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101°. On the afternoon of the 11th she died of hemorrhage from can you buy abilify online the intestine. As far as the speaker was informed, atten- tion hail not yet been called to the differential diagnosis be- tween typhoid fever and cerebro-spinal meningitis. He had made brief search and buy 20 mg abilify online had found only one case of septicemia following typhoid fever. In this case no lesion was found in the spinal cord; the brain was not examined. Feb. 26, 1887.1 PROCEEDINGS OF SOCIETIES. 243 NEW YORK SURGICAL SOCIETY. Meeting of January 26, 1887. Dr. Robert F. Weir, Chairman. Osteoplastic Operation abilify mg after Necrosis of the Femur. — The following case was reported by Dr. Lange: " The patient whom you see before you is forty-six years old, and is a native of northern Germany. When ten years old he had, accord- ing to his statement, a serious and very painful affection of his right knee and thigh, abilify order online which kept him in bed for one year. His physicians had proposed amputation to him, but, through the wisdom and clever- ness of a midwife, as be said, his limb was saved, and he was able to get up on crutches. A number of sinuses had opened, and for about eleven years suppuration persisted, but then ceased. The shape and shortening of the limb had always been the same since that acute dis- ease as buy generic abilify online at present, and at no time had any surgical operatiou been done, nor bad any bone come away spontaneously, until about sixteen years ago; that is, for about nine years all remained healed. Then, however, sinuses formed again, and did not heal. I saw the patient about one year ago. He attributed this renewed suppuration to his habitually having a board on his knees over which he can i buy abilify online used a heavy flat-iron while working at his trade as a tailor. " There was a profuse offensive discbarge from a fistulous open- ing buy 2mg abilify online near the external edge of the right patella, just buy abilify online no prescription above the condyle, at the bottom of which necrotic bone could be felt. The whole limb presents a rather monstrous deformity. There abilify prescription program is bony ankylosis of the knee joint at an angle of about 140 degrees. abilify prescription coupon The femur is about eight inches shorter than that of the other side, and there is a distinct angular bend at a point between the middle and lower third of buy abilify online canada the femur. "Just about a year ago I performed necrotomy by making an H- shaped incision, forming flaps which included the periosteum, and re- moving the patella and the anterior portion of the lower third of the bone, so that, after the removal of the numerous sequestra which you see here, a shallow bone cavity was formed, into which buy abilify online the soft parts were depressed and fixed by strong, straight needles. "The healing process took place very rapidly, so that after about four or five weeks the patient went home with a few granulating su- perficial wounds, which finally healed under an ointment dressing. "About three months later a fistula formed again, and in September of last year I had to make a thorough revision, to scrap. t and chisel away some carious bone at the bottom of the former cavity. At present everything seems perfectly solid and cicatrized, and the patient u>e s his leg as well as his high heel (for equalizing the shortening) allows him. "The case is very interesting in some respects. When a boy of ten the patient doubtless had a severe acute osteomyelitis with spontaneous fracture of the thigh, but no necrosis of any great extent could have existed. Otherwise tho suppuration would not have ceased for fully nine years. No doubt the pieces of dead bone which I found at the operation a year ago belong to a process of secondary necrosis. They also present a character quite different from that of the usual sequestrum, they look like dead cancellous tissue, and were found in a por- tion buy abilify 5mg online of bone which normally bus no bony substance in ils cen- ter. The whole lower third of the thigh-bone abilify mg size proved to be filled with a new Formation of bone, and that had undergone partial necrosis, apparently in a very chronic manner. The primary acute osteiiic process had not had the immediate effect ol necrosis, (hough il must have I n scry severe, judging from the spontaneous fracture of the bone, but it led to diffuse ossi- fying osteitis. no prescription abilify Probably some of the infectious mat* rial remained encysted until, later on, in consequence of Some noxious influ- ■ ence, it muM have been set free, and, by its injurious action upon the newly formed central osteophyte substance, eaused necrosis of the same. This secondary necrosis or breaking down of newly formed substance, especially in the lower third of the femur, is not uncommon. " About three years ago I presented before this society three cases belonging to this group. In all of them extensive cavities in the lower part of the femur existed, and plastic operations similar to that just described proved to be effective. If let alone, these bone-cavities, in persons of somewhat advanced year-, will not heal. The cavity must be obliterated by a plas- tic inversion of soft parts, which, in cases like these, where bony ankylosis of the knee joint exists, are best taken from the anterior aspect of the thigh, the patella being removed. These operations must, of course, be done aseptically, if union of the flaps by first intention is to be expected, and it is by no means easy to do the order abilify no prescription operation with such thoroughness that a perfectly aseptic wound is left. The sharp order abilify online canada spoon, chisel, and disinfecting fluids must be used carefully in all the remote corners and granulating recesses, which, if left untouched, will, of course, become the seat of suppuration. " I regard this method of dealing with bone-cavities as a de- cided advance in modern surgery, and 1 can not recommend it too highly also for certain cases of abilify order canada necrotomy in younger per- sons, where large bone-cavities remain after the operation. There happens, though exceptionally, a certain kind of necrosis, the so-called 'necrosis disseminata,' in which numerous seques- tra are scattered all through the hone, lodged in small, shallow lacuna;, which are generally connected with each other by nar- row canals filled with granulations. [A number of illustrative specimens were presented.] It requires not infrequently great care to order generic abilify trace these canals, and, after thorough removal id' nil

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