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[June 27, 1896 viagra price ukraine The patient was permitted to sit up the next day. No- ticing the gradual improvement in the patient, we de- cided to give him another injection. This was done on discount viagra 100mg March 13th, and at this time a strength of one thousand units was given. From this day until the present time there has been a marked improvement in the patient and a gradual disappearance of his former unpleasant symptoms. He has no more difficulty in articulation or deglutition. He is able to employ his arms and to walk about the wards. This is the second case of severe post-diphtheritic paralysis within six months in an adult in Dr. Sei- bert's service, and in discount viagra 100mg neither patient was any antidiph- theritic serum used. Whether or not the improvement of the paralysis in this case is due to a possible action of the antitoxin must necessarily remain doubtful un- til discount viagra 100mg the complete action of the remedy has been fully analyzed. March 30, 1896. progress of 3*lertical Science. Pylephlebitis and Abscess of the Liver discount viagra 100mg Follow- ing Typhoid. Dr. Lannois has recently described pylephlebitis and abscess of the liver following ty- phoid, in which the bacillus of Eberth was present in the pus from the abscess, though not in pure culture. He states that liver abscess following typhoid is very rare, occurring, according to Schultz, of Hamburg, once in thirty-six thousand and eighty cases. Lan- nois divides abscess of the liver following typhoid into three classes: (a) Metastatic abscesses having an external suppurative focus as a point of origin. (l>) Abscesses from typhoid ulceration of the biliary passages. (7) Abscesses due discount viagra 100mg to pylephlebitis. He places his case in the last class. The case occurred in a man of twenty-eight years of age and came on at the end of the attack, the patient having been afebrile for three days. At the end of this time he was taken with a violent chill with fever, and the signs of pleu- ral involvement at both bases. This was followed by swelling of the abdomen and great pain in the right hypochondrium. There were no positive physical signs in the abdomen, and the case was regarded as one of tuberculous peritonitis on account of the pleural involvement and the swelling of the abdomen. The patient died three days after admission; the autopsy showing healed ulcers in the ileum, and also partly healed ones, both in this part of the intestine and in the appendix. The vena porta;, the inferior mesen- teric vein, and the splenic vein all contained adher- ent ante-mortem clots. In the liver a number of ab- scesses were found containing creamy yellowish pus. discount viagra 100mg A number of organisms were present in the pus, and one was isolated which resembled the typhoid bacillus in every way, except that it slightly liquefied gelatin. The author ascribes the liquefaction to impure cul- ture, and states that this is the only case recorded where a satisfactory bacteriological examination has been made. Revue de Mddctine. Is Surgical Intervention Warranted in Primary- Renal Tuberculosis ? This question was the subject of an address delivered recently by Dr. Pousson. He first described the different methods of invasion in pri- mary and secondary infection, viagra price ukraine as the bacilli locate in the vascular zone of the organ in the former case, and produce the phenomena of congestion, pains, and he- maturia. Secondary infection attacks the zone of the pyramids and is a mixed process starting in the blad- der, and revealing its presence chiefly bv suppurative lesions, or pyuria. The haematuria is often the only symptom of infection for quite a while, and he cites many cases where it persisted alone for months. Here he thinks surgical intervention entirely uncalled for, as this form is not exposed to complications from other infections, owing to the isolated position of the organ. Only when it is accompanied by severe pains preventing rest, or excessive, weakening haematuria, which forces the hand of the surgeon, as it were, is a surgical operation legitimate and nephrectomy indi- cated. In all cases in which the other organs seem viagra price ukraine to be exempt, he agrees with the majority of French physi- cians, that local attempts to exterminate viagra price ukraine these bacilli from the system are apt to be fruitless and followed by their reappearance there or elsewhere. Archives de Bordeaux. Fistula in Ano. Dr. B. B. discount viagra 100mg Porter (Journal of Med- ical Science) offers the following hints: i. Remember to operate upon all cases of fistula where there is suffi- cient vitality or nutrition to heal the wound. Always divide the fibrous membrane at the bottom of the tract and pack the wound at the bottom for the purpose of healing by granulation. 2. Remember always to open abscesses early to prevent viagra price ukraine fistula in ano. 3. Remem- ber, if you operate on a fistula in a tuberculous patient, to give him the benefit of the doubt. 4. Remember that you should never fail to examine your patients thor- oughly for small amis leading out from the main tract, and examine for an associate stricture, which may be the cause of the fistulous tract. 5. Remember that you are never to cut the sphincter but once in any operation, and be careful and warn your patient of the danger of incontinence. 6. Remember that you are to confine your patient in bed, not trusting to care of the nurse exclusively. Tuberculous cases should be an exception to viagra price ukraine the rule; give them moderate exercise and fresh air. 7. Remember that physiological rest is the first principle in the cure of discount viagra 100mg all diseases. 8. Remember that in all operations involving the rec- tum, discount viagra 100mg it is good discount viagra 100mg surgery to dilate the sphincter. 9. Remember that all cases of fistula in ano should be operated upon, and best by the knife, except in cases of Bright's disease, cancer, cardiac and hepatic affec- tions. On the Line of Action to be Adopted in the Case of a Woman Who is discount viagra 100mg About to Die while yet Undelivered. Remy advises under such circum-