Related article: febrile condition produced by the condition of the bowels and not by the condition of the uterus. A case came to mind while the paper was being read about which I am in doubt. My preceptor had a daughter who married one of my fellow students. She was confined, and after the con- finement she grew weak, pale, and produced an immense amount of milk. Consultations were Bactrim Mrsa held. It was feared that she was exhausting herself by lactation. An effort Uti Bactrim was made to stop the flow of milk with success. Diarrhoea, however, came on and she was in great danger from that. The movements were lessened after much effort, and then the force of the system seemed to fail and the woman died of exhaustion. Xow was this a case of septicaemia, or one of those freaks of the nervous system swinging out of its ordinary lines so to speak? A friend of mine attended his own wife, using all possible precautions against septicaemia. A few weeks after the con- finement she was weak, had chills, fever. A consultation was held and the consulting doctor thought she must have malaria. It was in the Mrsa Bactrim country in the dead of winter, and a region where malarial fever Bactrim And was unknown. Another a physician was called, who thought it must be septicaemia. Acne Bactrim I saw the case Buy Bactrim about four weeks from the confinement and she was having an excessive flow of milk. I suggested to stop the flow of milk. But the temperature remained high ; there were sweats and chills . The woman grew weaker, paler, and at the end of six weeks from confine- ment died. Was that a case of septicaemia? Dr. : Prophylaxis is a very good thing, and Generic For Bactrim I would simply say that I recall two cases in which the cul- tures given to me came from patients who had died of puerperal septicaemia. I found they contained the colon bacillus. It would, therefore, seem to me important to protect the anus at the time of labor. SEPSIS IN MASSACHUSETTS. Sulfa Bactrim 433 Dr. Reynolds : Dr. Stevens speaks of wiping out the uterus with gauze in mild cases. I purposely omitted any reference to the procedure of wiping out the uterus rather than curetting it, because I hoped Dr. Stevens would speak of that himself. I believe Bactrim Bactrim that is a great deal better method than the use of intra-uterine douches. Bactrim Generic I believe that if the practitioner Uti And Bactrim feels himself incompetent to use the curette, and unable to obtain the assistance of some one who is able to use it, he cannot do Bactrim 800 Mg better than wipe out the uterine cavity carefully and thoroughly with gauze ; but I believe it to be a very much less efficient method of treatment than Antibiotics Bactrim the use of the curette. I believe that in fairly competent hands the use of the curette is safe enough to be advised even in mild cases, rather than wiping out the uterus. In direct answer to Dr. Brown's criticism of a sharp curette, I would say that I began with a dull wire curette, and used it for some years, because I was afraid of the sharp curette. I kept getting new curettes made, and each one made a little sharper, and I kept getting, as I thought, a little better results. I now think that if a sharp curette is made large enough, it is about as little likely to perforate the uterus as the Bactrim For Mrsa small dull curette which is ordinarily used. The distribution of the pressure over a wide area makes the sharp curette safe. I do not believe that a man who is in- competent to use the sharp curette better ever use any curette at all. I think the fact that some twenty-five gentlemen who have been house physicians at the Lying- in Hospital have curetted cases without any accident, is a pretty good argument against the great dangers of the sharp curette in inexperienced hands, though Bactrim Tablets I think it an operation which ought to be conducted with care. Finally, I think that if the practitioner is not capable of applying what he believes to be the best treatment, he had better get somebody else to do it. As regards the criticism of my use of corrosive sublimate. I do not see any reason why we should not use perman- ganate of potash, but if corrosive sublimate is followed by boiled water, or carbolic solution, or anything harmless, to wash out the corrosive, there will not be any trouble follow, at Purchase Bactrim least I have never seen any. I do not think Antibiotic Bactrim that this is a very important matter. 434 PUERPERAL SEPSIS IX MASSACHUSETTS. One gentleman raised Bactrim And Uti two points on which I am sorry I did not make myself clear. In the first place about con- stipation. I think constipation will make more temperature during the puerperium than at any other time, yet I do not think it is sufficient ground for any excessive or prolonged elevation of temperature, unless in the most extreme cases ; but there are many of the profession who think that it is, and I hope that that opinion will grow less prevalent. As regards constitutional treatment. I did not have time to 2:0 into that at leno-th. I mentioned it as an abso- lute necessity when constitutional symptoms are once present. I believe that even then there is but little hope for the patient unless the source of the poisoning is Bactrim 400 Mg elimi- nated from the system by local treatment. When that has been done constitutional treatment is of the utmost im- portance, Generic Bactrim it is the only means of treatment left. As regards the reference to the bacillus coli communis, and the necessity for looking out for the anus, I do not think that in practice the infection is apt to come from accidental contamination of the vagina from the rectum in any but one way. I think that when the perineum is lacerated, and the finger is inserted into the rectum to sew it up, there is danger of carrying infection into the vagina, unless the finger is kept in the rectum until the last suture