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bedded extraperitoneally between the abdominal voltaren 50mg diclofenac muscle and the anterior abdominal fascia. BULLETIN DE L'ACADEMIE DE MEDECINE. March 30, JQ13. Pathogenesis and Prophylaxis of Anal Fistula, by Paul Reynier. — Anal fistula is often associated with voltaren 100 mg retard tuberculosis caused in nearly all instances by swallowing sputum. In only six of sixty-seven cases of anal fistula was the author unable definitely to affirm the existence of pulmonary or laryngeal tuberculosis, either incipient or in the open stage. Fistul?e forming in the presence of open tuberculo- sis were observed to be much more refractory to treatment than others. Frequently, the generic name for voltaren fistulas oc- curred as the first manifest sign of tuberculosis in individuals still apparently in good health ; upon auscultation and careful inquiry evidence of a con- comitant and even preexisting lung tuberculosis was found. Thus, among the sixty-seven cases, twenty instances were found in which fistula led to the dis- covery of incipient tuberculosis. Sixty-one patients admitted that they swallowed their sputum. This suggests strongly that failure to spit is a cause of fistula. Patients should be warned against the dan- gers of swallowing sputum. Special Sense Disturbances in Wounds of the Head, by Edmond Delorme. — In nearly 200 cases of head injury by military projectiles visual disturb- ances were associated more frequently than mental disturbances or sensory motor phenomena in the ex- tremities. If vision remains good in one eye, the in- volvement of the other is frequently overlooked, by the patient himself and by the attendants. Such visual disturbances appeared independently of the portion of the brain injured, and commonly consisted in reduced acuity of vision, with or without voltaren xr 100 concen- tric narrowing of the visual field. Ophthalmoscopic examination occasionally revealed, in the severe cases, optic atrophy or evidences of capillary stasis. Where the visual deficiency had appeared just after the injury and was of slight degree, it often disap- peared rather quickly. Auditory disturbances, com- prising partial deafness, tinnitus, and occasionally vertigo, voltaren sr 100mg were also frequently noted, though less often than the disturbances of sight. Latent Wounds of the Brachial Artery, by O. Laurent. — In the course of forty-two operations in cases of nerve injury, sustained four to seven months before, the main artery of the limb — nearly always the voltaren in usa brachial — was found to have been trauma- tized in eight instances. In four cases it had be- come completely occluded. Severe trophic and cir- culatory voltaren generic name disturbances in limbs with injured nerve trunks are ascribed in part to such actual lesions of voltaren ec 75 mg the arteries. In the examination of old nerve wounds of the arm, especially involving the ulnar and median nerves, comparison of the pulse on the Ti84 PITH OF CURRENT LITERATURE. [Xew York Medical Journal. two sides is considered always advisable, to detect arterial injury where it exists. The left radial pulse commonly was found deficient. In all oper- ations on nerves in the arm the main arteries should be examined. RIFORMA MEDICA. May 8, voltaren in canada 1915. Dysentery, by M. Ascoli. — There are two well recognized forms of the disease, the amelyic and the voltaren rapid 25mg bacterial. The treatment of the amebic type has been simplified by the introduction of the use of emetine. It is used hypodermically voltaren 75 sr in the dose of 0.02 to 0.04 gram on the first day, and the dose in- creased up to 0.15 gram given at intervals of two or three days. At the same time intravenous voltaren xr 100mg injec- tions are given beginning with o.oi gram in 150 c. c. water, increasing up to 0.06 gram. The bacil- lary type is caused by voltaren for sale the bacilli of Celli and of Flexner. This is the form generic for voltaren of the disease found in epidemics. There is also a sporadic form of the dis- ease in which neither amcebae nor bacilli can be made out. The treatment of the bacillary form is not very satisfactory, and consists of the use of cal- omel, castor oil, and sulphate of sodiimi, with en- teroclysis of large quantities of tepid antiseptic so- lutions at low pressure, and intravenous injections of hypertonic solutions of sodium chloride. The diet is light in the mild cases ; in the severe cases tea, hydrochloric acid lemonade, sago, arrow root arc given. Venesection voltaren topical seems to produce marvelous effects in apparently hopeless cases. REVISTA DE MEDICINA Y CIRU6IA PRACTICAS. April 28. 1915- Tendon Reflexes in Psychoneuroses, by Fer- nandez Sanz. — Many authorities state that there can be no alteration of reflexes in functional nervous diseases, but that, on the voltaren ec other hand, any condition accompanied by change in the reflexes must be or- ganic in origin voltaren sr 75 mg tablet and nature. Sanz maintains that in twenty-five per cent, of cases of true hysteria there is exaggeration of the tendon reflexes. An exhaus- tive review of the literature seems to justify the fol- voltaren xr 100 mg lowing conclusions : In psychoneuroses the tendon and bony voltaren ec tablets 50mg reflexes are normal or uniformly slightly exaggerated. The psychoneurosis in which is seen most frequently such reflex increase is neurasthenia, where it is almost constant ; in hysteria it is less com- mon, and in psychasthenia it is exceptional. In hys- teria there is never intense nor unilateral exaggera-

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