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enema of two teaspoonfuls of sodium bicarbonate to a quart of warm water is given every six hours for the first day or levlen price two. All food is withdrawn and water forced. To encourage the drinking of wa- ter, it may be given as iced tea, lemonade or orangeade, sweetened with saccharine. If the baby refuses to take the fluids, or if there is marked nausea or emesis, sterile tap water should be sup- plied by hypodermoclysis, six to eight ounces every six to eight hours to an infant six months old. Should acetone appear in the generic levlen urine, the solution should contain one per cent, citrate and two per cent, glucose. A less preferable method of intro- ducing fluid is through the stomach or duodenal tube. The least satisfactory method is by procto- clysis. As soon as the castor oil is out of discount levlen the stom- ach, give a lactic acid bacillus tablet in sweetened water every two hours ; these to be continued purchase levlen until the stools are normal. As acidosis is the great dan- ger, the urine should be kept alkaline with bicarbo- nate of soda, or sodium citrate, five to ten grains every two hours to a child six months old ; it is rarely necessary to continue this longer than forty- eight hours. If the baljy is breast fed nursing is resumed at the end of twenty-four to forty-eight hours, the baby to nurse one minute from each breast every four hours, to be preceded with lime and plain water. If the infection is due to order levlen online the gas bacillus, the baby is given lactic acid milk, or pro- tein milk, before each nursing; this replaces the lime and plain water. If the infection is due to the dysentery bacillus, the nursing is preceded by a October 23, 1920.] PRACTICAL THERAPEUTICS AXD PREVEMIVE MEDICIXE. 649 lactose barley solution, varying in strength from two teaspoon levlen ed tablet fills each to two tablespoonfuls each to the pint of water. If the baby is bottle fed, the same levlen ed tablets treatment -is carried out except as to the nurs- ing. Although carbohydrates are contraindicated in gas bacillus infections, they must be given in threatened acidosis. Toxic nephritis with impend- ing anuria is best combated with levlen 28 hot baths, hot packs, and warm soda flushes of the colon. For restlessness give chloral by enema, or morphine by injection. As a stimulant, levlen online atropine in fairly large doses gives good results. Now and then one will meet with a case of vasomotor paralysis which can be buy levlen online benefited by an intravenous injection of adrena- lin. When the stools are large, frequent and wa- tery, opium is often a life saver ; paregoric by levlen ed mouth or morphine by cheap levlen hypodermic injection. For tenesmus the writer likes an enema of silver nitrate solution, one half to one per cent., in distilled water. Intestinal antiseptics and astringents are mentioned only to be condemned. The Therapeutic Use of Oxygen. — R. D. Ru- dolf {American Journal of the Medical Sciences, July, 1920) says that oxygen is of value whenever a state of anoxemia exists, as in cases of moimtain sickness, sickness from high flying, in poisoning by carbon monoxide, nitrites, and arseniuretted hydro- gen, and in the effects of purchase levlen online enemy gas. It should be tried in all cases of cyanosis, and in such acute respiratory conditions as pneumonia when anoxemia threatens. The ordinary method of giving oxygen b}- holding a funnel connected with the oxygen cylinder near the face of the patient is practically useless ; a better method is to give the gas levlen cost through a rubber tube inserted into one nostril, and this may be made 'more effectual if the opposite nostril is rh3'thmically compressed during inspiration, the mouth being kept closed. The oxygen chamber is a very effectual way of giving oxygen, but it involves much expense and care. A very tri levlen useful and ef- fectual appliance levlen 21 for the administration of oxygen is Meltzer's apparatus for oral insufflation. Vaccine Therapy in the Acute Osteomyelitis of Adolescents. — Raymond Gregoire {Journal de medccine dc Peris, April 5, 1920) states that in certain selected cases of this disorder vaccine treat- ment gives excellent results. In the septic form of osteomyelitis prompt surgical treatment is, of course, indicated, though vaccine treatment might prove order levlen of some value as an au.xiliary measure. In the acute or buy cheap levlen subacute cases, in which the general condition is less seriously impaired, the advisability of vaccine treatment depends entirely upon the state of the involved bone. Where a more or less exten- sive portion of bone has become transformed into a sequestrum, vaccine treatment is inappropriate and the foreign substance must be surgically re- moved. Such a condition is detected b}' x ray examination. buy levlen In all other cases, however, irrespec- tive of the duration of the case, extent of local inflammatory reaction, and condition of neighboring joints, vaccine therapy may yield surprising results. Cases were thus cured after several weeks of sup-

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