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{Continued from page 399.) The Serum Treatment of Meningitis. — Dr. Simon Flexner said that the serum treatment of epidemic meningitis glucophage tablets began in 1907, coincident with the decHne of the severe wave of epidemic meningitis which spread over Europe and America in 1904-5. Weichselbaum had found that the men- ingococcus was the etiological factor. price of glucophage Figures were obtained as to the mortality of the disease, accord- ing to localities, and the fluctuations in mortality and incidence according to districts. A definite basis was established for a conception of the value of therapeutic measures. There was no agreement as to mode of penetration of the germ to the men- inges. If blood cultures were made in persons in glucophage diabetes the first days of the disease, positive cultures were often obtained. The significant point was obvious — either the meningococcus first got into the blood and from thence invaded the meninges, or, perhaps secondary infection of the blood occurred. At cer- tain periods of the disease metastatic infections oc- curred : with involvement of the meninges were seen lesions of joints, thorax, eye, etc. On the whole the opinion had been held that the blood infection was order glucophage secondary, and that the meningeal infection was lymphatic, by direct extension. Practice, based on the older opinion, was influenced by clinical ob- servation on cases observed for hours, days, or weeks before diagnosis of meningitis could be made, when infection of the central nervous system was well glucophage 500mg established. Under these circumstances, an- tisera, to be effective, must be injected directly into the subarachnoid spaces. If the antiserum, how- ever, was effective in the meninges, it would prob- ably also be so in the blood. Many cases could be aborted by early intravenotis injection of the serum. Atcording to Dopter's work in 1909, the menin- gococcus was not a fixed form, but involved a group. Two glucophage buy strains might be buy glucophage online distinguished cultur- ally, but not clinically. Each glucophage cost strain had a number of variants. Specific therapy, to be effective, must be truly specific. 'J"he dose must be in accordance with immunological relationship and antibodies must generic for glucophage be adopted to the antigenic properties of the organism. A movement was on foot to substitute a monovalent serum for the polyvalent menin- gococcus serum now used, just as soon as the ex- act type of organism could be ascertained. Intravenous Serum Treatment of glucophage generic Cerebro- spinal Meningitis.— Major cheap glucophage W. W. Herrick, of .Vow York, said that in glucophage price tiie military cantonment life there had been an unusual opportunity for clinical research and this had been used as a means of mak- ing and keeping men fit for active service. cost of glucophage Epi- demic cerebrospinal meningitis cases had been seen early and so it had been possible to control them effectiveh'. The disease was not primarily a men- ingitis, but took the form of sepsis in the blood stream which later localized in the meninges. Forty- five per cent, of the cases were discovered in the premcningeal stage, with generalized infection and no local involvement. About two weeks after the blood .stream infection, meningitis developed. One patient, the head nurse in the ward, who had poly- arthritis due to meningococci, was treated with glucophage sr antiserum intravenously and made complete re- covery. Complications of the diseases were many — pleuritis, orchitis, pericarditis, arthritis, etc. Cases in early stages responded at once to intraven- ous treatment. The method of treatment was simi- lar to Cole's method with lobar pneumonia. The patient was given a desensitizing dose at the earli- est possible moment, then after a dose of morphine and atropine, glucophage xr a test dose of serum intravenously. The serum was introduced slowly at a rate of not more than one c. c. per minute. If untoward signs appeared, the treatment was suspended, but re- newed a little later. A 150 c c. dose had been given in serious cases. Treatment with large glucophage online doses had proved of value ; patients receiving 500 c. c. did better and there were fewer deaths. If the in- travenous treatment was to have any success at all, the serum had to be used boldly and in large amounts. The intraspinous method had not been neglected, but it was not used in the premeningitic stage. The combined treatment had been success- fully applied. In serious cases, with the patient unconscious and covered with a rash, recovery to the t>oint glucophage mg of being tablet glucophage out of danger had taken place within forty-eight hours. The largest intravenous dose that had been given was 705 c. c, and the greatest number of injections, ten. Disappearance of the meningococci occurred glucophage xr 500mg within a few days. There was very little of the delirium which had characterized the 1904 epidemic. If the cases were diagnosed early and treated by the intravenous method, and the later cases treated by the com- bined method, the mortality could be kept down to fifteen per cent. These epidemics would in future therefore be considered with more equanimity than they had been in the past. A Potent Antimeningococcic Serum. — Captain H. L. Amoss, M. R. C, di.scussed three essential points: The passage of immune bodies from the blood to the spinal fluid ; the mechanism of infec-

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