Cialis Ordering | OVERNIGHT Delivery!







































analyzes this case and concludes that it is most probable that the optic atrophy was due to the sensi- tizing effect of energetic t reatment which this pa- "Berliner klinische Wochtnsclirift, December 19, 1910, 51, p. :34*- 210 '•m.riTZER: Cialis Ordering SALfARSAX. [New Yo« Medical Jootuia tient had previously undergone with arsacetin and enesol. It must be added that in the most recent literature, the number of reports of cases of cranial nerve lesions Cialis Ordering other than optic, occurring after sal- varsan. is increasing, Cialis Ordering aiTd the matter must be re- garded still Cialis Ordering sub jvilicc. I have dwelt on this matter a little fully because of its vital importance for the whole question of the use of salvarsan. As to the minor objections to the use of Cialis Ordering the drug, they are based mainly on the details of its applica- tion. In a moderate number of cases, severe pain follows the injection and sometimes sloughing of the skin occurs, or an aseptic abscess is produced. I may say at once that the failures, the recurrences of the lesions, and the local accidents occur with all methods of preparation of the drug. They are only seldom due to an error in technique on the part of the operator. JMarks\ an assistant of Ehr- h'ch, expresses the hope that the administration of salvarsan will be left in the hands of the specialists, just as laparotomies are done for the most part by surgeons. I shall not here go into the details of the tech- nique of the preparation and administration of the drug. I desire to dwell on a few points only. The- oretically, the intravenous method should give us the most complete sterilization of Cialis Ordering the infected host. Practically, however, recurrences develop after this method as after all others. The intravenous method has the advantage of comfort for the patient. A chill, a few hours of moderate temperature, some nausea, perhaps vomiting, and that is all ; no sub- sequent pain or tumor or possible abscess and slough. It hag the disadvantages of necessitating several days' stay in the hospital and of requiring a certain amount of skill and training on the pnrt of Cialis Ordering the operator. Furthermore, Cialis Ordering not every patient has arm veins that are available for the injection. The intravenous method can never become the pop- ular method, and moreover, I am not sure that it is worth while. The subcutaneous or intramuscular injections Cialis Ordering of neutral suspensions or alkaline solu- tions of the drug, have the disadvantages alreadv referred to, pain, abscess formation, etc., and fur- thermore, the preparation of the dose for each in- jection requires an aseptic technique, considerable skill, and a great deal of time. It Cialis Ordering was therefore with great interest, when the hope of a sterlisatio magna Cialis Ordering seemed futile, that I read of Kromayer's application of the drug in the form of a suspension in oil, analogous to the sus- pension of the insoluble salts of mercury that we are all familiar with. Kromayer" reported that the immediate clinical results of an injection of salvar- Cialis Ordering san in liquid paraffin were contrary to the theoretical considerations, just as prompt and effective as when the drug was used by other methods. Tiie rapid ab- sorption of the Cialis Ordering drug from its oily suspension is proved by its prompt appearance in the urine after injection. Rosenthal'^ confirmed these observa- tions. The use of the drug in oily suspension of- fers so many advantages of convenience, that I have of late been employing it in this form. The sus- pension may be prepared in larger quantity — pre- pared aseptically and protected from light it keeps ^*Berliner klinische Wochenschrift, September 12, 1910, p. Cialis Ordering 1698. and September 26, p. 1791. '^Berliner klinische Wochenschrift, November 21, 1910. p. 2137. perfectly — and small doses may be given in office or dispensary practice and repeated at short intei vals. The immediate symptomatic effects of thes injections I have found in my small experienc quite equal to those by other methods of injectioi and I venture Cialis Ordering to believe that this simple, practia method of administration will come to be the on most Cialis Ordering commonly employed. I was much gratified at learning Cialis Ordering very recentl that others, Cialis Ordering much better qualified to judge Cialis Ordering than ] have seen the advantages of the oil or fat suspen sions Cialis Ordering of the drug. ( Within a fortnight Cialis Ordering I have re ceived a personal communication from Professo Neisser, of Breslau Cialis Ordering — and no one stands higher tha he as a syphilographer, and few have had as muc experience with salvarsan — from which I ar at liberty Cialis Ordering to communicate his method of employiti! the drug. He writes: "Every syphilitic who ha suitable veins and is w-illing to stay two weeks i: the hospital receives an intravenous injection of o.i gramme of salvarsan, which is repeated once o twice, at intervals of three or four days, and fol lowed by an injection of a fatty suspension of th drug. In cases Cialis Ordering in which the intravenous injection are not available, the patient receives four or fiv or more injections of the fatty suspension, eacl containing 0.4 gramme of salvarsan, at intervals about ten days each." The details of the composi tion of his fatty suspension will soon be published Neisser regards this as the simplest mode of appli cation of the drug. At the same time, and in ever^ case, he employs the most energetic treatment b} mercury, using injections of gray oil. From this communication it is evident that th< eminent syphilographer of Breslau does not trus; to salvarsan for the cure of his patients, but em- ploys it merely as an adjuvant to the treatment witf mercury; second, it shows that after seven month? experience, he has no fear of harmful effects fron the new drug; and, finally, it stamps with his ap proval the use of the. drug in its convenient fatt_\ suspension.