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troduction to the projected work, Trileptal Generic Name their investigations show that over half the dairies supplying the town Cost Of Trileptal do so with milk in which (he tubercle bacillus can be dem- onstrated. It is greatly to be regretted that any such work Order Trileptal should bo interrupted, and especially by the death of the distinguisheil pathologist who had undertaken it. It is, of course, impossible to say how the causal rela- tion between the two phenomena, tubercle bacilli in the milk and tuberculosis in those who drank it. was to be (lemon.'stratod, but presumably through charts showing the Trileptal Coupon coincidence of the two phenomena. Directiv con- nected with this method of the invasion of the tubercle bacillus into the body nmst be studiinl the question of the paths which it travorscs from (he Trileptal 450 Mg alimentary canal to the {Kiint where it causes the formation of tulvrcle. If we could supjKise that tuU'roulosis of the rwjiiratory organs arose from infection carried by (he in.spinnl air, and that tuKTcle oliiewhen' conublom would itocm simple, but a very litde study of the question • ttmtm-h. mni. HWA , No 1, ISM. I APurchase Trileptal Online be remembered that Cornet, in the series of papers which he published ten years ago, showed that dust in the rooms of persons suffering from phthisis pul- monalis contained tubercle bacilli in large numbers. He also showed that this apparently was due to the pulveriza- tion of the dried sputum from such patients. He made, however, the comforting statement that the cough of phthisis patients did not spray tubercle bacilli into the air, because bacteria can not arise from the moist surface of the mucous membranes. Bacteriologists not only con- firmed experimentally Cornet's observations in regard to the dust, but they reiterated his statements in regard to the tenacity with which bacilli cling to damp surfaces. I am sure that other laryngologists besides myself placed little dependence upon the latter assertions. It is one of the tricks of the laryngologist's trade, which the nov- ice must learn early in his training, to dodge the glob- ule of Order Trileptal Online mucus as it is hurtled through the air from the gaping glottis of his patient. The knowledge that these viscid drops from a tuberculous lung are apt to contain bacilli always adds an extra agility to his movements. A recent paper of B. Fraenkel * reviews the work of Pfliigge,! who has shown conclusively that phthisical patients do in the act of coughing, sneezing, clearing the throat, etc., spray tubercle bacilli into the air, and that in all probability this is the origin of many of the tuber- cle bacilli in dust. While this may be the origin of many of the tubercle bacilli in the dust, such numbers as could be expelled from the mouth in this way must, of course, be insignificant in comparison with the numbers expelled voluntarily in the profuse purulent expectoration of phthisical patients. It is a significant fact that in spite of the constant exposure of laryngologists to such con- tagion in their daily examination of the upper air-pas- Trileptal 150 sages of tuberculous patients, no notable preponderance of tuberculous disease among them has been record- ed. This is one of Trileptal Tablets many practical observations which has convinced us that the majority of individuals are immune Trileptal Cost to ordinary doses of the tubercle bacillus acci- dentally taken in, and yet there are Trileptal 150 Mg some individuals who are apparently infected by the smallest of such doses. It requires but very little reflection to perceive in this view Trileptal 60 Mg of the case how important a factor in the etiology is this individual index, but the fact must never be lost sight of that tliis individual immunity varies from time to time, and even that it is quite possible that such a dose may be taken in as would overcome the strongest systemic resistance. Fraenkel says that he bas induced a large number of his phthisis patients to wear over their mouths a device for filtering the expired air, and in this wny Buy Cheap Trileptal protorfing thn?n with whom they associate. I ilients may be induced to ♦ JJrrlincr klnuKi/ir WiwhinHi-hrift, No. 2. 18(11). t ZcitHrhri/t f. Ilyijitne, Danil xxv, S. IHS. do this under the delusion suggested to them by their medical attendant that the odoriferous medication with which the filtering cloth may be saturated is efficacious when continuously breathed in. Doubtless there are plenty of credulous patients to be found on whom this deception could be practised, but I am happy in the be- lief that there are not enough medical men in exist- ence who would so far forget their own dignity and that of their profession as to make this suggestion of any value in cheeking the ravages of tuberculosis ; while, on the other hand, I doubt if any other means could be adopted to make Trileptal Vs Tegretol phthisical patients generally use this altruistic device. The behavior of the larynx toward tuberculous infec- tion has long been an interesting puzzle to laryngolo- gists. I have Buy Trileptal Online long believed that its careful study would elicit important hints as to the mode of tuberculous in- fection and as to the means by which tubercle is dissemi- nated throughoiit the body. One very great stumbling- block in the discussion of the means by which Cheap Trileptal the larjmx becomes tuberculous is contained in the terms of the Trileptal Acne problem itself as usually expressed : " What is the cause of tuberculous laryngitis?" It would be better to put the question thus : " Trileptal 135 Mg Why is it that the larynx usually es- capes infection with the tubercle bacillus ? " Whether we suppose the tubercle bacillus to enter beneath the epi- thelium in the Tegretol Vs Trileptal fauces or to pass downward with the air and secretions to the alveoli of the lungs, or whether it enters the system through the intestinal tract and is carried to the periphery by the blood or the lymph chan-

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