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associated w-ith lowered order lisinopril resistance the soil was pre- pared for infection. The socalled catheter system following operation was open to criticism. lisinopril 20mg It was too much the custom to delay catheterization and trust that retention would not occur, and it was too fre- quently assumed that catheterization was responsible for infection. So long as patients were catheterized by the clock, just so long would infections continue to be a reproach to lisinopril 10 the physician. All these patients should be regarded as likely to have retention. The bladder should never be allowed to lisinopril hctz 12.5 mg become distended above twelve ounces. If early catheterization was carried out, postoperative cystitis would become a rarity. The first group of cases was that in which kidney function might be below normal and the cause lay outside the urinary tract. In this group pressure from the outside produced interference with the urinary outflow, leading to lisinopril 40 mg congestion, which prepared the soil for the infecting organism. lisinopril buy In this group came lisinopril 5 mg the pyelitis of pregnancy as well as the socalled spontaneous cases associated with disease of the large intestine, such as mucous colitis and ulcerative colitis. There lisinopril 5 was also a group of cases occurring in adult life, particularly in women suffering from constipation and visceroptosis, and another group in female lisinopril 10 mg children in which lisinopril 20 we had been accustomed to blame the condition on the ana- tomical conformation. If these infections in female children were due to the introduction of the colon bacillus by way of the tirethra, it was strange that they were not more common. Experiment purchase lisinopril had shown that introduction of the hctz 12.5 lisinopril colon bacillus into the blad- der did not produce lisinopril 12.5 mg pyelitis, and clinical experience was against this view. It might well be that the colon bacilli affected the kidneys of those who had little re- sistance. The use of formaldehyde in local irrigation of the kidneys had been much in vogue, but it had failed to live up to its temporary reputation. It was quite strange that patients with a stormy onset and severe symptoms were most likely to go on to complete recovery, while chronic cases lisinopril 10mg often resisted treatment. Attempts with autogenous vaccines might at times relieve the symptoms but failed to remove the infection. He was not sure they had pushed the use of autogenous vaccines to their logi- lisinopril 12.5 cal conclusion. There was need of further study of bacilluria, and perhaps conditions in the large intestine might give a clue to the treatment of pye- litis. Dr. Edward L. Keyes, Jr., of New York, asked Dr. Cabot concerning the relation of the passage of instruments into the ureter to pyelitis. Atteinpts to wash out 20 mg lisinopril the pelvis of the kidney had not proved online lisinopril satisfactory. It was possible that cheap lisinopril a certain amount of benefit might be due to the straightening out of the ureter by the passage of the instrument em- ployed in giving the irrigation. Dr. A. W. Brasch, of North Germantown, ques- tioned whether the large intestine was the etiologi- cal factor in pyelitis. It was his impression that the connection between the colon and the kidney was limited. In treating pyelitis he removed the foci of infection in the teeth or tonsils if any were present and then employed lavage of the kidney pelvis with silver nitrate, placing the patient in the Trendelen- berg position. He passed good sized bulbs that straightened out any stricture which might be pres- ent, and he believed this cured pyelitis in a large proportion of cases. (To be continued) Ut u New York Medical lisinopril hctz 20 Journal INCORPORATING THE Philadelphia Medical Journal ?,"' Medical News A Weekly Revieiv of Medicine, Established ISJfS. Vol. ex II, No. is. Ni:w YORK. SATURDAY. OCTOBER ?,0. 1920. Whole No. 2187 Original Communications

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