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more or less dropsy is present; (,2) when walking brings on severe dyspnea or pain, and (3) when the circulatory condition is so bad as to cause danger of syncope. Digitalis is the best of the heart tonics. Next come caffeine and theobromine. Nu.x vomica and strychnine should not be held back until the patient is in extremis. Erythrol tetranitrate is his favorite vascu- lar depressant in half grain doses (tablet) every four hours. It occasionally causes severe headache and must be withheld. It may be given alternately with digitalin. For purgation he prefers elaterum. Purchase Zaditor Online Oxygen inhalations may be tried, but Saundby has little faith in their efficiency. They may be ordered for patients who Zaditor Coupons are in a hopeless condition to satisfy the desire of the friends that something should be tried, but the difficulty being not to get air or oxygen into the lungs, but to carry on the pulmonary circulation with greater rapid- ity, no advantage accrues to the patient from a higher proportion of oxygen in Zaditor Drops the air inhaled, as only a defi- nite arnount of oxygen can be taken up by the blood, and this is determined not by the quantity present, but by the state of the circulation. Berliner klinischc Wochenschrift. October 15, 1906. A Contribution of the Serum Buy Cheap Zaditor Treatment of Order Zaditor Online Syphilis. — Engel describes observations made in three cases of syphilis treated by means of injections of an autoim- mune serum obtained in the following way. About twice a week 10 cc. of blood was taken from the fore- arm of the patients, and after heating for half an hour in order to inactivate the complement was injected into the peritoneal cavity of a rabbit. After twelve injec- tions the rabbit was bled from the ear on ten different occasions and from 1-5 cc. of the serum obtained was injected under the skin of the arms or backs of Zaditor Price the patients. Each injection was followed by a sharp local and general reaction. All of the lesions subsided, ap- parently in consequence of the treatment, and there have been no fresh manifestations during several years. The author describes hemolytic and other tests of the serum produced which lead him to believe that it really contained antibodies, and he suggests that other dis- eases such as pernicious anemia and some forms ot nephritis may be amenable to treatment carried out along the same lines. The Early Diagnosis of SsTJhilis. — Danziger is of the opinion that the spirochete question has reached a stage of development which renders it available in the Order Zaditor early diagnosis of primary syphilitic lesions. He gives the histories of five cases in which it was possible to identify spirochetes in secretion obtained from genital lesions whose character was still indeterminate and which subsequently developed into chancres. He there- fore urges that this method be applied more generally, though he points out that only a trained observer can give a reliable opinion as to the nature of any organ- isms that may be discovered. Miinchcncr medicinische Wochenschrift, October 16, 1906. The Treatment of Fresh Wounds with Dried-Out Dressings. — Asbeck considers that attempts to disinfect fresh wounds are ordinarily ill advised, for in general it may be said that all such may be regarded as not being seriously infected. It is. therefore, unnecessary and even injurious to attempt to cleanse or disinfect such a wound, for it is impossible to wash out or kill any germs that may be present without at the same time impairing the vitality of the body cells. Naturally, any visible particles of foreign matter must be removed. Disinfection and cleansing of the surrounding parts causes the Alaway Or Zaditor uper layers of the skin to became softened and washes infectious organisms into the wound. The method which he has employed in over 500 cases of fresh injuries consists in covering the wounded area with a compress of gauze impregnated with iodoform or with some of the newer substitutes for this without any preliminary cleansing operation. Plain gauze and absorbent cotton are placed over this and the dressing is completed with a gauze bandage. These procedures are carried out under aseptic precautions. The injured part is then exposed during a period of from one-half to three-quarters of an hour to the radiating heat em- anating from some powerful heating apparatus, in fac- tories Zaditor Eye Drops or forges, the furnaces being used, and in house- hold practice, the kitchen stove. For small injuries the Bunsen burner may be used. When the dressing is to be changed the removal of the adherent gauze is facilitated by the use of peroxide of hydrogen. The rapidity of healing and the freedom from complications under Eye Drops Zaditor this treatment are said tn be astonishing. The Technique of Skin Grafting. — Waljaschko says that none of the various substances in common use for dressing cases of skin grafting satisfactorily fulfill the requirements of facilitating healing of the wound and of immobilizing the grafts. He has found the follow- ing method very satisfactory: A piece of tulle a little larger than the denuded area is boiled in soda solution and wrung out in sterilized gauze. It is then spread over the grafted surface and its edges are cemented to the surrounding skin by means of collodion. The ordi- nary dressing of sterile gauze is then applied. In order to prevent maceration of the grafts they are never ap- plied overlapping each other, and they also must not overlie the skin at the wound edges. The gauze outer dressing is changed daily, but the tulle is not removed until the tenth or twelfth day. The tulle dressing is particularly ad\'antageous in maintaining the grafts in position in difficult situations such as the chin, the jug- ular fossa, between the fingers, etc. Deutsche medicinische Wochenschrift, October 18, 1906. Hycirocyanic Acid Poisoning. — Tintemann describes an instance of poisoning by hydrocyanic acid which though followed by serious symptoms did not terminate fatally. A young student of chemistry, at the conclu- sion of some work with this acid in cleaning the test tubes used, allowed one of them to fall into the sink, and in bending over to pick up the fragments inhaled the hydrocyanic acid fumes. He was uistantly seized with extreme dizziness so that he saved himself from falling only by grasping the water faucet. After about a quarter of a minute the dizziness grew less and the patient was able to seek the open air, hoping that this would bring relief. Instead of this, severe cardiac op- pression, palpitation, Zaditor Tablets and dyspnea appeared so that he was forced to go to bed. It was not until nine days later that the urine became free from albumin Zaditor Cost and casts, and the temperature remained elevated for about Buy Zaditor a week. Other symptoms that were prominent during this period were great unrest, obstinate insomnia, severe headache, and total distaste for food. In dis- cussing the case the author lays special stress on the parenchymatous degeneration of the kidneys that was caused and on the elevation of temperature. The for- mer important complication he says has heretofore not been observed or at least has not been reported. Further Observations on the Penetrating Action of the Hot Water Alcohol Method of Hand Disinfection. — Ahlfeld endeavors to refute the contentions of his op- ponents by citing further statistics obtained in his ob- stetrical clinic at Marburg. Kronig, in referring to the particularly strict asepsis of the Leipsic clinic, notes that after the omission of all operative cases and some others, in 2,094 labors a mortality of o.l per cent, was recorded, and that in a series of 980 normal cases there was a puerperal morbidity of 42 per cent. Ahlfeld, dur- ing the last year, has had in all 750 deliveries, with no septic deaths and a morbidity of only 29.7 Zaditor Eye Drop per cent. These figures include all cases, operative deliveries, pla- centa previa, eclampsia, and cases infected on admis- sion. During this period six courses of instruction have been given to midwives and others, so that in ad- dition to the regular staff 200 to 250 other persons made vaginal examinations of the patients. Ahlfeld has the conviction that if his method of sterilizing the hands is used no appreciable danger attends vaginal examination. He gives the detailed statistics of about 3,500 cases, different groups of w-hich were examined 1-5 times, 6-10 times, and 11-15 Cheap Zaditor times, respectively. The percentage of morbidity in the first group was 30.24 per cent., in the second. 31.85 per cent., and in the third, 28.89 per cent., the standard of morbidity being any ele- vation of temperature over 38° C. The Extraction of the Tom-Off After-Coming Head. — Borginis says that although owing to the greater fre- quency of forceps operations, the practitioner is now, fortunat«ly, seldom in the unpleasant position of being obliged to remove a head from which the body has been torn, this condition must still sometimes be dealt with. In some cases in which the usual methods fail he has found the following procedure very useful. The head is fixed from without through the abdominal wall and is then grasped securely with a volsella or simi- lar type of clamp passed through the cervi.x. To Buy Zaditor Online the end of the instrument projecting from the vagina a cord is attached leading over the foot of the bed and having a weight at its extremity. In the course of a comparatively short time the cervi.x will be sufficientl}' dilated, even in cases in which considerable contraction had already taken place, to enable the head to be re- moved without great difficulty by the application of forceps. Nov. Zaditor Coupon 10, 1906] MEDICAL RECORD. 755 On Leprosy .\nd A Statement of Facts and Explanations. By Jonathan Hutchinson. F.R.S. and F.R.C.S. ; LL.D., etc. London: Archibald Constable and Company, Ltd. ; Chicago : W. T. Keener & Co., 1906. The object of Mr. Hutchinson's book is to present facts, statistics, and documentary and other evidence in support of his conviction that "the fundamental cause of the malady known as true leprosy is the eating of fish in a state of commencing decomposition." The author limits his accusa- tion distinctly to bad fish, adding that the fish supplied in the English market is "obviously quite free from the risk of causing leprosy." He believes that the cause of leprosy is some product of decomposition or some parasite presenl in decaying fish. The free use of salt in communities where fish is eaten in large quantities is the best preventive of the disease. The author has devoted to the study of leprosy a great deal of his time since 1855. In 1S63 he wrote a paper in which he foreshadowed most of his present conclu- sions, and his research in this line, including travel to vari- ous parts of the world, has been unremitting. The work practically represents a life-long study of leprosy from the viewpoint indicated. The book contains a mass of most interesting material, carefully and systematically collated, and pleads the cause most eloquently, though unconvinc- ingly. It is a curious instance of a man sticking to a theorj' against reason and against Purchase Zaditor facts. Diet and Dietetics. By A. Gautier. Edited and Trans- lated by A. J. RicE-OxLEY, M.A., M.D. Philadelphia: J. B. Lippincott Company ; London : Archibald Constable & Company, Ltd., 1906. In this work the translator has made accessible to English readers the painstaking but by no means original work of Gautier. The book is, in fact, a compilation of the observa- tions and views of the recognized authorities on dietetics up to about two years ago, and in view of the vast impor- tance of recent contributions to the study of food metabo- lism, it is necessarily already somewhat out of date. The author has divided his work into three parts. Part I treats of "Principles and Methods." After some general consideration of the mechanism of assimilation, normal proportions of the organic fundamental principles of ordi- nary alimentation, etc., he arrives at his conclusions as to the food requirements of the average healthy individual by an exhaustive study of the quantities and relative propor- tions of the food supply to the city of Paris for the decen- nial period, 1889-1899, and accepts the figures which thus represent what the average inhabitant of Paris actually consumed during that period as a criterion. Thus, he esti- mates that the healthy individual, under ordinary conditions of life, requires no grams albuminous food. 68 grams fats, and 425 grams carbohydrates. These quantities and pro- portions are practically those of the older accepted stand- ards of Voit and others, and perhaps will in the end be found physiologically correct, but one is tempted to criti- cise the method employed for determination of this standard as unscientific and empirical. In Part II the author discusses at considerable Generic Zaditor length

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