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eighteen inches, and then the patient should be in an absolutelv upright sitting posture. Do not have simply the head and shoulders iiigh, but be positively sure that the pelvis is at least 75 degrees or more upright. This can be insured by having pillows in the small of back between bedrest or a chair in the bed. This posture is the great essential of the treat- ment, praziquantel tablets since it is now known that drainage in buy praziquantel for humans the ab- domen will only take place by gravitation during the first twelve or twenty-four hours, never longer. Secure therefore the most upright position possible where to buy praziquantel so praziquantel mg that the infectious material may gravitate early and be in the pelvis where, if necessary, it can be reached later moxidectin praziquantel through the rectum or vagina. I have done this last in three of my patients with fine re- sults. 6. After placing the patient in bed give continu- ous normal salt solution by rectum. Do this by in- serting a rubber catheter with the end cut off, about three inches into the rectum, attach this catheter to a fountain syringe, and have the lower end of bag only two inches above the rectum. The patient will not be aware of this procedure and will take up great quantities of the solution, several ]iints in eighteen hours. It relieves thirst, fills abdominal lymphatics with solution, and will not move the bowels if given gently. Later, if the patient has the inclination, remove the tube. 7. (iivc no food by moutli for four days, and al- ways wash out the stomach just before praziquantel cost the patient comes out of the an;esthesia, or immediately after- ward. This is most essential. The patient will tol- erate the washing very well, if you cocainize the throat wilii a 4 per cent, solution, ;iii(l \v;iit at least Jul.\ 20, 1907.] THERAPEUTICAL NOTES. 123 5 minutes before using tube, which is Ochsner's method. Feed by bowel ever\^ four hours, beginning with the second day, egg water, liquid peptonoids, etc., one ounce of food with three of salt solution. 8. Morphine should be given by hypodermic in- jection for a stimulant, also to act as an abdominal " splint." It relieves the nervous tension and praziquantel price is ab- solutely indicated after operation. Use no other heart stimulant. 9. If pulse drops to 100° then everything looks favorable. 1 never pay any attention to the tem- perature until after the third or fourth day. If it then begins to show signs of suppuration, the pus can be reached by rectum praziquantel biltricide or vagina, since by the exaggerated upright method it has gravitated to the pelvis, and you have a pelvic abscess to deal with that has been walled off from the general peritoneal cavity. 10. On the fourth day I always move the bowels by a high enema of milk one pint, and molasses one pint, mixed and warm. This is the best enema I have ever found. I have rarely buy praziquantel seen it fail and I use it in all my abdominal cases. If the first one does not act repeat two or three times. Never give a cathartic by generic praziquantel buy cheap praziquantel mouth until there has been a praziquantel uk sufficient result from the enemas. Begin then to feed with small quantities of fluid stuffs, and if the tempera- ture goes up pav no attention to it, but if the pulse gets rapid and there is gas in the abdomen, wash out stomach and give calomel praziquantel online in small praziquantel 600 mg doses, or purchase praziquantel online castor oil. I order praziquantel am a firm believer in this treatment. In those cases in which the entire peritoneal cavity is in- volved with rapid pulse and anxious look, cases which I used to consider hopeless, I now believe that nine out of ten can be saved by this treatment. II East Chestnut Street. Cbtraptul'ual llotfs. The Protection of the Heart in Fever. — Step- lane Leduc, of Nantes, directs attention to the dan- ger to the patient of paralysis of the order praziquantel online heart in febrile diseases, and believes that many lives may be saved if ])rompt attention is buy praziquantel online given to the condition of the heart. The necessity of preserving the horizontal posture is generally recognized. Sudden death is most frequent in those patients who, rising from the bed, attempt to stand upright on the floor. This is owing to tlie sudden purchase praziquantel increase in tiie intracardiac pressure. 'i"he heart wall is also weakened by the ilcvatfd tcin])erature of the blood (thermic myo- carditis). This may in great measure l)e prevented

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