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the anterior annular ligament. When pus is found in any of these synovial sheaths, that sheath is to be laid wide open over the place where the pus is, and for at least one to two centimetres above and below this. When the tendon sheath is involved, any attempt to move the tendon causes pain, and there is local tenderness over it. When pus has. invaded the great bursa at the wrist, the anterior annular ligament is cut through and the hand and fingers dressed in hyperextension and left so until healing is well advanced. When the hot bath is used, the part must be kept on the splint while in the bath, and the solution should be as hot as can be borne without blistering. On no account should the temperature of the bath fall below 110° F. In weak patients it is not well to continue the bath day and night, because of fatiguing the patient ; therefore during sleeping hours the part, still on the splint, is placed in large, hot packs wrung out of the solution and wrapped in waterproof cover, and the whole surrounded with hot water bags which are frequently renewed. If an infection of the palm is properly opened and treated as outlined above, the progress of the ^ In my service ethyl chlorid^ has been esthetic for short operations since 1915. 670 KRCPP: X RAY A GUIDE /.V PNEUMOTHORAX. [New York DicAL Journal. disease is quickly checked. The drains are Nizagara Online removed in from three to ten days and the wound kept open so that pus cannot be retained and burrow. Active motion is encouraged for a few minutes at a time two or three times daily as soon as the drains are removed and gradually these periods of activity are increased and lengthened. Only those too long immobilized or improperly handled fail to regain useful function. 405-413 University Club Building. Buy Nizagara THE X R-AY Order Nizagara AS AX ESSENTIAL GUIDE FOR PRODUCING ARTIFICIAL PNEU- MOTHORAX IN ADVANCED CASES OF PULMON.A.RY TUBERCULOSIS * By D.wid Dudley Krupp, M. D., Brooklyn, N. Y., First Lieutenant, Medical Corps. U. S. A.; Rontgenologist to the U. S. Army General Hospital, Fort Bayard, New Mexico. The purpose of this article is to show the advan- tages of the use of the x ray in the control of the production of an artificial pneumothorax in ad- vanced cases of pulmonary tuberculosis ; and to demonstrate the necessity of a careful study of such cases before attempt is made to produce this con- dition. In advanced cases of pulmonary tuberculosis, the almost constant harassing cough and frequent hem- orrhages are the most difficult symptoms to treat. Flc. 1. — Condition of lungs prior to injections of air (Case I). Narcotics and other methods are used to give relief, which is only temporary. With the production of an artificial pneumothorax, the affected lung is Buy Nizagara Online col- laji^ed and the annoying symptoms are more or less permanently relieved ; certainly to a more marked extent than by the use of narcotics, and without their undesirable depressing effects. The purpose of the pneumothorax in these cases is not to produce a cure, Nizagara Tablets primarily, but to render the patient's life more comfortable and possibly increase his chances for recovery. This relief from the harassing cough •Published by pennissic Army. Now on duty at N. C June. 1920.

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