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present in these localized forms of the process is absolutely different from that of true gas gan- grene. It comprises almost exclusively Cabergoline 0.5 Mg the ordinary pyogenic organisms, such as the staphylococcus, Cabergoline Buy streptococcus, colon and typhoid bacilli, to which are added some aerobic or anaerobic gasogenous saprophytes. Consequently, in contradistinction to what occurs in ordinary true gas gangrene, the development of gas is only a phenomenon of sec- ondary importance. The bacterial flora of true gas gangrene is most varied and there is no specific type of organism for this process. Usually, anaerobic bacteria, combined with the ordinary aerobic germs, are found, but exceptionally one may find only aerobic organisms, of which some are gasogenous. In true gas gangrene, the organism most commonly en- countered is the perfringens, in sixty-six per cent, of cases, after which comes the septic vibrio, thirty-three per cent. The perfringens may be the only anaerobic organism Order Dostinex Online present, but it may be associated with other nonpathogenic Order Dostinex anaerobic germs, such as the putrificus coli or the bacillus 424 MEDICINE AND SURGERY IN THE ARMY AND NAVY. [New York Medical Journal Clostridium foetidum. In the more serious cases, which were usually fatal, the perfringens alone was present. On the other hand in a case where the patient recovered, the perfringens was associ- ated with other nonpathogenic anaerobic Dostinex Price bacteria. The above Generic Dostinex Purchase Dostinex remarks do not apply to the septic vibrio, for which the gravity of the infection ap- pears to depend entirely on the degree of virulence of the germ Cabergoline Tablets itself. From this it would appear Buy Dostinex that the special pathogenic power of the perfrin- gens is to cause gas gangrene, and therefore its importance is greater in this respect than that of other bacteria. A bacteriological examination nmst be Cabergoline 0.5 made in every case of gangrene Purchase Dostinex Online because a prognosis can then be reached and the proper treatment applied. If the perfringens alone is present, the prognosis is very serious and immediate energetic therapeu- tic measures must be used. If, on the other hand, the perfringens is associated with other anaerobic germs of a nonpathogenic type, the prognosis is better, while the treatment may be less radical. The same indications cannot be derived from bac- teriological examination when the septic vibrio alone is present, because Dostinex Cost in this case the gravity of the infection depends entirely upon the degree of virulence possessed by the vibrio. IMTULHRANCE TO .-VNTITETANIC SERUM. I will now refer to the important work done by Tizzoni on anaphylaxis and intolerance for anti- tetanic serum, a subject which Cheap Dostinex has not been studied sufficiently. The initial injection of antitetanic serum, be it a prophylactic or curative dose, Dostinex Mg can always be given with impunity, but Buy Cabergoline if, on account of the gravity of Buy Dostinex Online the wound, prophylactic injections must be repeated, it Dostinex Online is better to give the second injection as soon after the initial one as possible and at all events before the lapse of ten days. When a prophylactic injection is given more than ten days after the preceding injection, the disturb- ances which may accrue, are never of very serious moment. They usually consist in local anaphylactic phenomena, the so called minor anaphylaxis. Therefore, no hesitation is permissible as far as giving a second prophylactic injection is concerned. Before removing foreign bodies which have been embedded for a considerable length of time in soft structures, a prophylactic injection should be given, whether or not the patient has received Dostinex Tablets an initial injection at the time of the injury and regardless of the lapse of time since it was given. The injection given before a surgical interference prevents the lighting up of a latent tetanic infection, because the toxin may very well have remained inoffensive be- cause of its inclusion within the fibrous envelope wliich develops around retained foreign bodies and appears to be an etificacious barrier to the diffusion of the toxin. When, in the treatment of confirmed tetanus, phenomena Buy Cheap Dostinex of minor anaphylaxis appear, the injec- tions of the scrum may be stopped if the patient has received a sufficient quantity and if the tetanic phenomena have commenced to regress. Otherwise, the injections of serum should be continued in

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