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them as follows: i. "Early" cases, where the infec- tion is found at the operation to be still limited to the appendix, there being as yet no evidence of peritonitis. 2. " Abscess " cases, where an abscess is present, more or less securely shut off by localized peritonitis from the rest of the peritoneal cavity. 3. " Diffuse spread- ing " peritonitis, where the peritonaeum becomes rap- idly and progressively infected, without any attempt at 'limitation of the buy singulair online process. 4. " General " peritonitis, where at the operation it is actually seen that the peri- tonitis extends everywhere. The author maintains that, for a disease which in its early stages is a purely local infection, appendicitis has yet far too high a mortality. Early removal of the infected singulair price appendix is the only means we have for reducing the mortality to a minimum, and will, he is convinced, ultimately be- come the generally adopted rule of practice. 4. Gastric and Duodenal Ulcers. — Thomas montelukast price draws special attention to one of the many complications of gastric and duodenal ulcers — the immediate treatment of perforation of ulcers situated in these viscera. In many cases immediate surgical interference is not avail- able — yet many such cases recover. The author has studied a number of such cases, recovering without operation, and as a result of his observations has for- mulated the following mode of treatment, which should order singulair online be carried out in every case, whether operation can be done or not: i. Place the patient in the horizontal position. 2. The administration of morphine in singulair cost sufii- cient doses to relieve pain and to check peristalsis. 3. The avoidance of palpation and manipulation of the abdomen. 4. The emptying of the stomach by means of a stomach pump. Ordinary siphonage is unsatisfac- tory, because the .solid contents of the stomach cannot be 'thus satisfactorily removed. 5. No food or drink to be given by the mouth. 6. The abdomen should be montelukast tablets covered with several inches thickness of cotton wool and bandages. 7. \\'ater and food to be given bv the PITH OF CURRENT LITERATURE. rectum only. Never blister the abdomen in acute ab- dominal pain of unknown cause. 11. Chronic Aural Suppuration. — Heath states that aural appendicitis is the name by which chronic aural suppuration might purchase singulair online be known, for disease of that levocetirizine montelukast mucous cul de sac, the mastoid antrum or appendix of the ear, is responsible for the perpetuation of the discharge. Like appendicitis in montelukast sodium tablets the abdomen that in the ear is also a latent danger. In both situations it is a montelukast tablet grave dis- ease on account of its liability to infect neighboring and vital parts. In the abscess it may cause local ab- singulair online scess or fatal septic infection of the serous peritonaeum (peritonitis) ; in the ear it may cause local or cerebral abscess, or fatal septic infection of the jugular vein or the serous singulair tablets pia mater (meningitis). No careful sur- geon waits for abscess in abdominal appendicitis, nor should he wait for it in the ear, for just as removal of the purchase singulair abdominal appendix will eradicate the danger there, so will timely elimination of the aural appendix usually restore the ear to function and to safety. LANCET. hdy IS, 190/. 1. cheap singulair Plague singulair mg (Ci'oontjn Lectures. II). By W. J. R. Simpson. 2. The Most Frequent Hernia in Childhood and Its Sig- nificance, • By E. M. Corner. 3. On the Treatment of Lupus, By Dr. Dreuw. 4. A Case of Acute Lead Encephalopathy Following the Use of (?) Diachylon Pills as an .\bortifacient, By H. F-. W.^RNER. 5. .'V Xcw Method buy singulair for Using X Rays, By A. H. Pirie. 6. The Prophylactic Use of Antitoxine in Epidemic Diph- theria, By E. E. NoRTO.N. 7. Oil the Use of a New Fluid for the Hsmocytometer. By .\. Edington. 1. Plague. — Simpson, in his second Croonian lec- ture, discusses the pandemic of plague prevailing at present, especially in generic singulair India, and states that the preven- tion of plague is the most important question for India and England at the present time. It is now accepted that the order singulair importation of plague into a healthy locality can be effected by an infected human being, or an buy cheap singulair in- fected rat, or infected clothes. Infected grain may also he an agent in the importation of the disease. Once imported, the dissemination of the disease is effected by similar agents as those bringing about ini- portation. Except in pneumonic cases rats are the prin- cipal agents in the dissemination of the disease, though personal contact, as in typhoid fever, plays a part. The writer accepts Simond's theory that the flea on the rat,

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