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INTUBATION OF online priligy THE LAKY X X . By JOHN B. WHEELER, M. D., BURLrSGTON, VT. Examination of the reported cases of intubation of the larynx leads me to suppose that the result of the following case is rare enough to render it of interest to the readers of the Journal. The case was one of membranous croup in a strong, healthy girl, three years and a half old, of French Canadian parentage. Intubation was performed January 16th, at 8 a.m. The child had been sick only twenty-four hours, but was already becom- ing cyanotic, and had an extremely labored respiration of 48 to the minute, priligy tablets with marked dilatation of the nostrils and recession at the ensiform cartilage. The respiratory murmur was very faint ail over the chest. No membrane was visible upon palate, fauces, or pharynx. The pulse-rate was 156. An O'Dwyer's tube of the newest pattern, and of the size marked 3-4 on his gauge, was introduced, with immediate improvement in the symptoms. In five minutes the number of respirations bad fallen priligy price to 30 a minute, and the pulse- rate to 120; the manner of breathing had changed, the com- plexion improved, and air entered the lungs freely, as shown by auscultation. priligy cost The child was perfectly comfortable all day, sleeping quietly a great part of the time, and taking nourish- ment, both solid and liquid, without the slightest inconvenience. 1 luring the evening the child breathed noisily, as though there were a good deal of mucus in the tube, but apparently without any dapoxetine india impediment to respiration. At 10 p. M. she bad a severe fit of coughing, and, dapoxetine purchase according to her mother's account, "choked up dapoxetine in india and died in about two minutes." The distance be- tween my (.thee and the patient's home, one mile, rendered it impossible for me to be of any assistance. No autopsy was allowed, but on extracting the tube it was found to be plugged with a large piece of false membrane, which extended almost to the top of the tube and protruded a quarter of an inch from its lower end, forming as complete an obstruction to the passage of air as the obturator itself would have purchase priligy online done. The general treatment of the case consisted in the adminis- tration of one tenth of a grain generic priligy of calomel every hour, and in keeping the air of the room moist with steam. A snow-pack to the throat was ordered the evening before the operation, but I think it. was not applied. The termination of order priligy this dapoxetine buy case is unique, so far as purchase priligy I have been able to discover. A few cases buy cheap priligy of intubation are re- ported, two of them by Dr. O'Dwver, in which the tube became plugged with false membrane; but in these cases the tube order priligy online was at once coughed out, thus preventing the suf- focation which proved fatal in my case. As this is my first case of intubation, and as my experi- ence of tracheotomy is small, owing to the reluctance of buy priligy online parents to consent to the operation, a positive expression of opinion regarding the comparative merits of the two opera- tions would be premature. My tracheotomies number only two, both fatal. The result in each case is fairly attributa- ble to negligence on the part of the attendants, who were too stupid and careless to follow out directions. As nearly all cases of croup, in this part of the country at least, occur cheap priligy among that class of people, the most desirable operation would seem to be the one which depends least for its suc- cess upon skilled or even intelligent nursing. This opera- tion is generally acknowledged to be intubation, as com- pared with tracheotomy. In the case which I have re- ported, the result might, to be sure, have dapoxetine hydrochloride been different had any one been present who knew how to extract the tube when it became plugged. But this buy priligy is only one case in a total of some two hundred which have thus far been reported, while there is no case of tracheotomy which does not call for more skill in its management than is usually to be found in the homes of the poorer class of patients. Feb. 26, 1887.] L EA DING A R Tl GL ES. 239 NEW YORK MEDICAL JOURNAL, A Weekly Review of Medicine. Published by D. Applkton & Co. Edited by Frank dapoxetine online P. Foster, M. D. NEW YORK, SATURDAY, FEBRUARY 26, 1887. THE ALLEGED IDENTITY OF SMALL-POX AND COW-POX. In our issue for December 11, 1886, we spoke approvingly of tbe efforts made by an English veterinarian, Dr. George Fleming, to point out the fallacy of the doctrine of the identity of these two diseases. We stated that the doctrine rested upon a flimsy foundation. Our statement called forth a letter from an esteemed member of the Massachusetts Medical Society, calling attention to an account of a presumed instance of the conversion of small-pox into cow-pox, ;'. e., the production of

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