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The clinical business proper was also duly gone through. This consisted of a case of ulcerative (or, according to another's view, membranous) colitis, treated successfully Norvasc 7 Mg by inguinal colotomy, and subsequent irrigation with boric solution of the surface between the anus and the ar- tificial opening ; two cases of chronic albuminuria of long standing, twenty-five and forty-three years, respectively ; fatal asphy.xia following self-administration of nitrous o.xide. The Royal British Nurses Association has obtained a charter of incorporation. Sir William Jenner, in his retirement, has arranged some of his scattered lectures and communications for publication in book form. His valuable studies on fevers and diphtheria will appear in the first volume, now in the press. I hope he will do justice to the late Dr. A. P. Stewart's work in discriminating typhus and typhoid. THE USE OF NITRATE OF SILVER IN SOLU- TION IN GASTRIC ULCER. To THE Editor Norvasc 7.5 Mg of the Medical Record. Sir : The admirable article by Dr. I. Boas, of Berlin, in the Record of June 17th, calls the attention of the pro- fession to the Norvasc 2 Mg use of nitrate of silver in gastric ulcer, and especially to its use in solution. I can add my testimony to its efficacy, used in this way, but with a modification which permits the administration of larger doses when advisable, without any unpleasant effects. As long ago as 1SS7, I began using the nitrate of sil- ver in Norvasc Cmi solution in chronic gastric catarrh, and in cases of obscure stomach disease, where great pain on pressure over a small area and distress soon after eating led me to suspect the presence of an ulcer ; but where some of the more characteristic symptoms were wanting to es- tablish a certain diagnosis, my plan of giving the silver in solution has been as follows ; .\t first the patient is directed to drink eight ounces of warm water, and after half Generic Norvasc 10mg an hour, another glass of water in which one grain or more of the nitrate of silver has been dissolved is taken, this to be followed in fifteen minutes by a cup of water containing a pinch of chloride of sodium ; this last procedure is, of course, not necessary when small doses are given ; but it enables us to administer large doses, well diluted of course, when desirable, and as in these cases it is the local effect of the remedy we desire, it is just Norvasc Coupon as well to neutralize the drug, in part at least, be- fore its absorption. The history of the first case in which I used the remedy in this way is as follows : Mrs. B , a widow about fifty years of age, con- sulted me in October, 1887. and gave a history of long suffering from inability to digest food. She often vomited and suffered great pain in the epigastrium, the pain was circumscribed, was transmitted through to the back, and was much intensified upon pressure ; there was no history of vomiting of blood, nor had blood been observed in the Generic Norvasc Price stools. There was constipation and great emacia- tion, and all kinds of food were imperfectly digested. I directed the patient to take in eight ounces of Norvasc Other Names warm water, one grain of nitrate of silver, after previously tak- ing the warm water as above noted, and this latter to be followed in fifteen minutes with a cup of water containing a few grains of salt. This procedure was repeated once a day for a few days only, and after that every second or third day for a while. The result was excellent and the patient very much relieved, she could digest carefully se- lected food, and gained a considerable degree of health. A year later there was a slight relapse, but this yielded to treatment, and the patient remained up to about a year ago, when I last saw her, much improved. I ha\'e since that time made occasional use of the nitrate of silver in solution, in cases where a rather chronic ulcer of the stomach has been suspected, when great emaciation and a cachectic appearance had led me to fear malignant dis- ease. In such cases I believe it efficient. In more re- cent cases, where the symptoms have not been so severe, I have not found it to be generally superior to the use 01 small doses of the silver salt in pill form. These, how- ever, I generally give on an empty stomach, and let the patient drink a little water, and rest for a time after tak- ing them, no food to be taken for an hour. The question arises how the silver acts, and whether it is not speedily neutralized by the hydrochloric acid it meets, or Norvasc 100 Mg may meet, in the stomach. Without Norvasc 5mg Generic going fully into the subject it is fair, 1 think, to assume that when taken fast- ing, and not within an hour of meal-times, it will act efficiently without chemical change. The method of giving from one-half grain to two, or even five grains in solution in from two to twelve ounces of water, seems to promise the best results, when its local action is desired, and its neutralization by the administration of the chlor- ide of sodium permits the administration of large doses when necessary. S. S. Jones, M.D. 20 East Sixty-third Street. ^Mtcal Stems. Contagious Diseases — Weekly Statement. — Report of cases and deaths from contagious diseases reported to the Sanitary Bureau, Health Department, for the week end- ing June 24, 1893. Typhus fever Typhoid fever Scarlet fever Cerebro-spinal meningitis Measles Diphtheria Small-pox. Cholera Varciella Pertussis Erysipelas Leprosy The Prognosis of Pott's Disease must be considered under four headings : as to life, as to the complications, abscess and paraplegia, and as, to the deformity. .\s to life : Although Pott's disease is a most prolonged and serious disease, the prognosis as to life is remarkably good ; only about eight per cent, die of those receiving proper nursing and treatment. In these few the cause of death is invariably due to tubercular meningitis or general tuberculosis in which the meningeal symptoms play a most prominent part. The abscess of Pott's disease, if uninterfered with, rarely causes trouble. If the area of bone disease be efficiently immobilized, the abscess, in about half the Norvasc Pi cases, disappears without com- ing to an opening. In the remaining cases it bursts, discharges for a longer or shorter time, and closes. Treated by aspiration and the injection of the iodoform and glycerine mixture, the cure is hastened in a certain number of cases ; in other instances nothing seems to be gained by the jirocedure. and in a few cases a true sup- 32 MEDICAL RECORD. [July I, 1893 purative process is grafted on to the tubercular inflamma- tion. Treatment by incision, scraping, and drainage in l)ure tubercular abscesses, untainted with septic infection, rarely aids the cure in the slightest, and greatly adds to the risk from general tubercular infection and from septi- Cceniia. The paraplegia, which occurs in Buy Norvasc 5mg a considerable number of cases of upper dorsal Pott's disease, though rarely in cervical and lumbar disease, Norvasc Coupons need cause little anxiety. Rarely is the paralysis due to ])ressure of bone, or to tuberculosis of the cord itself. The acuteness of the angle of deformity bears no relation to the paralysis, Norvasc Logo since we not infrequently see the paralysis pass off while the deformity continues to increase. Cases of paraplegia from bony encroachment invariably terminate fatally, unless the pressure be relieved by operative interference. Cases in which the tubercular inflammation has invaded the cord itself always die. In the vast majority of cases the paralysis is due to a peripachymeningitis, and the prognosis is good, provided the patient can be kept re- cumbent and the area of disease immobilized. Relapse may occur, but ultimately the paralysis is fully recovered from. The prognosis as Cheap Norvasc Online to deformity and function de- pends upon the location of the disease and the amount of consolidation present when treatment is commenced. If consolidation is not already present, deformity can be fully corrected in the cervical spine, and normal function regained. In the dorso-lumbar region Norvasc 50 Mg — tenth dorsal to third lumbar inclusive — the deformity can be somewhat reduced, and at times in young children wholly effaced. Some rigidity usually remains, but in the very young, if the deformity is fully corrected, full motion may be re- gained. Disease in the upper dorsal region invariably results in some deformity before a positive diagnosis is made, and this, as a rule, increases somewhat during treatment. Disease at the fourth and fifth lumbar verte- bra; must be treated with complete recumbency for a long period if deformity would be avoided : when, how- ever, deformity has occurred, it cannot, as a rule, be remedied. The prognosis as to deformity, wherever the disease is located, depends very much upon the time of making the diagnosis, and the ability to carry out an ideal line of treatment. If the disease can be diagnosti- cated before deformity has occurred, and if proper treat- ment can be persistently carried out, deformity may be prevented in all cases and the duration of the disease greatly lessened. — John Ruh.on, M.D., in the Chicago Medical Recorder. Berlin boasts of its four lady doctors already — whether the profession will be further increased through feminine assailants remains to be seen ; but if Herr Baumbach's motion is carried, which he brought forward lately with much eloquence in the Reichstag, asking that women be permitted to present themselves tor the Staat's Examen — with a view to practising medicine — if this is finally car- ried we can only imagine that the existing female practi- tioners will have their numbers largely augmented in Ber- lin as in other German towns. — The Hospital. Grafting a Dog's Skull. — From Paris comes an ac- count of an operation performed by M. Ricard, on a woman of forty five, who* had suffered from a tumor in the frontal bone. A portion of the bone had to be re- moved in Norvasc Canada order to get rid of the tumor, and as the brain was laid bare in consequence, cerebral hernia ensued. M. Ricard had the idea of removing a piece of living bone from a dog's skull, and cutting it exactly to fit into the void in the woman's forehead. He took antiseptic precautions — the grafted piece was knit with the frontal bone, into which it was inserted, and the patient made a good recovery. Dr. Polaillon has presented a report on the case to the Academie de Medecine, and speaks of the operation as the first successful one of the kind ever per- formed. The operation is in the same line with others done in this city. Salol combined with phenacetine is especially useful in influenza and rheumatism. — Shokmaker. BOOKS RECEIVED. Brain Surgery. By M. Allen Sarr, M.D., Ph.D., Professor Norvasc 5mg Price of Diseases of the Mind and Nervous System, College of Physicians and Surgeons, Medical Depart- ment of Norvasc Patent Columbia College, New York ; President of the New York Neurological Society: Consulting Neurologist

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