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pendicitis stiddenly developed on the tenth day ; re- covery in two maxalt rpd 10 weeks took maxalt mlt generic place in both instances under rest, dieting, and local application of ice. RIFORMA MEDICA. April 34, 11)15. Primary Degeneration of the Commissure of the cost of maxalt Brain, by P. Guizzetti and G. Tomasinelli. — This condition, first described by maxalt tablets Marchiafava in 1897 i^ always caused by chronic alcoholism and is comparatively rare, as in 13.000 autopsies at the- university of Parma only one case was found. Cultivation of Tetanus Bacillus from. Blood of Tetanic Patients, by G. Sinigaglia. — Blood taken from a case of tetanus was added to pancreatin broth and incubated ; on the fourth day typical bacilli were recovered from the cultures. This is another instance added to those already reported, and tends to verify former experiments on which doubt was cast by maxalt cost many recognized authorities. It seems to strengthen the modern contention that bacteriemia is a phase of tetanus. This bacteriemia would not seem to be a true septicemia, but only a transitory condi- tion, its presence or absence not having any eft'ect on either the prognosis or the course of the disease. Tetanus and diphtheria have long been considered the two typical infections with localization of the in- fective bacteria at the point of infection, and a dis- tribution of toxins alone through the circulation, thus apparently breaking the usual rule of bacteriemia in infectious diseases. However, the not infrequent presence of both these bacilli in the circulating blood and in the urine has been demonstrated. Syphilitic Meningomyelitis, by U. Scinicariello. — This case in a man aged thirty-seven years is worthy of note on account of its complex symptoma- tology, its duration of ten years, and the short in- terval between the initial infection and the appear- ance of the nervous symptoms. Within forty days after the appearance of the primary lesion there order maxalt online was disturbance of vision with diplopia, rapidly maxalt mlt coupon followed by ataxia and incontinence of urine. SEMANA MEDICA. .-ifril I. igii. Incrustation Cystitis, by E. Pozzi. — This is a rebellious form of cystitis which cystoscopically shows alteration in the bladder wall with incrusta- tion and deposit of phosphates and urates. Ulcera- tion is not necessary for such alteration. True in- crustation is shown by the fact that the act of de- taching the deposits strips oiT the epithelium, and microscopically there is observed intimate attaclimcnt of the crystals to the epithelial cells. It must be distinguished from vesical calculus and the diagnosis is made by the use of Guyon's explorer and the cys- toscopy The immobility and attachment of the mass to the bladder wall is characteristic in incrus- tation. The treatment most successful is instillation of silver nitrate in solutions of one to three per cent., maxalt melt 10mg though gentle curettage may be needed to maxalt melt de- tach the incrusted masses. Prognosis is not serious except that the course is prolonged. Two cases are described of this condition, in one of which supra- pubic cystOtGniy was resorted to for drainage. Perforation of Appendix in Pregnancy, by R. F. Coulin. — Acute appendicitis in pregnancy has its characteristic symptoms unaltered by gestation. Mortality is thirty to forty per cent. maxalt melts ; fetal mortality still higher ; and when perforation occurs followed by general peritonitis the death rate is greatly raised. In peritonitis the fetus almost invariably dies in utero, and brings about premature delivery. Tem- porizing methods are extremely dangerous, though advocated by some, and the only justifiable pro- buy maxalt online cedure is immediate surgical intervention. One may conclude that the rapid advance of acute appendicitis in pregnancy with its possible fatal is there a generic for maxalt results calls for immediate stirgical intervention, even in desperate cases of general peritonitis ; spinal anesthesia in such cases is a failure, and the use of ether maxalt rpd 10mg intraabdom- inally in general peritonitis maxalt mlt price presents great and en- couraging possibilities, as price of maxalt evidenced by its results in eight cases reported by Coulin. Relation between Nasal Respiration and Phthisis, by A. Philibert. — Chronic nasal afifec- tions play cheap maxalt an important part in pulmonary tuber- culosis, consequently correction of such conditions must be an important factor in the prevention of that disease, as well as in its actual treatment. The necessary pulmonary maxalt mlt tablets ventilation cannot be obtained without perfectly free maxalt canada nasal respiration. BRITISH JOURNAL OF CHILDREN'S DISEASES. May, 1015. Suppurative Parotiditis Following Pneumonia, by J. Porter Parkinson.- — ^A boy, aged three years, having signs of resolving pneumonia was admitted to the hospital. Five days later the temperature which had been in the neighborhood of 99.5° F. reached 104° F. No signs in the chest were de- monstrable, but on the following day a hard, tender swelling appeared in the right parotid region. Three days later a deep incision below the right ear reached an abscess and a small amount of pus was removed. The smear showed pneumococci and a few staphylococci. The temperature fell and the recover}^ was uneventful. The infection probably took place through the blood stream as there had been no sputum coughed maxalt 5 mg up. Myelitis in a Child, by Plugh T. Ashby. — The child, aged five and a half years, had complained of vague pains in the chest and legs. The patient was slowly losing the use of his legs and on admis- sion there was paralysis of both legs and back with anesthesia extending from the toes to a line drawn around the chest just below the nipples. The tem- perature which had been fairly nomial during the course of the disease rose just before death. The heart and lungs remained normal. There was no

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