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following descent there occurs also a rise of Cefaclor Price five to ten millimetres of mercury in the diastolic pressure. Again, during flight there is a stage of lowered dia- stolic pressure, and after descent a diminution Order Cefaclor Online of as iviuch as twenty millimetres in the systolic pressure, which may persist an hour. The cardiac hyper- trophy may logicallv result from the stages of ele- vation of the systolic and diastolic pressures, but lowered pressure might also be a cause, repeated artificial hvpotension in rabbits having been ob- served to induce marked cardiac enlargement. End Results of Ovarian Conservation. — J. O. Polak (American Journal of Obstetrics, August, ii)i8) states that in a series of 132 hysterectomies with retention of one or both ovaries, Purchase Cefaclor the influence of the ovarian secretion on the nervous mplimina of the operative menopause was found to depend Cefaclor Ceclor on the general health Cefaclor Tablets of the patient and on whether the uterus was removed for fibroid or inflammatory disease. The symptoms are less after extirpation for Buy Cheap Cefaclor pelvic inflammation than for fibromyomata. Thev are more marked if the patient is operated upon in comparatively good health, with a high pre- operative blood pressure, than when the blood picture shows anemia or toxemia. A conserved ovary, if unhealthy, will leave the patient in a worse state mentally, nervously, and physically, than if total extirpation had been done. Case records of over 300 patients followed for five years show that the average life of the ovarian function after the uterus has been removed is not over two years, and that within that time flushes, dizziness, and pre- menstrual pain occur in the large majority of cases. Ovulation without menstruation has little psychical value. In inflammatory conditions requiring radi- cal pelvic surgery the contiguous inflammation re- sults in a cicatricial thickening of the tunica albuginea, which promotes the formation of reten- tion cysts, increased weight of the ovary, and pro- lapse. In fibroid tumors circulatory stasis is a con- stant concomitant, and likewise leads to thickening of the tunica Cefaclor Mg albuginea. Furthermore, removal of the uterus itself causes disturbance of ovarian cir- culation and innervation. Pathological studies after reoperations in seventy-three cases in which one or Cefaclor 500mg both ovaries had been conserved showed the fol- lowing ovarian lesions : multiple cystic Cefaclor Monohydrate changes ; cirrhosis ; cystic formation ; infection, and thin walled cyst with dense adhesions. Routine con- servation of ovaries without due consideration of the ovarian and contiguous pathological conditions in the individual case is not good teaching. Re- generation of Purchase Cefaclor Online the conserved ovary depends largely on the type and duration of the existing infection and the condition of the tunica of the individual ovary. Even when the most delicate technic is ob- served the ovarian circulation is impaired. The retained ovary without the uterus is always a focus for possible trouble. Streptococcic Infection in Wounds. — Plisson, I.. Ramond, and J. Pernst (Pressc medicate, Au- gust 1, 1918) assert that streptococcic infection may be suspected in all wounds that Cefaclor Antibiotic are not pro- gressing favorably. Bacteriological examination, however, is alone decisive. Examination of a smear is insufficient, for the organisms are but rarely disposed ii' chains in the wound secretions. A liquid culture is therefore necessary — preferably a mixture of four parts of ordinary bouillon with one part Order Cefaclor of Sacquepee's soda albumin. In this elective medium the Cefaclor Generic streptococcus shows Cefaclor Generation chains within three hours in eighty per cent, of cases and within six hours in ninety per cent, of cases. In- oculations should also Cefaclor 250mg always be made on an agar slant, in the water of condensation, and in Veillon agar, in order to ascertain the associated aerobic and anaerobic flora as well as to confirm the pres- ence of the streptococcus. Occasionally the wound discharges fail to show streptococci. Here the Cefaclor Cost organisms are present only within the tissues them- selves. Negative reports are thus not conclusive, and must not be relied on as absolutely excluding streptococcic infection unless repeatedly obtained. In the treatment, the authors dissent from the view of Gross Cefaclor Cd and Tissier that, after primary suture of a wound, discovery of streptococci in it indicates immediate section of the sutures. In a number of such cases they allowed most of the sutures to re- main in spite of the intensity of the inflammatory reaction, and no untoward results followed. In most instances the tissues kept in apposition till the tenth or twelfth day united by first intention. In wounds left widely open, the object during the first few weeks should Buy Cefaclor Online be to favor elimination of dead tissues and combat the streptococcic as well as sec- ondary infections. All antiseptics, however, includ- ing Dakin's solution, are powerless to overcome the streptococcus. Repair by granulation is obtainable, with silver nitrate cauterization of exuberant gran- ulations, occasional dressing with ointments, and heliotherapy. The period o.f recovery can be Cefaclor Antibiotics short- MISCELLANY FROM HOME AND FOREIGN JOURNALS.

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