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first attack; in these, unless sure subsidence of the symptoms occurs within twenty-four hours Amoxicillin 500 of the onset ; and in all cases in which there has been a previous attack. I have treated many in the past ten years without operation and have operated upon more, but the more I see of the disease and its re- sults in my own hands and Order Trimox the hands of others, with and without early operation or without operation at all, the mere the above conclusions are forced upon me. When the tube alone is involved, a much greater latitude is allowed for conservatism. Many milder cases can be best managed by ice, Trimox Side Effects rest, and Trimox Online laxatives. The onset of pus formation can with safety be awaited, while in a considerable propor- tion, not of the Trimox Antibiotic severer types, the interests of the patient are best served by awaiting the subsidence of acute symptoms, including the diminution of leu- cocytosis, before radical operation is undertaken. Less tissue will then require removal and the chances of infecting the peritonaeum will be dimin- ished. As a general rule, purulent gonorrhceal in- fection leaves little field for conservatism, and though the ovaries may be left, both tubes usually require removal. Complete resolution may occur in puerperal cases in a most surprising way. In appendicitis, whether acute or chronic, where sup- puration has occurred, practically all cases require drainage after removal. In appendicitis, treatment by drainage without removal, whether above or be- low the pubis, is out of place, barring a few des- perate dying cases ; while some forms of salpingitis, especially streptococcus infections of puerperal ori- gin, are most safely treated and Amoxicillin 500 Mg many are most suc- cessfully cured by vaginal operation. Early cases of salpingitis, especially puerperal, may be managed without sacrifice of tissue through the posterior vaginal incision. Bad pus tube Generic Trimox cases, Buy Amoxicillin especially of gonorrhceal Trimox Indications origin, bear radical operation well, and yield a lower mortality than extensive suppurations of the pelvis due to appendicitis. The principles of operative treatment are the same, and consist of skillful walling off with gauze, gentle removal of pus with gauze, removal of diseased parts, and drainage in tube cases whenever the integrity of the bowel wall has been invaded; in appendix cases, whenever pus outside the organ or rupture, or gangrene has appeared. 1831 Chestnut Street. October 17, 1903.] OUR SUBSCRIBERS' DISCUSSIONS. 751 #ur Subsmbers' i!liscussrons. A SERIES OF PRIZE ESSAYS. [Questions for discussion in this department are an- nounced at regular intervals. So Amoxicillin Amoxil far as they have been decided uf'on, the further questions are as follows: XXVI. — How do you treat "habitual abortion"? (Un- der adjudication.) XXVII. — How do you treat paraphimosis? (Under adjudication.) XXVIII. — What do you rely on in the diagnosis of small- pox in the papular stage? (Answers due not later than November 10, igios.) Whoever among our subscribers (with the limitations mentioned beloiv) answers one of these questions in the manner most satisfactory to the editor and his advisers will receive a prise of $2$. No importance whatever will be at- tached to literary style, but the award will be based solely on the value of the substance of the answer. It is requested (but NOT REQUIRED^ that the answers be short, if practicable, no Buy Trimox Online one answer to contain more than si.r hundred words. Only subscribers to the New York Medical Trimox Dosage Journal and Philadelphia Medical Journal (including regular and volunteer officers of the Medical corps of the United States Army, Navy, and Marine Hospital Service, commissioned or under contract) ivill be entitled to compete, and all per- sons l;nown to be engaged in medical journalism are dis- qualified. This price will not be awarded to any one person more than once within one year. Every answer Trimox 500 Mg must be ac- companied by the writer's full name and address, both of which we must be at liberty to Trimox 500 publish.] The price of $25 Where Can I Buy Amoxicillin for the best essay submitted in answer to question XXV has been awarded to Dr. I. R. Clemens, of Amoxil Trimox St. Louis, ivhose article appeared in Where To Buy Amoxicillin our issue for October loth. PRIZE QUESTION NO. XXV. THE TREATMENT OF DELIRIUM TREMENS. (Concluded from page 707.) Dr. Dudley Fulton, of South Bend, Ind., ivrites: The essential indications in the management of acute alcoholic insanity or delirium tremens are: I, Withdrawal of alcohol as speedily as the condi- tion of the patient permits ; 2, To improve by fre- quent feeding the impoverished nutrition induced by the accompanying gastritis ; 3, To produce sleep. The patient should be put to bed in a quiet, darkened room. The mild, coaxing restraint of a nurse is always to be preferred to mechanical Buy Trimox or other re- straint. The use of alcohol is harmful, and should be discontinued at once, except in old and debilitated persons, and in those in whom circulatory failure and threatened collapse are not easily controlled by other stimulants Trimox 500mg and heart tonics. The second in- dication, feeding the patient, is important. The nutrition of these patients is usually gravely poor, incident to the long continued anorexia, gastric in-

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