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tion. Charles F. Mason, Captain and Assistant Surgeon, United States Army. Camp Thomas, Chi kamauoa Pakk, Ga., May 6, 1898. MEDICAL PROGRESS. Pains in the Lower Extremities. — elavil mg Mettenheimer {Zeitschr. fiir rat, prak. Aerite, January 18, 1898) takes up the subject of pains in the lower extremities, and discusses it in a online elavil scientific manner. The expression SchmerMen in dte Fuesse, is familiar to every one who has come into contact elavil 25mg with the Polish population in dis- pensary work. The author says these pains are due to a plethdra of the veins in the lower elavil buy extremity, although they may also occur in other parts of the body. elavil 25 mg As special causes he mentions an undue amount of standing, or of walking, or the use of wine, especially sour wines, or standing in cold places, or working in a sitting posi- tion in cold rooms. In some patients there is not a trace of varicosity to be seen in the veins. Nevertheless, the pains are due to the insufficient circulation of blood in the skin. Such pains are often spoken of as rheumatic, an entirely misleading name. As treatment, are to be mentioned bandages, a elavil 25 horizontal position, rest, avoid- ance of over-exertion, etc. Unfortunately, it is impossi- ble for most elavil used for of those who suffer from these pains to com- ply with such directions. The author says he has obtained good results by cold applications, pouring cold water daily over the affected parts, or if time and opportunity per- mit, cold baths. Added to this there should be a dry friction of the skin. This elavil uses should be superficial, and not a deep massage such as one gets from rubbing in a salve. Electricity will also be found to be of service, but the most practical remedy, both on account of its cheapness and its ready application, as above stated, is cold water, followed by dry friction with the hand. Tuberculosis of the Spleen — Hayden elavil 50 {[our. Amer. Med. Assoc, April 2, 1898) treated for several weeks a patient with swelling in the splenic region without bene- fit. In fact, the patient grew steadily worse and the swelling increased in size. An exploratory operation was ' cocoa performed, and a large cyst in the spleen was found and its contents evacuated. These examined microscopically were found to contain pus-corpuscles and tubercle ba- cilli. Soon after, secondary tuberculosis appeared in the other organs, and the patient died four months after op- eration. Very few cases of primary splenic tuberculosis have been recorded. The writer believes that had the spleen been removed at the time of the operation second- ary tuberculosis would have elavil 10 mg been avoided, although the great elavil for anxiety risk attendant upon the removal of this organ in- clined him to the opinion that it ought not to be at- tempted. To Determine ¥ery Small Effusions into the Knee- Joint — Fiske {Med. Record, March 12, 1898) says that small effusions into the knee-joint are best made out if the pa- tient stands with the knees fully extended and with both hands resting on the anterior surface of the thighs at about their middle. elavil 10mg Any fluid present in the joint at once sinks and settles behind the patella, causing it to "float." This position of the patient is one of ease and anterior relaxation. The muscular rigidity often present in ordinary examination of the knee-joint is absent. Care should be taken to strike the patella exactly in its center. Otherwise, one may obtain a deceptive tilting. THERAPEUTIC NOTES. Lysol as a Disinfectant. — At its recent annual elavil 50 mg meeting the Illinois State Board of Health expressed concur- rence in the elavil 10 following recommendation made by Dr. John A. Egan, its secretary : Although corrosive sublimate is a cheap and reliable disinfectant, great care must be ex- ercised in its use. All the solutions named are poisonous, and a child might c^rink sufficiently of No. 3 (1 dram each of corrosive sublimate and muriate of ammonia dissolved in 1 gallon of water) to cause its elavil for death. Carbolic-acid solutions are also poisonous, and might be drunk by a child or adult, causing at least injury to the throat. Lysol has none of these objections, being toxic only in large doses, and elavil 50mg having a pronounced taste, thus precluding the possibility of it be- ing swallowed by mistake. A two-per-cent. solution of lysol equals a five-per-cent. solution of carbolic acid. This preparation can be used instead of the carbolic acid, in the strength of 2>£ ounces to the gallon of water. A Specific Galactagogue. — Dr. Thos. More-Madden {International Medical Annual, 1898) calls attention to an article by Dr. Richard Drews, who states that soma- tose exercises a specific action upon the mammary gland of nursing women in that it produces an abundant buy elavil online secre- tion of milk and rapidly removes the disorders of lacta- tion. It is therefore recommended, when the quantity is insufficient, and when at the commencement of lactation the flow seems about to cease. Of course, the integrity of the gland must be perfect, and there must not be present any diseases which contraindicate nursing. The dose is 3 or elavil amitriptyline 4 teaspoonfuls daily, taken in milk, hot bouillon, or Digitized by Google 626 cheap elavil GLOVES FOR ARMY SURGEONS.

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