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in some cases secreting glands still persist that under stimulation are capable of producing a sub- stance as irritating, and poisonous, as the hydro- chloric acid of generic conjugated estrogens the stomach — indeed, in their atrophying, perhaps many times more irritating. The effect of this fluid, poured into the empty and contracted appendix, would be just such as we order premarin see in those cases of fulminating appendicitis where the reaction is intense, and no germ has been re- covered from buy premarin the lesion, except those native to the intestines, and to a certain degree harmless. It is a bold, but nevertheless true expression, that the ordinary case of appendicitis, under the present methods of treatment, is a benign disease. Even with rupture and abscess formation there are com- paratively few deaths, but in spite of this fact we must acknowledge that every once and a while we are confronted with cases that die before we have really settled down to any plan of treatment. These fulminating cases can be compared with great profit to a condition that .gives rise order premarin online to almost the same set of symptoms, and which in fact is some- times mistaken for them, that is, perforation of the stomach or duodenum. The sudden onset, the shock, the small, irregular pulse, the pain and rig- idity in the hypochondrium, as the acid stomach contents trickle downward, strongly simulate a severe ajipendicitis. Even when the patient comes to operation, except the i)erforation has occurred while there is food in the stoinach. so that particles of it may be seen free in the abdominal cavity, rtie error may not be discovered, for the grayish fluid may be mistaken for pus. while the deep suf- fusion of the intestines and the appendix seems to confinn the diagnosis — so the appendix is removed, and the patient left to his fate. Now if we look on the appendix as a vanishing organ of digestion, having its utility in some previ- ous age, when the sustenance of the human familv was of such a nature that it required a longer time, and a somewhat different apparatus to digest, and that this atrophying organ is still capable of producing under certain stimulation a digestive fluid, we can see immediately the sequence-^death 37C' DLXSTliX: XOXXITROGJiXIZED AXD XITROGEXI/.IU) FOOD. (New York Medical Journal. from ;i strongly irritating chemical poison. If these deductions are correct, there is only one method of treatment for such cases, and that is immediate removal of the appendix. It is a well known fact that extraordinary results have fol- lowed in almost moribund cases where sluicing with warm saline solution was resorted to, follmv- ing removal of the appendix, and even large quan- tities left in the abdominal cavity. This would be a logical treatment where a chemical irritant was the cause of the condition, though contraindicated in the purchase premarin online ordinary cases of bacterial infection. C.VRBON, OXYGEN, HYDROGEN GROUP, PLUS NITROGEN OR NONNITROGEN- IZED AND NITROGENIZED FOOD. By J. C. Densten, Ph. D., M. D., Scranton, Pa. cheap premarin Food, or aliment, as distinguished from condi- ment, means, in the scientific sense, any substance that, being taken into the generic premarin body of animal or plant, serves through organic action to build up normal structure or supply the waste of tissue. Liebig classifies buy premarin online food into (i) nitrogenized elements of nutrition, or those that serve for the nutrition of organized tissue — flesh formers; (2) nonnitro- genized elements, or those that are consumed in respiration — buy conjugated estrogens heat givers. Therefore, we have, from the nitrogenized and nonnitrogenized ele- ments, not only tissue building material, but also fat forming elements, each belonging to the carbon, oxj'gen, hydrogen group ; one a carbohydrate ; the other a hydrocarbon. These elements exist, in some form of combination, in almost every sub- stance used as food, and, in the process of digestion, become subsen'ient to the premarin mg function of organic action. buy cheap premarin To this carbon, premarin online oxygen, hydrogen group belong all substances containing the elements of starch, and it is confined to the vegetable world ; potatoes and the cereals being the most active source of production. All foods containing starch we term carbohydrates ; but carbohydrate food will not build up or maintain life indefinitely without the combining eflfort of the added element, nitrogen. We must therefore have, not only carbohydrated buy conjugated estrogens online food, but nitrogenous food also ; and since nitrogen premarin price is found largely in meats, eggs, fish, etc., we have learned to partake of mixed foods, containing both starch and nitrogen. Now, what is the modus operandi within the animal economy, as the result of this mixed diet? Let us first premarin tablets inquire into the chemical changes neces- sary to maintain life and produce tissue. Starch and nitrogen, given per se, will mean nothing to- ward sustenance until the animal economy has con- verted these elements into tissue building material. Metabolism is the all important factor in the main- • tenance of life and health. Heat afld energy be- come absolutely necessary in order to convert the nitrogenous or protein purchase premarin elements into proteids and thence into tissue and fat. In order to get this heat and energy our body burns carbon, and thereby gets the heat, while the energy is supplied, as the result premarin cost

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