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[N. Y. Med. Joub.. tissues, it is especially open to the objection that, by bring- ing repeatedly into play the contractile power of these structures, it may ultimately weaken their walls and lay the foundation for a permanent dilatation of the erectile cells. In calling attention to these disadvantages of its continuous use in these affections, I do not by any means desire to question the many excellent virtues of this remedy. In certain acute affections of the hctz 12.5 lisinopril mucous membrane, and for its effect on the nasal erectile structures, pointed out by Bosworth, it is a God-send, but I am convinced cheap lisinopril that at present it is too indiscriminately and injudiciously em- ployed. In the disease under review, it has in my hands utterly failed to dissipate, except temporarily, its symptoms, or to abridge, in the slightest degree, its course. For a short while amelioration is secured, but, at the expiration of a period varying from half an hour to two hours, the symptoms recur, and the drug lias to be used again and again. My custom is to treat this affection as I would any other chronic disease of the nervous system. The lisinopril 12.5 mg commenced ment of the treatment, accordingly, should date from the first appearance of the patient for consultation, and termi- nate, it may be, long after he is apparently free from his disease. I can not insist too strongly on the importance of prolonged and continuous tonic treatment addressed to the nervous apparatus. It may at first fail, and the paroxysms return again and again with all their accustomed severity; but. if it he persisted in, the time will come, sooner or later — lisinopril 40 mg provided there is not some incurable lesion — when the in- tervals between the paroxysms will be less and lisinopril 20 less, and the attacks themselves less severe, until finally they cease alto- gether. The great mistake which is universally made, it seems to me. is the suspension of treatment upon the termina- tion of the attack, ami I therefore online lisinopril wish to emphasize tie importance and necessity of continuous treatment throughout the interregnum of fancied immunity from the disease. In carrying out this remedial course two difficulties wili present themselves: the firmly-rooted belief in the patient's mind that there is nothing the matter with him in the in- tervals of exemption, and his natural discouragement when, in spite of treatment, he may have an occasional return of his old disorder. The general tonic and hygienic treatment will vary with the Individual peculiarities of the subject and the conditions of his environment, and will usually consist, to speak in genera] terms, of prophylactic measures directed against the development of nervous and catarrhal affection-.. Among the many remedies I have tried in the constitu- tional management of this class of affections, I would men- tion ami recommend arsenic, phosphorus, zinc, quinine, and mix vomica. These drugs may he used alone or in combi- nation for an almost indefinite time, if the usual precautions in regard to their physiological lisinopril 10mg effects are exercised. The following method of administration, although it has failed me at times, has, nevertheless, been so generally beneficial in my practice that I do not hesitate to recommend it for vour trial : (10 Tf, Zinc, phosphid S r - tV i Quin. sulph gr. ij ; Ext. nuc. vom gr. £. M. Ft. pil. no. j. S. : To be taken before meals. (2-) 5 Liq. arsenic, et hydrarg. iodid., gtt. iij ad v. S. : In wineglassful water, after meals. Formerly I used Fowler's solution, but for the past year have substituted the iodide of arsenic and mercury (Dono- van's). The quantity of the purchase lisinopril ingredients should be in- creased according to the judgment of the physician. Should the physiological effects lisinopril buy of any of the remedies manifest, themselves, it should be stopped for a week or so. and then resinned in the same or lisinopril hctz 12.5 mg diminished doses. I may lisinopril hctz 20 add, in leaving the subject of constitutional treat- ment, that for several years I have employed the above- mentioned lines of treatment in simple inflammatory condi- tions of the nasal passages and throat, and have found them important auxiliaries, especially in the earlier stages of the simple inflammatory process, when the vaso-motor element of inflammation lisinopril 10 mg is chiefly evident from the repeated and sudden erection of the turbinated structures.* I have also seen good effects lisinopril 12.5 from lisinopril 20mg the continuous use of the bromides lisinopril 5 mg and the iodide of potassium. lisinopril 5 In two cases I have made 20 mg lisinopril use of the constant, current (from ten to fifteen cells), placing one electrode over the nape of the neck, and passing the other extremity of the current alternately over the region of the superior cervical ganglion and through the nasal passages. In one, apparent, and in the other de- cided, relief to the symptoms was obtained. Although my experience with this agent has not been sufficient to war- rant me in pronouncing either for or against its use, I con- sider it, nevertheless, worthy of lisinopril 10 further trial. In one ease a satisfactory result, as far as the ameliora- tion of the symptoms was concerned, was secured bv par- tial obliteration of the pharyngeal vessels with the galvano- cautery. The patient, a physician, suffered from the pharyngeal variety of vaso-motor neurosis, associated with an abnormally large, swollen, ami varicose condition of the veins on the posterior wall. The vessels were cut order lisinopril across in a number of places, and since the operation the paroxysms have been notably less severe. In regard to the topical treatment of existing nasal dis- ease, I can only repeat what I have said over and over again? that any treatment addressed to the nasal chambers accom- plishes one result, and one only — it closes one door against will be of itself sufficient. The nasal passages may be the sole avenues through which the nerve-center?

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