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414 THE MEDICAL RECORD. [October ii, li partial mind, and he had been disappointed in the re- sults. In many cases he found no such results as Dr. Thomas and others had claimed. There were two cases in particular, which he had in mind, Coupon For Avelox where the coil had been used most thoroughly. At first its influence had been to reduce the temperature and pulse, but after a time the temperature ran up to 104^ or 105° F., and the pulse became quick, while associated with it was a very bad general condition. He had found symptoms of general depression and impending pneumonia or bron- chitis. The whole abdomen was pale, the capillary cir- culation almost arrested, with doubtless, in consequence, a hyperemia of the deejier-seated organs. After remov- ing the coil and the administration of stimulants, and ap- plication of turpentine to the abdomen, the most marked improvement occurred. The temperature fell, and the pulse became slower and stronger. These e.Avelox 400 Mg Price a self-possessed and calm temperament, but suffering such agony that she could hardly bear a sheet upon her. The abdomen was puffed up and very sensitive. Dr. Barker gave a hypodermic of fifteen minims of Magendie's solu- tion. After waiting half an hour, there being no abate- ment in the pain, he sent for an ether-spray apparatus, and at the same time gave her another hypodermic injection of fifteen minims. He thought that there was an in- cipient peritonitis, and that the cold might act favorably upon that as well as have a direct anesthetic action. The patient meanwhile had commenced vomiting. He then SPR.'VVED THE WHOLE ABDOMINAL SURFACE until it was very cold, as if it had been covered with ice. The rehef was remarkable ; the pain disappeared, the hand could be pressed firmly upon the abdomen without causing pain, and the patient went to sleep. The pulse became quite natural also. Next day the menstruation came on again, and the patient seemed ver)' well. Dr. Barker thought that he had very possibly aborted an attack of peritonitis by the use of the cold. This case had naturally prepared him to expect much from the treatment of obstetrical peritonitis by cold. But the question was whether, as he had said, the condi- tions were the same here as in surgical peritonitis. In puerperal peritonitis we have a natural and necessary wasting of tissue. This is not the fact in traumatic peri- tonitis. The prolonged ajiplication of cold has a paral- yzing and depressing effect. It reduces temperature, but does it relieve the disease ? The speaker thought that the use of cold in puerperal peritonitis was a measure of doubtful utility, especially its prolonged use. In incipient cases it is extremely useful, but in advanced cases it has a merely temporary effect. Dr. Barker was led by a recent experience to speak of another point, viz. : THE SAFETY OF HOT INJECTIONS IX ABORTION. A lady who had been confined last spring, had made a good recovery, and had spent the summer at a watering- place, came to the city a few days before in order to make some purchases for a new house which her husband, a wealthy man, was building. She had only menstruated once since her confinement, and was at the Avelox Strong Antibiotic present time eight weeks advanced in her second pregnancy. She had finished her work and was expecting to start on the next morning for Chicago. In the night (October 2d) she was taken with flooding and pain. Dr. Katzenbach was called in to see her. There was not much hemor- rhage, but the pains were severe. An examination showed that there was no protrusion of membranes. To- ward morning, therefore. Dr. Katzenbach began to use vaginal injections of not very hot water. He used a Davidson syringe with a nozzle having only lateral open- ings. While giving the second injection, the patient suddenly went into a state of collapse and appeared as if she were going to die at once. Stimulants were given, and Dr. Barker was summoned. They had been fighting all day to keep her alive. Toward night she Generic For Avelox had become better Avelox Online and seemed to be reacting from the collapse. The patient was of Avelox Generic Name a fine, sensitive temperament ; and the speaker believed that she had suffered from nervous shock. There was no evidence at all that air had passed into the uterus or Fallopian tubes, and the warm injec- tions had been given very carefully. During the day the membranes and fcetus came away and there was no more hemorrhage, nor had she lost enough blood to account for her collapse. Dr. Barker had never had an experience like this be- fore. In response to a question he said that he did not think that this case showed that it was dangerous to use hot vaginal injections in abortion. He admitted that the relation between the injections and the shock might have Purchase Avelox been one of coincidence. Dr. William M. Polk said that there were three points Buy Avelox Online in the therapeutic use of heat and cold of especial interest, viz., the use of cold in high temperatures, the use of heat in post-partum hemorrhage, and the use of heat Printable Avelox Coupon as a vaginal application in cases of pelvic inflam- mation. With regard to the use of cold in hyperpyrexia, it was capable of doing a great deal of harm. In other words, the mere fact of a high temperature does not it- self indicate the use of cold. Several years ago, while visiting the general medical service at Bellevue Hospital, he had used cold applications a great deal. Upon the class of cases which we come in contact with in the hos- pital it did not act very well. It reduced the temperature, but at the expense of the vitality of the patient. He had found, too, that it was a matter of great importance to look into the condition of the kidneys, because in cases where there is much degeneration, cold is liable to act badly. Such a contingency is to be looked for in typhoid fever and post-partum peritonitis more than after Generic Avelox ovari- otomy. As to post-partum hemorrhage, he was much more disposed to rely upon the use of heat than of cold in its treatment. It had seemed to him that when he had used cold there had been such an amount of after-dejiression as to add very much to the danger of the patient. He had found hot-water injections quite as efffcacious in checking post-partum hemorrhage as cold. As to the use of hot injections in pelvic inflammations, he had found them very valuable. The inflammatory exudation differs, however, in its absorbability in differ- ent persons. There is a class of cases belonging to what we used to call the strumous diathesis, and with these the exudations about the uterus Bayer Avelox are very slow in being absorbed, while the long-continued use of Avelox Generic Equivalent hot water seems to retard rather than help. Dr. Hunter said that he entirely agreed with Dr. Barker in his opinion as to the use of cold after confine- ment. He did not think that the cold coil was so good jn obstetrical as in surgical peritonitis. •ctober ii, 1884.] THE MEDICAL RECORD. 415 With regard to the fall of the temperature and not of the jnilse, Dr. Hunter said that while this might accom- pany attempts to reduce fever rapidly, he had generally advised a slow reduction. Dr. Poi.ic referred to a case of scarlet fever where the HIGH TEMPERATURE WAS REDUCED BY HOT APPLICATIONS. It was that of a boy who had been showing most un- favorable symptoms. His temperature ran up to 106°, and there seemed little hope of effecting any relief. Dr. Afetcalfe advised that cloths be wrung out in hot mustard and water and placed about the patient. In half an hour the temperature began to fall and favorable symp- toms set in. It was the only measure that seemed to do any good whatever. Dr. Smith referred to a case in his own experience almost identical, where a child suffering from scarlet fever received no benefit from cold applications. Hot cloths wrung out in mustard-water produced a fall in the tem- perature and the development of favorable symptoms. Dr. C. L. Dana asked Cheap Avelox if there were yet any trust- worthy statistics from American practice showing the efficacy Buy Avelox of COLD APPLICATIONS IN TYPHOID FEVER. Since Avelox 400mg Tablets the beginning of his practice he had been greatly interested in this subject, having, while an interne at Bellevue Hospital, seen it extensively tried, and with doubtful results. Shortly after leaving Bellevue he had collected statistics of the cold-water treatment of typhoid fever in that hospital, and they had not made a favorable showing. The statistics quoted from Dr. Peabody by Avelox Generic Dr. Hunter, as to the results of cold applications in typhoid, were of hospital cases and contained nianv sources of error. The statistics compiled by Brand liad in particular been shown to be most fallacious. The speaker said that the result of the long debates on ty- phoid fever at the Acadiinie de Medecine of Paris had been unfavorable to the use of cold applications. In England, too, the sentiment and evidence against it were very strong. In Germany, recently, an opposition to the once popular use of cold was apparently developing. The speaker only contended that experience had not yet justified the routine use of antipyretics. Dr. KiNNicirr thought that the statistics of the cold- water treatment Avelox Antibiotic 400mg of typhoid fever in this country were not sufficiently large to judge from them of its efficacy. In Germany the belief in its efficiency Avelox Iv was still fully main- tained, he thought. A careful study of the last debate on this subject by London hospital physicians and the statistics fiirnished by them, led to different conclusions, it seemed to him, from those obtained by Dr. Dana. In France, the opinion of at least the Lyons physicians, was all in favor of the cold-water treatment. Wound ok Abdomen — Protrusion of Intestine — Rapid Recovery without Peritonitis. — The following case, reported to us by Dr. E. H. \Vard, Avelox 400 Mg Dosage of Greensborough, Ala., illustrates the innnunity against inllanunation which the peritoneum sometimes shows. In a " rough and

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