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and other types, in the postpyloric the total suprax 400 mg tablet acidity and the free acid were relatively high, and the per- centage of free acid was greater than fifty per cent. : it was similar to the suprax generation condition in gastric generic suprax ulcer, but in the retention meal the percentage was less than in the Ewald order suprax meal. In none of these cases of post- jjyloric ulcer were there evidences of retention and in suprax mg none was lactic acid found. In the other type of duodenal ulcer the percentage of free acid did not exceed fifty per cent, and in the retention meal it ranged from zero up to thirty-two per cent. In gastric carcinoma the free hydrochloric acid ranged from zero up to forty, and in the retention meal it ranged from zero up to suprax cefixime twenty. In these cases there was free hydrochloric acid. In normal cases the average ])ercentage of free to total acid was forty following the Ewald test purchase suprax meal. In gastric ulcer the projjortion of free to total was greater in the retention meal than in the Ewald meal. In postpyloric ulcers the percentage of free hydrochloric acid was not as high as in gas- tric ulcers after suprax 400mg the retention meal. .So far as examination of the feces was con- cerned, there were two factors ; one was the diastase activity of the stool and the suprax cefixime tablets other was the presence of occult blood. In the diastase the normal activity of the stool varied from twenty-five to thirty jjer cent. When stools were incubated with starch thirty per cent, of the starch was converted into sugar. In diseases of the pancreas the diastase activity of the blood was increased, whereas the diastase activity of the stool was either absent or greatly decreased. Practical Clinical Examination of Upper Gas- trointestinal Tract. — Dr. Allex A. Jones, of Buffalo, presented a tabulation of diseases most commonly encountered. In gastric and duodenal ulcer, pain was one of the most important manifes- tations. Many times in young wometi the first symptom was hematemesis. He had noticed pain to be more frequent in men than in wonien. Pain was relieved by digestion, and it supervened sooner after eating in gastric than in duodenal ulcer. If the ulcer was located far back postprandial pains oc- cured ; the pain was intermittent in cases with peristalsis. Typical hunger pain usually felt as a gnawing, was strongly indicative of buy suprax online duodenal ulcer. The pain of gastric and duodenal ulcers was suprax tablets tempo- • rarily relieved by alkalies. Pain simulating hunger pain might arise from extragastric conditions. Vomiting or lavage relieved the pain of suprax cefixime 400 mg ulcer suprax injections but not the pain from extragastric conditions. In perfora- tion the pain was excruciating and prostrating and was accompanied by increased frequency of the pulse and muscular rigidity : a leucocytosis was found soon after perforation occurred. Pain in the back suprax antibiotics at or near the tenth dorsal vertebra was an import- ant symptom, as it indicated ulcer on the posterior wall suprax 100 of the stomach. Tenderness due to ulcer antibiotic suprax was usually present in some part of the epigastric re- gion. A full stomach gave rise to tenderness. \'omiting was not common in ulcer unless stenosis existed. Hematemesis was one of the classical sym- toms of ulcer. In some cases of ulcer with hyper- esthesia vomiting was present. Fever suprax injection might be ^ present if there was suppurative peritonitis. Anemia was common in gastric ulcer. The most important symptoms of cholecystitis and cholelithiasis were the irregular temperature, pain, and tenderness in the region of the gallbladder. Suppurative cholecystitis might be suspected if there was a decided leucocytosis. If cholangitis accom- [janied cholecystitis there was evidence of some de- gree of jaundice. In rupture there were tenderness over the liver, rising pulse, and shock. The symp- toms of cholelithiasis often occasioned confusion. This affection was often painless buy suprax and the symptoms might be gastric. Some sensory gastric disturbances might lie present. Tenderness over the liver was a varying factor, which might be elicited only on pres- sure or by Murphy's hammer stroke over the suprax antibiotic for children liver. Pyloric spasm, turbid bile withdrawn through Ein- horn's tube, and traces of bile in the urine were not infrequently found in gallbladder disease. Acute gastritis with its distress after eating should be remembered as a cause of sudden pain in the up]ier abdomen. {To be continued.) New York Medical Journal INCORPORATING THE Philadelphia Medical Journal "e Medical News A Weekly Review of Medicine, Established 18^3.

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