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cision of the intestine. It is an indisputable fact that increased peristaltic action has a tendency to re- tard repair of intestinal wounds, as the continued shaking up of a buy levlen fracture retards the repair of the bone. With this in mind, levlen ed tablet it is highly important that the cheap levlen intestinal tract should be as nearly immobilized as possible after an operation, and kept so until the process of repair have sufficiently advanced to make it certain that there will be no extravasation of intestinal contents into the abdominal cavity. For the reasons given I feel that I am justified in protesting against the use of levlen ed cathartics prior to oper- ations upon the intestinal tract, and also in insisting that only remedies should be used which have a ten- dency to empty the intestinal canal without generic levlen leaving the bowel in a state of irritation to complicate the dangerous operation which may soon be necessary. To reiterate my position I maintain that in all cases in which intestinal obstruction is suspected and in which the use of mild laxatives, together with en- emas and massage, fails to give relief, the employ- ment of drastic cathartics should be guarded against. I believe it is much safer to make an early explora- tory incision, if need be, to determine the diagnosis order levlen than to continue the administration of drugs which may cause inflammation, a serious complication we should always seek to avoid. levlen 21 RHINITIS FIBRINOSA, INCLUDING A BAC- TERIOLOOIC AND HISTOLOGIC EXAMINATION OF CASES. By GEORGE L. CHAPMAN, M.D., OF CHICAGO; ASSISTANT IN PATHOLOGY AND IN LARYNGOLOGY IN levlen online THB CHICAGO POLYCLINIC The purchase levlen subject of rhinitis fibrinosa is as a rule very briefly if at all, treated, in such text-books as might be expected to contain a detailed account of it. This disease was recognized and described by B. Frankel, Hartmann, Seifert, and others. It is referred to un- der a variety of names, viz. , croupous, membranous, fibrinous, primary pseudomembranous, plastic and fibrinoplastic rhinitis, and nasal diphtheria. Rhinitis fibrinosa is not a common disease; therefore, when levlen 28 observed, it deserves more than passing notice. It is characterized by an acute inflammation with a fibrinous exudate limited to the nasal cavities. The symptoms are usually benign, the most distressing being sudden nasal occlusion, necessitating almost constant oral respiration, mucopurulent discharge, and a somewhat chronic course. The etiology of this form of nasal disease, as has been demonstrated by careful study, is not uniform. A few years after it had purchase levlen online been generally recognized that the cause of a certain form of primary faucial diphtheria was the Klebs-Loffler bacillus, this micro- Digitized by Google April 30, 1898] RHINITIS FIBRINOSA. 555 organism was looked for, and found to tri levlen be present in a large percentage of the cases of rhinitis fibrinosa in which a bacteriologic examination was made. Concetti was the first to call levlen price attention to the conta- gious nature of the disease, and he recommended isolation and disinfection. The first authors who undertook discount levlen the bacteriologic examination of cases of rhinitis fibrinosa were Gradenigo and Maggiore. They claimed that the staphylococcus pyogenes aureus was the cause of the affection. Lieven isolated a staphylococcus which he claims is similar to the staphylococcus pyogenes aureus, but not levlen ed tablets identical with it. It is distinguished from the staphylococcus pyogenes buy levlen online aureus by some cultural features and by its lesser virulency. levlen cost Abel did not find the diphtheria bacillus, but isolated pneumococci buy cheap levlen having a very mild degree of virulency. Abbott reports three cases in which he found the diphtheria bacillus. His work is of special interest because of its thorough character. In two of his cases he found a bacillus similar to that of true diphtheria, but of lessened vitality. In the other case the bacil- lus found could not be differentiated from the typical diphtheria bacillus. M. Ravenel, in an investigation of ten cases, followed Abbott, and found in all but one a bacillus similar to the Klebs-Loffler bacillus, except for a lessened vitality and virulency. In one case, he found a bacillus which could not be order levlen online differ- entiated from the true virulent, diphtheria, bacillus. Bluder examined six cases, finding the diphtheria bacillus in all. Buys examined one case, finding the diphtheria bacillus. D. Braden Kyle reports two cases in which he found the staphylococcus aureus; he described the exudate as organized, laminated, fibrinoplastic.

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