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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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