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stasis, even though it involved a serious oi)eration. It there was a well defined kink, the patient should he Clomipramine Ocd operated on and cured. However, if a surgeon should operate on a movahle kidney simply because it was movable, he would not necessarily cure that particular patient. The trouble might be elsewhere. He had known of at least two cases where the coloii was not the seat of the trouble. In one case in which an ileosigmoidostomy was done, the stomach was not examined at all, but while Clomipramine Hydrochloride Tablets the patient was relieved temporarily of the gastric trouble, x ray examination disclosed a serious obstruction at the outlet of the stomach. He believed a large ma- jority of these cases had a congenital element rather than an acquired one. Dr. Robert T. Morrts, of New York, quoted Doctor Jones as saying that most of these patients suffering from chronic intestinal stasis were amen- able to medical treatment. He thought this was quite right. There was too much surgery, but also too little surgery. Half of these patients came un- der the observation of internists who wanted to give them something. If the diagnosis in these cases was made early and proper medical treatment resorted to promptly, very little surgery would be required. Dr. James T. Case, of Battle Creek, Michigan, emphasized the point that carcinoma of Clomipramine Buy the colon was found particularly Anafranil Clomipramine in two places, the pehnc colon and the cecum. He had found stasis in the same part of the colon, the pelvic colon and cecum, and sometimes in the right half of the colon. The Infected Colon and Its Surgical Therapy. — Dr. Clomipramine 20mg John W. Draper and Dr. Jerome M. Lynch, of New York, read this paper, which will appear :n the Journal. Dr. Martin B. Tinker, of Ithaca, said there were a number of surgeons who had taken up the less radical operations very similar in character to those described by Doctor Draper. In the Journal A. M. A. a short time ago, there appeared a paper by Dr. William J. Mayo, in Clomipramine Tablets which he advocated a very similar procedure and reported some satisfac- tory results. He believed that this less radical pro- cedure had a limited field of usefulness. With re- gard to the severe infectious cases brought up by Doctor Draper, almost every surgeon of large ex- perience had seen some of the serious cases and they all knew how hopeless hemorrhagic colitis cases had been considered. It was known that a large proportion of cases in which multiple polypo- sis was followed by Clomipramine Hydrochloride degeneration into cancer and death. He recalled assisting Dr. W. W. Keen in doing a Kraske operation, resecting a large segment of the lower bowel to get rid of this condition. It was a very radical measure. As he understood it. Doctor Lynch and Doctor Draper were propos- ing ileostomy as an alternative in these cases. As far as his observation went in many of these cases of colon infection, medical measures had been futile, and very little had been suggested in a sur- gical way. Ileostomy was a simple procedure, and he felt sure surgeons would be inclined to try it In these desperate cases. Dr. Jerome M. Lynch, of New York, stated that the early diagnosis of cancer Clomipramine For Ocd was extremely difficult in the hands of the best men. Doctor Dra- per had spoken of anemia, loss of blood, constipa- tion, diarrhea, mucus and blood in the stools, and a number of other conditions Clomipramine Anafranil that gave these similar symptoms. Let them take, Buy Clomipramine for instance, hemor- rhagic colitis, simple intussusception of the bowel, amebic dysentery ; they should be exceedingly care- ful to eliminate these conditions gradually. The x ray ini fortunately, except in late cases, was not valuable. In the early diagnosis of cancer the x ray was not helpful. That was his experience. The diagnosis between diverticulitis and cancer was al- most impossible in some cases. Recently he report- ed a case before the New York Pathological So- ciety in which a man had both diverticulitis and cancer. The cancer evidently was the result of tlie diverticulitis. He had both an acute and inflam- matory condition, as well as a malignant condition at the same time. Indigestion was a very early symptom of cancer of the colon. Early Recognition of Cancer of the Stomach. — Dr. Julius Friedenwald, of Baltimore, stated that unless the diagnosis of cancer was made clearl\'. surgical intervention could only be in the nature of relief and not of cure. The earlier the stage Buy Clomipramine Online of the growth, the less positive were its manifestations. Even though the disease assumed considerable pro- portions, many of the important symptoms might be absent, so that at this stage a correct diagnosis might be impossible. Patients developing this disease were not, as a rule, chronic dyspeptics. The mo^^t important symptoms were anorexia, Clomipramine 10 Mg vomiting, pain, hematemesis, melena, and the presence of occult blood in the stools ; dysphagia, Clomipramine 50mg loss of flesh, the presence of a palpable tumor, dilatation of the stom- ach, ascites and edema of the extremities ; certain rontgenological findings, serodiagnosis by the Ab- derhalden method, etc. Vomiting was of frequent occurrence in cancer. Pain was present in 93.1 per cent, of 1,000 cases, and extended more or less over the entire abdomen. Hematemesis occurred in twenty-two per cent, of cases ; in eighty-seven per cent, the hemorrhages were multiple, and in ten single. Melena or tar colored stools appeared in eighteen per cent, of the cases. Occult blood in the stools was present in Clomipramine 25mg 64.2 Clomipramine 50 Mg per cent. Dysphagia existed in six per cent. Loss of flesh was a sign of considerable value and occurred in ninety-eight per cent., the loss varying from five to seventy-eigh: pounds. In only thirty per cent, could a mass be palpated, six months after the appearance of symp- toms. Dilatation of the stomach occurred in forty per cent., and this condition, when present early, was of great diagnostic value. Ascites and edema of the extremities appeared in twenty-one per cent, of cases. What Stomach Symptoms Justify Surgical In- tervention? — Dr. Martin B. Tinker, of Ithaca, said a reduction of the present high death rate from

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