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New York. While nasal polypi are of comparatively common occurrence, nasopharyngeal polypi are rare. They originate cymbalta discount program most often generic cymbalta available us in the discount prescription card cymbalta maxillary sinus but may occasionally originate generic cymbalta in the sphenoidal sinus or generic cymbalta online pos- terior ethmoidal cell. The polypus is pear shaped and histologically does not differ from the ordinary nasal polypus. Authorities differ on the tendency of the polypi to recur after removal and in case of recurrence ihe maxillary sinus should be opened. 1 have had the good fortune to see two cases of nasopharyngeal jx)lypi. Both cases occurred in young girls. Cask I. — M. S., twelve years old, liorn in New York, came with a school nurse to St. Mark's Hospital Dis- pensary some seven years ago, complaining of difficulty in breathing, especially at night when lying down; the nurse told me that the patient was stupid and absent minded in school. On examination I found a large nasopharyngeal polypus extending just beyond the soft palate and uvula. I took her into the hospital and under general anesthesia removed the polypus with a Jarvis snare through the nose. A few months later I saw the nurse again and she told me that M. discount cymbalta 60 mg was now cymbalta online pharmacy the discount cymbalta coupons brightest girl in her class. Case II. — C. M., a young girl of eighteen, born in Hun- .gary, was referred to me by Dr. A. Gumbar in April, IQ18. About a year ago she noticed an irritation in her throat causing her to cough. She also had great difficulty in breathing, especially at night; and suffered from head- aches and pain in the back. On examination I found a very large nasopharyngeal polypus hanging down behind the soft palate touching the generic cymbalta from india tongue. I took her into the generic cymbalta 60 mg St. Mark's Hospital and under a general anesthetic tried discount cymbalta to remove the growth, but did not succeed, as the polypus disappeared behind generic cymbalta 2013 the soft palate while she was lying down. The next morning she came to my office and under cocaine I removed the growth through the left nostril with a generic cymbalta from canada Jarvis snare. The polypus was 3^ inches long and Yn inch wide. All her symptoms disappeared after its removal. 640 Madison Avenue. The Protein Nature of Antitoxins. — W. N. Ijerg, biochemist, and R. A. Kelser, veterinary in- spector, of the United States Department of Agri- culture, have just completed a series of experiments with tetanus antitoxin whose ultimate object was to determined the chemical nature of antitoxins in gen- eral, and the possibility of their prep:iration in the pure state. No antioxins have as yet been separated from their associated proteins. The well known tetanus and diohtheria antitoxins contain nearly all the im- munitv units present in the original serums, but only discount generic cymbalta a { art of the proteins. The failure of all attempts to obtain a protein free antitoxin has led some to the conclusion that the antibody cymbalta discount prices or group of anti- bodies which constitutes the antitoxin is one of the serum proteins, and hence cannot be completely sep- ? rated from protein. On the other hand, the con- centration of antitoxin that can be obtained by concentrating the antitoxic serum without a corre- sponding concentration of protein is regarded as an indication that the antitoxin may be a body of nonprotein nature. If tetanus antitoxin is of nonprotein nature the exjjerimenters thought that it should be possible to prepare artificial digestion mixtures containing the antitoxic serum or derived globulin in such a manner that the protein would undergo digestion without loss of antitoxin. If, on the other hand, the anti- toxm is a protein, and its power to neutralize the corresponding toxin is a function of the intact pro- tein molecule, then the antitoxin would be destroyed buy online cymbalta in every case where the proteins had undergone cleavage, whether the cleavage was caused by pro- teolytic enzyme or other chemical agent. The toxin might possibly be destroyed bv the chemical agents used. Proteolysis was determined by chemical measurements, and inoculation experiments on guinea pigs indicated any loss of antitoxic units. The results indicate that tetanus antitoxin is a substance of nonprotein nature. But the stability of the antitoxin is so dependent upon that of the protein to which it is attached, online cymbalta petition that whenever the protein molecule is split, the cymbalta 60 mg discount card antitoxin splits with it. The results are summarized below : 1. Tetanus antitoxin in 0.5 per cent, cymbalta discount card sodium car- bonate solution was slowly and completely destroyed. At the same time no significant chemical changes in the proteins were detected. 2. In solutions amphoteric or faintly acid to litmus paper, trypsin destroys the antitoxin and at the same time tlie associated proteins are digested. The rates of antitoxin destruction and protein split- t'ng were substantially the same.

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