secondary masses be accelerated by the removal of
the primary tumors, and will life thereby' be short-
ened or prolonged? Also, do the procedures fol-
lowed in the course of physical examinations or sur-
gical operations increase or diminish the incidence
of metastases ? The results obtained in Tyzzer's in-
vestigation find practical application in the manage-
ment of tumor patients. They are of such char-
acter that every physician should realize the irre-
parable harm which may result from the manipula-
tion of malignant tumors in their early development.
Although the present obsen-ations are made on a
tumor in which dissemination usually takes place
by way of the blood stream, it seems reasonable to
expect similar results with human tumors which be-
come disseminated by way of the lymphatics. The
course of procedure to which the patient is fre-
quently sub'ected — the palpation of the mass in
question in repeated physical examinations, the vio-
lent scrubbing often employed in preparing the field
of ooeration — is almost identical with that which
Tyzzer employed for the e.xperimental production
of metastases. It would be of advantage to the
patient if each questionable tumor of the breast, for
example, could be regarded as a high explosive, the
least manipulation of which should be absolutely
avoided, both prior to and during the operation. It
is not improbable that by this means metastasis and
extension beyond the field of operation could be
prevented and the proportion of cases cured by
operation increased. From the point of view of
metastasis, it would appear from these results much
less serious to cut into a tumor than to exert pres-
sure upon it, although the effect of the distribution
of tumor tissue throughout an extensive operation
is quite generally tmderstood.
MONTHLY CYCLOPEDIA AND MEDICAL BULLETIN
r-.ine, 1913.
Scarlet Red in the Treatment of Gastric benoquin monobenzone cream and
Duodenal Ulcer. — Julius Friedenwald and J. F.
Leitz, reporting upon thirty-seven cases of ulcer
in which scarlet red was employed, assert that this
agent is a useful adjuvant in the treatment of pep-
tic ulcer. While it cannot replace the usual forms
of treatment (Leube and Lenhartz), when admin-
istered in conjunction benoquin vitiligo with them, it often renders
the cure more complete. As a help in ambulatory
cases it is of great benoquin 20 service, its effect being appar-
ently even more favorable than that obtained from
bismuth. Its use need not in any way interfere
with the giving of other remedies, such as the alka-
lies or belladonna, when indicated. It is best ad-
ministered in dose? of fifteen grains, three or four
times daily, before meals. It may, however, be
given in much larger doses. No toxic effect was
observed during its employment in over one hun- monobenzone benoquin
dred patients.
Pulmonary Syphilis Complicating Pulmonary
Tuberculosis. — F. N. Robinson mentions as evi-
dences of the coexistence of these two conditions:
( I ) Marked dyspnea in a case buy benoquin of lung tuberculosis
only of short duration; (2) primary affection of
the larynx, the picture upon local examination being
that of syphilis, not tuberculosis: and (3) abundant
expectoration of mucous or slightly mucopurulent
material. Upon physical examination, the most
striking feature is the extensive pulmonary involve-
ment, with otherwise an apparently excellent state
of nutrition. A ''rustling" murmur over the junc-
tion of the middle and lower lobes and ''burr" or
"snoring" heard over the bronchi benoquin cream for sale are also charac-
teristic. The sputum shows but a small number of
tubercle bacilli and occasionally nonmotile spirilla ;
there is a great disproportion between the number
of polynuclear and of mononuclear cells. The Was-
sermann reaction is. of course, also available for
diae^nosis. In the treatment, the use of mercurx
should be buy benoquin cream limited to mild inunctions, administered
only at intervals. Iodine is benoquin price indicated above all. The
author gives tincture of iodine in doses of from
two to five drops, three times daily, increased up to
ten or twenty drops, in a wineglassful of milk. He
has seen favorable results in two cases from the
administration of salvarsan." As for the proenosis.
when tuberculosis attacks a syphilitic in the primary
and secondary periods the prognosis is grave, while
in the tertiary period it is somewhat better. When
August 9, I9'3 1
PKOCEEDl.\i.;S UI' SOCIETIES.
299
a tuberculous patient becomes infected with syphilis,
the prognosis is bad in projiortion to benoquin online the period of
previous existence of the tuberculosis.
OPHTHALMIC RECORD.
July. 1913.
A Case of Spring Catarrh: A Pathological
Report.— Uanford AlcKee found the following
histological changes in tissue removed from a case
of vernal catarrh: i. The epithelium was thick-
ened to three or four times its natural depth ; 2, It
dipped into the tissue beneath, giving the well
known epitheliomalike picture ; 3, beneath the epith-
elium were foci of degeneration. There was also
fragmentation of the connective tissue, with collec-
tions of basic staining debris, leucocytes, and lym-
phoid and plasma cells. Ingrowths of new capil-
laries were noted ; 4, the deeper buy benoquin online parts, too, were
infiltrated with plasma cells and eosinophiles. There benoquin cream
was a marked preponderance of the latter, which
were often seen between the epithelial cells: 5,
Plasma cells were also found in folliclelike groups,
but these were very difTerent from the typical lym- benoquin cream 20
phoid follicle. The histological picture was there-
fore one of a chronic inflammatory process, with
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