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securing pure air. Tompkins found Generic Dostinex in Leicester, England, that in one section of the town where diarrhoeal diseases were very prevalent there were from three to six times as many bacteria in the air as in other sections. The water supply was the same for all, and the food not essentially different. Equally important is cleanliness of the mouth. Van Puteren found in infants suffering from thrush that the number of bacteiia in Buy Dostinex Online the stomach was Dostinex Cost forty trmes as great as when this condition was absent. To secure a soil unfavorable for bacteria we must have healthy digestion and absorption. This means a great deal. To secure it we must, in the first place, build up the infant's constitution ; secondly, food suited to the powers of the di- gestive organs should be given ; Buy Dostinex thirdly, regularity in feed- ing must be insisted on, and night nursing and feeding stopped as e.rly as possible ; fourthly, the stools should be inspected to see whether what is given is properly absorbed; fifthly, all minor derangements should be attended to; sixth- ly, during the hot summer season the amount of food should be materially reduced, and infants should be allowed water freely.* As to treatment, three distinct indications present them- selves : 1. To nourish the patient. 2. To combat the abnormal bacterial growth. 3. To treat the lesions. All these indications must be considered if success is to be the result of our efforts. The force of the different indications Dostinex Mg may vary in different stages of the morbid pro- cess ; thus, early in the disease the second indication may be the Order Dostinex Online most important, while later on the third indication comes into great prominence. * Under this last point I wish to call attention to an experience of Dr. David Little, of Rochester, N. Order Dostinex Y., which he published in "The Transactions of the Medical Society of the State of New York " in 1884. In an orphan asylum in his city where every previous Dostinex Price summer had witnessed a number of deaths from diarrhrpal disease, he directed that infants should be fed at three-hour intervals during the day and should have nothing at night. Water was allowed freely at all times. The season passed without a fatal case from diarrho'al disease. At the close of the season he remarked to the sister in charge that Cabergoline 0.5 the new rules of feeding had proved beneficial. She replied : Dostinex Online " Yes, but it did seem, rather cruel to feed the infants only three times a day.'''' These were the directions as she had understood them and as they had been rigor- ously carried out. The moral is plain. In all stages we have to deal with a Purchase Dostinex very complex process, and its management will never, I think, be reduced to so simple a thing as the discovery of a pathogenic microbe and the giving of its appropriate germicide. 15 East Fifty-fourth Strkkt. PRIMARY CARCINOMA OF THE PANCREAS.* By W. GILMAN THOMPSON, M. D. The patient, J. S., female, aged fifty-five years, married, Ger- man, and a Dostinex Tablets dressmaker by trade, was admitted to the New York Cancer Hospital, Buy Cheap Dostinex September 15, 1888. There was no pertinent family history. The patient had been in average health until two years previous to her admission, when she had occasional digestive disturbance, consisting of vomiting, slight epigastric pain, and discomfort. No decided symptoms were observed, however, until six months before admission, when she noticed a small nodule deeply seated in the lower epigastric region toward the left. This mass had grown steadily and rapidly. During this period there had been considerable vomiting at in- tervals, especially after Buy Cabergoline meals, but no constipation at any time. Physical examination showed the patient greatly emaciated, the height five feet three inches, and the weight only one hundred and ten pounds. She was very anaemic, but not jaundiced. The blood contained 40 per cent, of the normal amount of hasmo- globin. There was a pulmonic systolic bruit and a venous hum in the neck. The lungs, liver, and spleen were apparent- ly normal. A large, solid mass larger than the adult fist was felt situated at the junction of the epigastric and left hypo- gastric regions, and extending into the umbilical region. The tumor elevated the surface of the abdomen about half an inch, and the larger portion of it was below the Purchase Dostinex Online umbilicus. It was bard, movable, gave no sense of fluctuation, and no pain or nausea on deep pressure. The percussion note over the mass was distinctly dull. The patient Cheap Dostinex was put upon symptomatic treatment, with careful regulation of the diet. Lavage was em- ployed and the food was fairly digested. I examined the tumor from time to time and found it altered considerably in positiou, and also in the character of its percussion note, which on one occasion became distinctly tympanitic. This circumstance, to- gether with the fact that Cabergoline Tablets so large a tumor had at no time occa- sioned very severe gastric symptoms, Cabergoline Buy led me to suspect the pos- sible presence of a pancreatic cyst. I ordered a large dose of cod-liver oil, in order to see if it would be voided in the stools. None appeared, iiowever, and as there was no jaundice, I in- ferred that there was enough bile present in the duodenum to emulsify the fat and replace the pancreatic juice. As the diagnosis was Cabergoline 0.5 Mg far from certain, I had the contents of the stom- ach tested with great care for the presence of hydrochloric

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