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produced in another way : the increased peristalsis which accompanies the catarrh hurries the food along before ab- sorption can take place, and in this way also addH to the bulk of the decomposing mass lower in the bowel. Tlic final results in every Order Oxybutynin Online case are: 1. Innutrition of the pati(!nt. 2. Catarrhal, (Toupous, or follicular inllaniiiiation of Generic Oxybutynin the mucous metnbrane. ;}. Toxic Hyujptoms from the; absorption of ptomaines. With our present knowledge it is not possible; to Hay (M'rtairdy whether the develo[)ment of abnormal bacteria is to be regarded as the primary cause of digestive derange- ments or the result of it. The facts, as we now understand them, seem to be most (tasily reconcilePurchase Oxybutynin Online with the latter view. In what, then, consists the peculiar susceptibility of chil- dren under two years? W^e may not attribute it to the milk diet, for this food is taken almost as freely during the third as during the second year without any such injurious results. We do not yet know of any anatomical or physio- logical differences in the intestinal Order Ditropan tract in later childhood sufficient to explain Buy Cheap Oxybutynin the fact, and we must fall back to the view that there is then increased power of resistance to bacteria ; that Buy Ditropan in children over two years the intestinal tract almost ceases to be a vulnerable point for bacterial Purchase Ditropan Online attack. The comparative immunity of children in the country, and of the better classes in the city, is to be explained in Order Oxybutynin the Oxybutynin Online same way. Breast-fed children Generic Ditropan escape by rea.son of the fact that their digestive organs are usually healthy and their food is free from germs. Hand-fed children suffer most — first, because they are almost always overfed; secondly, because many of them suffer a large Order Ditropan Online part of the Buy Oxybutynin Online time from a Purchase Ditropan mild type of catarrh ; thirdly, because in summer their food contains germs in abundance. In the absence of the third condition the two others are not usually potent enough to produce serious con- sequences. But the union of all three gives us our worst cases. To summarize Buy Oxybutynin : 1. We accept, then, the doctrine that we are concerned most of all, in the gastro-intestinal disorders of infancy, with the development of abnormal bacteria, but as the first step there is a failure of complete digestion and perfect ab- sorption. 2. Mechanical diarrhoea from the presence of foreign bodies, or food which acts as such to infantile digestion, and that resulting from the ingestion of poisonous ptomaines, Cheap Ditropan are probably the only varieties to be excluded from this class. 3. The anatomical changes are those of inflammation of the gastro-intestinal mucous membrane ; but the lesions are the results, either directly or indirectly, of the micro-organ- isms. Since micro-organisms are found in numbers only superficially, except where ulcers exist, it seems most likely that their action is an indirect one through their ptomaines. 4. As Ditropan Online to the exact nature of the processes of putrefac- tion which take place in the intestine, and the bacteria which produce the different forms, we are as yet almost in entire ignorance. I April 13, 1889.J THOMPSON: PRIMARY CARCINOMA OF THE PANCREAS. 407 5. One Buy Ditropan Online clinical form of diarrha'al disease — viz., true cholera infantum — has many features which Purchase Oxybutynin point to a spe- cific germ as a probable cause. To what views of prophylaxis and treatment of intesti- nal disease does the foregoing discussion lead us? Time will not permit here more than an outline. Two things are essential to active bacterial growth — the entrance of living germs in numbers, and a proper soil for their development. Prophylaxis must have regard to both these conditions. Germs are to beexeluaed by Buy Cheap Ditropan sterilizing milk for all chil- dren under two years, by absolute cleanliness of bottles and everything with which the milk comes in contact, and by

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