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deficiency in ventilation and lighting in our public schools. ( I ) Dust is hard to control, yet where it is produced as a by-product in the course of manu- facture, much may be done by the introduction of improved machinery or by the use of suitable fans for the abstraction generic name for prevacid of dust from work shops. Street dust is harder to control, but much could be done by insisting on better pavements, more thorough street cleaning and systematic sprinklirfg. (2) De- ficient ventilation and lighting act in two ways which are detrimental: (a) It reduces the resisting powers of the persons subjected to the unfavorable conditions and (b) the vitiated air poisons directly the mucous membranes. 3. Puerperal Insanity. — Palmer believes the following classification to be the most convenient one : ( i ) " Insanity of pregnancy, which is usually melancholia; (2) puerperal insanity proper, which comes on in a limited period after delivery and is usually in the form of mania, and (3) insanity of lactation, which is mostly melancholia." Each one of these forms is considered in some detail, and gen- eral advice is given with regard to treatment. Con- cerning puerperal insanity proper he has this to say of the prognosis : " The prognosis is favorable : 75 to 80 per cent, recover, but a large proportion die of exhaustion " — a statement which may not be al- prevacid sale together clear to some readers. 5. Mastoid Disease and Meningitis. — Oppen- heimer asserts that the only hope in cases of menin- gitis of otitic origin lies in operative intervention. It is therefore important prevacid chewable tablets to know how such forms of meningitis arise and how they may be recognized clinically. As regards infection, practically prevacid 24hr coupon but two forms of otitic meningitis may be cheap prevacid online considered : the first results from infection by absorption into the circulation, the other prevacid generic equivalent depends upon the extension of the inflammation by contiguity from the mastoid region to the dura and from there to the other mem- branes enveloping prevacid otc 30mg the brain. The former variety is rapid in its onset, tisually diffused, prevacid naprapac 500 and once estab- lished is necessarily fatal, while the latter form con- sists of a gradual process, usually localized in its .incipiency and when diagnosticated early is sus- ceptible of cure by free prevacid coupons a radical operation. Purulent leptomeningitis is usualh" fulminating, sets iit sud- denly and terminates in but a few hours, or ma\' prevacid ac continue before a fatal issue ensues for several days. \\"hile the prevacid for sale localized focus analogous to an epidural abscess is more or less chronic, with mild symptoms which may apparently intermit from time to time before a regular course is established and whicli may last prevacid 42 count for several weeks or even months. When a mastoid empyema is about to infect the meninges there is almost invariably marked local pain, usually associated with fever. \\'hen such a condition oc- curs, especially in the prevacid otc coupon presence of a diminished aura' discharge, the patient should be considered in seri- ous danger of cerebral complications. The chief symptoms of meningeal irritation are headache, oc- casional nausea, vomiting, vertigo, moderate in- crease of temperature and some acceleration of the September 19, 1903.] PITH or CURRENT LITERATURE. S8i pulse rate, while thirst, anorexia, and constipation arc mostly complained of, but are not characteristic. Percussion of the skull affords generic prevacid otc but little evidence as it may be either painless prevacid savings card or painful above and be- hind the auricle. The differentiation between men- ingeal irritation and true meningitis is almost im- possible, although the latter may be recognized when the headache becomes persistent and is followed by the group of symptoms coupons for prevacid 24 hour above mentioned with, in addition, drowsiness, delirium and stupor, while the pulse at first accelerated, later becomes retarded. Constipation as a rule is obstinate and specially so towar'ds the end of fatal cases, while if diarrhoea is present or the bowels are normal, brain abscess and meningitis may, with a certain degree of assur- ance, be eliminated. BOSTON MEDICAL AND SURGICAL JOURNAL September 10, 1903. 1. Cancer of the Intestine, Etc. ; Its Surgical Aspect, with Report of Cases, By Homer Gage. 2. The Relations Existing Between Respiratory and Intra- pelvic Diseases, By Daniel H. Craig. 3. Carcinoma of Chorioid, Metastatic from Prostate, By Allen Greenwood. 4. .\ Case of Carcinosis with Secondary Nodule in the Eye, By E. E. Southard. 5. Mechanical Vibration: Its Theory and Application in the Treatment of Disease, By Maurice F. Pilgrim. 1. Cancer of the Intestine. — Gage reports four cases of his own, all treated by operation, and re- views the results obtained prevacid discount card by operative intervention by some of the best known surgeons, in prevacid en espanol cases of malignant disease of the intestine. He calls atten- tion to the fact that the best results have prevacid 24 hour coupon been ob- tained where the tumor was situated about either the ca:cum or the sigmoid flexure of the colon. In judging of the results of operative treatment, one must distinguish between immediate and eventual results. With this in mind the author asserts that operation should be performed early or not at all. He advises against palliative operations as tending only to prolong the patient's suffering. Colostomy and the various forms of intestinal anastomosis and

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