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base of the brain may prevent one from reaching the lumbar portion of the spinal canal, hence a dry tap-." Again, one may also get a dry tap as a result of adhesions around a point of a previous puncture (17). It is, therefore, advisable, in the treatment of a case of meningitis, where you expect to give serum injections, to begin at the lowest point possible in order to avoid such occurrence. When- ever such adhesions have taken place we must utilize the lateral Clonidine Dosage ventricle^. Holt (4) reports a dry tap in four out of thirty-nine cases. In a case of cere- bral hemorrhage in a newborn baby admitted to the Post-Graduate Hospital, Clonidine 0.1 in May, 1918, on which several attempts to obtain some spinal fluid made by myself as well as by two mett of the house staff', Clonidine Dose were unsuccessful. The necroosv findings bv Dr. 1024 l-NJEDM.IX AND GREENFIELD: MIDDLE EAR DISEASE IN CHILDREN. [New York Medical Journj McNeal justified the dry tap by disclosing a large blood clot extending from the brain into the spinal canal. These facts are sufificient to prove that a dry tap is not always explained by an inefficient technic. A word concerning possible accidents in the course of or following lumbar puncture. Breaking of the needle happens occasionally, and should not frighten one. If you are careful and avoid using a long pointed needle, and if you do not bend the needle while introducing it, you may save yourself that accident. If the needle should break, unless the broken end can be easily extracted, it is Catapres Clonidine best to defer its removal to a future time when the patient has recovered from the acute stage of his illness, and even then you may decide to leave it alone. Koplik (21) Clonidine Catapres reports two cases of apnea from, shock more alarming than a broken needle, but he does not tell us the state of health of the patients at the time of the puncture. In such an occurrence one Clonidine Hydrochloride should stop the operation immediately, lower the patient's head, resort to artificial respiration, administer adrenaline, Clonidine Tablets and apply external heat to the body. In cases of Clonidine Tablet chronic hydrocephalus, where one expects to Clonidine Patch remove large quantities of fluid, the patient should always be kept on his side during puncture, in order to avoid undue shock. Clonidine Clonidine The wound should always Withdrawal Clonidine be properly dressed, with cotton and collodion, or with adhesive plaster. It is not advisable to use What Is Clonidine collodion when repeated punctures Buy Cheap Clonidine are planned. Occasionally a bloody fluid Buy Clonidine complicates the procedure. By using Clonidine Mg a short pointed needle this may be avoided. This is not a dangerous accident, but a bloody specimen is useless for the purpose of examination. Occasionally only the first few drops are bloody, when a fresh test tube will collect a desirable specimen. CONCLUSIONS. The operation is simple, with practically no danger to the patient. Its usefulness for diagnostic pur- poses is indispensable, and should be done early in the cotirse of the illness. The technic should be learned by all physicians. REFEREXCES. 1. Cook. E. P.: New York Medical Journal. Feb- ruary 25, 1905. 2. Neal: Clonidine Buy Archives of Pediatrics, 1916, p. 596. 3. Idem: Archives, Buy Clonidine Online 1916, p. 403. 4. Holt: Infancy and Childhood, Appleton & Co. 5. KoPLiK, Osu;r and McRae : Modern Medicine. 1913. 6. Heiman : Archives of Pediatrics, 1916, Cheap Clonidine p. 581. 7. Michael: Archives of Pediatrics, 1916, p. 281. 8. Cook : New York Medical Journal, 1905. 9. Clonidine Dosing McDonald: New York Medical Journal, 1905. 10. Weinlander: Wiener klin. Wochenschrifl, vol. xxvi. 11. Regan: Archives of Pediatrics, March, 1919. 12. Quincke: Thcrapeut. Monatschdfte, July, 1914. 13. Kausch : Therapeut. Monatschdfte, July, 1914.

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