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systolic and diastolic pressures. The extent of diminution of the pulse pressure is of prognostic significance. Of seven shocked wound patients where the pulse pressure on admission was at least thirty mm. of mercury with the Pachon instrument, six recovered and the seventh died after thirty-six hours, not of shock, but of peritonitis. Of seven cases with a pulse pressure of twenty-five mm. or less, but one recovered, and this only with the help of adrenalin, which rapidly increased the pulse pressure. Above twenty-five mm. the Flonase Rxlist prognosis re- mains favorable in the absence of infectious com- plications. At twenty-five mm. precisely, the Flonase Discount prog- nosis is doubtful, and becomes the more unfavor- able the less persistently the patient reacts to cam- phorated oil, saline solution, adrenalin, and perhaps pituitrin. Below twenty-five mm. the prognosis Generic Flonase Nasal Spray seems to be fatal. Another sign of shock, likewise apparently related to vasomotor paralysis and the resulting exosmosis, is a marked rise of intraspinal tension. Among seven wound Purchase Flonase Online cases in grave, pure shock, Claude's apparatus showed tensions ranging from 303/^ to fifty, and averaging 39.6. Bacteriological Examination of Chancres. — L. Tribondeau (Paris medical, June 8, 1918) empha- sizes that microscopic examination of a chancre for detection of the spirochete of syphilis or Ducrey's bacillus is easily carried out by any physician and can be done in Flonase Nasal Spray Generic less than five minues. The procedure is of extreme importance because it is the only one permitting of early, efificient treatment of the true chancre and abortion of the disease before secon- dary symptoms appear. The public should be im- pressed with the fact that any genital ulceration, hovrever insignificant in appearance, should be shown to a physician without the least delay and should not be treated with even mild antiseptics un- til the bacteriological examination has been made. In obtaining material for examination the chancre should be wiped clean with moist, then dry, pledgets. In its most suspiciotis and indurated parts, at its mar- gins, a few small parallel scarifications, two or three mm. long, should be made with a Order Flonase Online scalpel or vaccinat- ing instrument, and the secretions brought up by pinching and flattened out Flonase Generic Name with the instrument on two glass slides. These are to be dried without heat or other artificial form of fixation. In the Fontana- Flonase Canada Tribondeau procedure three reagents are used : First, a mixture of pure acetic acid, one mil, com- mercial formaldehyde solution, two mils, and dis- tilled water, 100 mils ; secondly, a mordant solution of one gram of tannic acid in twenty mils of water ; thirdly, Fontana's solution, consisting of crystalline silver nitrate, one gram, Cheap Flonase in twenty mils Flonase Generic Price of distilled water with ammonia gradually added until the brownish precipitate first formed becomes decolor- ized and passes into a slight Flonase Ns opalescence. In stain- ing the slide for spirochetes, hemoglobin is thor- oughly removed with the first solution ; the prepara- tion is next washed with strong alcohol and fixed by igniting the alcohol on the slanting slide and almost at once blowing it out again ; then the mordant solu- tion is poured on and the preparation heated until it steams but does Flonase 0.05 not boil Flonase Alternatives ; the slide is now removed from the flame, but the solution not poured off for thirty seconds more ; the preparation is next washed for thirty seconds with tap water, rinsed quickly with distilled water, Fontana's solution applied and first allowed to act a few moments in the cokl, then renewed and heated until steam begins to arise ; the stain is allowed to act fifteen seconds, then dis- carded ; finally, the slide is washed with distilled water for a few seconds, dried with filter paper, and examined under oil immersion. The specific spiro- chetes are distinguished from others by their gracile form and fine undulations. For staining the Ducrey bacillus on the second slide, polychrome blue with ammonia is recommended. Adrenalin Test of Cardiac Resistance to Stress. — Loeper, Wagner, and Alternative To Flonase Dubois-Roquebert (Bulletins et mcm.oires: de la Societe mcdicale des Iwpitaiix dc Paris, February 7, 1918) believe Flonase Acne this test serviceable for ascertaining in anv individual the capacity of the heart to withstand the stress im- posed upon it in active military service. The pro- cedure consists in injecting one milligram of adre- nalin and securing a tracing of the cardiac outline with the X rays, immediately before and one-half liour, one hour, and one hour and a half after the injection. The first and third Flonase Generic Equivalent observations are the crucial ones, the peripheral vasoconstriction induced by the adrenalin, and its reaction on the size of the heart, often attaining a maximum one hour after the injection. Tests were made in over one hundred subjects. In normal individuals the heart outline obtained one hour after the injection was identical with the first outline, though occasionallv after an hour and a half the outline showed a slight reduc- tion in size, ascribed to the secondary constricting action of the drug on the heart muscle. In un- Flonase Generic Cost doubted cardiac impairment the test regularly showed a striking enlargement of the heart, amount- ing to one cm. Buy Generic Flonase or one cm. and a half one hour after the injection. In seventeen out of twenty-three Flonase Coupons Printable cases the enlargement involved the entire heart ; in

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