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have been reported. One attack usuallv follnvs shortly after the initial accident, Tlie prognosis in cases of double pneumothi rax is Biaxin 500 had. and the accident is usually fatal at once, al- though a few Antibiotics Biaxin cases have been Biaxin Antibiotics reported where life has been sustained for months under these circum- stances. Trt-iilinciil. — The treatment (if this cnndition has been tar from .satisfactorv , and much difTerence of Biaxin Xl 500 opinion has existed regarding it. Particularly is this true as to operative measures,' but certain pro- cedures are indorsed by all. .\t the onset there ar'e two iiifjications to be met, one being to relieve the pain and the other to stimu- late a Biaxin Price failing heart in those cases of shock which follow the accident. 'I"he relief of pain is the first ;ui(l most important Biaxin Xl 500mg consideration, and is best brought about by a iiypodermic injection of mor- lihinc. Not only does this relieve the pain, but it serves to quiet Cheap Biaxin the patient's respiratory eflForts and tints prevent tlie conversion of a valvular opening into a free one. Inha1ritinn< of oxygen are some- times useful in relieving the dyspnoea, but wt must not forget the warning of Lorraine Smith, who has called the profession's attention to the danger of the relaxing effects of oxygen upon the capillaries, thus causing oedema of the lungs. As Biaxin Order to operative treatment, Emerson in his ex- cellent review of this subject concludes that air in the pleural cavity may be disregarded, but he states that if fluid is present it should be aspirated, though with due caution as to the production of sufficient negative pressure to open the initial breach into the lung. It Biaxin Online has Biaxin Xl been shown that in the first few days, which is the period of greatest danger, every pneumo- thorax is either of the valvular or open variety. In the latter no possible good can come from removing the air, as it reenters as fast as removed. In the Antibiotic Biaxin former, conditions are favorable, for the air is un- der pressure and aspiration, or even puncture, may give decided relief. This relief will persist unless either a deep inspiration or a cough will cause the valve Biaxin 500 Mg like opening again to admit air. The teaching of a few years ago as to operative measures for the relief of this condition was ex- pressed in the words : " Leave the patient alone, as the patient will die anyway, Biaxin Buy Online and by operating you will but hurry the end." . The attitude of the pro- fession 'has much changed, and it is now generally held that if serum accumulates within the chest after a reasonable delay for systemic resorption to occur (West states the best time to wait as six weeks), the fluid is to be aspirated. If pus forms the sooner one or more ribs are re- sected in order Biaxin Cost to give free drainage, the better will be the chances of recovery. There have been so many successful operations upon supposedly hope- less cases which have proved conclusively that the •lung will reexpand even after having been com- pressed for a long Buy Biaxin period of time, that Biaxin Antibiotic the best pol- icy seems to be to have surgical advice at once in regard to the advisability of an operation. As to the after treatment of tliese rib resection cases, it is not considered good treatment Purchase Biaxin to irrigate with any antiseptic fluid, because of the danger of suflfocation by flooding of the bronchi. 2030 Chestnut Street. THE CR.WING FOR SWEETS I\ DI.\BETIC PATIENTS. By -■Xlbekt a. Rippercer, M. D.. New York, rb.vslclan to the Guniian Hospital. As is well known, the cardinal symptom of Order Biaxin dia- betes mellitus is glycosuria, that is, the excretion of sugar in the urine. Cdycosuria results from the presence Biaxin 500mg of an excess of glucose in the blood of dia- betic p:itients, a condition termed hyperglycemia, and undoubtedly due to a disturbance of the metab- olism in the retrograde metaiuor])hosis of carbohv- drates. llesides tlie pathological glycosuria of dia- betes, there are a number of conditions of nonilia- betic glxcosuria, among them the physiological glycosiwia. which occurs quite constantly even in healthy jxTsons, but only in a slight degree, rarely exceeding 0,05 per cent, of sugar. Furthermore, there is a so called alimentary glycosuria which fol- lows the ingestion of large (]uantities of sugar or stigar forming material (starch and dextrin'), and 64

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