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Related post: I would operate on him if these means failed to afford relief.
In April, 1888, he Buy Nymphomax returned again, saying that his pain had
grown steadily worse in spite of treatment, and that he had been
using morphine steadily. He was very much run down, his nerv-
ous system thoroughly demoralized, and I refused to operate Purchase Nymphomax on
him until he had cut off bis opium and rallied his shattered
nerves.
On .June 10, 1888, he was sufficiently imi)roved to enable me
to operate, which I did, assisted by my father, my brother. Dr.
Allen, and Dr. ('arlisle. All examined the case and all thought
there was a large exostosis pressing on the nerve. Under anti-
septic precautions 1 cutdown on the most j)rominent Buy Cheap Nymphomax part of the
curved femur, and found to my sur|)rise that yart of the vastus
externus nuisde was so twisted on itself as to run at right angles
to the long axis of the femur. I cut down to the bone and was
surprised to find no exosto.sis with the exception of a most mi- j
nute point which could hardly be considered abnormal, but which I
I nevertheless removed. I then passed my finger completely
around the femur, stripping up the muscles for an extent of Order Nymphomax Online two
or more inches, hoping to find some sharp projection to account
for the pain ; but, failing to find anything, sewed up the wound
with a rubber drainage-tube at the lower angle of the wound,
having many misgivings as to the benefit I had done the patient.
On tlie second day I removed the drainage-tube, and on the four-
teenth removed all the dressings, the wound being healed, and
the patient liaving had no rise of temperature.
At first he complained of some soreness in the leg, but the
old pain, on movement of any kind, disappeared from the time
of the operation. When the soreness from the operation had
ceased, in about a fortnight, the patient said that he felt well,
and, on being allowed to walk about, had none of his old stiff-
ness and neuralgia. He left for home a month after the opera-
tion and T have not seen him since, but received a letter from
him dated January 29, 1891, in response to an inquiry after his
health, in which he says: "The result so far is perfectly satis-
factory. I have had no pain, and now I am able to walk and
go all over without any trouble."
This case seemed to me to present points of sufficient
interest to be recorded : 1 . Tlie apparent relation of small-
pox in infantile life to the subsequent fragility of the right '
femur, which was broken in very nearly the same place on
three separate occasions, each four years from the other and
caused by slight violence. 2. The persistent neuralgia fol-
lowing the last fracture, and persisting for six years up to
the time of operation in spite of various measures that had
been tried, both by myself and by others, for its relief, and
which finally became so. intense as to give rise to the opium
habit. 3. The abspnce of an exostosis at the time of oper-
ation sufficient to have given rise to the symptoms, and the
August 22, 1891.]
HAMILTON: TWO CASES OF EXTRA-UTERINE PREGNANCY.
207
fact that relief was afforded by the operation. 4. The
simulation of an exostosis by what I presume was a tense
fiber of the fascia lata which had become so bound down as
to press on the muscles of the thigh, and, by girdling them,
caused the pain.
I do not clearly understand how to account for the re-
lief of pain. I do not think the point of bone I removed
was large enough to have made the trouble, and I did not
think when I passed my finger around the femur that I tore
loose any nerve fibers from the cicatrix. I suppose the ex-
planation is to be found in tlie relief of tension given by
splitting up the fascia lata, \\;hich certainly bound Order Nymphomax the mus-
cles very tightly, and I think the length of time that has
elapsed since the operation — nearly three years — is suffi-
cient guarantee that the cure will be permanent, especially
as the patient was addicted to the opium habit, and these
patients are proverbially hard to cure of neuralgia, as the
latter offers so good an excuse for resumption of their old
habits.
TWO CASES OF EXTRA-UTERINE PREGXAN'CY.
Bt WILLIAM D. IIAMILTOX. M. D., and
CHARLES S. HAMILTON, M. D.,
COLUMBUS, OHIO.
Case I. Extra-uterine Pregnancy ; Aidominal Section in
the Twelfth Month; Reinotal of a Dead Fcetus ; Recovery. —
Mrs. F., seen with Purchase Nymphomax Online Dr. I. N. Beach, of West .Jefferson, Madisoa
County, Ohio. She was forty-four years of age ; had bet-u
married twenty-five years; had had two miscarriages and six
children, the last in August, 1884. Her health was perfect
in November, 1880. Amenorrhoea existed from January to
August, inclusive, in 1890. She had morning sickness dur-
ing the early weeks. Buy Nymphomax Online For a fortnight or more in July she
had a free discbarge of water from the vagina. Her breasts

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