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sulphate. The use of magnesium sulphate as a ther- apeutic agent in tetanus was suggested by the dis- covery by Dr. S. J. Meltzer of the marked action of this salt, when applied to nerve-tissues, in inhibit- ing both afferent and efferent impulses. As noted in the Medical Record of December 16, 1905, Meltzer found that one cubic centimeter of a 25 per cent, solution of magnesium sulphate to every twen- ty-five pounds body weight was sufficient, when in- jected into the spinal canal, to produce surgical an- esthesia. Absorption from the spinal canal, however, is fairly slow, and definite action upon the nerve- trunks may be obtained, while the general effects upon the higher centers may not manifest themselves for several hours or may be wholly absent. In the case of lumbar injections into the subdural space, magnesium sulphate acts directly upon the nerve- trunks at the site tenormin iv of injection, and as it diffuses it- self upward along the cord its paralyzing effect extends to the trunk and upper extremities, dimin- ishing, however, in intensity as it progresses. Age and sex appear to have a direct bearing upon its action, and Dr. Blake thinks that, so far as is known, children are the most susceptible, and women more so than men. Up to purchase tenormin the present time but four cases of tetanus have been treated by this method, so that it is far too early to dogmatize as to the effect of magnesium sulphate on the course of tetanus. Dr. Blake's im- pression of the drug is that, although we cannot be certain of its effect, yet it is reasonably safe and offers us a means of modifying the convulsions and of relieving pain more satisfactorily than any other drug. Moreover, it produces anesthesia, which may be taken advantage of for intraneural or other in- jections of tetanus antitoxin and for local treatment of the site of the infection. JEJUNOSTOMY FOR THE HYPEREJVIESIS OF PREGNANCY. Hyperemesis of pregnancy is a condition for which an untold number of remedies have been suggested, the most effective of which seem to be those which are directed to the eliminative channels of the body, for undoubtedly the largest proportion of cases are due to autointoxication. But there are instances in which the cause for the disturbance is not a toxemia proper, and a nervous element is probably at fault, which, for want of a better name, has been called a gastrointestinal hysteria. In addition to these there is another class of cases in which some disease of the stomach is present, and the vomiting which is cheapest tenormin caused tenormin 25 by the latter is greatly aggravated by the advent of the pregnancy. An instance of this kind is reported by Brunon and Jeanne (Bulletin medical. No. 55, 1906), in which the patient for the period of a year had been subject to attacks of repeated and rebellious vomiting, which became greatly ag- gravated by an unrecognized pregnane)'. On ac- count of the progressively increasing emaciation a jejunostomy was suggested and carried out, with an immediately favorable result. This continued for a period of six weeks, during which the pregnancy was diagnosed, and then the patient withdrew from observation. Apparently uncared for, the vomiting returned, and then the uterus was emptied, but the Oct. 20, 1906] MEDICAL RECORD. 619 patient died from e.xhaustion shortly after. The favorable result which attended jejunostomy in this instance is, of course, insufficient to recommend the operation as a routine in such order tenormin cases ; but the fact that the symptoms completely disappeared after it was done is noteworthy, and the procedure may be carried out with comparatively little shock to the patient, if necessary, under local anesthesia. Although the performance of jejunostomy is a very radical suggestion, the fact ijiust be borne in mind that the induction of abortion is, in advanced hyperemesis, an operation which only too often results fatally for the mother, while, as already noted, a jejunal fistula may be produced with com- paratively little shock. As the vomiting usually stops spontaneously at or before the sixth month, the patient may thus be tided over by this means, and the sacrifice of the child's life not rendered necessary. Arteri.'XL Disease AFTER Adrenalin Injections. It has been found that the intravenous injection of adrenalin in rabbits may be followed by extensive change in the aorta and the larger vessels. This has been determined to consist of a localized destruction of the smooth muscle fibers of the media, accompa- nied by a rapid calcification and other characteris- tic alterations in tlie elastic-tissue elements. This results in a tenormin online narrowing of the lumen of the vessel and a diminution in its elasticity which is subsequently followed by a compensatory new growth of elastic fibers and of muscle and endothelial cells in the in- tima. Finally there is produced as the net result of these changes a series of aneurysm-like bulgings of the vessel wall. The adventitia and the vasa vaso- rum do not seem to be involved tenormin syrup in the process at any time. Erb, who presents a very interesting com- munication on this subject in the Archiv fi'ir experi- mentalle Pathologic mid Pliarmakognosie, Vol. 53, 1906, claims that these findings show there is no actual similarity between this condition and the arte- rial sclerosis which is found purchase tenormin online in the human subject. There is no sclerosis in the sense cheap tenormin of a thickening due to proliferation of the intima nor an atheromatous process. But there is apparently an analogy between the condition described in the rabbit after intra- venous adrenalin injection and the calcification of the media as found in the large arteries of the ex- tremities in man. Erb believes that this vascular disturbance is not due to buy cheap tenormin an increase in blood pres- sure or to nutritive changes brought about by spasm of the vasa vasorum, but is due rather to a direct toxic effect of the adrenalin on the smooth muscle cells of the vessel w^all. Oatmeal Diet in Diabetes. A few years ago von Noorden made the suggestion that oatmeal in large quantities be given to patients suffering from severe diabetes, and claimed that by this means the glycosuria and acidosis were favor- ably influenced. The oatmeal was cooked with but- ter and water, and then an egg albumin preparation was added, so that the patient received about 3,000 calories and a sufficient amount of albumin to satisfy the albuminoid demands of the body. Lipetz (Zeit- schrift fi'tr klinische Mediziu, Vol. 56) has made some further tests of the method, giving oatmeal to a patient who was free from any glycosuric symp- toms. An examination of the feces disclosed a large increase in the number of the bacteria, pointing to greater intestinal fermentation. In another case, a severe one of diabetes, the diet was absolutely with- out eft'ect — on the contrary the sugar excretion and the acidosis were increased. In a less advanced case the sugar was increased, but the acidosis dimin- ished. Other cases were subjected to the same re- gime, but without attaining the good results claimed by von Noorden. In explanation of this fact Lipetz suggests that the favorable effects obtained by the originator of the diet scheme in question were due to the nonabsorption of the ingested carbohydrates, although the latter had been taken in such large amounts. This is tenormin tablet simply another instance in which the contentions of one man, here seemingly rather extravagant, fail to be substantiated by another under apparently similar conditions. Strabismus and Epilepsy. We have learned in the last few years a great deal about the influence of visual disturbances on the production of functional diseases, until there are but very few left which fail to come under order tenormin online this cate- gory in some form or other. Prof. Schoen of Leip- zig {Wiener klinischtherapeulische Wochenschrift, September 9, 1906) is convinced that there is also a direct connection between vertical squint and epi- lepsy, and claims to have found this defect in a large percentage of the inmates of a German institution for epileptics. In addition to the epilepsy there were other symptoms, such as migraine, vertigo, nausea, gastric and cardiac complaints, neurasthenia, and hysteria, which are often associated with eye dis- turbances. Epileptic convulsions are known to be due to cerebral irritation, and Schoen claims that in uncomplicated cases the generic tenormin irritation is due to eyestrain, usually that due to vertical strabismus of congenital origin. The constant effort on the part of the child to bring the visual axes into the same plane results in a condition of tension which in the course of time brings tenormin 25mg about nervous disturbances of an intermittent explosive character and permanent changes in the brain. Schoen believes that proper glasses will in such cases bring about a total cure, but they must be applied early, as soon as the true condition is de- termined, and must be worn constantly. Southern Medical Association Organized. — After an existence of eighteen years, the Tri-State Medical Association of Tennessee, Alabama, and Georgia, at its last meeting, held at Chattanooga on October 5, relinquished its charter, and was buy tenormin online replaced by the Southern Medical .Association. The new organization comprises Mississippi, Tennessee, Georgia, buy tenormin Alabama, Florida, and Louisiana, and it is expected that the Carolinas and Kentucky will ulti- mately be tenormin 25 mg included. The newly elected officers are : President, Dr. H. H. Martin of Savannah, Ga. ; First Vice-President, Dr. Mack Rogers of Birming- ham, Ala. ; Second Vice-President, Dr. J. B. Cowan of Tullahoma, Tenn. ; Third Vice-President, Dr. J. R. Tackert of Meridian, Miss. ; Secretary, Dr. Ray- mond Wallace of Chattanooga ; Treasurer, Dr. Y. L. Abernathy of Chattanooga. Yellow Fever in Cuba. — Three new cases of yellow fever have been reported from Havana, and several others have appeared at Cienfuegos and Guines. Vigorous measures have been taken to prevent the tenormin 50mg men of the Marine Corps from becom- 620 MEDICAL RECORD. [Oct. 20, 1906 ing infected. Ten barrels of oil of citronella have been sent to Cuba, and every marine on guard duty will be supplied with a bottle of this oil to be used in protecting himself against mosquitos. All the marines in Cuba are supplied with mosquito netting for their beds, and head nettings are also available for their use. Water filters tenormin atenolol have also been sent to Cuba, and the officers in the island have been urged to caution the marines against the use of unfiltered water.

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