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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