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arranged hospitals and institutions, favorably cyproheptadine 4 mg located, represents the most popular thing in therapeutics in Ger- many at the present time. periactin uk I have mentioned the similar institutions for tuberculous patients before. They are springing up all over Germany now. Philanthropy is to a great extent taking the form of endowment and foundation for such institutions. Most of them are not intended for the very poor — the paupers buy cheap cyproheptadine — who it is con- periactin buy online order cyproheptadine sidered will be cared for, for the present at least, in public hospitals as they exist, but for that lower middle class who, though unable to pay buy cyproheptadine online much, are yet willing and ready to pay something, who are too sensitive to mingle with the paupers, and yet, who are eminently deserving of aid. The object of the charity is a most deserving one, and the manner in which it is offered most delicate, so that it may be expected that buy periactin a great deal of suffering will be relieved. As to the value of the therapeutic principle involved in the treatment of a certain class of patients, uniformity of life, diet, and habits being easily secured when all can be subjected to practically the same regime, this must wait further trial before it can be definitely accepted. Within the next few years it is to receive a most thorough trial here, and the Germans are assured that it will not be found wanting in its practical results. The outcome will surely be watched with a good deal of interest. A very interesting case of sporadic scurvy (scorbutus) has recently been reported here. It is one of those iso- lated cases which sometimes occurs even in people in reasonably comfortable circumstances, when no possible reason can be ascertained for the serious nutritional dis- turbance that develops. This patient had never been on a sea voyage, and had no capricious likes or dislikes for certain articles purchase periactin of diet, which might lead to the conclusion that buy cheap periactin some important nutritional element was lacking in his food. The first symptom noticed was blood-stained semen. Sometime after this an intense tired feeling and absence of all desire for exertion developed. Not until eight months after the first symptom was noticed did the spongy, bleeding gums, and the subcutaneous hemorrhages lead to the diagnosis of scorbutus. Despite every effort of therapy the nutritional condition grew steadily worse, and a fatal termination ensued. This is the first time that a blood dyscrasia, of which, however, absolutely nothing could be seen by microscopic examination of the blood, has been known to cause bloody seminal discharges, and there is a suspicion that the symptom may occur of- tener than is thought; but that its presence is not sus- pected, as usually opportunities for observation of it are extremely limited. Meantime the blood dyscrasia itself is thought to rep- resent one of those obscure pathologic modifications of the blood plasma, the study of which is the only hope of blood pathology at present; cyproheptadine 4mg for, after all the work that has been done on the morphology of the blood, there is com- ing the realization that in this alone there is very little of promise for the future. One of the most distinguished blood pathologists in Europe, Ehrlich, here at Berlin, has practically given up the study of blood pathology as there seems to be so little to be gained from it. If the further study of blood plasma will illustrate these sporadic cases of scurvy, of which a number of cases have been reported, one of the modern order periactin online medical mysteries will be solved. An epidemic of typhus (spotted typhus, as they buy periactin uk call it here, or hunger fever) is reported to be raging in the Bukowina, a province of the Austrian Empire bordering Hungary, Turkey, periactin price and Russia. The province is an ex- tremely poor one, and the people live with the worst hy- gienic surroundings, so that the typical conditions prevail for the development of the disease. Typhus is so com- mon in some of the outlying districts of Hungary that the affection is known in certain parts of Europe as the Hun- garian disease. Special medical interest has been aroused in the epidemic, which is not a severe one, by the hope that improved bacteriologic methods may lead to the dis- covery of the etiology periactin 4 mg order periactin cyproheptadine hydrochloride of the disease. The health authorities of neighboring provinces are be- stirring themselves to see that the disease does not spread beyond the district at present affected. Special care is being taken that tramps in their wanderings do not carry the disease with them ; for it is becoming very clear that these homeless wanderers, who sleep any place where they may lay their heads, who are not finicky about their surroundings and food, who use cast-off wearing-apparel without a word as to what may have happened to its former owner, who huddle together in the winter and so spread any germs with which they or their clothing may be infected, are responsible for the dissemination of more . disease than has heretofore been imagined. Of typhus, this seems particularly true, so that special regulation of tramps is to be instituted in the affected districts. Though typhus is considered to be essentially an epi- demic disease, every year there are occasional cases of it that turn up in the hospitals of Berlin. So that the disease is considered to have acquired a certain endemicity here, through the prompt intervention of the health authorities, and the immediate and thorough segregation of the cases, prevent anything like an epidemic. Of interest in the matter of tramps and the dissemination of disease, is the fact that during a recent small epidemic of cerebrospinal meningitis epidemica, the diagnosis being made by the finding of the meningococcus intracellularis, the first case occurred in a tramp, a member of a very respectable buy cyproheptadine family whose shiftless ways and love of wan- dering had brought him to this mode of life. Two interesting articles on appendicitis from the pens of cheap periactin German surgeons, who treat the question much more from the American standpoint than is customary over here, Digitized by Google April 30, 1898] periactin online

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