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Feron Paris used a pig's bladder for a considerable time as a colpeurynter, and then a rubber pessary.

The patient recovered, and had a child one year later without further injury.

Maruejouls cured a case using a Gariel pessary, and was able to discontinue after a few months. Conradi cured a patient using a golden button, the head being in the bladder, the neck in the fistula, and the plate in the vagina in five years fell out, and the patient was cured. Verneuil, Schup, Winckel, Depaul, Hildebrandt, Monod, Freund, and others saw the spontaneous healing fistulas without any local or general treatment at all. Not only small, but very considerable fistulas have closed in this way Guthrie, Marjolin, Hildebrandt, and should always first endeavor obtain Thus Palfrey, who formeily operated as soon as possible, now holds that procrastinating many patients can spared the necessity undergoing any operation at all. Two indications are fulfilled, effect a ready outflow through the urethra, and prevent an outflow through the vagina.

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The former indication met placing a metallic or elastic catheter in the bladder.

Thus Fritsch Von Heyne passes a drainage tube long and inch in diameter through the urethra in the bladder, and washes the vise out through Every two days the tube need help in essay removed and cleaned. The carbolic injections also exercise a mild cauterizing effect upon the edges the fistula. Two cases were cured in this way. If the catheter or drainage tube not well borne, must catheterize every hours. The second indication met a careful tamponade the vagina. The best material use for this purpose the ball doctoral dissertation writing help salicylated cotton covered with linen, which Esmarch has introduced into practice for small portions loose charpie and cotton can easily pass through the fistula into the bladder, and there form the nucleus for the formation stone.

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ghostwriting service The colpeurynter and sponges are not write dissertation sufficiently antiseptic, nor they fit well enough.

If the amount that passes through the vagina small, the tampon may remain in situ for several days in other cases must be renewed daily after evacuating the bladder with the catheter. The healing the fistula may favored placing the patient in an appropriate position, either lying the side opposite the fistula, or lying upon the abdomen.

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There are authorities who are opposed the above method, and who claim that the catheter not well borne an irritable bladder, and that vesical spasm, abdominal pain, vomiting, and other symptoms are caused Among them are Velpeau, West, Baker Brown and others. This sometimes the case and then can only pass the catheter every few hours, or perhaps not at all. The tampon will cause no trouble, and it may tried both in recent and in old cases. long as the patient improves continued, for months if necessary. If the fistula becomes no smaller, and the patient no better, operative interference indicated? and if what nature should be? The answer the first part this question depends upon the size, seat, nature, and complications the fistula. It depends also upon the experience the data analysis coursework surgeon Simon has cured many a fistula which other surgeons have failed remedy. 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