or lint in the wound and replace the flap. Apply a
mild antiseptic wet dressing and put the part on a
splint and the arm in a sling. Change the dressing
frequently and keep immobilized until well.
In Figs. 1 and 2, notice the socalled pulp of the
finger. Observe the lines stretching naproxen 500mg generic naprosyn from perios-
teum to skin. They represent dense, tough fibrous
bands or partitions. These divide the space between
skin and bone into innumerable chambers and each
chamber is filled with fat. Were it not for these
partitions, at every grasp sensitive nerve endings
would be painfully pressed betwen skin -and bone,
for the fat, being fluid buy naprosyn tablets at bod\' temperature, would
flow to one side of the point pressed upon. But
these same fibres prevent the skin from being pushed
away from the bone when exudation occurs between
the two. When for any reason, naprosyn 500 mg oral tablet therefore, an in-
flammation occurs here, it is naprosyn costochondritis not long until the pres-
sure against the skin on the one hand and against
the periosteum on the naprosyn sr tablet 1000 mg other, becomes sufficient to
imperil the vitality of oue or both, and also that of
the parts intervening. In such a circumstance the
fat and the fascia are always the first to suffer.
Always offering poor resistance to infection, when
thus injured they now favor the growth of bacteria
and a bad condition becomes worse.
For infection in the pulp the alert physician never
waits for the pointing of suppuration. An early
and free incision, not only through the skin naprosyn 500 mg oblong yellow tablets but
down through the pulp, with proper dressing and
fixation, will naprosyn ec 500 mg pl check the spread much does naprosyn cost of the trouble. Inci-
sion relieves the tension, and it is the tension which
causes death of the periosteum, the skin, the bone,
and of buy naprosyn 500mg all the intervening tissues, for the tension
soon shuts off the blood supply.
Fig. 2. — Diagram of longitudinal section through middle of distal
phalanx; lettering is the same as in Fig. I.
I have called' attention to the periosteum, saying
that it was firmly adherent to the bone except over
its articular surface. Exposed to trauma as the
distal phalanx is, and separated only such a short
distance from the surface as its periosteum is, it is
not surprising that the periosteum is itself often
October 30, 1920.]
COUGH LIX: SURGICAL TREATMEXT Of ffAXD IXFECTIOXS.
injured. When injured, blood or serum collects
under ec-naprosyn generic it, as all have seen it collect under the nail at
the site of trauma, and such small extravasation is
often a focus for the development of bacteria
lodged here by the blood stream.
When bacteria reach such a site the result will
Fig. 3. — a and b, incision through the inflamed fold of nail; c, flap
to be turned back to expose root of nail.
most probably be an abscess under the periosteum.
The signs are there generic naprosyn unmistakable. The patient com-
plains of naprosyn sr 1000 mg severe pain in the finger, which is con-
stant, throbbing and almost unbearable ; pus is
about to fonn, or has already done so, under the naprosyn gel costo
periosteum. The periosteum does not readily stretch
in any direction, but it yields a little in where can i buy naprosyn all direc-
tions around the naprosyn generic naproxen pus and soon the pus has lifted
it up can you get high off naprosyn 500mg from the bone over a considerable area. The
pus may pass completely around the bone, and
spreading ec naprosyn rxlist backward when it reaches the end of the
periosteum at the edge of the articular cartilage, it
may break into the joint. But before it has done
this, or afterward, it may break ec-naprosyn price through the peri-
osteum into the subcutaneous space — into the pulp.
Whenever the pus escapes from the periosteal
covering, then the throbbing pain is instantly re-
lieved. The patient will have pain later on but for
a while naprosyn ec fort 500 mg there is relief, and when the pain recurs,
which it does when the subcutaneous tension in-
creases, it is not so severe as it was at first. A
strange thing is, that at the onset of any subperi-
osteal suppuration, while the patient is complaining
so bitterly of the pain, there is very little swelling
of the part or perhaps none whatever. In fact,
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