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judicious treatment. After excluding this group of cases, and those in whom is found visceroptosis, obesity, arterio- sclerosis, early Cheap Atrovent pulmonary tuberculosis and hyper- thyroidism, Ritchie states that in over forty per cent, of these patients there is eviflence of some recent infection, and in an Buy Atrovent Online additional ten per cent, there is anemia, presumably of toxic origin. In all these cases, fifty per cent, of the total, the prognosis, in Ritchie's opinion, is good. In fact it is not the heart that is primarily at fault. Therefore do not give a guarded prognosis and coddle the patient. A good prognosis is the first essential in restoring the patient's confidence. He shovild be told that there is little the matter with him, not be allowed to remain in bed, nor waited upon more than is absolutely necessary. At first massage and passive exercise are of \a\ue and when he has begun to walk he should ije encouraged to undertake an increasing amount of physical exercise daily. He should soon be taking active exercise out of doors. Drugs are seldom in- dicated and digitalis is wholly useless. In the army this mode of treatment was remarkably successful. However, in civil life the prospects of good recovery are not so uniformly good. The patient does not lead such a healthy life as does a soldier; he is less amenable to control. Physical training under skilled supervision is costly, and not so efficient as in Atrovent Online the army : there are devoted relatives whose influence is the reverse of helpful, and in certain grades of the community there is the sure expectation that inca- pacity for work will be compensated by grants from public funds. Yet, with all these drawbacks, Ritchie assures us that brilliant results may be obtained, and a man or woman who has been practically bedridden for months may, within a few weeks, be leading an active and useful life. It is also instructive to learn that the cases in which the dominant manifesta- tions are those of neurasthenia are the most intract- able and the most prone to relapse. The Generic Atrovent diagnosis of heart disease, or rather the dif- ferential diagnosis of organic and functional heart disease, is a matter concerning which the general practitioner often knows little. Gross lesions he is able to detect, but the more subtle forms of heart disorder he is likely to pass by or to magnify greatly. This inability to diagnose correctly was shown over and over again during the war when Buy Aerovent men were labelled as having heart disease, who on examination by really experienced physicians were foimd to be practically sound in this respect. To Sir James Mackenzie is chiefly due the honor of demonstrating how to diagnose affec- tions of the heart and how to treat them. There is no doubt that Ritchie is right in recommend- ing that a good prognosis should be given in these Order Atrovent Online cases and that the patient should take October 16, 1920.] EDITORIAL ARTICLES 595 regulated physical exercise. Sane and rational ways of treating heart disorders have happily come into Buy Atrovent vogue based, of course, on correct diagnosis. It is obvious that in order that correct diagnosis may be arrived at the medical student and practitioner must be well trained in modern Purchase Atrovent methods of diagnosis and treatment. / PHYSICIAN-AUTHORS: JOSIAH GILBERT HOLLAND The medical profession is not always a royal road to wealth. This is not an exciting bit of news. A number of physicians have, from time to time, had more than a suspicion of Order Atrovent the fact. In sooth, there have been authentic instances where physicians have considered it necessary to abandon the profession to keep body and soul together — an extreme measure that reflects only on the resourcefulness of the physician. There is the case of Dr. Josiah Gilbert Holland. Whether it was youthful impatience, or injudicious location, or some other reason, is not known, but Dr. Holland became discouraged after about Purchase Atrovent Online two years' practice and returned to other pur- suits. He had studied four years Buy Cheap Atrovent at the Berkshire Medical College, at Pittsfield, Mass., receiving his degree in 1844, and entered practice at Springfield, ]\Iass. Holland did not immediately return to editorial

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