Generic Viagra Due Date | OVERNIGHT Delivery!







































ex. — //oit' do you treat flatulence!' (Ansu'ers due not later than May 15, igil.) CXL — Ho'lV do you treat acute infantile anterior polio- myelitis? (Answers due not later than June 15, 1911.) \]'hoever ans'icers one of these questions in the manner most satisfactory to the editor and his advisers zdll re- ceive a prise of $23- .Vo importance zfhatever zvill he at- tached to literary style, but the award will be based solely on the value of the substance of the answer. It is re- quested (but not required) that the answers be short: ii practicable no one an.Twer to contain more than si.v hun- dred words. All persons Generic Viagra Due Date wilt be entitled to compete for the price zi'hether subscribers or Generic Viagra Due Date not. This price will not be awarded to any one person more than once zi'ithin one year. Every anszver must be accompanied by the writer's full name and address, both of zvhich we iiinsl be at liberty to publish. 411 papers contributed become the property of the Jour- N'.M.. Our reader.s are -\sked t > suggest topics for dis- rrssioN, The price of $2fi for the best essay submitted in anszvcr to question CVIII has been awarded to Dr. J. H. Don- nelly, of Buffalo, zvhose article appears belozv. PRIZE QUESTION CVIII. THE TRE.'VTMENT Ol" HICCOUGH. By J. H. DoNNKT.T.v. M. D„ Buffalo, X. Y. The treatment of hiccough has been very un- satisfactory since the Greek physician recommend- ed to his patient .Aristophanes that he was tn hold his breath, gargle Generic Viagra Due Date with water, i^r tickle his ud^c with Generic Viagra Due Date something until he sneezed. We must consider a respiratory centre receiving impulses, and two nerves, the phrenic and the laryngeal branch of the vagtis to the glottis, acting as the efferent branches : also, we must consider the OUR h'1-..lDERS' DISCUSSIOXS. 831 diaphragm with its contiguous structures, liver, countenance, seeks plaintively tor relief. Generic Viagra Due Date Here kidneys, spleen, stomach, suprarenals, duodenum, more heroic measures are employed, and the gal- pancreas, oesophagus, pericardium, and pleurae, any vanic current has often proved a boon to the prac- one of which may have something to do with the titioner. The battery should have an electromotive cause of hiccough. We can conclude, therefore, force of forty volts. After determining the cathode that the intermittent contractions of hiccough have from the anode, by the more burning sensation to either a peripheral or a central cause, and 'Uir treat- the hand when the current is turned on, select elec- ment should be as scientific as possible. trodes of small area, moisten with water or salt There is no doubt that the cases caused by hys- solution, and you are ready for the patient, teria. epilepsy, shock, and cerebral tumors ; also the To determine the motor point of the phrenic idiopathic cases associated with gout, diabetes, and nerve, find the space between the clavicular and Bright s disease, act more or less directly through sternal head of the sternocleidomastoid muscle, and the respiratory centre, w^hile again certain Generic Viagra Due Date irrita- about three and a half centimetres above the clavi- tive and inflammatory conditions of those organs in cle. This point should be in line with the carotid relationship to the diaphragm act more or less di- tubercle. Place the cathode on this motor point rectly on the muscular, nervous structure of that and the anode first on the abdomen, where a strong organ and thus by reflex through the cord. In the Generic Viagra Due Date current is thrown into the circuit ; there is a mus- treatment of the nervous, either hysterical or epi- cular contraction produced. Allow this steady cur- leptic. the use of the following may prove effective : rent to Generic Viagra Due Date continue : there will likely be no more mus- Mixed bromides grs. xxx ; cular twinges due to shock. If the spasms of hic- Chloral hvdrate grs. x: cough Still continue, make and break the circuit. Syrup of lemon q. s g^d. at the Same time, have an attendant pull the M. Sig. Generic Viagra Due Date : For one dose. tongue well forward, thus trying to prevent the ■ Where the case is one of pure hysteria, apomor- sudden closure of the epiglottis. .Should this fail, phine, one eighth grain, Generic Viagra Due Date given hypodermically, change the poles of the battery, placing the cathod.' would bring about relaxation during vomiting, fol- on the abdomen, trying first a continuous current, lowed bv the sedative action of the morphine. then a make and break, keeping up traction on the To treat the cases associated with gout, diabetes, tongue. Or, again, you may place both poles on Rright's disease, or toxa?mia we must combat these the phrenic nerve, proceeding as before. poisons by elimination — catharsis, bowel washes. Doses of morphine, while efficacious when given steam baths, hot packs, etc. Pilocarpine, in large early, may hide the real cause of the hiccough and doses, depresses the respiratory centre, and where thus bring disaster to the physician in making some hiccough is caused bv acute uraemia this drug, in abdominal diagnosis. When you are sure that vou one thinl grain doses, may be employed with ex- can eliminate all inflammatory or irritative condi- cellent results. tions, which may become dangerous, then, to my In this class we have the inflammatory and irri- mind, you are on the safe side if you use morphine, tative causes, which through proximitv act on the ^^ r rr» r> 7 ■ n , ,■ diaphragm. In many cases, after anaesthesia es|)e- '^''- ^- f: Posthaucr. of Rronkhnc, Mass.. wntcs cially, abdominal hiccough becomes troublesome. ""^ follozvs. Often small quantities of ice or champagne quiet This afifection is Generic Viagra Due Date often very troublesome, but the spasm, or, again, sips of hot water and ch in-,;- cures itself, in ordinary cases, and where the excit- Generic Viagra Due Date ing the patient from the dorsal to the right lateral ing cause is lodged in the stomach, for the spas- decubitus brings about relief. modic action very generally removes the accidental In the hiccough caused by gastritis or some irri- irritant: and if not, the disorder usually yields to tant to the stomach, the following gives relief: very smiple antispasmodic remedies, as a draught Bismuth subnitrate grs. xx ; of cold water, a dose of camphor, or aromatic Cerium oxalate grs. iv; spirits of ammonia: in their absence a few drop« Cocame hydrochlonde gr. %. ^f vinegar or sugar will avriil. Where these fail M. S.g. : For one dose. ^ „ervous action of a different kind, and which Sometimes obstinate hiccough is relieved when seem.s to operate by revulsion, Generic Viagra Due Date has often been the patient is strong by having him hang with the found to succeed, such as holding the amis extended and grasping some beam or pole, so breath, thus producing a voluntary spasm of a rigid that his feet do not touch the floor, \^'ith all the and opposite kind in the diaphragm, or a violent abdominal muscles tense, Generic Viagra Due Date have him hold his breath fit of sneezing, produced by nasal irritation, snuff, as long as Generic Viagra Due Date possible, .\nother method of treating or other revulsive. .\n emetic will soinetimes an- the irritative form of hiccough is to extend the pa- swcr the purpose, as a hypodermic injection of tient fully across the bed, traction being made on apomorphine: and still more eflfectively, a sudden