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Clindamycin And Clindamycin Mg

Clindamycin And
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Cluneal Iftrtnn,
By Professor T. Gaillard Thomas, M. D. Reported by P.
Brynberg Porter, M. D.
Gentlemen : The first patient -whom Clindamycin 300 Mg I show you to-day is
Mrs. Lucy Clindamycin Clindamycin N., twenty-eight years of age, and a native of Ire-
land. She has been married fourteen months, and has never
been pregnant. Let us see if we can get a history of her
symptoms from herself.
What do you complain of? " Pain in the back and side."
"Where do you feel the pain in the side ? " As high up as the
waist." Is that all that troubles you ? " Yes, except an irri-
tation Dosage Of Clindamycin in the throat." Do you have the whites at all ? " Not
a great deal." Do you suffer much pain at the time you are
unwell ? "I always have a great deal of pain then." Do
you feel this pain during the flow ? " Yes." Ie it ever so
bad that you have to Dose Of Clindamycin go to bed on account of it ? " Yes, some-
times." How long do you nave to remain in bed at such
times ? " Usually a day or two." Did you have this same
trouble at your periods before your marriage, or has it come
on since ? "I always suffered much the same, though I think
it is rather worse now." Do you ever have any trouble in
standing or walking ? " No." 300 Mg Clindamycin
There are only two or three symptoms of any real value
here, and they are, the sterility (which, you remember, has
now lasted for fourteen months), the dysmenorrhea (which
existed Clindamycin Cream before the patient's marriage), and, possibly, the
backache. As to the pain in the side, of which mention has
been made, she places her hand over the region of the spleen
in describing its location, which brings it too high up to be
due to any trouble about the pelvic organs. I proposed an
examination for the purpose of finding out, first, why the
woman has never been pregnant, and, secondly, why she suf-
fers so much at her monthly periods, and will now tell yo u
what was the result of it.
On introducing my finger into the vagina, I at once de-
tected the cervix coming very low down. In addition, I as-
certained that it was very small and very conical in shape.
Stretching beyond it, in a backward direction, I could feel a
long ridge, which might either be the uterus itself or some
growth or deposit beneath it, of very symmetrical outline. In
order to settle the question, I resorted to conjoined manipula-
tion, which proved exceptionally Clindamycin Mg easy in this patient, and dis-
covered beyond the possibility of doubt that it was the body
of the uterus which Clindamycin 300mg had thus Clindamycin Gel fallen down out of its normal
position. Finally, I passed my finger completely around the
cervix, and then the whole case was clear before my mind.
After some little experience in the practical study of gynae-
cology, one gets accustomed to seizing upon a few salient
points in a case, and at once determining its real character
with considerable precision. You Dosage Clindamycin know how eminent natural-
ists like Agassiz have been able to give the description of an
entire animal simply from one of its teeth, or some small bone
belonging to it, which has been presented Clindamycin Phosphate Gel to them, on account
of their accurate knowledge of genera and species ; so that
afterward, when the remains of the particular animal to which
the part belonged have been discovered, it has been found to
correspond exactly in every particular with the one whose
construction had been described. The greater the number of
parts belonging to a certain animal that Clindamycin And can be brought to-
gether, the more easy it is for the naturalist to pronounce upon
its classification ; and so here, with the symptoms and physical
signs both before us, it is not a difficult matter to classify a case
like this. The uterus has fallen down out of its normal Clindamycin Benzoyl posi-
tion, the Clindamycin Dosing fundus gravitating toward the hollow of the sacrum,
and that there is an unusual pouch in the wall of the vagina
behind the cervix. The position of the patient being then
changed, I inserted the probe, and easily passed it to the fun-
dus, ascertaining by this means that this nulliparous uterus
measured fully three inches. When I endeavored to pass the
ej uterine sound, however, I experienced considerable difficulty ;
whence I concluded that the cervical canal was of abnormally
small caliber.
Now let us give the case a thorough investigation. " To
begin at the beginning," the patient has what is known as
612 LONG conical cervix:
a long conical cervix ; in the second place, some influence
(whether the unusual weight of the organ on account of hav-
ing such a long cervix, or something else, I am unable to
make out) has caused the uterus to descend in the pelvis until
it has reached the second stage of prolapse. In the first de-
gree of prolapsus uteri the organ merely descends, its axis re-
maining unchanged ; in the second, its axis is decidedly altered,
the fundus falling toward the sacrum ; and in the third, it has
descended so far that either a part or the whole of it is quite
outside of the body. The retroversion Dosage For Clindamycin found here is not true
retroversion, but only that degree of this condition which or-
dinarily accompanies the second degree of prolapsus. We
next inquire, Why has this woman suffered so much at the Clindamycin Dosages
time of her menstrual periods? This is due to the contraction
of the cervical canal, which Clindamycin For is almost always found with the
long conical cervix. The menstrual blood, being able to es-
cape but very slowly on this account, becomes dammed up in
the uterus, and frequently coagulates. The organ is excited
by the presence of the blood to efforts Clindamycin Dose like those accompany-
ing a miscarriage, and finally succeeds in expelling a number
of small clots. Then follows a period of repose, during which
the patient is more or less free from pain ; and after that the
same process is repeated, the patient again suffering the most
severe spasmodic pains.
This, then, is a case of obstructive dysmenorrhea. The
obstruction is not complete, but it is sufficient to interfere very
seriously with the escape of the menstrual blood from the
uterine cavity. If the blood remained in the fluid state, I
think there would be no pain here. On questioning the pa-
tient particularly upon Dose Clindamycin this point, however, she states that she
does not pass any clots during her sickness. Nevertheless,
she is very clear in regard to the fact that she has the most
severe bearing-down pains for the first day Clindamycin Dosage or two of the nien-
Btrual period. This is to be classified, therefore, as obstruc-
tive dysmenorrhea, due to congenital contraction of the cer-
\ ical canal. You will see in Barnes's and Sims's works (as
well as in my own book, copied from them) figures illustrating
the appearance of the long conical cervix ; but I think you
will be able to judge of the difference between that and the
normal cervix quite as well from the simple diagrams which I
now sketch for you on the blackboard.

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