Cialis Mg 50 | OVERNIGHT Delivery!







































recounted and an analogy attempted between the resulting abeyance of motor functions and conscious processes. Sixty per cent, of dreams relate to sight, five per cent, to hearing, three per cent, to taste, and only one and one half per cent, to smell. Infections of the Urinary Tract in Infants and Young Children. — Cliarlcs A. Sellers Cialis Mg 50 {Journal of the liidiaiai Stale Medical Association, March 15, 1018) claims that acute pyclocystitis is being over- looked in infancy because of the neglect of a routine microscopical urinary examination in all cases. While the condition is more frequent in female chil- dren, there arc many cases in males which have Ikcii overlooked. The theory that acute pyelitis is always an ascending infection with the colon bacilli Cialis Mg 50 from the soiling of the vulva, is losing its hold. The blood stream mfection route is the more prob- able. We are justilied in believing that there is some other cause in which either the kiilney resist- ance is below par, or there are conditions in the body fluids that increase the virulence of the colon bacdlus. Acute pyelitis is probably never primary. The disease, as a rule, responds promptly to the alkalmc treatment, especially potassium citrate or guiacol, through rendering the urine alkaline. Uro- tropme and vaccines are most disappointintr, and thiir use in young infants is not advocated. Metastatic Cancer of the Bone Marrow with- out Erythroblastic Reaction.— W. R. Jack and J. 11. Teacher (Ulas,jo:e Medical Journal, February, igi8), refers to tlie fact that some cases of gastric cancer closely sinndate pernicious anemia in general symptomatology. Blood examination has Cialis Mg 50 been held valuable where metastatic cancer of bone or bone marrow is suspected. In contrast with true perni- cious anemia, the anemia accompanving cancer is usually chlorotic in type, with low color index and without crytliroblasts. Harrington, Teacher and Kennedy had recently Cialis Mg 50 shown that upon the advent of Cialis Mg 50 bony metastases, the blood i^icttire mav so change as closely to reproduce the condition in Cialis Mg 50 pernicious anemia. Rone pains and an anemia with high color index and myelcmia in any case of carcinoma had been held by Harrington and Teacher to suggest the (li.ienosis of cancer of the bone marrow, 'the au- thors now report a case, similar to one recorded by -Middelton, in which there were secondary tumors in the bone marrow, implicating a considerable nmnber of bones, and yet in which the blood presented none of the characters of pernicious anemia. To explain the discrepancy the authors note that in these two cases the involvement might be called massive only in the sternum and pne or two ribs, m other bones forming merely isolated nodules, while in the for- mer cases tumor tissue was abundant in most of the bones invaded. An alternative explanation is that in the two cases without pernicious anemia, cancer- ous toxemia was such as to lead to an aplastic type of. anemia and prevent an erythroblastic reaction in the bone marrow. The chief conclusion is that the pernicious anemia blood picture is not a necessary Cialis Mg 50 accompaniment of metastatic bone marrow cancer"; a diagnosis of the latter may be justifiably made from the bone pains alone where the anemia is purely chlorotic in type. Use of Tuberculin in the Diagnosis of Eye Lesions. — L. .\. L'V.i]}]) {Archives of Diagnosis, Cialis Mg 50 ( )ctober, 1917) notes that many eye lesions formerly diagnosed as idiopathic are in reality tuberculous. Careful diagnosticians have, moreover, been cha- grined at the clinically tuberculous lesions showing a strongly positive Wassermann reaction and yield- ing to antisyphilitic treatment, as well as at lesions apparently sijecific but which are uninfluenced by antiluetic measures, and later show a focal reaction following a tuberculin test. The tuberculin oph- thalmic reaction is unsafe, the Von Pirquet cutane- ous reaction inconclusive. The diagnostic test of real value to the ophthalmologist is the focal reac- tion following subcutaneous injection of old tuber- culin. A positive general reaction without focal reaction signifies probably a tuberculous lesion in some location other than the eye. The focal reac- tion, if the lesion is corneal, consists in an increase in the circumcorneal injection with Cialis Mg 50 an extension of infiltration into the cornea. The disturbance Cialis Mg 50 may be merely slight. I f the case is iritic, there is increased circumcorneal injection with more numerous de- [)Osits on Descemet's membrane and some increa.se in cloudiness of the aqueous. If it is choroidal or ret- inal, there is increased edema and cloudiness of the vitreous, possibly with fresh hemorriiages if the vessels are chiefly alTected. In corneal lesions, a large di.ignostic dose, one to ten milligrams, can be used ; the former is usually sufficient. In acute iritis 0.5 milligram is appropriate ; in more chronic iritis, up to five milligrams. Cialis Mg 50 In very acute choroidal or retinal lesions, especially when near the macula, the eye should be jnit at rest till the condition is sub- acute or chronic, and even Cialis Mg 50 then only an exceedingly small dose used. In neglected cases with the tissues Cialis Mg 50 so cloudv that exact observation of the acufeness of the condition is impossible and where all other pos- sible sources of etiological factors prove negative, one should begin with very minute therapeutic doses, such as 1 :5uo,ooo milligram of T. O., and graduallv increase until some focal reaction or some improve- ment in the condition is noted. yoo MISCELLANY FROM HOME AXD FOREIGN JOURNALS. [New York DicAL Journal. The Lacha Marzo Sign in the Diagnosis of Death. Cialis Mg 50 — R. Alvarez de laledo y Valero {La Cro- nica Medica, Lima, January, lyiBj from observa- tions made on i8o dead and two thousand living sub- jects finds that this test is a certain sign of real death; that it is never found in life; that it is not constantly present; that it occurs usually from one half to seven Cialis Mg 50 and a half hours after death; and that low atmospheric temperature may impair its action. The sign is an acidity of the secretion of the Cialis Mg 50 Cialis Mg 50 con- junctival sac as shown by its reaction on tornasol paper.