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layed rash, although rather rare, is given as an example. The ofttimes close similarity in appear- ance of a streptococcus patch to that of the true Klebs-Loeffler membrane on the tonsils needs but to be mentioned. Even syphilitic patches may be confounded with both. My object in this paper is not to present any new theories or set of facts, but to call the atten- tion of throat specialists more closely to an inter- esting condition which is occasionally observed. Fig. II. — Koplik's eruption on the mucous membrane of the left cheek of the case illustrated in Fig. I. the mechanical introduction of the wooden tongue depressor as almost to prevent temporarily an in- terpretation of their real nature. The patient who furnished the accompanying pictures was a child five years of age, an inmate of the Massachusetts Charitable Eye and Ear In- firmary. He had been directly exposed to the contagium. A slight, infrequent, but gradually increasing cough was noticed eight days, the first Koplik spots three and one-half days, symptoms or coryza two daj's, and moderate temperature one day, before any eruption on the skin. The cough was the rather hard, dry, hoarse laryngeal cough almost peculiar to the condition. As measles is perhaps the commonest of the infectious diseases of childhood and very few in- dividuals arrive at adult age without having had an attack, the necessity of an early diagnosis for quarantine purposes cannot be emphasized too strongly. The Koplik eruption practically re- moves the greatest element of uncertainty in the early diagnosis, hence there can be little excuse for the continued and wide extension of the dis- ease. THE MEDICAL MUSEUM.* By D. BRYSON DELAVAN, M.D.. NEW YORK. In every great metropolis peopled by men of su- perior intelligence the museum is a preeminently well-recognized institution. Thus, the treasures of art and science contained in the British Museum and the Louvre, in the Museum of Northern Antiquities of Copenhagen, in the vast collections of Vienna, Berlin, Venice, Florence, Rome, Naples, Seville, and New York constitute at once order singulair online the chief orna- ments of these respective cities and one of the most potent of their educational factors. Among the various departments of science thus represented medicine has by no means been neglect- ed. All great cities which by any courtesy can be called centers of medical learning have their medical museums. Washington, Philadelphia, Boston, not to speak of many of the cities of the old world, have famous collections, too well known to you to require mention. Strange to relate, our city, the greatest and most progressive of them all, has prac- buy cheap singulair tically none. For many years it has been my hope that a collection worthy of the fame and wealth of New York might be established buy singulair here. Thanks to the gentleman now in the presidential chair of the Academy of Medicine, the initiative in this direction has been taken, for he has recognized the possibili- ties of the situation, and bv his own generous exam- ple and by the inspiration of his enthusiasm has opened the way for us to follow him in the accom- plishment of this important work. Should any question arise as to the value of the suggestion which he has generic singulair made, it may easily be an- swered. A collection singulair price such as is proposed for the Academy of Medicine has the same reason for its existence as has that of the Historical Society, or even the written pages of history itself. ♦Remarks on the presentation of a collection of laryngo- logical instruments to the New York singulair online Academy of Medicine, October 4, igo6. Oct. 20, 1906] MEDICAL RECORD. 613 To be of use our collection should represent levocetirizine montelukast a truthful record of the past. Its scope, for the pres- ent at least, should be mainly historical. It should include old instruments, most especially such as have been original models of new inventions or as offer good examples of standard instruments of the time. Many good specimens of this kind are now available which in a few years will be surely lost. Again, old prints and illustrations representing the men, the methods, and the customs of our pro- fession in the past will have great and ever-increas- ing value. Without such a collection a great library would certainly be incomplete. Finally, while the shelves of a practical working library should never be encumbered with obsolete trash, there are certain classes of ancient books which are of almost priceless value, for many rea- sons besides purely sentimental ones. Many of the objects contained in such a collection would be unique. If lost they could not be replaced. Their permanent preservation, therefore, is a matter of vital necessity. As to the functions of our museum, the speci- mens which it presents may be lively reminders of great men, and therefore worthy of contemplation. They are, moreover, mementoes of notable achieve- montelukast tablet ments, full of inspiration to the thoughtful mind. Again, marking the advance of knowledge, they are milestones in the onward progress of medical sci- ence. Practically studied, the objects which the museum contains may be divided into two classes, namely, the good and the bad. It goes without saying that the suggestions to be gained from a good model will always be valuable, not onlv in the department for which the given article was intended, but, occasion- ally, in other departments possibly remote from it. No warning, on the other hand, is more eloquent than the spectacle of failure. The exhibition of the mistakes of others should certainly tend to prevent their repetition. Finally, the settlement of questions of priority of invention is a matter of no small moment. Aside from personal questions involved, the fact that an instrument of ancient invention has been lost to sight is often owing to the reason that it was not singulair mg well adapted to the end which it was intended to serve. To revive such a model every few years under a new name is to confuse the mind of the profession and seriously to hamper progress. In- struments which to-day are bearing names contem- poraneous with our own have been found among the ruins of Pompeii, and may readily be seen in the Museum of Naples. For the furtherance of the various above-men- tioned ends and of others which montelukast price may reasonably occur to you, the collection proposed will be of great value. Other institutions having the proper facili- ties for so doing may establish museums of anatomy, biology, or pathology. W ith us such a course may not at present be open, either through favorable op- portunity for collecting or through available exhibi- tion space. There is plenty of room, however, for rare old books, for instruments of the right kind, and for interesting historical plates. If each one of us will do what he can as opportunity affords, that space mav soon be most satisfactorily filled. With myself this has been a long-cherished idea. In furtherance of it, I take pleasure in depositing the accompanying instruments, the beginning of a collection to which I hope from time to time to add, until it shall well represent the history of the early days of laryngolog}'. DRIED TETANUS ANTITOXIN AS A DRESSING FOR WOUNDS. By J. J. KINYOUN. M.D.. Ph.D.. GLENOLDB.S, PA. Some observations on the use of tetanus antitoxin in a dried and powdered form as a dressing for wounds have been made which seem to justify its mention. It may be mentioned that Calmette' pub- lished a note giving his experiences with purchase singulair online dried tetanus antitoxin in powdered form as an application to wounds infected with tetanus. I have confirmed his experiments, but have little or no success in preventing tetanus in the case of deep or penetrating wounds. In these, the preventive power of the pow- der is only slight, and in most cases its application is without effect. It occurred to singulair tablets me that it would be good practice to apply this powdered antitoxin to the minor in- juries, with a view of preventing tetanus, as many of the montelukast tablets wounds were contaminated with dirt. Many such injuries have come under observation. These consist of abrasions, or incised, contused, and lacer- ated wounds, and also a number of suppurating wounds. None of these, however, was to be con- sidered of a serious nature ; but not a few, such as injuries to the hand, were sufficient to keep the patient from work. Instructions were given that all such wounds were to be treated buy singulair online in the usual manner with addition of the powder. After quite a number of these injuries had been treated in order singulair this manner, it was quite evident that they healed more rapidly and with less disturbance than had been previously observed in those treated in the ordinary way. Since then a more careful supervision has been kept, and it has cheap singulair been demon- strated beyond question that the powdered serum was responsible for good results. A number of infected wounds also, due principally to vaccination and furunculosis, have been treated in like manner. The inflammation subsides, granulation occurs, and healing rapidly follows. One observation has been made on an operation for hypertrophy of the mucous membrane of the nose. The first operation was done in the usual manner, and it required three weeks before the wound healed. A second operation became neces- sarv. The nasal cavity was insufflated twice daily with the powdered tetanus antitoxin, and the wound healed within a week. Whether singulair cost this will follow in other cases remains to be seen. It is, to say the least, quite suggestive. No injuries of major char- acter have been observed, so it cannot be deter- mined what effect the dried serum would have on these. The results which have followed the application of purchase singulair dried serum to the wound show very conclu- sivelv that it possesses qualities other than its spe- cific body, the antitoxin. montelukast sodium tablets This must be of the nature of an immune body, which, when brought in conjunction with the serum or cells in the wound, becomes bactericidal. It may be that normal serum^ possesses this qual- ity and is not due to the serum of an immunized animal. It is believed, however, that, as a rule, we should expect to have better results from the serum

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