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should consist in caring for any condition that is found to be interfering with the patient's general health. Every organ in the system that may possibly be diseased should be investigated. Gouty, rheumatic, or lithemic condi- tions should all receive proper treatment. The writer has found the digestive apparatus to be one of the most frequent sources of poison to the general system. After the general practitioner has corrected any special dis- ease, the writer prescribes alteratives, tonics, and a free quantity of alkaline water, especially lithia water. The general tonics indicated are iron, quinine, strychnine, and gentian. The condition of each patient will indicate which of these tonics is demanded. Exercise in the open air is essential. Associated ocular diseases also require attention. The errors of refraction and accommoda- tion must be corrected. The writer believes that the wearing of a proper lens does more than any other remedy for low-grade inflammations of the uveal tract. Such patients should use their eyes sparingly, for the cataractous eye is a diseased eye and where to buy synthroid it needs rest. The writer believes that the preventive phase of cataract treatment has not yet come in for its share of attention from competent men. — Gaillard's Southern Medicine. Oct. 20, 1906] MEDICAL RECORD. 617 Medical Record. A Weekly Journal of Medicine and Surgery. THOMAS L. STEDMAN, A.M., M.D., Editor. PUBLISHERS WM. WOOD iL 00., SI FIFTH AVENUE. New York, October 20, 1906. FRUIT AS A FOOD. Of late years much has been written concerning vegetarianism. Not only has the literature on vege- tarianism been extensive, but many have adopted its principles and have lived on a diet from which meat has been excluded. buy synthroid In Great Britain this practice has had and still has a great vogue, cost of synthroid so much so that vegetarian restaurants flourish in many cities, and especially in London. Some physicians, too, in Eng- land advocate the exclusive use of a diet devoid of meat, arguing that it is healthier than the ordinary diet to which civilized individuals have been accus- tomed for many centuries ; and they point out that the Roman soldiers subsisted chiefly on food com- posed mainly of fruits and that the Japanese of the present day are more or less vegetarians. In a pamphlet reprinted from the Year Book of the Department of Agriculture for 1905, Dr. C. F. Lang- worthy of the Office of Experiment Stations deals with fruit and its uses as food in a comprehensive and interesting fashion. The composition of various fruits is discussed, and a table is given in which will be found the average composition of fruits and fruit products. These data show that fresh fruits are in general dilute foods — that is, the proportion of water which they contain is large compared with the total amount of nutritive material. In the majority of fruits and fruit products the carbohydrates are the food constituents most abundantly represented. The proportion of nitrogen-free extract varies greatly, being lowest in the fresh and highest in the dried and preserved fruits. The principal sugars in fruit are cane sugar, grape sugar (glucose), and fruit sugar (levulose), the last two, designated in- vert sugar or reducing sugar, being usually present together in equal quality. The acid in fruits varies within rather wide limits, i to 2 per cent, being re- ported on an average in synthroid tablets such fruits as apples, pears, plums, strawberries, etc., and as high as 7 per cent, or more in lemon juice. Extended investigations were undertaken at the California Experiment Station by Prof. M. E. Jaffa, the work as a whole being carried on in cooperation with the nutrition investigations of the office of ex- periment stations. Studies were made with persons who had subsisted on a fruit diet for many years and with persons who were accustomed to a vege- tarian and to an ordinary diet. These individuals were of different sexes and ages. The results ob- tained from the first series of studies which were made on women and children showed a range, cal- culated on the basis of amounts eaten per individual per day, of 47 to 80 gni. of protein, and 1,850 to 2,805 calories of energy, the cost of the daily food ranging from 21 to 55 cents per individual per day. In the next series of studies young and old men were the subjects of the experiments, and it was found that the protein supplied bv the daily diet ranged from 40 to 85 gm. and the energy from 1,712 to 3,305 calories, the average being 62 synthroid cheap gm. and 2,493 calories, the cost ransring from 18 to 47 cents per person per day. These studies covered from twenty to twenty-eight days, and the daily food consisted of diflferent combinations of fruits and nuts, of which the following day's ration may serve as a sample : 475 gm. apples, 1 10 gm. ban- anas, 850 gm. oranges, 5 gm. dates, 2 gm. honey, ID gm. olive oil, 55 gm. almonds, 70 gm. pine nuts, and 50 gm. walnuts. The result of generic synthroid these investiga- tions was to show that, while they were too limited to warrant the foundation of any very definite con- clusions, the statement might be confidently made that fruit and nuts should not be looked upon sim- ply as food accessories, but should be considered a fairly economical source of nutritive material. Experiments were also conducted by Professor Jaffa to determine the digestibility of fruit, and al- though sufficient data have not been gathered to justify dogmatic statements in regard to this point, enough, he says, has been done to show that they are thoroughly digested and have a higher nutritive value than is popularly attributed to them. With respect to the relative digestibility of different fruits, evidence is too scanty to make any exact statements, but apparently stomach digestion is influenced by the nature of the fruit and its stage of ripeness. Beaumont states that mellow sour apples require two hours for digestion in the stomach, and mellow sweet apples ninety minutes. Another observer has synthroid mg noted that about five ounces of raw ripe apple re- quires three hours and ten minutes for digestion in the stomach, but states that if the fruit is unripe, and consequently contains a high proportion of cellu- lose, a much longer time mav be required, .'\pples are viewed, from an economical and nutritive stand- point, as the best of all fresh fruits, especially when synthroid buy online eaten uncooked, while of dried fruits dates and rai- sins rank the highest. The conclusions reached as a result of the studies were that, in general it may be said that fruits are wholesome, palatable, and attractive additions to our diet, and may be readily made to furnish a consider- able part of the nutrients and energy required in the daily fare. Fresh : uits are dilute foods and closely resemble green vegetables in total nutritive value, but dried fruits and many preserves are much more concentrated, comparing favorably with some of the cereals and other dry vegetable foods in the amount of total nutrients and energy which they supply per pound. Characteristic chemical constitu- ents of fruits are carbohydrates, and so they are nat- urally and properly used in a well-balanced diet to supplement foods richer in protein, such, for exam- ple, as cereal grains, legumes, nuts, synthroid price eggs, dairy products, meats, order synthroid and fish. Intelligently used, fruits constitute a most valuable part of a well-balanced diet and may profitably be eaten in even larger quan- tities than they are at present by the majority of mankind. 6i8 MEDICAL RECORD. [Oct. 20, 1906 THE TREATMENT OF TETANUS. In the Annals of Surgery for September are two articles on the treatment of tetanus. The first of these deals with the therapeutic vahie of the anti- toxin treatment of tetanus and is written by Dr. Nathan Jacobson of Syracuse, N. Y., and Dr. Herbert D. Pease, Director of the Antitoxin Labora- tory, New York State Department of Health. It is pointed out that the bacillus of tetanus can develop but little, if at all, below 60° F., which, it may be assumed, accounts for the fact synthroid mcg that the organism is more active during the summer months. Another important point referred purchase synthroid to by the authors is that the bacillus is a frequent habitant of the intestinal tract of animals, especially of horses and cattle, and consequently all wounds received in stables or con- taminated with animal discharges are particularly to be feared. Again, tetanus can readily follow unclean surgical procedure, and therefore a sufferer from order synthroid online tetanus should be completely isolated from all other surgical patients. After describing at some length the conditions of infection, the distribution of the tetanus bacillus in the body, the period of incubation, and the relation of the toxin to the buy cheap synthroid nervous system, the authors pro- ceed to discuss treatment by tetanus antitoxin gen- erally. Stress is laid upon the fact that antitoxin, to be of the greatest service, must be administered be- fore the motor nerves have absorbed any toxin. Therefore the serum should be administered as soon after the infliction of the injury synthroid online as possible and should be given to every person who has sustained an injury in which dirt, manure, or other foreign substances could possibly have been carried into the wound. Injuries involving the nerve-trunks should be treated with antitoxin locally as well as sub- cutaneously, in order to prevent the direct absorp- tion of toxin by such injured nerves. For this pur- pose either liquid or dried antito.xin is suitable. As to the special purchase synthroid online methods of injection, the intracerebral method has nothing particularly to recommend it, in the opinion of the authors, nor is it free from danger. The injection of antitoxin into the subdural space finds little favor, while it is pointed out that the attempt to neutralize the toxin present in the large nerve trunks by the injection of antitoxin into them probably only prevents the absorption synthroid levothyroxine for the time being, and it is even doubtful whether it is possible to neutralize any considerable portion of the toxin in a given nerve by intraneural injections. The conclusions come to by Drs. Jacobson and Pease are that, as a prophylactic measure, the in- jection of antitoxin merits our fullest confidence, but as regards the treatment of tetanus after the disease is fully established, we are forced to admii synthroid cost that as yet no method has been discovered whereb> it can be administered so as to reach effectively the toxin not free in the blood or lymph. In the au- thor's review of cases of tetanus treated by anti- toxin it appears that subcutaneous injection was the method most generally used and that the mortality price of synthroid of the patients who were thus treated was less than that resulting from other methods. The second article relating to the treatment of tetanus is by Dr. Joseph A. Blake of New York, and treats of the therapeutic virtues of magnesium

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