Offers the Young Graduate for Medical Training.
By Henry A. Christian.
3. The Medical and Surgical Aspects of Perforating Ty-
phoid Ulcers. By Richard H. Harte.
4. Perforating Typhoid Ulcers,
By Frederick C. Shattuck.
5. Mistaken Diagnosis in Cases of Typhoid Perforation.
By C. L. SCUDDER.
6. Perforating Typhoid Ulcers, By Farrar Cobb.
7. The So Called " Ochsner Muscle " of the Duodenum,
By Walter M. Boothby.
3, 4. The Medical Aspects of Perforating Typhoid
Ulcers. — Harte remarks that perforation Purchase Cefaclor Online of the bowel
in typhoid fever is a much more common condition
than is generally supposed, being responsible for about
one death in everv three cases. The most common time
of perforation is between the fourteenth and twenty-
first days of the disease and occurs in all grades of se-
verity, Cefaclor Cd from the ambulatory to the hremmorrhagic type,
and does not seem to be any more common in the haem-
orrhagic than in Purchase Cefaclor the milder types of the disease. The
ileum is the most frequent site of perforation, in the
majority of instances the perforation occurring within
twelve to eighteen inches of the ileocoecal valve. The
ne.xt most frequent sites of perforation are the appen-
dix and the cjecum. Pain of some kind is Cefaclor Antibiotic present in 75
per cent, of all cases. In 50 per cent, of the cases the
onset is sudden and severe Cefaclor Antibiotics and of increasing intensity,
localizing itself to a special zone. In 20 per cent, of
the cases the pain is of slow onset, not localized, with
general distribution. In some cases no pain is Cefaclor Price com-
plained of and the usual symptoms of perforation are
absent. Tenderness and rigidity are present to a cer-
tain extent in all cases. When perforation is suspected
the temperature should be taken every hour, as it is
■only in this way that definite conclusions Cefaclor Cost can be drawn
with regard to any marked variation in this symptom.
Distention is a late symptom of perforation, usually not
making its appearance until some hours after the per-
foration has occurred. The obliteration of the liver
dullness is not regarded as a reliable Cefaclor 500mg sign of perfora-
tion. The Order Cefaclor Online study of the leucocytes is of little aid, al-
though occasionally their increase may make us Order Cefaclor more
positive of the diagnosis. The differential count is of
no practical value. Nature may occasionally close one
or more perforations, but the only rational procedure
where perforation occurs is surgical intervention. No
case is too desperate for an attempt, as it has not in-
frequently been noted that the mild cases succumb and
tile more desperate ones recover. — Professor Shattuck
states that perforation is the gravest complication of
typhoid fever. Fortunately it is rare. Of 2,047 cases
of typhoid treated in the Massachusetts General Hos-
pital in the past ten years, it has been known to have
occurred in 30, or in 1,4 per cent, of the cases. It is
most liable Cefaclor Tablets lo occur in the third week, but may occur
at any time after the middle of the second. It may
occur in the first or second relapse, the primary attack
or attacks having run a favorable course. There is Cefaclor Ceclor no
relation between the severity of the case and the liabil-
ity to perforation. The duties of the physician with
regard to perforation in typhoid arc four- fold: (i) He
must know the symptoms suggestive of its occurrence;
(2) he nnist be on the watch for them; (3) he must
sec that the nurse or altend.inl knows and is alive to
Related tags: Buy Cefaclor, Cefaclor Dosage, Cefaclor 375mg