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The symptoms are referable to the pathology of the disease. There is very irregular tempera- ture, depending upon whether the nervous sys- tem is in condition of excitement or shock. The same is true of the character of the pulse. The first symptoms are those generally of a conges- tion of the throat and nose, often a congestion of the conjunctivae, and generally a little deafness. Referred pains to the joints of the lower extremi- ties are frequent, there may be intense backache, may Vigora Price be shoulder and arm pains, generally severe headache, may be contraction of any group of muscles, more frequently the muscles of the back of Vigora 100 Tablets the neck. The next symptoms depend entirel}- upon where the greatest inflammation is located in the cerebrospinal axis and thep the amount of pressure from exudates and where that pressure is exerted. Reflex vomiting is due to cerebral irritation, and constipation is often due to retarded peristalsis from the same cause. Intermittent pulse and Cheyne-Stokes respiration show pres- sure on the medulla. After recovery left over stiffening of the muscles, stiffening of joints, neu- ritis, deafness, or actual mental deterioration, all depend entirely upon the previous Vigora Online pressure and therefore lack of nutrition, the different centres may have been subjected to during the acute process. The treatment, then, consists, there being no specific antidote to the disease or germ, in dimin- ishing the congestion if possible, Vigora 50 taking means to [prevent or relieve cerebral or spinal pressure, if possible, and combatting all acute symptoms and complications as they occur. Diphtheria antitoxinc in cerebrospinal menin- gitis is theoretically unsound and practically a failure, if the large number of careful observa- tions are to be considered Generic Vigora authentic. Spinal puncture has been proved not to be a curative Cheap Vigora procedure. It seems also not to ameli- orate acute symptoms sufficiently often to make it a procedure always to be followed. There is also some Vigora Oil slight danger connected with it. Also many punctures are made without the withdrawal of fluid. Injections of several antiseptic solutions into the cerebrospinal canal have been made, but none have been proved curative or even to amel- iorate the inflammation. Spinal puncture is cer- tainly positively indicated when there is cerebral pressure. As to whether it is indicated for diag- nostic purposes only I am very much in doubt except in rare instances. Not being as simple as an examination of the sputum in suspected pul- monary tuberculosis, or as the serum test in Buy Vigora ty- jihoid fever, also, the treatment of cerebrospinal fever not being specific, and the treatment of all cases of meningitis being based on the same prin- ciples, also, the diagnosis of a meningitis being generally most easy, I fail to see the necessity for spinal puncture with that object. The almost constantly beginning sore throat should be treated with antiseptic gargles and sprays, none better than the hydrogen peroxide solution. Conjunctivitis should be treated by simple boric acid drops. A calomel or saline purge should be given as is sensible in the begin- ning of all acute diseases and more particularly where there is cerebral Buy Vigora Online congestion. Painful joints, a frequent beginning symptom, should be wrapped with cotton Vigora Tablets and kept warm, and Order Vigora pain, Sfenerally the most early symptom, should be stopped with morphine by the mouth or hypoder- matically, depending upon its intensity. If there is vomiting or repugnance to food, it should not be insisted upon for the first two or three days, as the patient is better without it. He should have plenty of water to drink if he cares for it. If the vomiting is frequent and the nausea severe, morphine hypodermatically will, of Vigora 5000 course, stop it, and let me emphasize my belief that with severe pain anywhere morphine should be given in sufficient doses, whatever that dose ma}^ be, to stop it and hold it in check, and with the fre- quency that is needed. Nerve pains from cere- brospinal meningitis are exceedingly depressant to the heart. If the pain is not severe and there is no vomit- i ing, and if the pulse is good, the first day or two ■ Ijromides or chloral may be administered, but certainly they should not be given more than two or three days. Coal tar products I do not believe give the kind of action that we want, they are too depressant and debilitating and act badly on the blood. To quiet cerebral excitement and delirium and Vigora 100 also pain, and to diminish the necessity for large doses of morphine, in other words, intensify- ing the action of the morphine that must be given, I believe there is nothins: in the materia

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