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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. 667 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 a _ ._/ 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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