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was surprised to learn that the majority of the syphilitics had had very little treatment. Some were going to their family physicians and were car- rying anywhere from cost of benicar hct twenty-five to fifty mercury pills in their vest pockets. They had never received a salvarsan injection, for their doctors told them salvarsan was dangerous and did more harm than good. Others, on the other hand, were getting as much as one salvarsan treatment every six months. It was gratifying to learn that benicar hct tablets the patients going generic name for benicar to well organized and up to date clinics were re- ceiving adequate treatment. On account of the inadequate and inefficient treatment of the syphilitic, by his physician, I decided to choose the treatment of this class of oatients for the subject of my paper. The elements of the subject of the treatment of syphilis include the time for beginning benicar savings card treatment, treatment in the various stages, benicar uk hygiene of the pa- tient, the place of the newer substitutes of salvarsan benicar hct prices and neosalvarsan, the place of mercury and benicar generic alternative the value of the Wassermann reaction. A thorough physical examination is essential in determining the character and intensity of benicar generic equivalent the treat- ment. The examination should include the weight of the patient, the examination of the heart changes in blood and bloodvessels, the taking of the blood press- ure, the condition of the lungs, reflexes, reaction of •Read before the Brooklyn Urological Society, March 12, 1918. the pupils, examination of the mucous membranes of the mouth and rectum, condition of the kidneys, and abnormalities of the urine. After the diagnosis has been made by a carefully taken history and thorough physical examination, and by finding the spirochetes in the serum from the initial lesion by the dark field illumination or India ink smear, or by obtaining a positive Wassermann reaction from the blood serum or from the cerebro- spinal fluid, we are ready to begin the treatment. The important factors are immediate diagnosis and immediate institution of treatment. buy generic benicar In reference to the Wassermann reaction as a control in syphihs, in the majority of cases a strongly positive reaction indicates syphilis. There are a few diseases which we have to take into con- sideration in making our diagnosis, for they give positive order benicar online Wassermann reactions. Those diseases are : malaria, during the febrile stage ; yaws, a benicar equivalent dis- ease caused by a spirochete; cancer; scarlet fever; relapsing fever; occasionally, some case of leprosy; cases of autointoxication; and cases of diabetes, in which acidosis is benicar discount card present. The ingestion of alcohol, if taken within twenty-four to thirty-six hours be- fore a test is made, often converts a strongly posi- tive to a negative reaction. Even small amounts may cause this change, and where the reaction is usad as a control in the progress of the treatment, it may mislead us as to the real serological status of * the patient. The Wasserman is also of importance in the early diagnosis of the disease, as shown by Major Craig, Medical Corps, United States Army, in a series of 600 cases of primary syphilis : Thirty-six per benicar alternatives cent, of primary cases gave a positive Wassermann within the first week after appearance of the chancre; almost sixty per cent, benicar generic name during the second week; almost seventy per cent, during the third week; over seventy-seven per cent, during the fourth week ; over eighty per cent, during the fifth week after the chancre buy cheap benicar had benicar htc appeared. The Wassermann is therefore of distinct value in the early diagnosis of syphilis, where the spiro- chetes cannot be demonstrated. It is also of value in determining the progress of the treatment and, at times, it is the first clinical symptom in forewarning a relapse, before any benicar hcl other clinical symptoms are present. When beginning treatment the patient' should receive a pamphlet of instructions, concern- ing the general significance of his affliction, his diet, general hygiene, and the danger of communicating his disease to others. In a general way the aims of the treatment of lues should be: i. Destruction of the spiroch«t» pallida; in the circulation ; 2, pre- vention of the organisms from becoming benicar canada surrounded l)y infiltration ; 3, absorption of benicar hct cost the infiltration surrounding the organisms, so that they may be acted upon by our spirocheticides. TREATMENt OF SYPHILIS. In the primary stage. — If a chancre is diagnosed before, or even after, the Wassermann reaction be- comes positive, salvarsan should be immediately administered. If, for some reason or other, the pa- tient cannot be induced to take salvarsan, a wet antiseptic — mercurial dressings, such as lotio nigra, or weak solutions of bichloride ( 1-5,000)— should be used locally until the ulceration begins to granu- late. Then the blue ointment or white precipitate ointment should be applied until the sore becomes 4o6

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