S.UIIH: SAFETY PJ\ REMOVED FROM LARyW OF CHILD.
313
S\M:TV I'lX REMOVED FROM LARYNX
( )F CHILD cytotec price BY DIRECT LARYNGOSCOPY.
Bv H.\RMOx Smith, ^L D.,
New York.
Mary McD., aged two and one half years, was seen by
Dr. S. T. Quinn. of Elizabeth, N. J., on February 2j.
1913 ; at which time she was hoarse and had a online pharmacy cytotec croupy
cough, and e.vamination of the chest revealed some bron-
chial rales. Examination of the throat and nose were
negative. cytotec 200mcg The temperature was 99° F. and pulse 90. The
diagnosis of bronchial croup was made upon the evidence
found. The administration of syrup of ipecac and a la.xa-
tive relieved the condition.
Five days k.ter he was called again, as the child had
become suddenly worse, and he found marked dyspnea, a
dry croupy cough, and a temperature of 99° F. Ag:ain
the examination of the nose and pharynx was negative.
He called in consultation Dr. J. S. Greene, who made the
diagnosis of membranous laryngitis, and as the obstruc-
tion to breathing had increased, an O'Dwyer intubation
tube was inserted, which gave prompt relief to the ob-
structive symptoms but whicli was coughed up cytotec cheap on the
second day ; 3,000 units of diphtheria antito.xine
were also injected, although a culture from the pharynx
proved negative. The condition of the patient improved
in every respect except the hoarseness, which remained.
On March i8th, while Doctor Quinn was out of town,
the consultant, Doctor Greene, was called in to see the
child with another similar attack, and she again responded
to the administration of syrup of ipecac. On March 30th,
the hoarseness still persisting, it was deemed advisable to
have the advice of a laryngologist to ascertain, if pos-
sible, the occasion for its continuance. Dr. Norton L.
Wilson was cytotec mg called in consultation, and by means of the
laryngoscopic mirror thought he determined the presence
of a growth in the larynx, and concluded from the his-
tory that it must be a papilloma. He advised, however,
that the child be examined by the direct method, and sent
her to me for this purpose.
On March 31st, thirty-seven days after the child had
first been seen by Doctor Quinn, an cytotec buy online examination was
made with the Jackson laryngeal spatula, at the Manhat-
tan Eye. Ear, and Throat Hospital, under the adminis-
tration of chloroform anesthesia. Preparations had been cytotec 400 mg
made for the removal of the papillomata, if present, and
for the introduction of a tracheal tube, provided they
were of a multiple character. Considerable mucus filled
the larynx, and the breathing was of an obstructive char-
acter, which necessitated rapid work to obviate perform-
ing a preliminary tracheotomy. .-Kfter the mucus had
1)een sponged from the larynx, a bright object was seen
protruding from between the vocal cords. With a pair
of ordinary straight laryngeal forceps it was grasped and
e.xtracted. without difficulty and without hemorrhage. The
patient's breathing immediatelv became order cytotec online less labored, and
the cyanosis improved. On the following day the patient
was sufficiently well to be taken to her home in Elizabeth.
N. J,, where she made an uneventful recovery. For sev-
eral weeks the voice remained somewhat hoarse, but in
a subsequent report from Doctor Quinn he stated thai the
child's voice buy cheap cytotec had returned to normal and there was nn
sequence to her unique cytotec order experience. cytotec on line
The important facts in this case are. the liabilitv
of physicians, unsuspecting the presence of a for-
eign body, to diagnosticate the case in accordance
Avith the symptoms presented, without utiHzing the
.X ray as an infallible method of determining its
presence; secondly, that an intubation tube could
occupy the lar\nx at the same time with the safety
pin without giving evidence to the operator of its
presence, and that the tube could be coughed up
and the pin remain in situ; thirdly, that tjie ab-
sence of microscopical evidence of the Klebs Loef-
fler bacillus in the examination of a specimen from
the pharynx should direct the attention of the phy-
sician in charge to something else as a causative
factor, although in many instances diphtheria can
exist where the superficial culture will not reveal
the presence of the infection ; fourthly, that the ex- cytotec 200 mcg
amination of a child's larynx by the laryngoscopic
mirror, although performed l)y an expert, is inade-
quate, owing to the struggles of the child, cytotec 200 mg the small-
ness of the larynx, and the presence of mucus
which cannot be removed and which obscures the
character of the liody or growth.
44 W'e.st Foimv- ninth Street.
THE ETIOLOGY AXD TREATMENT OF
HYPERTRICHOSIS.
Bv purchase cytotec P.vcL online cytotec E. Bechet, y\. D.,
New York, where to buy cytotec
.\ssistant Physician, New- York Skin and Cancer Hospital; .Attend-
ing Dermatologist, Roosevelt Hospital Dispensary; .\ssistanc
Dermatologist, Presb>terian Hospital. Out-Patient
I>epartment.
The importance of this abnormality is, in mv
opinion, too frequently underestimated by medical
men. The tendency to bemean the operation of
electrolysis, to consider it only as a beautifying
measure, and not worthy of serious attention, is to
be deplored. The result of this policy causes a
number of women sutTering from this unsightly de-
fect to resort to "beauty specialists." accommodat-
ing druggists, or skillfully advertised, and often
hannful, depilatories. Hydrogen peroxide and am-
monia, pumice stone, epilation, depilatories, various
skin creams, and unskilful electrolysis, are tried one
after the other ; coarse hairs made cytotec cost coarser, downy
hairs transformed into coarse ones, unsightly scar-
ring, follicular buy cytotec infection, and eczematoid dermatitis
are some of the buying cytotec sequelae which frequently follow
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