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5. Infections between the flaps — five per cent. A further analysis of these complications shows the following: The patient who developed acute ethmoiditis got well after a week's stay allopurinol 20 mg in bed. The one with the sunken nasal bridge had a paraffin injection made into the depression a year after the operation with satisfactory correction of the de- formity. Two of the four middle ear infections cleared up in a week, the other two developed purulent otitis media with mastoiditis following, and got well after the mastoid operation was performed on them. On the infections between the flaps, I should like to dwell a little longer, because that com- plication was encountered quite frequently — five in every hundred, as we observe. allopurinol uk Although not a serious complication, yet it is very annoying. It usually shows itself on the third or fourth day after operation, and if promptly recognized readily yields to treatment, which treatment consists in making an incision at the lowermost point of the collection, evacuating allopurinol generic name the contents, and the insertion for several days of a small bit of rubber dam or gauze between the edges of the incision to prevent them from ag- glutinating. The nares are cleansed every cost of allopurinol day, the contents of the sac squeezed out by gentle pressure on both sides with a cotton tipped applicator, and the allopurinol cost piece allopurinol brand name of rubber dam or gauze replaced. All those cases heal completely within ten days without interfering in any way with the ultimate result of the operation. These infections occur in spite of all care. They have occurred in cases, where being more anxious for some allopurinol tablets 100mg reason, the operation w-as performed at a hospital, under the strictest possible aseptic precautions, while on the other hand, some cases reeking with pus at the time of operation, healed without any trace of infection. As we said before, these infections are more a matter of annoyance than risk, unless they allopurinol iv remain unrecognized and neglected. The pus is confined in a cavity completely lined by perichondrium — a non- absorptive membrane — allopurinol rxlist and cannot very well extend above, as it would have to be under very considerable pressure to dissect the flaps from the cartilage, and before any such dissection could occur, the original incision anteriorly would be more likely to give way, or the pressure relieved by the surgeon recognizing the trouble and providing the necessary drainage. One thing may occur as a sequence of such an infec- tion, and should be carefully watched for, and that is, a degeneration of the strip of cartilage left above for support, with a resulting dropping of the nose at the nasal bones. This brand name for allopurinol occurred in the case re- ferred to, where the infection was not recognized early allopurinol online enough and was allowed to work some mis- chief before it was properly treated. A careful study of the complications shows only one class that is order allopurinol really dangerous — I refer to the ear complications. Two patients of this class developed mastoiditis, and had to be operated upon. If we re- member, however, that they w^ere only what is allopurinol 300 mg two out of a thousand operations, and that the mortality of the mastoid operation itself is not very high, and that furthermore all those operations were done without any particular choice of cases, we can safely assume that the patient who has his nasal septum resected is not subjecting himself to any special risk. Another point of considerable importance, par- ticularly from the patient's point of view, is the pain io6o FISHER: NASAL SEPTUM RESECTIONS. 1\k\v York Medical Journal. and discomfort and the length of the disabihty that usually accompany this operation — there is remark- ably little, when we consider the apparent magnitude of the procedure. A number of patients buy allopurinol online were seen who had not the slightest pain or discomfort at any allopurinol 150 mg time, and whose usual allopurinol pharmacology routine of life was not in the least interfered with. One such case in particular — F. L., a young girl of twenty years, left my office after the operation, and went shopping. She did the same the following morning, stopped at my office during the course of the morning to have the pack- ing removed from her nose, and continued about her business. Several days later she was discharged as healing was complete, and there was nothing more to be done for her. This history is exceptional, and is merely cited as an example of how little disturb- ance it can produce in rare cases, and we do not wish it understod that we advise the patient to take it as lightly as this. As allopurinol brand names a rule, we can promise the patients that if the operation is performed, let us say on a Saturday morning, they will be about and attending to their business on Monday. With very few exceptions, that promise can be kept. There should be absolutely no pain during the operation, and to overcome the throbbing and beating that comes on as the influence of starting allopurinol the cocaine wears off, the patient is given a hypodermic injection of one quarter grain of morphine with one hundred and fiftieth of atropine about three hours after the opera- tion. With this plan the darting and stabbing pains arising because of the evanescent cocaine are met and soothed by the gradually increasing influence of the opiate, and the dreaded period of lancinating, throbbing pain is made comparatively comfortable. The presence of the packing in both nostrils is not a thing of joy or pleasure, to be sure, but if the nasal chambers are not packed too tightly, most patients do not mind it a great deal. How to do a submucous resection cannot be well told in words. The technic of any operation is largely a matter of individual choice and adaptability to solve a given problem, and in this operation more so than in any other no allopurinol 50 mg rules can be laid down. The

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