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The instmment which I have been using is roughly constructed, and imperfect in several respects, yet I have been able methotrexate canada to produce anaesthesia with ether in from two to twenty minutes. The quantity of ether used varied in different cases. I have generally found one-half ounce to two ounces sufficient for minor surgical operations. The stage of excitement I find to be scarcely percepti- ble, and my patients do not complain of difficult breath- ing. Their complexion may be flushed, but there is no coughing or jerky catching respiration. The quantity of mucus is not materially increased. Charles methotrexate generic name Truax (Ireen \- Co., of Chicago, 111., have made me an instrument constructed on the principles set forth in this ar- ticle. Its dimensions are as follows: I leight, a little over live inches ; greatest diameter, three and jne-half inches ; ca- fl^ ' pacitv of reservoir, ^ . ', three ounces. I believe this in- haler to be safe, economical, and as well adapted to the a d m i n i stration of chloroform or mixt- ures as ether. Sus- pended by an elastic cord from the ceiling, it makes a very convenient in- strument tor the administration of chloroform in obstet- rical practice. The patient methotrexate 12.5 mg grasps the inhaler and holds it down over her face, but as soon as the muscles methotrexate b12 of the arm and fingers relax, the elastic cord carries it away, and the valves close, preventing the escape of the anaesthetic into the room. Medico-philosophic Definitions. — Health. — A unit that gives value to the zeros of life (Jousset). Hunger. — Dyspepsia of the poor. Remorse. — Moral indigestion. Life. — That which holds matter together (Bichat). October 28, 1893] MEDICAL RECORD. 575 A NEW methotrexate usp INTRA-UTERINE IRRIGATOR. By ALAN B. MURRAY, M.D., COKEDALE, MONT. The ordinary metallic intra-uterine irrigator, having di- rect and return tubes, is objectionable for several reasons, the principal one of which is that it is almost impossible to properly clean the tubes. After having tried a variety of the instmments commonly in use, it occurred to me methotrexate india that an irrigator made of hard rubber, with the inner or direct tube removable, would do away with several of the objectionable features. Acting on this idea I have had Messrs. Tiemann & Co. make for me the instrument here illustrated. pharmacology of methotrexate Made of hard rubber, it is unaffected by any a new mask should be used for each patient, especially as the cost is so moderate. These masks may be obtained from E. B. Meyrowitz, 104 East Twenty-third Street, New York. BLUNT-HOOK AND HOOK-KNIFE FOR FACIL- ITATING THE OPERATION FOR SECOND- ARY CATARACT." Bv JOHN HERBERT CLAIBORNE, M.D., ADJUNCT-PROFBS; OPHTHALMOLOGY of the usual irrigating solutions. After use, the removal of the methotrexate cream inner 6 mp methotrexate or direct tube renders the cleansing of the return tube a simple matter. After methotrexate for ms properly cleansing and boiling, the instrument is rendered absolutely aseptic. There are no points within the tube for the lodgement of shreds of tissue or blood-clots. RING'S methotrexate 17.5 mg OCULAR MASK. By FRANK VV. RING, M.D., This mask is designed for the purpose of protecting eyes from injury, especially after cataract extraction. Eyes are not infrequently lost after extraction of cataract, from force inflicted by ^he patients, either consciously or un- consciously, and this device serves as a complete pro- tection, as it is i|uite impossible to disturb the eye with- out breaking the tapes. One great advantage consists in the security with which the bandage may be permanently removed at the end of from thirty-six to forty-eight hours, by simply filling in the oval depression in the mask with cotton — it being desirable to relie\e the eye from the pressure of the band- age, and consecpient heat and soaking there- -^ ~ '^ ^^*>^~^ by produced, as soon as -'^ possible. The patients are al- ways very anxious to have the mask applied, especially at night, as it gives them a feeling of security against acci- dent. This shield is made methotrexate sodium 2.5 mg of papier-mache, lined on the outside with silk and inside with linen. It is made to fit the contour of the average face. If the nose should be rather prominent, cut two snips either side of the nose-piece. If less promi- nent, fill in the space with a little cotton. Surgeons using other dressing than the roller bandage will find it of es- pecial advantage. It is designed to be used immediately after operation, and maybe continued for some days. If one desires to give the patient light, a perforation may be easily made with a penknife in front of the unoperated eye. As a matter of cleanliness and safety against contagion ^ The instruments which the accompanying cut represents are intended to facilitate the operation for secondary cat- aract. It is a well known fact that after the lens has been extracted from an eye the methotrexate and ms remains of the capsule are often found to be so dense and opaque that the usual good results of the op- eration are not attained. This ne- cessitates the operation for the so- called secondary cataract. Owing to the fact that the attach- ments of the capsule to the ciliary mus- cle are insecure and easily ruptured, and owing to the extreme instability of the capsule as it lies between the a(iue- ous and vitreous methotrexate 7.5 mg humors, it becomes a difficult undertaking to tear a hole in the capsule either with a single needle or with two. The endeavor to attain this end with one needle or knife has largely been supplanted by the operation with two needles, in methotrexate rxlist which it is at tempted to tease the capsule apart. That even this is difficult to accomplish will be recognized by all who have tried it. The methotrexate 2.5 mg tablet two instruments, as can be seen in the cut, are a methotrexate injection cost blunt-hook and a sharp- pointed knife-hook. The idea of having them constructed came to me in the following wise: I removed a hypermature cataract from methotrexate pharmacology a woman and had the misfortune to find an extremely dense capsule re- maining. It was, indeed, so dense that very little improvement in vision was attained through the operation. Two attemi)ts were made with the teasing needles to tear a proper aperture in the capsule. Failure attended each attempt. The capsule was slightly torn, but not sufficiently. A dense tongue of capsule hung in the rift, and could not be dis- placed by the teasing needles. Two weeks later I determined to use a small keratome and tear away the tongue with forceps. .\ small opening was made at the upper sclero-corneal margin with a keratome, but when I endeavored to grasp the piece of capsule it escaped from the jaws of the for- ceps and retired to the vitreous chamber. Repeated at- tempts failed. I was on the point of giving up the task when I thought of Stephens's small tenotomy-hook. I introduced this instrument through the wound and neatly tucked the tongue of capsule back behind the iris, leaving a perfectly clean and proper pupil. It has re- mained ever since. Stephens's hook is a trifle large and hardly has the proper cur\'e for this work. It will be seen that the blunt -hook here shown is beaked. The knife- hook has the same cur\'e, is very sharp-pointed, with a cutting edge that extends to the ' Tlie writer is not unaware tliat a hook has been devised by Stell- wag for the purpose of removing the entire capsule, when it under- topical methotrexate goes chalky degeneration, through a linear incision. The method of procedure suggested here differs from that of Stellwag in several re- spects. Hence he feels himself warranted in presenting the above. f 576 MEDICAL RECORD.

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