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in the hyperplasia of the adrenals. From another side, however, it seems that a most careful distinction of suprarenal structures must be made and a sharp line generic diflucan 150 mg of demarcation must be drawn between the cortical and the medullary por- tions of generic diflucan online this gland. I. ike iiiaiiy dtluT structures, July diflucan cost 13. 1007.] EDITORIAL ARTICLES. 79 notably the pituitary, the suprarenal consists of two very distinct structures, anatomically, diflucan gel costo embryolog- ically, and physiologically. M. Wiesel {Wiener jjicdizinische Wochenschrift, March 30, 1907) has found discount diflucan in patients suffering from nephritis with car- diac hypertrophy and supertension that the chromaf- fin cells -of the suprarenals were much augmented and further that other chromaffin cell diflucan 150 mg costo bearing or- gans in other parts generic diflucan fluconazole of the body were found to have undergone similar alterations. In conclusion, so far as the facts thus far at hand permit conclusions, it is evident that in the course of chronic nephritis there results a hyperplastic re- action on the part of the suprarenal glands. This hyperplasia seems to be total, involving not only the cortex, but also the medullary chromaffin cells. The Inperplasia of the cortical substance seems to find an explanation in the view that regards it as pos- sessing an antitoxic function, as is shown by its reaction to chronic intoxications and to the presence of lecithin in its cells. The medullary portion, how- ever, secretes a generic diflucan no prescription substance necessary to the organ- ism, the chromaffin substance, identical with adren- alin, which is the vasoconstrictive material indispen- sable to vascular tone. Its hyperplasia is not so readily explained, although the supertension of renal disease would seem to find an explanation in the increase in diflucan 150 costo medullary sul)Stance. Inasmuch as the cortical hyperplasia is conceived of in the light of a reaction diflucan cost with insurance to chronic intoxication, it would seem justifiable to regard the medullary in- crease as due to a necessity on the part of the organ- ism for increased generic diflucan over counter vascular tension. The suprarenal changes then would best be interpreted as compen- satorv reactions rather than as costo del diflucan exciting agents. THE TRE.\TMEXT OF MALTA FE\'ER WITH A VACCINE PREPARED FROM MICRO- COCCUS MELITEXSIS. The treatment of infections by bacterial vaccines diflucan compresse costo is a therapeutical procedure which has come to stay, and which gives excellent results if the patients upon whom the method is used are carefully selected. The method is of greatest benefit in diflucan cost without insurance those chronic infec- tions buy generic diflucan online in which the patient does not inoculate him- self generic diflucan cost with vaccines manufactured in his own tissues, on account of the development of a limiting mem- brane of more or less dense connective tissue. In the acute infections, on the other hand, where there is no effort on tlie part of Nature to wall off the in- fecting organisms, the injection of bacterial vaccines is sometimes accompanied h\ deleterious results. Malta fever is an acute infection with a very chronic course, if the paradox may be admitted. I'urthermorc, the phagocytes arc reduced in num- ber in the infection umler consideration. Bassett- Smith (Journal of Tropical Medicine and Hygiene, May 15, 1907) tried fresh yeast for a diflucan costo month with the hope that it would increase the number of poly- morphonuclear leucocytes, but without marked suc- cess. He then turned his attention to treatment with a vaccine prepared from cultures of Microccocciis melitensis, and used this method to the exclu- sion of drug treatment. In all cases the dose and the nature of the reaction were calculated by the method of recording the opsonic index. The vaccine was prepared from a strain of Micro- coccus melitensis freshly isolated from the spleen during life. Agar cultures of ten days' growth were emulsified in 100 c.c. of distilled water, which was then kept in a water bath at 60^ C. (140Ā° F.) for one half hour and finally preserved with 0.5 per cent, phenol. After twenty-four hours 0.5 c.c. of this vaccine was inoculated on an agar tube, in or- der to be how much diflucan cost sure that the organisms were killed and that no contamination had taken place. Bassett- Smith reports two series of cases treated with a vac- cine prepared in this manner, using pfizer diflucan costo doses of from one to five cubic centimetres: the injections were

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