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ately sealed in the presence of a witness and expressed to us. A copy of the prescription was asked for and obtained, which proved to be an accurate transcript of the prescription, bearing date Zetia Discount Card and number correspond- ing to those upon the label of the bottle dispensed. Upon examination the content of said bottle was found to be a fluid differing materially from , so as to be obviously recognizable as a plain violation of the physician's prescription. " Another written order for was sent to Drug- gist . Upon examination this proved likewise Zetia Coupons to have been filled w-ith a different and inferior fluid. " Subsequently, the same day, a messenger was sent to and asked verbally for four ounces of . He received a wrapped vial, Price Of Zetia for which he paid fifty cents. This bottle was found without label, and the messenger returned and asked to have the bottle la- belled. The druggist then simply labelled it with the name of the firm's preparation. Thereupon, the messenger requested the druggist to put 'all the name on the bottle.' The druggist told the messenger that he 'would not dare to put the firm's name on the label, although it was all the same.' The druggist finally admitted to the messenger that he was 'out of" the particular article and then returned the fifty cents. •■ There is one significant fact that should also be mentioned: the price charged in these cases (as in every instance coming to our knowledge) is the same as the patient would be charged by pharmacists who dispense the genuine medicine ordered. Comment is unnecessary. " In defence of our own rights, and in order that you may take such means as you deem best to protect Zetia Prices yourself and your patients, we advise you of these facts. We further respectfully request that in pre- scribing you will kindly send the prescription to pharmacists, of whom there are many, who will faith- fully respect their legal and professional obligations to physicians and to the public." The Pharmamitical Era, in commenting upon this miserable business, makes the following sensible re- marks : '"We fail to comprehend what a druggist is think- ing of when he permits such practices behind his pre- scription counter. Where is the profession of phar- macy drifting to if it has gotten to that point that a physician cannot depend upon a druggist filling his prescriptions with what is Buy Zetia ordered.' We should dis- credit these reports if they came from a less responsi- ble source. Such practice if continued will work un- told injury to the credit and standing of the entire pharmaceutical profession. Physicians are constantl)- claiming that Buy Zetia Online one of the principal reasons why they handle their own medicines is that they are then sure of what they are administering. Any such wholesale accusation against the integrity of druggists is as un- just as it is untrue. There are thousands of consci- Zetia Hair Loss entious, upright, honorable pharmacists, who would no more think of substituting in a prescription than they would of trying to pass a counterfeit bill. It is unfor- tunate that reflection must be cast upon these honest druggists by the acts of their unscrupulous brothers, but all of this hue and cry on the part of manufactur- ers about substituting cannot be ignored. Where there is so much smoke there must be some fire. " Every honest druggist owes it to himself and his profession to speak plainly on this subject. He should adopt the most strict rules for his own establishment, improve every opportunity to condemn the practice of substituting, and see that resolutions to this effect are passed by his local. State, and national associations. Each druggist should make it a point to give his phy- sicians and his customers to understand that when a prescription comes into his establishment it is filled with exactly what it calls for. There can be no mid- dle ground, no compromise, no question on this point. Physicians who pre.scribe them and the manufacturers who make the Zetia Cheap goods must have no good cause for such complaints. The honor of the drug trade demands that this stigma be removed. It is not a question of dollars and cents alone, but professional honor is at stake, and we know that every honest pharmacist will join with us in the statement that the druggist who l62 MEDICAL RECORD. [AuOrUSt I, 1896 substitutes in his prescriptions is a disgrace to his profession." Aside from the question of fair dealing between man and man, of ordinary justice in trade, and com- mon honor in protecting the consumer, this outrageous practice of substitution not only tends to distrust of the one in whom every confidence should be placed, but is a direct menace to the skill of the physician and the faith he may have in well-tried drugs. Further than this, the very life of the patient may hang upon the culpable waste of time that a substitution may en- tail or the substitution may eventually cheat the in- nocent sufferer of the only chance of ultimate recovery. Thus the physician becomes more than interested in the exposure of such nefarious practices. Every re- spectable pharmacist in any community owes it to himself by word and deed to frown on the culprits and to lend his efforts in exposing their fraudulent pro- ceedings. When the latter have been discovered no pains should be spared to make What Is Zetia the facts known, either by disciplinary action on the part of boards of phar- macy or by suits at law. The advice to patronize only such as are known to be honest is Zetia Discount perfectly sound. In the end we must narrow ourselves to this. There is nothing to prevent every physician who wishes to claim his rights in the premises from advising his pa- tients to patronize such pharmacists as he has good reasons for believing are above the usual temptations of fraudulent dealings. There are plenty such and these only should be encouraged. When a .substitutor is discovered he should be blacklisted once and for all. His very act, being deliberate, cold-blooded, and inexcusably dishonest, places Zetia Coupon him beyond the pale of possible repentance. He is the spotted leop- ard who cannot live without his skin. FRAGILITAS OS.SIUM IN THE INSANE. A FAVORITE theme for the sensational newspaper writer is the abuse of the insane by asylum attendants. It is assumed as unnecessary of demonstration that the latter are brutal by nature and still further hard- ened through contact with lunatics and observation of the many wiles and treacheries of these -poor suffer- ers. The specific charges of cruelty are often based upon the occurrence of fractures or of ecchymoses dur- ing the struggles of a patient to escape from his keep- ers for the purpose of committing some act of vio- lence. It is assumed as matter of course that no such accidents can occur except as the result of unjustifia- l)le violence. Zetia Online But the facts are the oih^^r way, for daily Cost Of Zetia obser\ation shows that it requires but a slight traumatism to produce ecchymoses in the insane, and a pressure on the skin no greater than that associated with the force necessary to prevent the escape of the patient may result in covering him with black and blue spots. From the same cause, the lowered nutri- tion in the insane, the bones may become exceedingly brittle and liable to fracture, as the result of almost inappreciable factors or even spontaneously. At the meeting of the .\merican Medico-Psycholog- ical Association, held last year in Denver, Dr. H. f. Eyman, of Toledo, reported a case of this nature which barely escaped being made the subject of a newspaper scandal. The case was that of a strong man, about sixty years of age, who had been admitted to the hospital suffering from delusional melancholia. He slept in a dormitory with twenty other patients. One night he became restless and wandered about the ward, finally stopping by the bed of another patient. The latter awoke suddenly and was alarmed at seeing a man so near him. He put his foot against the pa- tient's chest and pushed him away with some vio- lence, but not with sufficient force to throw him down. The man went back to bed, whence he arose the fol- lowing morning with the other patients and dressed himself quietly. During the day he became restless and suddenly attacked the attendant, a smaller man than himself, who was obliged to use some though no undue force in subduing him. While being conducted Zetia Cost to the disturbed Cheap Zetia ward he broke away and ran a consid- erable distance before being overtaken, showing at that time no evidences of soreness or illness. A few hours after being placed in the ward, however, he complained of being ill, and examination showed sev- eral fractures of the ribs. He was at once removed to the hospital, Zetia 10 Mg where he sank rapidly and died in a few days. At the autopsy nineteen fractures of the ribs were found, and the bones were as brittle as pipe- stems. The coroner made a thorough examination of the case and exonerated the attendants from all blame. The man's son took the body home and then consulted some physicians who were not disposed to agree with the coroner. The case was taken to the newspapers, but although it was in the very middle of the silly summer season, they did not care to make a sensation of it and .so it was dropped. This case, had it not been for the searching inves- tigations of the coroner and his exonerating verdict, might readily have been taken up by some scandal- mongering paper, and the physicians and hospital at- tendants would have been subjected to infinite worry and unpleasant notoriety. THE P.VRASITES OF WHOOPING-COUGH. The recognized contagiousness of whooping-cough at once places this disease Discount Zetia in the category of the in- fectious processes; but although a considerable num- ber of studies have been made to determine the causa- tive organisms, it cannot be said that this end has been .satisfactorily attained. Of all those that have Zetia Price been isolated from the sputum the greatest significance has been attached to the bacillus described in 1887 by .\fanasiew, but the pathogenicity of this Cholesterol Zetia also has been disputed. In a recent communication upon this sub- ject, Kurloff {Ccntralhlatt fur Bakteriologie, vol. xix., Nos. 14 and 15) details the results of a .study of the fresh, unstained sputum in a series of cases of whoop- ing-cough. This observer found an amoeba charac- terized by a finely granular protoplasm and great capability of movement, which he believes to be the infecting agent of the disease. As this organism grows it attains considerable size, large bright granular August I, 1896] MEDICAL RECORD. 163 spores appearing in its body, arranging themselves in concentric layers. Upon rupture of the cell the spores escape and proceed to increase in size, until finally, and partly within the body of the patient,

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