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of varying degree of penetration. The ulcer healed rapidly by cicatrization. It could be Buy Imigran Online said that opera- tive procedures had a definite mortality which weighed against this method of treatment. Un- less the cases were to be operated upon, healing must take place. Three points were connected with the healing of ulcers : \\'hat were the causes of ulcer : what prevented their healing ; what could be done to promote healing? By answering these (|uestions one could arrange a rational method of treatment. As to cause, the mucous membrane of the stomach, from Generic Imigran lowered resistance (perhaps vascular or perhaps from bacterial invasion) became digested and an ulcer was formed. Pepsin had a solvent action on albumin sensitized by free acid. In ulcer cases, therefore, it was necessary to de- =;troy the digestive action of the juice. This could be done by the method outlined. In pyloric ob- struction ninety per cent, of the patients had Purchase Imigran Online been relieved in from one to three weeks. Case of Bulimia. — Dr. George Dock, of St. Louis, in presenting this report reminded his hearers that the textbook descriptions of this condition agreed mainly upon the polyphagia, and that goitre was supposed to be a factor in this condition. In the case presented, the patient, an architect, aged thirty-six, was obliged to Buy Imigran eat ab- normally to avoid intense headaches which de- veloped when he felt hungry. Apparently he had no regular eating time, but always carried with him a quantity of toasted bread cubes and six to eight shredded wheat biscuits. The history was vague. He was well until twenty-one, then began to suffer from eructations of gas, a condition which he called "gastritis." At twenty-two he had paralysis of the right arm. He now weighed 215 pounds. Gland extracts Buy Cheap Imigran had no effect on his condition. He was a large man, but with no pathological distribution of fat or hair. There was evidently a slight neuras- thenic element in the case. Upon examination it was found the man had marked nasal obstruction by polyps, with suppuration of both antra and ex- tremely bad teeth. There was a slight polycythemia. The Wassermann test was negative. The stools were very large and full of undigested fibre. Bulky vegetables were supposed to relieve the patient's September 7, 191.S.] BOOK REVIEWS. 443 hunger better than meat. In twenty-four hours he consumed about 7,000 calories. The stomach and ahmentary canal were normal, but rather large. The patient showed marked impatience with tests that interfered with his eating. No metabolic, in- Imigran Tablets testinal, or pancreatic diseases were discovered. The marked sinus disease suggested irritation by an impulse such as known in itching diseases. Treatment was instituted and consisted of removal of bad teeth and draining of the sinuses, which were full of foul pus. After this the headaches^ and abnormal appetite disappeared within one month. "The patient had a normal weight and was without symptoms. It was a platitude in medical teaching that diagnosis meant covering the whole Imigran Price condition of the patient. In this case there seemed no connection between the disease and the cure ; the condition was mentioned as being unusual in its cause and treatment. Comparative Food Value of Protein, Fat, and Alcohol in Diabetes Mellitus. — Dr. H. O. Mosen- TiiAL, of Baltimore, in this paper said it was de- sired to maintain the protein tissue in spite of using a carbohydrate free diet. The patient was put upon 1,000 calories with a constant proportion of protein and fat. Then 500 calories of protein, fat or alcohol were added. Three periods were used : fat period, alcohol period, Imigran Online protein period. Finally there was a control period. On 1,000 calorie diet there was a constant loss of nitrogen. When 500 calories of fat were added there was no great im- provement in the nitrogen balance. The fat was assimilated, but did not spare the protein. The same held true with alcohol. The alcohol possibl5' saved the body Imigran Cost fat but not the nitrogen. The re- sults with protein addition were Order Imigran strikingly different. The positive nitrogen balance was very marked in- deed with 1,500 calories. There was thus opened up a method of therapeutic treatment for these patients, which seemed to be brought about in a way which did not occur in the ordinary individual. The previous diets had evidently affected the pro- tein. Two patients who had Purchase Imigran not taken the alcohol did not get tJie results. The fat and alcohol had been used to Imigran Mg conserve the fat of the body, while the protein Order Imigran Online preserved the protein. Fractional Examination of the Duodenal

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