The differential diagnosis for lower abdominal and pelvic pain following Cesarean section includes many causes, such as endometritis, abscess, pelvic hematoma, wound complications, pelvic vein thrombophlebitis, gastrointestinal dysfunction and obstruction. Colonic obstruction secondary to intussusception is a rare cause. We present a case of post-Cesarean section pain in a 26-year-old patient due to obstructing colonic intussusception secondary to colonic adenocarcinoma. Review of the literature failed to identify a previous case report of colonic adenocarcinoma with intussusception presenting early in the postpartum period. The diagnosis was initially made by ultrasound, and later corroborated by computed tomography, barium enema and laparotomy.

Reports indicating the value of quinidine sulfate in angina pectoris led to (1) a search for related drugs which were equally effective but less toxic, and (2) a study of the mode of action of these drugs. It was found that quinidine, quinine, cinchonadine, and cinchamidine decrease the frequency of attacks in daily life and increase the exercise tolerance as measured by a standardized test. Quinine sulfate (0.3 to 0.4 Gm. every eight hours) appears to be the drug of choice from the standpoint of availability and low toxicity as well as effectiveness. The value of these drugs is apparently due to a vasodilating action which in turn is dependent on the presence of the quinoline ring.P REVIOUS studies1-6 have demonstrated the value of quinidine sulfate in the treatment of some patients with angina pectoris. However, most general practitioners and, in fact, many cardiologists hesitate to use quinidine in angina because of the complications which occasionally follow its use in the treatment of cardiac arrhythmias. Furthermore, many physicians hesitate to use quinidine in angina pectoris because its mode of action in this condition is not clear. It seemed worthwhile, therefore, to study the activity of drugs related to quinidine in an attempt to find a substance equally effective but possibly less toxic and also to throw some light on the mechanism of action in the treatment of angina pectoris.The comparative value of 12 pharmaceutical preparations was investigated in patients with angina pectoris. Five of these 12 were cinchona alkaloids (the sulfate salts of quinidine, quinine, cinchonine, cinchonidine, and cinchamidine); these were studied to determine whether drugs which were similar to quinidine in chemical structure but different in cardiodynamic and cardiotoxic effects were of therapeutic value in angina. Procaine amide (Pronestyl) was included because, like quinidine, it is of value in eliminating ectopic ventricular beats. Three

Forty cases of acute and subacute leukemia were treated with one or more of various folic acid antagonists, usually aminopterin. Thirty-two cases were treated for at least one week, remissions occurring in 10. The remissions were of a temporary nature and variable in duration. As of June 1, 1949, two patients were still alive and in good condition, seven and one-half and thirteen months, respectively, after onset of therapy. Clinical, hematologic, and to lesser extent, marrow remissions were obtained most commonly in the lymphocytic type, none in the 4 monocytic cases. The subacute cases responded far better than did those of the acute, fulminating variety. The exact mechanism of action of the folic acid antagonists is not known, although one may speculate that anti-PGA, an anti-growth factor which resembles PGA so closely, is readily accepted by the primitive white cell with resultant cell death. The margin between a therapeutic or effective dose and one causing a toxic reaction is a narrow one. A "toxic" reaction may in fact be an indication of a therapeutic response. The pattern of therapy was (1) administration of the drug, usually by parenteral injection until a toxic or a pronounced hematologic reaction occurred, at which point (2) the drug was discontinued. With subsidence of the toxic reaction, (3) a maintenance dosage was then given, usually in the form of oral medications, 0.5 mg. daily for adults and 0.25 mg. for children. Transfusions and antibiotics were administered as indicated. Frequent transfusions were usually very helpful at the time of the initial reaction when anemia was ordinarily severe. Penicillin and other antibiotics were used for supportive therapy. Thrombocytopenia and hemorrhage were exceedingly difficult to control. The observed remissions appeared to be directly attributable to the action of the drug. Although temporary, they indicate that acute leukemia is not necessarily completely irreversible. Thus, there is hope that more potent anti-growth factors may someday be discovered which will be of value in ultimate control of the disease.

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