cle with or without injuries to the aorta and other
organs are related, death being caused by shock,
hemorrhage, traumatic aneurism, or secondary inllam-
mations. In only eleven of Tricor 48 Mg eighty-two cases collected
by Schuster did the patient survive more than twenty-
Two highly suggestive cases are recorded by Hoch- Tricor Price
haus.' The first was that of an adult, forty-three
years old, previously healthy, who fell from a wagon,
breaking some ribs, though not in a locality involving
injury to the heart. His heart later was found to be
somewhat dilated, pulse 100-120, small and soft. He
became premanently disabled on account of his car-
diac malady. The second was a similar though more
complicated case resulting from a fall on the back.
Both were regarded as cases of chronic myocarditis of
traumatic origin. Tricor Coupon
It is to this class of cases of injur)' to the heart
muscle due to non-penetrating injury that the case
above narrated probably belongs. The lesion is sup-
posed by Schuster to be caused by concussion or bv
the direct crushing of the heart between the sternum
and the vertebra-, the latter springing back into place.
It seems not impossible that cardiac laceration may be
produced by spasmodic contraction excited by the
shock of the accident, as occurs not infrequently in
the case of the voluntary muscles.
In looking over the recent literature of this subject
I could find very little about the matter. It is not
probable that such cases are extremely rare. It is not
improbable that traumatism has a larger share than is
generally recognized in chronic diseases of the myo-
' Jacoby: X. Y. Med. Journal, 1S93, 373.
' Prodsting : Deutsch. Archiv f. klin. Med., x.\xi. , p. 349.
' Rev. de Med., i88g, p. 755.
* Brain, Vol. 4.
' Langenbeck's .Vrchiv, Bd. ix.
' Zeitschr. fiir Fleilkunde, 18S0-S1. p. 417.
■ Deutsches .\rchiv f. klin. Med., ii., p. i, 1S92.
cardium, as exemplified by the two cases related bv
Hochhaus above referred to. The effect of trauma-
tism on the cardiac valves has long been recognized.
I publish this case in the hope that it may attract at-
tention to the less readily recognized lesions of the
myocardium due to injury and lead to the publication
of illustrative cases.
106 West 0.\-e Hlndkeu and Coupons For Tricor Twentv-Second Street.
A CASE OF GLOSSITIS.
Bv W. WASHBURN, M.D.,
J. M. H , aged forty-five, commercial traveller, had
generally enjoyed good health, but had been subject
to what had been termed malarial attacks, for which
he had been treated by quinine. About December
I St the patient discovered a small ulcer on the inside
of the left cheek, which after washing with witchhazel
disappeared. He had not had syphilis.
On December 5th the patient presented himself at
my office for treatment for sore throat and pain down
the left side of the neck. He was well nourished,
rather fleshy. The skin was of good color and the
eyes were clear. The pulse was 90, temperature 100^
F., respiration 22. The left tonsil was enlarged Tricor Coupons
slightly, with marked redness, localized on the an-
terior inferior surface. I ordered a gargle of tannic
acid and potassium chlorate. Early the following
morning I was summoned in haste, the messenger
saying that the patient was choking to death. When
I reached the patient he was in bed, conscious
but unable to speak, and had a feeling as though he
could not breathe. The nose was, however, free and
with a little encouragement he soon learned that he
could not only breathe properly but also swallow
without any great difficulty. The mouth was forcibly
open and the tongue filled the whole opening, the
teeth being embedded in the tongue. Closer exam-
ination showed that the left side of the tongue was
extremely thickened — nearly three inches thick — and
that the right side was very little affected. Cracked
ice was immediately applied to that portion of the
tongue that could be reached. Diagnosis: Left hemi-
glossitis. The sublingual veins were opened as soon
as a knife could be procured, some fifteen minutes
later. The patient could articulate (very thickly)
immediately after liie blood began to flow, and his
mental condition improved at once. Ice was ordered
now for external application, as the left cheek and left
side of the neck were beginning to swell rapidly. An
hour later more blood was drawn from under the left
side of the tongue, with relief (for the patient had again
become unable to articulate. The bleeding was re-
peated each hour thereafter until about noon, after
which the swelling did not again increase on that side of
the tongue, but began on tiie right side and rapidly in-
creased, so as to make articulation Tricor 145mg again very difficult.
The same treatment was applied on the right side of
the tongue that had been given to the left, and in the
mean while three leeches were applied to the lower
angle of the left jaw. At i p..m. the pulse was 108;
temperature, 101 ' F. : respiration 18 and pretty full.
The leeches were still on the left side, and the right
side of the face and right side of the neck were swelling
but under control by blood-letting from the under sur-
face of the tongue. Here a different course had to be
adopted in bleeding, for the veins could be seen, there
having been so mucli rolling over of the tongue to the
right side, and longitudinal cuts were therefore made
as near the under side as possible. Tricor Online The bleeding was
at first not very free, but a little later the veins were Purchase Tricor
reached and the improvement was as rapid as it had
August I, 1896]
been on the left side. A catheter was left with the
nurse, with instructions how to use it in case of oedema
giottidis. Solution of acetanilid in fifteen-drop doses,
about one grain, was given every hour. Swelling of
the right side of the tongue began to go down rapidly
about 2 P.M., but the glands of the neck on that side
The mouth was now douched with ice water, as pa-
tient could control the water from going down the throat.
This was continued for ten minutes and repeated each
hour. Mustard leaves were applied to the Tricor 145 feet and
removed when these became very red. Hot applica-
tions to the abdomen were also made.
The subsequent incisions in the tongue showed
white lines of tenacious pseudo-membrane Tricor Mg (the knife
and hands were thoroughly aseptic). The mouth was
sprayed Buy Tricor Online every hour with a solution of the perman-
ganate of potassium. Patient left the city on Decem-
ber loth and has not been heard from since.
The case presents some peculiar features. No cause
could be found for the glossitis —there were no sharp
edges of any of the teeth. The patient had never had
syphilis and no other known poison had been absorbed
or injected; recovery took place without the forma-
tion of pus. The case is reported as interesting be-
cause of these features and the probability, so far as
can be seen, of the glossitis being the direct result of
cold, as is claimed by some authors, among whom Tricor Cost
Cohen, in " Pepper's System of Medicine," may be
One other feature deserves mention — the fact that
first one side of the tongue only was affected and then
the other, and to this may be attributed the further
fact that there was no protrusion of the tongue, as is
usually the case, but rather a rolling over and point-
ing downward of the tip, which was caught behind
the lower teeth and during the time it was swollen
could not be dislodged from that position, except
BIL.\TERAL ORCHIDECTOMV, SUPRAPUBIC
CYSTOTOMY. FOLLOWED BY ,\(;;UTE MA-
XLV AND DEATH.
Bv WILLIAM WARREX TOAVXSENH, M.D.,
CEKITO-L"RINAi;V SLRL.EON, \ERMONT STATE HOl'SE OF CORRECTION.
Re.alizixg that the advisability of bilateral orchidec-
tomy Order Tricor for prostatic hypertrophy is still under discus-
sion, and believing that it is the duty of every operator
to give a full and detailed history of cases that come
under his observation, I report the following:
S. M. P , aged si.xty-seven, farmer, came to con-
sult me in regard to a bladder trouble which he had
had for the past five years, and gave the following
history: L^p to the beginning of his trouble he had
always enjoyed good health, and had been a hard
worker. He was always very energetic se.xuallv. He
gave a complete history of beginning prostatic hvper-
trophy, namely, frequent and nocturnal micturition,
lack of force to stream, etc. The use of the catheter
began two years before, as voluntary micturition had
become impossible, and .since then he had consulted
a number of physicians, who advised various internal
remedies, vesical irrigations, and suppositories. Since
using the catheter he Cheap Tricor had been growing worse; intro-
duction of the instrument was getting more painful,
and had to be performed every hour, day and night.
The urine contained a large quantity of pus and
some blood. The prostate was enlarged to about the
size of a goose egg. The passage of a searcher
through the prostatic urethra excited a severe parox-
ysm. The bladder contained 55 c.c. of residual urine
whicli was ammoniacal. Stone was suspected but was
not made out by the examination, as this was quite
painful and the patient would not consent to an anaes-
thetic merely for an examination. Cystoscopy was
not performed for the same reason. As the case
seemed to me to be an ideal one for bilateral orchi-
dectomy, and as the patient was in excellent con-
dition in other respects, I advised operation, which
was assented to. November 3, 1895, I performed the
operation in the presence of a number of my associ-
ates. The first forty-eight hours after operation the
patient was in excellent spirits, Tricor Fenofibrate and other than pain
from the wound and that occasioned by catheteriza-
tion, which was performed every two or three hours
instead of every hour, as had Buy Tricor been done previous to
operation, he suffered little. On the third day the
dressings were removed and the wound was found
to be healed. A collodion and gauze dressing was
put on and from the time of operation up to the fifth
day all went well. Catheterization was performed
every two or three hours and frequently when the beak
passed the cut-oft' muscle urine would flow out along
side the catheter.
Beginning Tricor 145 Mg about the fiftii day the patient, after the
bladder had been voided of its contents, experienced
severe pain near where the beak passed into the pros-
tatic urethra, and after the bladder had been voided
of its contents.
?"xamination of the prostate by palpation per rec-
tum showed that there had been atrophy. In passing
the catheter I detected a distinct grating on with- Tricor Prices
drawing the instrument, and with the searcher and
various manipulations vesical calculus was made out.
Operation was Cost Of Tricor advised and one week from the day of
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