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which come through exact and many sided medical training and experience, are not infrequently all im- portant as guides or coimselors of surgery. There is little doubt that at present there is much unnecessary surgery, and the time has come for physicians to take up again the too readily relin- quished role of advising when an operation is justi- fied by the indications and probable results. When men of the highest calibre and skill, like John B. Deaver. of Philadelphia, and Charles Mayo, of I^ochester, Minn., raise their voices in this direction, as they did at the last meeting of the American Medical buy cyproheptadine online Association, it is time to cry a halt. Dr. John M. T. Finney also deprecates periactin 4 mg the tendency to operate. He writes cyproheptadine hydrochloride : "There is far too great a tendency to operate nowadays, and the average doc- tor resorts to this shorter route, when j^erhaps a more careful diagnosis would show some other course buy periactin uk to be preferable. Many operators — and I use the word advisedly — into operations with no clear idea whatever of the nature of the disease which they are endeavoring to combat, and for this reason manv operations are needlesslv performed" (13)- I note with great satisfaction, as does American Medicine (14), the drift toward saner thinking and doing. The return should be" to the old position when the periactin price physician took charge of the patient throughout the whole course of the disease and in- voked the surgeon's mechanical talent only on those occasions when it was evidently required. The journal mentioned asks pertinently, "Who is the proper judge as to the necessity for an ojX'ra- tion, the man who gets a big fee for doing it or he who gets a little fee for cyproheptadine 4mg advising it?" Further, it purchase periactin June 5, i9'5] BERN ART: INTRAVENOUS TREATMENT OF GONORRHEA. 1 145 writes : "The fee should go to the physician who will pay the surgeon for his services." To carry this judgment to its final, logical con- clusion, and as I would have it for the greater wel- fare of all patients, this role of family physician should be extended to every case in which the services of a specialist are required. REFERENCES. I. Br. Med. Jour., Jan. 4, 1913, p. 8. 2. Bost. Med. and Surg. Jour., April 8, 1915, p. 10. 3. New York Medical Journal, March 20, J915.P. 591- 4- Internat. Clinics, 11, 24, p. 72. 5. Am. Jour. Med. Soc, November, 1914, p. 65. 6. Jour. A. M. A., April 25, 1914. 7. New York Medical Journal, October 14, 1914, p. 1227. 8. Pro- gressive Medicine, iv, Dec, periactin uk 19:1, pp. 100, 102 and 103. 9. Merck's Archives, Sept., 1914. 10. Therapeutic Gazette, Nov. 14, 1914, p. 777. II. Loc. cit., p. 634. 12. Internat. Clinics, ii, 24, 1914, p. 178. 13. Johns Hopkii'.s Hosp. Bull., July, 1914. 14. American Medicine, Nov., 1914, p. 740. 42 West Thirty-seventh Street. THE INTRAVENOUS USE OF ANTISEP- TICS" IN GONORRHEA. Some General Observations on Intravenous Ther- apy. An Introductory Article. By William F. Bernart, M. D. Chicago. A review of literature on the treatment of acute gonorrhea permits of the deduction, that except for a general refinement in technic and the addition buy cheap cyproheptadine of more acceptable drugs, little advancement has been made. The large number of drugs recommended as applicable plainly show that the ideal order periactin treatment is yet to be discovered. Even under the local ap- plication of the more modern preparations, fortified by the use of biological products and specially rec- ommended drugs for oral administration, the results of treatment vary so markedly as to justify these statements. As the treatment of gonorrhea has al- ways followed certain stereotyped lines, the lack of better results may be due to the fact that no decided tangent has ever been attempted from the estab- lished circular routine. When we consider periactin online the ease with which the gonococcus is destroyed in cultures outside buy cheap periactin of the human body, compared cheap periactin to most other organisms, and that its culture media must be "just right" for its growth, it would appear to be a sim- ple matter to find some drug which would assist in the rapid destruction of so vulnerable a germ. So far, I possibly have not found order cyproheptadine the chemical sub- stance which will answer the purpose most effec- tively, but periactin buy online I have proved without a doubt that the buy cyproheptadine intravenous use of acceptable antiseptics, combined with a mild local application, will reduce buy periactin the time of treatment and tlie percentage of complications. Every attribute of the gonococcus, everything in the pathology of gonorrhea, invites the use of intra- venous medication. Regarding the germ, it is hard to cultivate on artificial media, animals are immune to it and placed in subcutaneous tissues it dies quickly ; these three factors alone argue in cyproheptadine 4 mg favor of a weak resistance. As the germ reproduces itself every ten minutes, a order periactin online drug injected into the circula- tion would unquestionably produce a germicidal state for a sufficient length of time to cover several cycles of multiplication, and if there is a period during the growth of this germ when its resistance to outside influences is less than at other times, the

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