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around joints that were worse on rainy days. Not in- frequently there was a thickening of joint tissues. It was said not often to follow acute rheumatism, but to come more generally after subacute rheumatism. All three forms of rheumatism could be grouped under the head of toxsmia, whether the poison was considered to be of microbic or of metabolic origin. The term toxic arthritis conveyed a more definite idea of the causation of the affection than the word rheumatism. Dr. WisNER TowNSEND, of New York, was not pre- pared to accept the term toxic arthritis, but there was no doubt that topamax generic brand it was time to make an effort to get rid of the word rheumatism. Surgeons saw many cases of topamax generic availability svphilitic, tuberculous, and other joint affections due to definite causes which had been diagnosticated as rheumatic. There were a number of varieties of rheu- matoid arthritis which deserved special study. The two principal forms topamax order were hypertrophic and atrophic. It was not known as yet whether these were infectious or toxic. Dr. Vander Veer, of Albany, said that Dr. Fair- bairn's suggestion that a change of name should be made was timely. The more cases were investigated 320 PROCEEDIXGS OF SOCIETIES. [Nbw Yobe Medical .Toornal. the less frequenth- was the diagnosis of rheumatism made. Many of the vague conditions around the joints were undoubtedly due to autoinfeclion. This came mainly from intestinal trouble, and how much the con- dition of this tract might affect a patient, topamax order online surgeons knew because of the better conditions when the intes- tinal tract was thoroughly cleansed topamax generic weight loss before an operation. There was still much to learn about the causation of these affections, and the 100 mg topamax less pretense of knowledge there was the more would the next generation feel the necessity for studying them. Dr. B. O. KiNNE.\R, of Clifton Springs, said that many of the joint affections were due non prescription topamax to over rich ■blood. Dr. J.vcOBi said that rheumatism might mean almost anything, but polyarthritis order topamax canada was a definite affection, not always due to the same microorganism, however, but sometimes to a streptococcus, sometimes to a staphy- lococcus, and sometimes to the gonococcus. It used to be thought that when a single joint was aft'ected the arthritis was of gonococcus origin, but now it had been shown that gonorrhoeal arthritis might affect half a dozen joints. When there was a single joint affected, especially in children, the disease was almost sure to be tuberculosis. This was true in nineteen out of twenty cases. These cases topamax 50mg and weight loss must not be treated surgically alone, but also medically. Good air and good food were not the only things needed ; guaiacol, arsenic, and phosphorus gave excellent results. Dr. W.'iLSH said that the use of another general term like toxic arthritis would almost surely lead to as many abuses as was now the case with regard to the word rheumatism. What was particularly needed was more study of individual cases. Many cases of so called acute recurring rheumatism and of subacute topamax generic price rheuma- tism were really forms of beginning rheumatoid arth- ritis ; hence the crippling which eventually occurred. Many of the cases of chronic rheumatism had nothing to do with the joints at all, but were nerve and mus- cular affections. Many buy topamax online without script cases of chronic rheumatism were really due to the faulty use of muscles topamax mg for weight loss in some occupation in which they had to be frequently em- ployed. Very often the basis of this was buying topamax online a low need prescription topamax grade inflammation of the nerve leading to a group of mus- cles which had become especially lacking in resistive vitality, and liable to infectious processes because of the amount of work required migraine prescription topamax of it. Some of the so called rheumatisms were the pains of old dislocations of fiat bones, and the like. Dr. Bristow said that two terms in medicine more than any others covered a multitude of diagnostic sins. They do i need a prescription for topamax were rheumatism and malaria. Fortunately ma- laria had gone out before the microscope. Now it was time to get rid of rheumatism. Dr. Fairbairn's paper was not so much a plea for change of terminology as ■for better diagnosis and individualization of get prescription topamax cases. Much work of great value could be done topamax 100 mg weight loss along topamax generic vs brand this line. (To be continued.) WESTERN SURGICAL AND GYNECOLOGICAL ASSOCIATION.

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