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if you give them sufficient nourishment, more than enough to keep the body in balance. They will add tlesh too, and as soon as cheap levlen they are stronger they are able to fight the disease and do not require so much medicine. I have seen such cases. I particularly re- member a patient who lost fifty to si.xty pounds from chronic diarrhoea. She did not eat anything that was forbidden her, and she thought that milk in- creased the diarrhoea, also bread, and she did not wish to eat. Ultimately she levlen price took nothing. Her condition was so bad that she was almost a skeleton, but after I allowed her to eat and gave her in addi- tion some slight remedy, after a few weeks she picked up and in two or three months recovered. It is thus with a great many other patients, and I think it is very essential to bear in mind how impor- tant a part nutrition plays in prolonging life and curing disease. 20 East Sixty-third Street. .'So BALLIS: SCRCERV OF THE THYREOID GLAND. [New Yokk MEDICAI, .InlKNAL. SURGERY OF THE THYREOID GLAND.* By max generic levlen BALLIN, M. D., detroi.t, mich. Under the head of surgical levlen 21 diseases of the thy- reoid the injuries of the gland and the malforma- tions .should be considered first. The former have no special pathological interest ; consideration of the latter, which includes also the question of accessory thvreoid and parathyreoid, is a very interesting chapter but buy cheap levlen woukl lead too far into embryological and histological discussions, so that 1 will confine my purchase levlen remarks this evening to the inflammation levlen 28 and different new formations of the thyreoid gland. THVRKUintTIS. In most of the cases observed the inflamniation of the thyreoid gland is secondary to an infectious disease. Cases of levlen online thyreoiditis are recorded during or after typhoid fever, cholera, smallpox, diphtheria, measles, influenza, articular rheumatism, parotiditis, puerperal fever, etc. Besides this secondary form of thyreoiditis, a primary form is known purchase levlen online in which the thyreoid is clinically the first and only diseased ors:an. where clinicallv, at least, the affection is confined to the thyreoid alone. Pathologically both forms are practically identical, levlen ed as also in the seem- ingly primary form infection by the blood current ensues from diseased tonsils or slight intestinal dis- ease. Kocher could prove that at least in preex- isting goitre inflammatory processes are usually caused by intestinal micoorganisms. Syiiif'tonis. — The infection of the thyreoid gland is usuallv levlen ed tablets benign in character : swelling, redness of the skin, pain in swallowing and difficultN' in breath- ing, in some cases hoarseness and pupillary con- traction (pressure on sympathetic and recurrent nerve) are the .symptoms usually present. In most of the cases only one lobe of order levlen the thyreoid gland is involved. Diagnosis. — The diagnosis of thyreoiditis is usu- ally buy levlen online easy. Similar symptoms are present in .some cases of inflammation from htiemorrhage in pre- existing buy levlen goitre, so called strumitis, in tuberculosis, syphilis and discount levlen malignant tumor of the gland. Differential Diagnosis. — Strumitis is an inflam- matory process in preexisting goitre, usually caused by haemorrhage into goitre cysts. It is well to dif- ferentiate this levlen cost affection, from thyreoiditis, an in- flammation of the otherwise normal gland. The French authors make a strict distinction in the name, calling the former strumitis ( struma ^ order levlen online goitre) , the latter thyreoiditis. a distinction that should be generally adopted. The German authors, however, sometimes use strumitis for inflammation of the normal gland, thinking that inflammatory processes did levlen ed tablet not occur except in strumous glands. Micros- copy, however, has plainly shown that there is a primar\- thyreoiditis without preexisting goitre. Strumitis can be excluded by the record of the case telling us whether there was any goitre pre- existing or not. Primary circumscribed tuberculosis or syphilis of the thyreoid is very rare tri levlen and of slow development in comparison with the acute onset of the thyreoid- itis. Tuberculosis of the gland during miliary tu- berculosis need not be considered here. Some cases

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