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I have knowledge, however, nine cases besides own in which a fatal result was all but reached. One these occurred in the practice of an old fellow-student mine who now fills a chair in a western college. In this case the doctor left a student watch his patient, and was recalled in haste two hours later. He found necessary to apply pressure with a sponge a holder for many hours, and has stated that without the recollection experience and treatment guide him buying college papers he would have been at a loss know what From the statistics which I have at hand, based chiefly the practices leading surgeons, I disposed think that a dangerous degree hsemorihage occurs in about i per cent, all tonsillotomies.

If with proper after treatment thus frequent, may not consider its risks greater in connection with that slap-dash and happy-go-lucky surgery with which even in Ontario are not altogether unacquainted ? We know how often some physicians meet with post-partum haemorrhage, and are apt connect this frequency with a faulty or careless treatment the third stage labor.

That obstetrician will see least probably, who has its dangers and its prevention most constantly in his mind.

The same reasoning will apply this form haemorrhage. With the conviction that the liability haemorrhage from the stump an amputated tonsil will lessened by the right performance the operation that may cause I submit without arguments the following conclusions for your adoption or amendment The surgeon who proposes remove a tonsil should have at hand a strong and perfectly manageable light such as i? obtained from a student's lamp and a forehead protector four inch diameter and short focus. He should not dependent upon the kitchen cupboard for a part his armament, but should have a good tongue depressor, and this almost the same as saying that he should have Turke's model, as for any operation the back the throat best resume writing services in atlanta ga the only good one.

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He should use the tonsillotome preferably for children, and especially if ether not given. If the part removed prominent should use this instrument for adults also and should prefer McKenzie's or Hamilton's models, which cut by propulsion any the forms i which a sickleshaped knife makes the section as being He should use the vulsellum forceps or doublehook and probe-pointed bistoury forallcasesin which the gland sessile, or in which a particular portion excised.

In operating should stand before the patient, seize the left tonsil and cut from above downwards, as remove all that projects beyond the anterior pillar the fauces.

Then, standing behind the patient, should remove the same degree the right gland cutting Bearing in mind the manif risks operating even small inflamed argumentative essay help parts should select a period quiesence for the amputation, paraphrasing a paragraph the exceptions this rule being first, that class cases in which the gland very small and flat between the catarrhal attacks upon its secretmg surface and second, the rare condition actual danger life from combined hypertrophy and inflammation.

The surgeon alter a tonsillotomy should not lose sight his patient for several hours, but should make frequent and careful inspection the throat. He should remember that, especially in children, blood may pass into the stomach and give no external sign till blanching the face or faintness shows its loss.

Should this examination leveal actual hemorrhage in unsafe amount should resort at once direct pressure, either with the fingers or a sponge a firm holder.

After this has been some time applied should examine for bleeding points, and if found they should be caught and twisted. Cold, in the form icewater or ice substance may made use but IS belter avoid the application the styptic preparations iron or other astringents. In the rare event pressure, torsion, and cold being, when properly applied, insufficient, the ligating the ternal caruiid artery, and this also failing, the common trunk may taken into consideration. vorable result the treatment, but because the case made a profound impression and because I have often asked myself if I could have done better had I taken a different course. We have a right pride ourselves our successes, but experience that are taught more by On last creative writing service month, I was called at midnight see a patient some eight or nine miles distant was told was a case confinement online essay proofreading and that the woman was very bad. I took with instruments, chloroform, ergot, and my ordinary pocket-case. I got there between one and two, and found that the patient a primipara had been delivered before I was sent for, having had a very easy and short labor, the nurse a neighbour's wife who attended her, telling that she had not had more than a couple of real labor pains, and that she was over before they could get a messenger ready send for After her delivery she said she was pretty comfortable, but had a slight headache and pain in the stomach. Without the slightest warning she went into convulsions. When I saw her she had just recovered from a convulsion, the seventh or eighth.

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