orchidectomy I did a suprapubic cystotomy, and re-
moved three calculi weighing in all forty-eight grams.
The patient recovered from the shock of the opera-
lion and on the day following was doing well; the
urine was draining from the bladder and his condi-
tion was good.
The second day following the operation the temper-
ature ran up to 102° P., whereupon the gauze packing
was removed, the bladder washed out, and a drainage
tube inserted; the temperature came down to 101° F.
following the dressing. Pulse and respiration were of
good character up to within a few hours of death. The
next morning he had a normal temperature, but was
somewhat delirious. Thinking that there might be
some septic condition, I removed the tube, irrigated,
and repacked with gauze. He grew more delirious,
was very restless, and insisted upon getting out of bed.
Bromides and suiphonal failed to quiet him, and on the
following morning I found him in a maniacal con-
dition and requiring the services of several attendants
to keep him in bed. I called Dr. L. C. Stillings in
consultation, who advised hypodermatic injections of
liyoscine and feeding with the cesophageal tube intro-
duced through the nares (as the patient refused nour-
ishment, thinking that we were trj-ing to poison him).
This form of treatment was carried out until death
took place from exhaustion, eight days after the supra-
pubic operation and fifteen days after the bilateral
What caused this maniacal condition? We can
certainly eliminate Order Zestoretic the idea of sepsis, as the wound
was perfect in each operation, and so far as urrtmia
is concerned I think that also can be eliminated,
because a very careful examination, both microscopi-
cal and chemical, was made of the urine and no sign
of kidney lesion was discovered. Was it possible for
the mental condition to be due to the severe strain in
undergoing two such serious operations in so short a
time when recovery or rather alleviation from the
painful symptoms was anticipated as a result of the
orchidectom\? This we might expect in an hysterical
subject, but hardly in the patient in question.
[August I, 1896
In reviewing the literature, I find a quotation from
the British Medical Journal, May 18, 1S95: "The au-
thor reports seven cases in which this operation was
performed and in the first hemiplegia occurred, with
death four weeks Zestoretic Online after the operation. The second
developed signs of acute mania six days after the ope-
jation and died ten days after; the third also devel-
oped mania and died on the twelfth day; the fourth
exhibited the same symptoms with the Zestoretic 20 25 Mg same result,
death. The fifth had no appreciable mitigation of
the urinary trouble thirty days later. The sixth was
one of single orchidectomy, Ijut the patient died in a
few days in a state of mental aberration; and finally
the seventh, also a single orchidectomy, developed
distinct mental weakness, and death followed."'
It is well known that when oophorectomy was first
teing done, numerous cases of mania were reported
following the same. Should the testicle and brain
not maintain the same relation to each other as the
ovary and brain? I will leave this to the neurologists.
In conclusion I will say that as for the operation
relieving the prostatic hypertrophy it was a success,
as there was a marked decrease in the size of the
gland, determined not only by rectal palpation but by
palpation and ocular demonstration through the supra-
pubic incision. Although unfortunate in not being
able to report a favorable case, I will operate again,
as the favorable cases that have been reported out-
number the unfavorable ones. In the case just re-
ported the prostate did decrease in size and I have
•every reason to believe that, had the patient lived, the
prostate would Zestoretic 20 have been reduced so as to have allowed
the urine to be voided voluntarily /<:■/■ vias naturaks.
NARCOTINE IN MALARIA.
By LOUIS C. AGER, M.D..
ASSISTANT BACTERIOLOGIST TO THE HOAGI-AND LABOKATORV, BROOKLYN.
Ix the Buy Zestoretic Online Medical Record for September 21, 1895, the
statement was made that the opium alkaloid " narco-
tine" or " anarcotine" was being used ver)' successfully
in India as a substitute for quinine. The drug was
recommended in the acute forms of malaria only, but
it occurred to me that it miglit be useful in hemicrania,
supraorbital neuralgia, and the other chronic forms of
malarial poisoning that are often so difficult to deal
with. After considerable difficulty I got some of the Order Zestoretic Online
drug from a wholesale house in New York and put it
up myself in two-grain capsules. The first case in
which I used it was that of a woman about thirty-five
years old. She had had acute malarial fever a few years
before and had been troubled with neuralgia in various
forms ever since. About a month before I saw her
she had a severe attack of hemicrania, which had only
been controlled by the hypodermic use of morphine.
When I saw her she was suffering from a similar at-
tack of a severe character. I gave her three two-grain
doses of narcotine half an hour apart, then two grains
every four hours, till about fourteen grains had been
taken. The patient was much relieved after the third
dose, and has had little Lisinopril 20 or no return of the Purchase Zestoretic trouble in
the last three months.
Since that time I have used narcotine in a few simi-
lar cases with very good results. In one case there
was considerable heart depression about two hours
after Zestoretic Price the third dose, but not Zestoretic 20 12.5 Mg so much as sometimes
occurs after full doses of the coal-tar analgesics.
Although my experience with the drug has been Buy Cheap Zestoretic far
too limited to furnish any positive knowledge of its
usefulness, I feel encouraged to try it further and to
:suggest it to others.
The Hot Iron. — Before using it render the skin
area ana-sthetic Zestoretic Tablets by applying pure synthetic crystallized
guaiacol, in quantity of from twenty to sixty drops.
Epitheliomata of slight extent often give way to
such mild means as the following solution frequently
I? Resorcin 2 gm.
Potass, chloral 10 "
Aq. dest 300 "
Burns of the Second Degree. —
I( Carbonate of lime 10 gm.
Oxide of zinc 5 "
Starch, Zestoretic Generic
Lime water aa 10
Ichthyol 1-3 "
M. — Leistikow.
Orchitis. — Apply a few drops of guaiacol over the
scrotum. — Balzek. Generic Zestoretic
Analgesia, without irritation of the skin, is best
obtained by adding an equal part of glycerin, or some
vehicle which can Cheap Zestoretic be absorbed by the skin, to guaia-
col, and covering with tissue to prevent evaporation. —
Tedious Purchase Zestoretic Online Labor After a case of tedious labor, an
iodoform pessary is to be Zestoretic Strengths inserted in the vagina. A
similar pessary is to be Zestoretic Cost used night and morning for
the first three days, and once in twenty-four hours for
the next six days. — Clifton Dispensary Rules for Mid-
Dr. Cheever, in the Boston Medical and Surgical
Journal, says it is not advisable to operate in glandu-
lar infiltrations so extensive as to preclude entire
removal ; neither is it w ise to operate when you can-
not remove the whole disease, as in a tuberculous or-
gan of which you excise a part, nor in a sarcoma of the
antrum in which you cannot extirpate the splienoid
cells. It is allowable to depart from these rules when
the pain is so agonizing that unless the suffering can
be palliated the patient had better die than live; and
also in a " forlorn hope," so-called, the patient is en-
titled to an operation if he assumes the responsibility.
Even then it is well not to operate unless there is some
slight chance of success.
Deaths from Anaesthetics. — The German Surgical
Society gives the following statistics for the past five
years in regard to mortality from anaesthesia: Chloro-
form was administered 201,224 times, with 88 deaths,
or in the ratio of i in 2,286; ether, 42,141 times, with
7 deaths, or in the ratio of i in 6,020; chloroform
and ether, 10,162 times, with i death; chloroform,
alcohol, and ether, 5,744, with i death; ethyl bromide,
8,967, with 2 deaths.
Spontaneous Straightening in Rickety Curves of
the Legs. — Dr. liruns concludes from observations
in Tiibingen (Beitrdge Cliir., vol. xvi., i) that tlie
greatest niunber of cases undergoes spontaneous cure
in from two to four years. If the curves are unchanged
at the sixth year, spontaneous cure does not occur.
The chief aim of treatment should be to improve the
general health. Of the number of cases under obser-
vation 75 percent, were cured, 15.3 per cent, were
improved, 9.7 per cent, remained unchanged. He
considers that after the acute stage it is not harmful
for children to be on their feet.
August I, 1896]
Epididymitis. — The testicle should be wrapped in
lint Lind moistened frequently with lead water and
opium, or the following:
K Tincture of aconite.
Tincture of opium aa 3 i.
Dilute lead water,
Water aa ; ij.
Osteomyelitis. — Dr. Funkhouser, of St. Louis, Buy Zestoretic says
the chief diagnostic point in osteomyelitis is the
acutely sensitive spot near the junction of the epi-
Fistula in Ano. — Dr. Gibbs, in the JVew York
JA-i//u!/ /I'/o/ia/, March 21st, gives two reasons for
failure in treating this trouble, i. We are by no
means sure of starting with an aseptic wound, though
it is a simple matter to lay open a small, superficial,
straight tract, and after thorough cleansing obtain im-
mediate union. It is a different matter with an old
fistula running under the skin and up around the in-
testine, with pockets and ramifications difficult to
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