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Treatment of Gastric Ulcer by Excision. — E. Stanley Ryerson, in the University of Toronto Medical Bulletin for May, 191 4, makes an appeal to the practitioner not to allow cases of chronic gastric ulcer to become so advanced before consider- ing Trental 400 operative treatment that only some palliative surgical procedure can be carried out. He regards as chronic all cases in which symptoms have yielded repeatedly to medical treatment, only to recur later, with a progressive increase in the cicatricial tissue deposited in the gastric wall around the site of the ulcer. There are at present various opinions as to the best means of treating such cases, especially in the presence of a small ulcer on the anterior wall or lesser curvature, feeling like a button in the stomach wall. Some advocate a gastroenterostomy in such patients ; others, the production of pyloric obstruction followed by a drainage operation, and others still, excision of the ulcer. The latter is con- sidered by the author the ideal operation, since it deals directly with the pathological condition. The chief argument against it has been the supposedly high mortality ; the mortality from excision having been stated as about twenty-five per cent, and that from other methods as only from Trental Generic two to five per cent. This statement the author believes to be in- correct, the impression Buy Trental Online Trental Price of a high mortality resulting simply from cases where the ulcer had extended deeply into the pancreas or liver, or with extensive adhesions. If, on the other hand, gastric ulcer was treated Trental Indications by operation at Trental 100 Mg a comparatively early stage, the excision consisting merely in the removal of an elliptical or V shaped portion of the stomach wall. the mortality could not but be low, and in this type of case excision alone should usually be sufficient to cure the patient. This ideal method of treatment demands that physicians urge their patients to un- dergo operation much earlier than is now the case. Ryerson insists that the correct time to advise opera- tion is, as soon as the ulcer has become chronic ; this Purchase Trental is indicated pathologically by the extension of the ulcer through the muscular coats — a condition Pentoxifylline Trental which can be frequently detected by fluoroscopic examina- tion, and by the formation of adhesions to surround- ing organs and of fibrous tissue in the stomach wall, in and around the ulcer. Adhesions can often be seen either by means of the fluoroscope or by x Trental Tablets ray plates of a bismuth meal ; while the number of years over which the history of the case extends, with the number and length of the attacks, give very tangible evidence upon which to estimate the extent of cicatricial deposit. The definite de- cision that a chronic ulcer exists in some cases may not be reached for six months to two years, but once it has been made, excision should be advised. Trental Injection Extraction of Trental Cost a Missile from the Left Lobe of the Cerebellum under Local Anesthesia. — Rochard (Presse medicale, December 3, 1914) describes a procedure carried out successfully by Martel for the extraction of a shrapnel bullet from the left cere- bellar lobe. Anesthesia was induced locally by en- dermic and Purchase Trental Online subcutaneous injection of a solution of epinephrine in conjunction w^ith a commonly em- Order Trental ployed proprietary analgesic drug. To expose the field of operation Trental Mg a quadrilateral flap with base below was raised as far as the posterior margin of the occipital foramen. An opening fourteen Trental Online mm. in diameter was then made in Buy Cheap Trental the squamous portion of the occipital bone, the left half of which was easily and rapidly destroyed. The sinus having been ex- posed above, the exact location of the occipital crest and midline was ascertained and the dura mater in- cised vertically at a distance of one cm. from the midline. Hernia of the brain tissue then took place, and incision into this hernia opened an abscess in the centre of which the shrapnel bullet was found. Drainage was established and a dressing applied. Improvement immediately followed the operation. The advantages of the procedure are stated as hav- ing been, i, the very favorable position of the patient during operation — sitting upon a chair with his arms resting on its back and his head firmly planted on his arms ; 2, the absence of hemorrhage ; and, 3, the avoidance of all malaise and vomiting after opera- tion. Treatment of Pemphigus. — Von Leszczynski, in Zentralblatt fi'ir innere Medizin for December 12, 1914, is reported to have administered fifteen grains (one gram) of a quinine salt in 250 c. c. of ])!iysio- logical salt solution intravenously in cases of pem- phigus, with a Generic Trental clearly favorable effect in all in- stances. Use of Coaltar in the Treatment of Eczerha. — G. Thibierge, in Progrcs medical for .\pril 11, 1914, is stated to have pointed out the especial value of coaltar Order Trental Online in the treatnient of certain varieties of ec- zema — those with considerable weeping and edema. The greater the local moisture and acuteness, the greater the likelihood of rapid and favorable results. June 5. I 9' 5-] EDITORIAL ARTICLES. 1177 NEW YORK MEDICAL JOURNAL INCORPORATING THE Philadelphia Medical Journal and The Medical News. A Weekly Review of Medicine. Buy Trental

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