Nonsurgical Treatment of Cirrhosis of the
Liver, by Dr. Purchase Avandia N. S. Davis, Jr. — See Avandia 4 Mg this Journal
for July 5, p. 50.
AuKUSt 9. 1913]
/'//// or PkocREssjyE literature.
295
MEDICAL RECORD.
.'i,;.v .'0. ;y;.,-.
Is Appendicitis Ever Catarrhal? — [•'. A. Palmer
sa^s lliat the caption catarrlial ap]jendicitis is une
found in all classifications of disease of the appen-
dix, and is used to designate clinically those patients
who show only slight but long continued or per-
sistently recurring symptoms. Clinically the mean-
ing of this term is clear and may suffice, but when
the cases come to be classified upon the basis of the
pathological condition present we hnd the widest
tlivergences of opinion and description. In view of
the predominance of lymphoid elements in the
apjK-ndix, and the types of intlaninialion usually
found upon microscopical examination of appen- Avandia Cost
dices, it is the author's opinion that the primary
inflammation of the appendix is lymphoid, rather
than catarrhal. From Iiis studies on the subject the
following conclusions seem warranted: i. The gross
appearance of the appendix is never a sufficient
criterion of the Generic Avandia severity of the pathological condi-
tion present. 2. Absolutely no idea of the nature or
severity of the inflammation can be formed from
the clinical symptoms. 3. Appendicitis may run its
course through perforation and subsequent healing
without symptoms which will admit of its recogni-
tion, or, indeed, severe symptoms of any kind.
4. The clinical condition designated as catarrhal
appendicitis does Avandia Mg not have a catarrhal inflammation
of the appendicular mucosa as a pathological basis,
and is, therefore, a misnomer which is dangerously
misleading to the general profession. 5. No catar-
rhal inflammation, truly speaking, has ever been
described as a pathological finding in appendicitis.
For all these reasons the term should be definitely
abandoned. Lastly, appendicitis is much more fre-
quent than is usually assumed or than is indicated
by our present means of diagnosis. The mortality
of this disease is still large, and the only measure
which oflfers any prospect of immediate reduction ot
this mortality is early operation upon all recogniz-
able cases.
The Beneficial Effect of Duodenal Alimenta-
tion in Cirrhosis of the Liver. — Max Einhorn
fays that if we consider the intimate connection of
the liver with the Purchase Avandia Online digestive apparatus, we have
reason to expect that the rest given to the stomach
by means of duodena! alimentation may have some
bearing Avandia Tablets upon its neighboring organ, the liver. If
the liver is diseased, its function of working Avanafil Buy up the
portal blood and making it fit for the vena cava is
slackened. What now happens is either the en-
trance of faulty metabolic products into the circu-
lation or. if the supervision of the liver is still effi-
cient but slow, an accumulation of blood in Cheap Avandia the liver,
i. e., this organ becomes unable to work up all the
blood flowing in during the process of digestion.
Thus it becomes temporarily swollen. In some in-
stances both factors coexist. In cirrhosis this diffi-
culty in functionating is always present. In duo-
denal alimentation the upper part of the digestive
system is not working, and is kept at rest. The
venous circulation there is not Buy Avandia very active : the
portal vein is thus freed of part of its blood supply,
and the entire work of the liver is made easier.
Duodenal alimentation was applied in six cases of
beginning cirrhosis. During this in all the six
patients (,five of whom Buy Avandia Online had ga>lric ulcer j the liver
l)ecame Avandia 8 Mg markedly smaller. In four the result was
lasting ; in one, the liver began to grow larger a
few days after the termination of the feeding; and
in one patient, with pure cirrhosis and dilated heart,
ihe liver quickly resumetl its original proportions.
In this last case the influence of the procedure was
\ ery marked, but not lasting. The author concludes
that the cirrhosis of the liver and allied conditions
accompanied principally by swelling of the hepatic
tissues form a field in which duodenal alimentation
may be applied apparently to great advantage.
The Diagnosis and Prognosis of Duodenal
Ulcer. — In the observation of some two hundred
cases, by J. T. Pilcher, the history of an uncompli-
cated duodenal ulcer has in the great majority of
them elicited four preeiriinent factors: i. The
chronicity of the complaint ; 2, the periodicity of
the exacerbations of epigastric distress : 3, the
occurrence of pain of a peculiar character (burning Buy Cheap Avandia
or gnawing) with precise time of onset (between
tw-o and one half and four hours after eating) ; 4,
the control of this discomfort by the ingestion of
food or alkalies. In his experience, cases properly
chosen for medical or surgical treatment appear Buy Avanafil to
have remained fairly comfortable, and he feels
justified in saying Avandia Canada that the prognosis in the great
majority of cases is Avandia Price good.
Treatment of Progressive Cases of Pulmonary
Tuberculosis. — Mary E. Lapham believes that
the recognition of Order Avandia the progressive Avandia Online nature of a case,
far from releasing the physician from responsi-
bility, adds another burden, that of deciding what
nnist be done, and when. He must first of all be
able to recognize when a patient is unable to make
his ow-n fight, and then come to his relief : first, by
attempting an artificial Order Avandia Online pneumothorax, and, if this
faiU, then by resecting the ribs. The reported re-
sults from these procedures have been most encour-
aging.
AMERICAN JOURNAL OF OBSTETRICS AND DISEASES
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