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Case VII. — Mrs. M. E.. forty years, secundapara, last child nine years ago, Buy Erectalis referred by Dr. J. Hartranft, Southold, L. I. During the past four years, on an average of once every six weeks she suffered an at- tack of very severe pain in the right hypochondrium, extending toward the navel, was sick at the stomach, and vomited ; her right side was enlarged and was very hard. After loosening her clothes and lying down the attack passed away, and the next morning she was all right again. Examination : Height, 5 feet 3 inches ; weight, 171 pounds; waist, 32j-i inches; hips, 45 inches; abdominal projection on level with the anterior supe- r'or spines, 4-14 inches; the greater curvature of the stomach lay chiefly in the right iliac fossa ; the lower pole of the right kidney was on a level with the ante- rior spine. Conjunctiva was bile stained. Diagnosis: Dictl's crises, due to prolapsed kidney : gastrectasia ; lacerated perin.-vum. A special corset was put on Feb- ruary 121I1, and a tablcspoonful of bran taken each night. .Ml went well until April 8th, when in the afternoon she was taken with violent pain in the right back and loin of a neuralgic character, Erectalis Tablets requiring mor- phine. The pain easeil up the next day, but came back on the third day with fever 100.6" F., pulse 90. The bowels moved freely, but there were two chills during the day, tcni|)erature still 100.6" F., pulse qo, and she was feeling nuich better. Her .skin was de- cidcilly jaundice a cystic mass the gallbladder presented just below the border of the ribs, and the kidney, enlarged and tender, could be palpated for two inches of its lower pole, was adherent and could not be replaced. Diagnosis : Cholecystectasia with gallstones induced by kidney prolapse. Treatment : Elevation of foot of the bed, a very snug abdominal binder was applied ; salines and water were given every two hours. In view of the severity of the jaundice she was advised to have an operation later ; but the wearing of the binder prevented any further attacks, and she had been satisfied to let well enough alone. Case IX. — Mrs. G., quintapara; seen with Dr. C. C. Miles, Greenport, L. I. Ever since the birth of her last baby, one year ago, she had suffered from attacks of pain in the right hypochondrium, with a feeling of being puffed up and for four hour periods as if she was going to be unwell ; relieved only by loosening her clothing and lying down. One attack, August 9th, another on the 14th. She was very nervous, but had never noticed any jaundice. She could not fall asleep. Examination : Transverse colon low down ; caput coli displaced inward, tender appendix not palpable. Les- ser curvature of the stomach was 2 inches below the xiphoid, greater curve 2 inches above the symphysis ; there was succussion sound at the umbilicus. Free edge of the liver w-as one inch below chondral bor- Buy Erectalis Online der, gallbladder projected, and was very tender; right kidney was palpable one and a half inches, and ad- herent. Treatment : A pattern was cut out for a " stock " binder to be worn until a corset could be made, but this had been so satisfactory that she is still wearing it {Journal of the American Medical As- sociation, xlvii, p. 1357, October 6, 1906). Operation was advised if fever came on with an attack. Case X. — Mrs. J- W., fifty-six years of age, sexta- para ; youngest child, twenty years old ; referred by Dr. B. D. Skinner. Greenport, L. I. About three weeks after the birth of her last child she had had an attack of vomiting, some fever, and very severe Erectalis Online pain in the right hypochondrium, requiring morphine. These at- tacks came on suddenly, the abdomen swelled up, and the discomfort could only be relieved by loosening the clothing. The eating of rich food seemed to bring on an attack, and there had been on the average one or more a year. During the past five weeks she had had four attacks, coming on suddenly, with fulness and pain in the epigastrium, free vomiting of a green matter, and a cold feeling. The pain left suddenly, but dur- ing the attack she could not lie down, as it aggravated the pain. Her skin had been jaundiced during the past four weeks, and the urine was saffron color. Dr. Skin- ner diagnosticated gallstones thirteen years ago, but none were ever looked for in the stools. Last attack was two days ago. April 18, 1907: Examination

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