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for recurrence. It would seem from a careful ex- amination of the literature and from our experience, that the following mode of treatment should be adopted : 1. All papillomata should be treated primarily with the high frequency stromectol uk current in view of the high percentage of recurrences following open operations — fifty per cent. — and the high mortality — ten per cent. 2. They should be watched for recurrence over a period of one year. 3. A specimen should be examined in every case by a pathologist and, if found malignant, the tumor stromectol 3 mg should be treated accordingly, for up to the present time fulguration has not proved effective in cheap stromectol malig- nancv. LITERATURE. I. EDWIN BEER: Tlie Treatment of Papillary Tumors of the Urinary Bladder with the buy cheap stromectol High Frequency Current Oudin, Jour. A. M. A., Nov. 16, 1912. stromectol for lice 2. HUGH HAMPTON YOUNG: The Present Status of the Diagnosis and Treatment of Vesical Tumors, Ibidem, Nov. 22, 1913. 3. E. S. JUDD: Results in the Treatment of Tumors of the Urinary Bladder, Ibidem, Nov. 16, 1912. 4. WILLIAM L. CLARK: The Desiccation Treatment of Congenital and New Growths of the Skin and Mucous Membranes, Ibidem, Sept. 12, 1914. 5. E. S. JUDD: Tumors of the Bladder, Jour. Minn. State. Med. Ass'n and Northzvestern Lancet, Dec. i, 1909. 6. ALEXANDER A. UHLE: The Treatment of Bladder Papilloma ivermectin stromectol by High Frequency Destruction. Annals of Surgery, September, 1914. 7. HERMAN L. KRETSCHEMER: Fulguration Treatment of Tumors of buy cheap ivermectin the Bladder, Jour. A. M. stromectol purchase A., Mar. 27, 1915. 8. ABRA- HAM L. WOLBARST: Multiple Papilloma of the Bladder Consti- tuting an Obstruction of the Vesical Neck: order stromectol online Successfully Treated with the Oudin Fulguration Current, Urologic and Cutaneous Re- -■iew, xvii, 10, 1913. 9. B. A. THOMAS: The Destruction of Tu- mors of the Urinary Bladder by a High Frequency Current Effect Known as Desiccation, Surgery, Gynecology, and Obstetrics, April, 1912. 327 First National Bank Building. Treatment of Trypanosomiasis. — J. Danysz, in Paris medical for January 2, 191 5, describes a new chemical combination of dioxydiamidoarsenobenzol with silver, bromine, and antimony, which is assert- ed to possess great value in the treatment of sleep- ing sickness. The therapeutic action of the arsenical compound in this disease is enhanced by its com- bination with the other elements mentioned, while its caustic eft'ect on the tissues is, on the contrary, reduced. June 5. 1915. j JACOBS: GENERAL ANESTHESIA. I 167 GENERAL ANESTHETICS. M'^ith Special Reference to Anociassociation (Crile). By L. M. Jacobs, M. D., Philadelphia, Anesthetist, American Hospital for Diseases of llie Stomach, and Lebanon llosi)ita!. The state induced by the administration of in- halation anesthetics is designated by the scabies stromectol usually ac- cepted phrase, general anesthesia, anesthesia, or narcosis, each signifying unconsciousness with gen- eral loss of sensation including, of course, loss of pain sense. The chief anesthetic agents of the in- halation group, which, in the hands of anesthetizers, stromectol buy have fulfilled the foregoing requirements are: Ni- trous oxide; 2, ether; 3, chloroform; 4, ethyl chlor- ide; 5, combinations of these one with another and with oxygen. I fully believe that the time is very near when we shall rely on nitrous stromectol canada oxide in combination with ether and oxygen and aided by the anociassociaticwi of Crile, as the selected anesthetic for all major opera- tions. We have in this group a combination of anes- thetics which eliminates all unpleasantness, which produces sleep quickly and quietly, which can be given for an indefinite length of time, and as the operation continues, can be easily regulated as to the amount of nitrous oxide, ether or oxygen, increasing or decreasing each as occasion arises. Finally, stromectol price with the assistance of the anociassociation of Crile we have shock reduced to a minimum, and the amount of anesthetic reduced to an appreciable extent. While I am fully convinced that this method of anesthesia is by far the best, there are several fac- tors which have kept, and will buy stromectol online keep it down for some time to come ; stromectol online the first stromectol for scabies is the bulkiness of the outfit, and the second is the cost of the nitrous oxide and oxygen. If we could eliminate these tw^o buy ivermectin fac- tors, the method would undoubtedly replace ether in almost every instance. Owing to the second reason, I am sorry to state that my experience with this meth- od has been limited. Nevertheless I am convinced even with this limited number of cases against the large number of generic stromectol cases I have anesthetized with ether, that this combination is far superior in every respect to the straight ether method, no matter how skillfully given. Of course this method is more or less complicated, and I should not advise any one order stromectol to attempt it unless he is skilled in the use of the sim- pler anesthetics. Just a passing remark in regard to chloroform. My experience with this drug, while of a limited character, has been very satisfactory, but its use is

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