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hand, the bronchi and lungs elavil used for may become involved. .\- persistent anterior unilateral nasal discharge is highly elavil 10 suggestive of buy elavil online sinus infection, provided the presence of a foreign body can be eliminated. A posterior rhinoscopic view showing pus or muco- pus in one choana is similarly strong evidence of a nasal sinusitis. It is necessary to make examina- tions on more than one occasion to eliininate the possibility of an adventitious collection being mistaken for a persistent secretion. According to Watson- Williams, the most useful methods of elavil 50 mg examination are endorrhinoscopy and exploration of t!ie sinuses by the suction syringe. elavil 10mg Endorrhinoscopy in cliildren over seven years of age is often possible with local anesthesia, but, oil the other hand, it is often impossible without general narcosis. When a definite streak of pus is seen coming from the sphenoethmoidal region or from the middle meatus of one or both elavil 10 mg sides, the evidence of the correspond- ing sphenoidal elavil 50 or antral cavities being the source of the purulent discharge is almost conclusive. Exploration of the maxillar\- antra or sphenoidal sinuses by means of the suction syringe is most valuable, but necessitates a general narcosis in children. Unfortunately, the exploration of the sphenoidal sinuses in young rhildren is far less easy than the exploration of the maxillary antra, and is not so free from risk. Nevertheless, the exploration of the sphenoidal sinuses in children is usually a elavil amitriptyline fairly easy elavil 25 and safe procedure, provided one is accustomed to such investigations in adnlt^. DRIED MILK AS A cheap elavil FOOD. When the elavil buy great number of women in America who do not nurse their babies and who rely on sul)- stitutes for mother's milk to feed them is elavil 25mg taken into consideration, it is obvious that the greatest care should be taken in the selection of a substitute. Upon the proper rearing of a child during the first few years^of life depends largely its future health. Also upon the proper rearing of children in the mass depends the health and therefore the prosperity of a nation. online elavil Of course, the most common substitute for an infant's natural food is cow's milk racxlified December 25. 1920.] EDITORIAL ARTICLES. 1037 in the manner which the inedical attendant, as a rule, prescribes. But even when the most careful atten- tion is paid to obtaining a milk as uncontaminated as possible, there is no certain guarantee that this end is always achieved. Sterilization and pasteur- ization elavil for both have their drawbacks, and therefore any substitute for mother's which possesses the nutritive properties of cow's milk and elavil 50mg which, in addition, can be guaranteed as absolutely clean and free from hurtful germs, would be hailed with ac- clamation by all those who have the health of the people at heart. B*- some if is asserted that dried milk possesses these attributes, which are absent in many instances from milk transported considerable distances and probably subject to contamination or perhaps infection before it is used as a food. Among those who have recently spoken in favor of dried milk as a food is Col. R. J. Blackham, AI. D., who gave an address on the matter before the British Sanitary Congress, held in Birmingham in August last. Blackham has had much experience in the use of dried milk in the British army and in civil life, and his conclusions are valuable. His ad- dress was somewhat lengthy, as he dealt with the question from all aspects and minutely, so only the outstanding points will be discussed briefly. Fats are no longer in emulsion, but in a condition resembling butter and quite granular. When mixed with water the fat globules elavil for anxiety are considerably fewer and much larger elavil uses than in fresh milk. Albumin and gloiiulin are coagulated, but caseinogen is not coagu- lated. All observers are agreed that the protein content is more digestible than in fresh milk. The milk sugar is unchanged. The ferments are all destroyed, but Lane-Claypon has shown that this loss is of no importance as regards the value of dried milk for hand feeding of infants. As for the vitamines, according to existing views an essential part of the infant's diet, Blackham I)oints out that until Professor Halliburton found that some vitamines will stand high temperatures, it was generally thought that the milk \-itamines were destroyed by the heat used elavil 25 mg in the elavil mg process of manu- facture. Funk, however, demonstrated the presence of vitamines in dried milk, and showed that there was sufficient of the antiscorbutic substance in boiled milk to supply the needs of infants, although some

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