether the latter had pointed into the stomach, viagram could not be determined. A jejunostomy was viagram immediately made, but the high fever continued and the patient died. Dr. Gerster recommended a posterior incision under suitable circumstances. Dr. Willy Meyer of New York reported three cases of splenectomy; the first, done about twenty years ago, was a case viagra price in bangladesh of leukemia, which was before the time that viagram this condition was recognized as a contraindica- tion to splenectomy; the patient ded from secondary oozing. The second case viagram was one of sarcoma of the spleen, evidently a primary viagra price in bangladesh tumor, as viagra price in bangladesh the liver was not involved; the patient died six viagram months later from metastasis. The last case was one of splenomegaly in a man over forty years of viagra price in bangladesh age with recovery. Dr. Meyer stated that all of these operations viagra price in bangladesh had been done with the T-incision, first in the median line, then with another incision at right angles, meeting the costal margin outside. He emphasized the necessity of im- pressing upon the medical man the fact that sple- viagram nomegaly is a viagra price in bangladesh surgical disease and that these cases are curable by operation. Dr. Francis T. Stewart of Philadelphia called at- tention to a case resembling that detailed by Dr. Ger- ster, in which he was so certain of the diagnosis of ab- viagram scess of the spleen that he viagra price in bangladesh made no preliminary punc- ture, but performed a splenectomy only to find the condition to be one of leukemia; the patient died. Dr. William J. Mayo of Rochester, Minn., alluded to the apparent size of the viagram spleen, and stated that few surgeons recognized enlargement of the spleen unless able actually to feel it beyond the costal viagram margin. Jaundice, which viagra price in bangladesh formerly was viagra price in bangladesh thought always to mean something in connection with the biliary tract, gall- bladder, or pancreas, was now known to be due also to a diseased spleen and its effect on the red blood cells. He mentioned three cases of so-called leukemia, showing, however, no increase of white cells, in which splenectomy was followed by recovery. He insisted that true leukemia viagra price in bangladesh was a non-surgical viagram condition, but