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porary expedient when immediate danger threatened. The methotrexate rxlist treat- ment which could give real relief must in his judgment be that which re-established the flow of urine from the kidney. As Dr. Delafield had said, coma and convulsions were to be feared early in the disease, and in alcoholic patients, he would add. chiefly. In the long-lasting cases patients died in exhaustion with ty- phoidal symptoms, not in urajmia. The latter condition, then, was not due to suppression of urine, as was commonly supposed, even when long continued. He had methotrexate 2.5 mg tablet observed that acute uraemic attacks came in two quite different methotrexate usp classes of cases ; in some patients coma and convulsions vfere accompanied by a high ar- terial tension, but in others topical methotrexate sudden coma would be developed without any increase of methotrexate and ms arterial tension, and in these cases heart stimulants were of most service. Dr. J. E. Winters said, in reference to Dr. Delafield's advice that patients with subacute nephritis should seek another cli- mate, that, however desirable this might sometimes be, we had to do something for a large class of patients who either could not afford or were in no condition to go away from home. In these cases abundant exercise seemed to do the most good, especially when taken together with all natural means by which the flow of urine was found to be increased, for this was in his experi- ence methotrexate sodium 2.5 mg the best test of an improved condition. Whenever patients came under his care at the beginning — that is, suffering from acute nephritis — his first care was to keep them in bed for weeks running, or as long as the general nutrition could be supported under these conditions and the amount of albumin in the urine not become increased. Rest and keeping the functions of the skin active, together with a diet in which an excess of albumin was not present, were to him the most important elements in the treatment of acute nephritis. He allowed only the white meat of fowls, milk, and fish of delicate fiber, and encouraged the liberal use of methotrexate for ms fats and oils, especially cream and cod-liver oil, April 20, 1889. PROCEEDINGS OF SOCIETIES. 439 whif'h he considered of great value. He doubted whether iron in the una3mia following nephritis had the same eftect as in ansBiiiia due to other causes ; it had not seemed to him to im- prove the condition of patients to whom he had given it, appre- ciably. He agreed with Dr. Delafied that the escape of serum into the subcutaneous tissue and into the cavities of the body was apt to afford relief to the nervous and cerebral symptoms, and lessened the tendency to uraemia, as if some of pharmacology of methotrexate the poison which the kidney could not dispose of was filtered out of the general circulation. Dr. Laceenoe Johnson spoke strongly of the value of pilo- carpine in acute nephritis ; he had employed it for a number of years in the ureemia of pregnancy, and here his results had been most favorable. Thus a lady in the eighth month of gestation had been suddenly seized with ura^mic convulsions, which had been repeated ti ve times in the next six hours. On arriving at methotrexate canada tlie house he had given the sixth of a grain of the hydrochloride, methotrexate pharmacology and had repeated the dose every twenty minutes for three doses, and had given the fourth after two hours and a half. It had caused profuse sweating without in the least enfeebling the ac- tion of the heart. After six hours there had been a free flow of urine. The remedy was methotrexate 17.5 mg also methotrexate india of use in the non-puerperal forms 6 mp methotrexate of nephritis. He had seen complete relief follow its use in coma accompanying acute bronchitis. There was no danger in using it in any recent case of nephritis occurring in a well- nourished patient, but, on the other hand, it was never to be given to weak and debilitated patients. The President thought the first thing to be taken into con- sideration when dealing with acute nephritis was the general condition of the patient apart from the renal symptoms, as de- termined by his age, predispositions, and habits. The same treatment would certainly not be called for in an infant and in a man of fifty. However, as a rule, rest in bed, moderate pur- gation, and liquid diet were enough, unless the methotrexate generic name accumulation methotrexate 7.5 mg of excrementitious products was such as to threaten convulsions. For deci-easing arterial tension he preferred calomel and the saline cathartics, and added counter-irritation over the kidneys and stimulation of the skin functions. methotrexate b12 Subacute nephritis was a diflacult thing to handle well. He had long opposed the use of any measures tending to deplete the patient, such as hydragogue cathartics. To improve the general nutrition should be the main object, methotrexate 12.5 mg and, he would add, iron did not do this. A change of climate was of an importance hard to overestimate. In regard to the giving or withholding of cardiac tonics, including digitalis, he would say that whenever, in subacute nephritis, the heart was found to be failing, we had a good reason for resorting to sonae form of cardiac stimulant, and continuing its use as long as it increased the absorption of excrementitious materials from the tissues and the production of urine. When the weakening of the heart was due to methotrexate injection cost the accumulation of poisons in the system, rather than to degenera- tive changes in its wall, he knew of no drug which could keep such a heart at work as well as opium in small doses. Dr. Delafield replied to Dr. Jacobi in regard to his having recommended coffee or caffeine. He had only quoted from a French writer who advised its use. As to the great value of the bichloride of mercury, he could only say that it was an old stand-by, and it was perhaps a rule methotrexate cream to give it; but he had never been satisfied that it alone was likely to improve the patient's

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