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the ovarian vessels and of their alteration of position is to throw the rectum somewhat back of the line along which it usuallv crosses the brim to unite with the sig- FiG. 4. — A Diagrammatic Section of the Broad Ligament THE Pelvis, n, the aorta; r, the rectum; «, the uterus. and round ligaments to this border has already been men- tioned in speaking of these structures. Our only concern now is with the relation of these ligaments to the uterus and pelvic diflucan compresse costo cavity. In the non-pregnant condition, then, the whole of these structures is below the level of the pel- vic brim, within the pelvic cavity. The generic diflucan over counter Broad Ligaments iinth the Gravid Uterus at Term (see Figs. 1, 2, and 4). — The ascent of the uterus is such as to lift these structures out of the cavity of the true pel- vis, and generic diflucan no prescription their outline is so altered that they become generic diflucan cost triangu- lar costo del diflucan instead of quadrangular. The inner border, much elon- gated, still reaches from the cornua to the level of the inter- nal OS. Some lessening of the intimacy of the attachment of its layers is noticed ; this is specially evident in the anterior layer as it passes over the lower segment of the uterine body. The diflucan gel costo superior border, with all tiiat portion of the peri- tonieum stretching between the ovarian vessels and round ligaments, is spread out at the sides of the uterus in the shape of an acute-angled triangle, with the base at the brim pfizer diflucan costo and the apex at the cornua ; this conformation is the result diflucan cost with insurance of the tension how much diflucan cost exercised by the ligaments and vessels as the uterus ascends. The inferior border or base-line, shortened by the diflucan 150 costo expan- sion of the uterus, runs from generic diflucan online the internal os to about the linea terminalis, thus occupying a level corresponding in the main to that formerly held by the superior border. From this it will iippi'Mr tliat the outer border is virtually Fig. 6.— After Grav, showi s: the inner face of the regions above and below Pouparfs ligament. moid Hoxuro. The ascent of the lateral pouches of Doug- las, and consequent ascent of the utcro-sacral ligaments, serves to throw its upper portion farther back toward the central sacral line, so that at term the intestine as a whole May 3, 1884.] ROBERTS: MEGHANICO-THEEAPY IN HIP DISEASE. 489 runs nearer this line than before pregnancy. If we seize a gravid uterus at term and make traction upward, we lift the peritonseum along the face of the psoas muscles from the sacro-iliac synchondrosis to Poupart's ligament. If we make an incision parallel to Poupart's ligament about the level of the internal inguinal ring and push the gravid uterus well over to the opposite side, we may pass from the ring to the interior of the true pelvis without touching the peritonaeum, our line buy generic diflucan online of approach being be- neath that of the round ligament. The effect of pregnancy is, in fact, to loosen, and even diminish, the area of perito- neal attachment in the iliac fossae, generic diflucan fluconazole so that separation, as has been repeatedly pointed out, is a matter of ease. Before closing diflucan cost I must explain the reproduction of Gray's well-known plate. It is offered in connection generic diflucan 150 mg with the four we present in order to complete, as far as we can, the illus- tration diflucan costo of this region. ExPLAIfATlON OF FiGS. 1, 2, AND 3. Fig. 1. — A front view of the uterus at term, showing the broad ligaments, the round ligaments running along the ante- rior discount diflucan margin, and the ovarian vessels running along the posterior margin. Fig. 2. — An antero-lateral view of the gravid uterus from the left side, showing the broad ligament extended. Fig. 3. The gravid uterus at term. — The pelvic diflucan cost without insurance bones diflucan 150 mg costo in front of the pectineal eminence have been removed, and the broad and round ligaments have been out away, showing the external and internal iliac vessels, the uterine artery and its branches, the ovarian vessels, and the obturator nerve. The rectum is turned up against the aorta. The posterior wall and base of the bladder cover the anterior cervical and vaginal walls. The

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