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salvarsan. Dreyfus begins to treat with old salvar- san, generally starting with a small dose, o. I, and never goes beyond 0.4 of old salvarsan. The dose is repeated every second day. If at any time dur- ing the treatment the patient has a febrile reaction after the injection, the treatment is discontinued and not begun again until the patient is free from fever for at least two days. The use of neosalvarsan is preferred at the be- ginning in early brain syphilis, because it rarely pro- duces the febrile reactions of old salvarsan. \\ hen old salvarsan is used in the beginning, the tempera- ture frequently is excessively high and sometimes the patients are delirious for eight to twelve hours. The total amount of old salvarsan given in purchase inderal online the course of six or eight weeks is four to five grams. If the patient consents to take two courses of treat- ment, he receives in the course of four months, six to eight grams of old salvarsan and two to three grams of neosalvarsan. In patients who stay four months, the W'asser- mann test is, as a rule, negative in the blood and fluid, and globulin and cell count are also negative. The jiatients who take but one course of treatment have generally a positive W'assermann in the fluid, globulin slightly positive, and the cell count is diminished to one half or one third. These patients are always advised to return for a second course of treatment in two or three months. The prognosis in early brain syphilis is made favorable ; in fact, a positive cure is promised to all who return for reexamination and take the treat- ment if the physician advises it and considers it im- perative. Patients who leave the hospital with a jjositive VVassermann in inderal tablets the fluid, slightly positive globulin, and only slightly diminished cell count, frequently return at the end of two or three months complain- ing of eye sym])toms, deafness, and generic inderal some complain of facial palsy. The Wassermann purchase inderal test, inderal online cell count, and globulin re- action are the index of the success of the treatment. If a case after one buy inderal course of treatment has a nega- tive Wassermann. negative cell count and globulin, a second course of treatment is not advised. I.ATi: STACF. OF rEREBROSPINAL SYPHILIS. The majority of the cases in the Dreyfus clinic purchase propranolol are of this type, and the prognosis is generally favorable for improvement, but not for cure. After a thorough physical and serological examination, the patient is allowed to rest in bed for two or three days \vithout therapy ; he then receives three mer- curial injections, one every other day ; after the third injection, the treatment is begmi with old sal- varsan and continued every other day buy cheap inderal for six or eight weeks. The total inderal price amount of .salvarsan given intravenously averages four or five grams. There are two classes of this kind of cerebro- spinal lues. One class shows a negative Wasser- mann in the fluid and negative serological findings, 'idiesc inderal mg cases, though favorably influenced by the treatment, do not show the remarkable iiuprovement of the other class with i)ositive \\ assermann in the fluid and positive serological findings. In the first class it is thought that the «lisease has become sta- tionary, with online propranolol an irreparable anatomical defect. iii6 CONZELMANN: SYPHILIS OF NERVOUS SYSTEM. [New York Medical Journal. while the propranolol hydrochloride 80 mg for anxiety second inderal cost class is considered as active syph- ilis., with curable pathological lesions. Among the second class, hemiplegias, spastic paralysis, parethe- sias, deafness, oculomotor symptoms, headaches, and dizziness all may disap]:)ear during cheap inderal the course of treatment. TABES. In tabes cases, Dreyfus always treats the patient with salvarsan alone for three weeks, giving one injection of salvarsan of o.i to 0.2 gram every other day. At the end of three weeks he combines the treatment with mercury. In tabes he always exer- cises great caution in selecting the mercurial preparation, as he purchase propranolol online has frequently found that the patients showed a marked intolerance to some mer- curial salts and not to others. As a rule, he prefers mercurial inunctions in cases of tabes, but often uses the mercurial salicylate. With this form of treatment, the patients improve rapidly, gastric buy propranolol and lancinating pains disappear, the ataxia and visceral symptoms improve; the tabetic cases with a negative Wassermann in the fluid also show improvement with this form of treatment. The tabetic buy inderal online patients are always emphatically ad- vised order inderal to take a course of treatment every three months until four courses are taken, and in general it is thought order inderal online that several courses of treatment are necessary to obtain any marked improvement. TREAT.MENT BY MODIFIED SWIFT-ELLIS METHOD. I may here state that whenever a lumbar punc- ture was made, either for the purpose of diagnosis or for the purpose of treatment, the patient was in- variably made to lie flat on the back for twenty- four hours. It is hardly necessary to state that proper antiseptic measures were observed in making a puncture and giving the treatment. In the intraspinous administration of salvarsan,

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