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tion. Upon cost erythromycin ophthalmic ointment autopsy, recent haemorrhages were found in the subarachnoid space upon the level of the sixth cervical vertebra, together cost erythromycin topical with a small clot in the subdural space at the level of the ninth cost of erythromycin 500mg dorsal and other much larger clots on the surface of the left occipital lobe. Bennett himself says that, in view of the time that had elapsed since the operation, and consider- ing that the quantity of fluid draining away had become so small, he does not believe that death was in any price erythromycin philippines way caused by the escape of cerebrospinal order erythromycin fluid, but would attribute purchase erythromycin it rather to vomiting, which produced the cerebral haemorrhage, or to the apoplexy resulting in vomiting, collapse, and coma: and price erythromycin ophthalmic ointment that " it is by no means clear that his death was even remotely connected with the operation." Chipault's patient went into sudden coma thirty- six hours after the operation, without apparent cause, but having lost a great deal of cerebrospinal fluid, and died on the third day. Upon autopsy, the entire subarachnoid space of cord and brain, as well as the ventricles, was found entirely dry. and there were disseminated hremorrhagic foci price erythromycin ointment in the brain and marked sclerosis of the cerebral vessels. From this material Chipattlt draws the conclusion that the operation is one of great danger. In view of the number of cases which I have tab- ulated, in which no untoward occurrence took place as a result of the operation, and considering the varied interpretation which is permissible in these fatal cases, it does not seem to me that the operation presents cost erythromycin gel any greater danger than an\- laminectomy in which the dura has to be opened ; in other words, the resection of the posterior roots does not add to the danger of the laminectomy. While it is by no means my intention to speak here of matters purely surgical, there are certain questions pertaining to the technics of the opera- tion which are quite as nuich of neurological as of siu-gical interest. The indicatiiin t"or the operation having been 194 JACOBY: RESECTION OF NERVES. clearly decided upon, the precise nerve roots which are to be resected must of course be determined before the operation is begun. Our knowledge of the distribution of each of the posterior roots should he ample for this purpose, as is shown in the accom- panying charts (I^igs. i and 2). online erythromycin The various ques- FiG. 2. — Areas of radicular distribution of the spinal nerves f after Kocher). Bacli view. price erythromycin india tions concerning the distribution of the nerve fibres in the skin and their terminal relations do not con- cern us here so much as the relation of the roots with their dermatomeres. We know that the nerve trunks which go to form the plexuses constitute a group of nerve fibres in which no very definite functional arrangement can be made out, and which in their course do not correspond to any real sys- tematization. On the other hand, the relation of the roots with their dermatomeres is very simple. These dermatomeres assume the form of circular bands arranged at levels, each level succeeding the preceding one in the order of the roots themselves. cost erythromycin eye ointment The dermatomeres may easily be pictured by con- ceiving of the individual as placed how much does azithromycin cost in the posture of a quadruped, the skin being divided into as many superposed zones as there are pairs of spinal nerves. In the upper limb these zones are projected into its length in parallel, more or less cheap erythromycin continuous bands, while in the lower limbs these bands are, on account of developmental distortion, rendered more or less discontinuous. During the course of the operation we can buy cheap erythromycin more certainly determine the price erythromycin gel root which is cost erythromycin to be cut by its relation to the spinous process (see Fig. 3) as ).\c }NV well as by direct faradaic excitation of the corre- sponding anterior root, cost erythromycin ophthalmic aided by our knowledge of the motor innervation territory of such root. average cost erythromycin

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