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trate the occurrence of pneumothorax in those cases free, as far as can be determined by physical exam- ination, from tuberculous disease. The condition usually arises from the rupture of a cavity through the vrsceral layer of the pleura. In many instances such an accident is prevented by the thickening of the pleura over the caseous spot or in the neighbor- hood of a superficial cavity, and were it not for this protection given by the thickened pleura the acci- dent would be luuch more common than it now is. But this fibroid thickening is not invariably benicar hct cost a pro- tection, for should it be torn from the lung by an cost of benicar hct undue respiratory effort a breach may be made in the lung tissue and the air may rush into the cavity. The chances of finding the perforation seem to depend on the length of time the patient lives, as order benicar online tlic longer he lives llic greater chance of the per- foration becoming closed. ( )ften the only way of finding the perforation is to search for it before re- moving the lung from the body, wiien serum is j)resent in i|uaiitity, or in its absence filling the pleu- ral cavity with benicar hcl benicar generic alternative water and gently driving air into tlic lung from benicar htc the trachea, when the bubbles will reveal the perforation. In the majnrit\ of cases this jierfdration is small and single and usually cir- cular. abdiU one sixth of an inch in diameter, but it may be multiple, and may be benicar uk much larger, several having been reported as large as a silver dollar. The usual position for the perforation is the lower part of upper lobe in the axillary line, and this is the spot to which the patient usually refers his ])ain. From the time of the earlv studies on this condi- benicar hct tablets tion it has been noted that there has been no neces- sary relation between the amount or extent of tu- berculous disease in the lung and the occurrence of pneumothorax. It is noted that the liability to this accident is most marked in those rapidlv advancing cases, and perhaps this may be explained by the ab- sence of adhesions. In a large number of reported cases there was very little disease of the lung and tuberculosis had not been suspected in the patient, until the occurrence of the pneumothorax. This will account perhaps for the fairly large number of cases reported as coming on as the direct result of sudden strain, a hard cough, or perhaps a severe attack of vomiting, and the patient recovering from the pneumothorax and never showing tuberculous lesions during life. Several of these cases were \\atched by Weil and afterward came to autopsy, and the old lesion was found completelv healed. The pleuropulmonary orifice usually has a valvu- lar mechanism, the condition being classified into open, closed, and valvular, which names need no ex- planation. Ef?usion occurs in most cases which last any considerable time. There have been reported eleven per cent, of cases free from fluid. Of the cases with fluid there seems about an equal chance of finding serum, seropus, or pus. The serous etTu- sions often generic name for benicar remain serous for buy generic benicar some time, and if they become purulent it is due to subsequent infec- tion. In many benicar canada cases the e'flfusions do become puru- lent, and this benicar generic equivalent is invariably the case when the side has been opened either intentionally or by spontanef- ously discharging its contents. The Mechanism of buy cheap benicar Pneumothorax. — This de- pends upon the negative pressure formed in the pleural cavity benicar equivalent by the elastic tension of the lung. This elasticity benicar discount card serves to hold back the entrance of the air as it enters the chest, and as the lungs are placed in an air tight chamber the intrapleural pres- sure is equal to the atmospheric pressure minus the elastic tension of the lung. The benicar hct prices moment air enters the pleural cavity this difference of pressure is equalized and the lung collapses as a result of its own elasticity, and as the pressure is equal there is no tendency to expand again. Sym/^toms of the Condition. — Sudden pain in the affected side and increasing difiiculty in breathing are the usual symptoms. The pain is severe and ■■ tearing " in character, so much so that patients often state that they felt something " benicar alternatives give way in- side." The pain benicar generic name is of comparatively short duration, lasting from a few moments to several hours and infre(|uently several days, but the pain^ is so inti- mately blended with the discomfort of the ilyspnoja that it is difticult to determine benicar savings card which cause is re- s])onsible for the patient's discomfort. These symp- toms are often made more severe by a cough which, coming in paroxysms, ailds to the distress of the patient. I'!xce|)tionally the severity of these symjifoms l>roduces immediate imconsciousness, and in a few cases has produced sudden death. This siuklen on- set is the ordinary history, and usually the symp- toms are all severe. 1 once observed the onset of a pneiuui "thorax which was both sudden and severe. The p.itieiit entered the hospital for a surgical con- dition, giving a history of perfect health except for a hernia for whidi he wishctl to be operated ivjion.

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