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in the care of a limb in which a nerve has Purchase Pantoprazole been sev- ered there were many considerations other than those that appear on the surface. The inevitable paralysis of a certain group of muscles carries with it a whole Purchase Protonix train of consequences, many Purchase Pantoprazole Online of which are by no nieans inevitable. Leaving on one Buy Protonix Online side the muscles directly affected, the loss of the normal range of movement will lead to the formation of adhesions between other muscles, around tendons, and within joints. The limb may readily fall into positions of deformity which give rise to the stretch- ing of muscles and ligaments, the skin itself will suffer from disuse, and the limb will suffer Buy Cheap Pantoprazole from its corresponding loss of excretory power. It is therefore evident that in estimating the value of any one method of treatment the limb as a whole must be considered and the vision must not be Buy Pantoprazole bounded by the narrower field of the small group of muscles which may be paralyzed. In the application of electricity the primary object is to evoke contractions in the paralyzed muscle. By doing so it is compelled to fulfill its normal func- tions, in however diminished a degree, and the uni- versal experience is that this is essential for the pre- vention of atrophy in any tissue. The tissues re- quire for their nutrition something more than the supply of food, even something more than perfect innervation. They must work, and according to Souttar' electrical stitnulation can do for the muscle something quite out of the reach of any other method. Indeed, the prima facie evidence of the value of contractions of paralyzed muscle is so over- whelming, that it would require the strongest prac- tical evidence of their uselessness to justify their being ignored. Order Pantoprazole Yet, if electrical treatment is to be really effective Order Pantoprazole Online one condition must not be overlooked : if the muscle as a whole is to receive the same Protonix Mg bene- fit as the fibres which contract, it must be made to contract as a whole, and this result is often exceed- ingly difficult to obtain. As Souttar pointed out, the ideal means of stimulation would be the passage through the whole limb of a current which would stimulate the paralyzed muscles, leaving the intact muscles imdisturbed. This is not as yet solved, al- though the researches of Lapicque and of Tur- rell have brought this ideal within measurable dis- tance. For the contraction of paralyzed muscle spe- cial forms of current should be developed. The discovery of some simple means by which the con- traction of every fibre of a paralyzed muscle Buy Pantoprazole Online could with certainty be obtained would give a powerful impetus to treatment. Souttar holds the view that there is little fear of overfatiguing paralyzed muscles by continued stimu- lation. Major Cooper has put the matter to a direct test and has found that after six hundred contrac- tions in fifteen minutes a paralyzed muscle showed no evidence of fatigue. Consequently, it seems to be indicated that each muscle might be exercised for a longer period than Order Protonix is usual with great advantage. As for the faradic current which does not produce con- tractions Souttar is of the opinion that apart from- its indirect action through the muscles, it is prob- able that a faradic current has a direct stimulating action upon the circulation, either upon the vessels themselves or through the sympathetic system, and in this way it may have a direct action upon the vitality of the limb as Cheap Protonix a whole. But further it has recently occurred to him that a faradic current stimulating the muscles antago- nistic to those which are paralyzed, might probably ha\e a good effect. While no evidence exists to show that the mere passage of a current through a limb has Cheap Pantoprazole any effect on the growth of a divided nerve^ Buy Protonix there is every reason to suppose that the growth of a divided nerve is influenced by the activity of the cell from which it arises, and Souttar asks Pantoprazole Online what better means could be found of stimulating the an- terior horn cell than the production of the physiolog- ical reflex arising from the contraction of the an- tagonistic muscle group? There is little Generic Pantoprazole doubt that there is a great future for the electrical treatment of paralysis caused by nerve injury. It also appears certain that the modes of applying such treatment are developing in a satis- factory manner. However, those who apply the 684 EDITORIAL ARTICLES. [New York edical journ^ treatment should be experts and thoroughly under- stand the end they have in view. Much has been learned in this direction during the war, and it is to

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