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She became rapidly worse after this, and constipa- tion and colicky pains were frequent. Great care was taken with the diet, but brought no improve- ment, and the patient was sent, in November, to the Roosevelt Hospital with a view to operation for ap- pendicitis. Here a blood examination, the blue line on gums, the colic, tremors, arthralgias, and con- comitant physical symptoms, revealed the fact that she was suffering from lead intoxication. She im- proved and returned home after three weeks. At home zithromax-cheap.net she did badly. She had frequent pains in her abdomen, could not retain her food, and became greatly weakened through loss of food and sleep. .-X 1 192 PROCEEDINGS OF SOCIETIES. [New York Medical Journal. order zithromax over the counter few days before her admission, she began to have severe pains in her legs and head, she became dizzy ; her sight had been failing for several days, and she could neither sew nor read. She could not fix things in her mind. The day previous to admission she developed an acute delirium. Examination showed a woman of slight stature, weak and emaciated. Her breath had a metallic odor, her teeth were in bad condition, and a large typical blue line was apparent on her gums and upper lip. Her bowels were constipated. Her heart was very rapid, sounded labored and of poor quality. She presented the general features of an acute toxic dehrium. She complained of pain in her abdomen, back, hips, and feet. She talked buy cheap zithromax online incoherently and incessantly and had visual hallucinations. She saw imaginary persons about her room, at the windows, and was anxious and restless. She walked out in the corridors and to another patient's room. She order zithromax for chlamydia was very weak on her feet and tottered and staggered as she walked. There was marked weakness of all extremities, but no definite palsies ; she had tremor of her face, hands, tongue, and coordination was dis- turbed and difficult. The deep reflexes were absent and the plantar reflexes were diminished and of the flexor type ; the abdominal reflexes could not be ob- tained. order zithromax online no prescription Ocular movements were normal, and there was no nystagmus. The pupils were equal and re- acted normally. Both fundi were negative. No sensory disturbance was elicited ; speech was in- coherent, confused, and safe order zithromax online rambling; temperature was 101° F., pulse 120, blood pressure 160. The blood showed the typical basophilic granulations of lead intoxication, and the Wassermann was negative. Her muscles were can you order zithromax online very tender. With the previous history there was no difficulty in recognizing an acute lead psychosis. The source of the generic zithromax (azithromycin) lead was obscure. Three days later, after sedative and elim- inative treatment, the patient improved greatly. She could stand steadily with her eyes shut, and her gait was natural. She had no incoordination. Her re- flexes were all active and equal. Her temperature dropped to normal and her circulation improved. The mental condition persisted and resembled a mild Korsakoff's psychosis with fabrication, disor- ders of attention and memory. The thickness of speech improved slowly. For the past three or four days the mental condition had been almost normal. There was still anxiety, talkativeness, and at times depression and crying spells. An interesting feature was that the source of the causative toxin still eluded search. Various clues and theories had been exhausted. One possibility remaining generic zithromax 500mg cast sus- picion on her teeth, which generic zithromax z pak almost without exception had large metallic fillings. Although lead intoxication was usually chronic the resulting psychosis might be either acute as in this case, or of a chronic cheap zithromax type. The chronic cases much resembled general paresis, and it was a curious coincidence that the blood often gave a positive Wassermann reaction, though no history or sign of syphilis was present. All the somatic conditions of general paresis might be present, but there was usually cheap zithromax online a mental sluggishness and generic zithromax price an absence of the expansiveness of true paretic dementia. order zithromax online uk An important point regarding the treatment usual- ly recommended, was that concerning the use of the alkaline iodides. These favored the elimination of lead from the system, but if given too early or generic zithromax no prescription in too large doses a patient might thereby be re- poisoned by lead which had been dissolved out of his own tissues. These drugs should therefore be avoided in severe and acute forms and should be used only in mild cases after the bowels had been well moved. The administration of the iodides to persons impregnated with lead under unfavorable conditions might precipitate acute mental or neuritic symptoms. It was significant that this patient had taken a preparation of the alkaline iodides just previous to her acute mental condition, at a time when her gas- generic zithromax cheap trointestinal tract was obstinately constipated and deranged. Amyotrophic Lateral Sclerosis with generic zithromax z pack Bulbar and Spinal Amyotrophy. — Dr. T. S. Keyser presented a married man, forty-six years of age, who was always quite healthy until the onset of the present illness. The family history was entirely negative. No definite etiological fac- tor was ascertained. He was a driver by occu- pation and therefore had been exposed to the in- clemencies of the generic zithromax 250mg weather. The present illness be- gan in January, 1914, with a sensation of numbness in the fourth and fifth fingers of the left hand. In a few weeks he noticed that he could not pronounce words so distinctly as usual. This dysarthria grad- ually became more and more marked up order zithromax canada to the

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