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Related post: has also given good results in some instances.
Treatment of Influenza by an Apparently Spe-
cific Method. — l->ancis E. Park (Medical Record,
January 10, 1920) gives histories and temperature
charts in thirty consecutive cases treated by his
method with uniform Purchase Herbolax Online success. He prepares a so-
lution as follows : Dissolve in sixty c.c. of physiol-
ogical saline solution 1.3 grams each of sodium
salicylate and soluble iron phosphate. Filter and
sterilize by heat, then add one c.c. of a saturated
solution of beechwood creosote in lime water. The
dose of this solution is from three to five c.c. re-
peated in twelve hours if needed. Never more
than four injections were needed. The injection
is made into a vein with a 26 gauge needle which
is preferably attached to an all glass syringe which
has the nipple on the side rather than on the middle
of the end of the barrel.
Miscellany from Home and Foreign Journals
Varying Symptomatology of Lethargic En-
cephalitis. — Achard {Bulletin de l Academic de
medecine, February 3, 1920) points out that even
the fundamental symptoms of this disease, somno-
lence, is subject to variation. Some patients cannot
be awakened by external stimuli. Others wake up
when spoken to loudly, answer questions, and go to
sleep again. Somnolence may be intermittent. Thus,
one patient rose each morning, walked about, made
his bed, then slept again for a long period. This
condition persisted for some time in spite of return
of the temperature to normal and descent of the
originally high spinal lymphocytosis to an even
standard of ten Order Herbolax cells per cubic millimetre. In some
cases there is no true sleep but merely a "dazed"
condition. The patients partly sit up in bed, with
their Buy Herbolax Online eyes open, and without the head resting on the
pillow. They remain motionless and their limbs, if
moved, frequently show a catatonic condition. The
open eyes do not appear to see, and fail to move
when some object is passed in front of them. The
lids close only at long intervals. These patients do
not answer questions, do not appear to hear or Purchase Herbolax un-
derstand, and seem to be afraid of moving. Two
young patients showed this condition temporarily
before regaining consciousness. Another patient, a
young girl, remained thus for several days, and
when finally gotten out of bed, showed a tendency
to fall backward. Mental depression is in some in-
stances replaced by a low delirium, even during som-
nolence. One patient, though asleep, spoke of
various episodes in his previous professional career,
and at times became restless, moving his arms about
and taking his legs out from under the covers.
Spoken to loudly, he usually answered, in a weak,
poorly articulated, and monotonous voice. Ocular
paralyses are frequently lacking, or may be very
transitory, slight, and of limited extent. Other
cranial nerves may be affected, typically, in the dis-
crete, partial manner emphasized by Widal. The
limbs may be involved. One young patient, ad-
mitted with a temperature of 40° C. and unable to
answer questions, showed a flaccid monoplegia of
the left upper limb ; his cerebrospinal fluid showed
only about ten lymphocytes per cubic millimetre. On
the next day his mind was restored, fever had
dropped, and the paralysis had disappeared. Spas-
modic manifestations may be added to or replace the
motor disturbances. Some of the reflexes may be
exaggerated and circumscribed myoclonia occur.
One patient, in a deep sleep on the day of admis-
sion, with myosis, loss of knee jerks, normal cere-
brospinal fluid and high temperature, woke up the
next morning, but showed myoclonic movements in
the shoulder and the left side of the thorax. Sub-
sultus tendinum was witnessed in four patients, in
a more marked form than is generally seen in ty-
phoid fever, and with extension to the lower ex-
tremities. In general, the motor disturbances are
varied, disseminated, fragmentary, and mobile.
Constitutional manifestations are likewise incon-
stant. Some patients show a very high temperature, Buy Herbolax
others no fever. Constitutional symptoms may pre-
cede somnolence by a considerable interval. One
patient had had high fever — up to 40.5° C. — for ten
days, with headache, slight Order Herbolax Online nocturnal delirium, no
paralysis, very slight anisocoria, no facial motor in-
volvement, and no somnolence. Two days later, he
developed the characteristic somnolence ; lumbar
puncture yielded normal fluid. At other times, fever
may continue after cessation of somnolence. Again,
in two patients who had shown a pronounced men-
ingeal reaction, intermittent somnolence was still
present two weeks after defervescence. This poly-
morphic and acyclic character of the symptoms in
lethargic encephalitis may be regarded as of some
diagnostic importance.
Chemical Composition of the Cerebrospinal
Fluid in Lethargic Encephalitis. — Pierre Marie
and Mestrezat {Bulletin de I' Academic de medecine.
February 3, 1920) comment on the diagnostic impor-
tance of the question of meningeal reactions in
lethargic encephalitis. Although Achard, Netter,
and Widal have reported instances of unexpectedly
marked evidences of such a reaction in the cerebro-
spinal fluid, the fact should not be lost sight of that
the disease is not a meningitis, and that frequently Buy Cheap Herbolax
it entails no jironounced meningeal reaction. In six
cases Marie found, with the Nageotte counting
chamber, thirteen, eight, 10.5, twelve, twenty-six,
and twenty-four lymphocytes, respectively, in the
cerebrospinal fluid; these figures manifestly imply
only a very moderate lymphocytosis. The albumin,
meastired in two instances with the Sicard tube, was
0.25 and 0.55 gram, and estimated in four instances
by the opacity inde.x, was 0.25, 0.55, and 0.65, and
0.14. These figures, although denoting increased
albumin, do not approach those obtained in menin-
gitis, and it is well known that an albumin increase
may occur independently of any meningitis. In the
sixth case detailed chemical studies were made,
showing but little change from normal cerebrospinal
fluid. Conditions as regards albumin, fibrinogen,
chlorides, dry extract, and ash were practically nor-
mal, while urea and sugar were definitely increased
and acetone present in small amount. Comparison
of these results with those obtained in tuberculous
meningitis, or different forms of acute meningitis,
shows marked discrepancies which are of diagnostic
import. In the si.xth case of encephalitis the fluid
was clear, sugar somewhat increased, and the albu-
min, chlorides, extract, and ash normal ; in menin-
gitis cases, on the other hand, the fluid is usually
more or less . turbid, albtunin greatly increased,
chlorides greatly diminished, sugar absent or greatly
diminished, extract increased in nontuberculous
forms of meningitis, and ash diminished in tuber-
culous meningitis. On the whole, a moderate menin-
geal reaction in a patient with encephalomeningeal
symptoms does not exclude lethargic encephalitis ;
if a marked reaction does occur, the clinician should
be on his guard not to mistake a true meningitis for
lethargic encephalitis — a diagnostic error now being
fre(|uently committed.

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