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point of view. It is hardly necessary to say to those who attended the Denver meeting of tlio Amoricnn Med- ical Association a year ago that Colorado has changed governors. It was most gratifying to listen to Gov- ernor Adams's just and appreciative words; it is humiliating to reflect that he has so soon been suc- ceeded by a demagogue who, as the Colorado Medical Journal phrases it, rates the medical profession as " be- neath the quacks, blacksmiths. Christian Scientists, pugilists, and gamblers." PIED FORCfi IN SOLDIERS. Military medical officers well know the trouble that is occasioned in troops on prolonged marches by a swollen condition of the feet, which has Cefaclor 250mg been the sub- ject of many and various interpretations. The actual nature of these lesions has been carefully studied by M. Boisson and M. Chapotot, military medical officers of the French army, who report their results in a valuable paper in the Archives de medecine et de pharmacie mili- taires for February. The condition itself has been described in turn by Pauzat in 18S7, Poulet in 1888, Martin in 1S91, and Busquet Cefaclor 500mg in Cefaclor Cost 1897. The principal characteristics are the su|)ervention during a march of swelling Cefaclor Ceclor on the dorsum of the foot, accompanied by pain more or less severe, either occurring spontaneously or provoked by pressure or movement, and functional incapacity. Pauzat's ex- j)lanation was that of traumatic periostitis, due, in his opinion, to the footgear and leading to exostoses on the second, third, and fourth metatarsals, those on the second being the most frequent; but he made no reference to crackling or crepitation, sj-mptoms which, according to Boisson and Chapotot, are almost always present. The exostoses, however, he did not Purchase Cefaclor Online find Cefaclor Price Cefaclor Tablets in the earlier exami- nations, a fact which has considerable bearing on the authors' subsequent explanations. Poulet considered the lesions to be of the nature of rheumatic osteoperios- titis, and in his opinion the footgear was Purchase Cefaclor in no sense responsible, though he omits to say whether in his cases any history of traumatism was forthcoming. Martin referred the condition to arthritis and synovitis, as a result of eightwn observations. Finally, Busquet pub- lished in the Cefaclor Antibiotics fievue de chirurgic a memoir U]>on ossify- ing oster leatlior of the shoe Order Cefaclor Online he consid- ered to play an imi>ortant a'tiological W>le. 2. Indirect tmtimatic jM-riostilis. 3. Diathetic jH'riostitis. At the Congn«!>.i of llygieno and Demography, held 784 EDITORIAL ARTICLES. [N. Y. Med. Joub.,. in April, 1898, in Madrid, Stechow, of the Prussian guard, made a Cefaclor Monohydrate communication on fractures of the meta- tarsals as a cause of swollen feet in soldiers. Con- cerning the mechanism thereof, Stechow says: Order Cefaclor If the heads Buy Cefaclor Online of the first and fifth metatarsals are joined by a straight line, the heads of the others will make a sahent angle in the form of a segment of a circle whose centre will be found in the anterior part of the first cuneiform, and whose radius will be about seven or eight centime- tres. In the normal position the big toe and its Cefaclor Antibiotic meta- tarsal bear the shocks coming from in front, but when the inner edges of the feet Cefaclor Generation are parallel, it is the second metatarsal whose head is in advance, and it is this or the others which will bear the brunt of a shock to the skeleton of the foot coming more or less from the side. Stechow, reasoning from skiagraphical examinations in thirty-sis cases, arrived at the conclusion that in nearly all instances a fracture of Cefaclor Generic the metatarsals was the cause of the injury under investigation. The left foot suf- fered more than the right, and the bones fractured were respectively as follows: First metatarsal, one; second, nineteen; third, Cefaclor Mg fourteen; fourth, two. The authors, carrying on their researches from this point, endeavor to show that it is the act of marching to which these accidents, whether fractures or arthritis, must be attributed. In all the cases examined by them in the great autumn manoeuvres of 1898 the second metatarsal was the seat of injury. Occasionally, also, the third suf- fered. The fracture always occurred in the continuity of the diaphysis, usually at the junction of the posterior third with the anterior two thirds, though at times in the middle. The fractures commonly occurred in a V shape, with the concavity forward. Sometimes the frag- ments were displaced, the branches of the V being more or less widely separated, and the anterior fragment somewhat deflected externally. In one case only was the fracture comminuted, and in no case was it trans- verse. The rapid swelling, remaining for a long time, es- pecially if the subject continues to march, the custom- ary absence of ecchymosis, the support offered by the other metatarsals, and the small dimensions of the metatarsal diaphysis render it extremely difficult to elicit crepitation, which, however, may often be obtained by perseverance. An additional sign of the nature of the injury is to be found in pain on pressure over the Beat of fracture and at a distance from the articular surfaces. A subjective sign of value in the diagnosis between fracture and arthritis is found in the fact that, in consequence of the support lent by Cefaclor Cd the Buy Cheap Cefaclor other mctatar- sala, it is possible for the soldier to raise himself on tiptoe, which is impossible in arthritis in consequence of the pain occasioned.

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