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three or four hours, and in thin subjects, these areas may be padded with gauze. And in the treat- ment of fractures, Nitroglycerin Tablet care must be taken in applying splints or casts to Nitroglycerin Sl avoid pressure necrosis over bony prominences. The bed should be kept smooth and dry, and the sheets should be changed at least once a day, or oftener if soiled. The mattress should Nitroglycerin 2 be yielding and kept free from ridges. The skin of Buy Nitroglycerin Online these patients requires particular attention and in this hydrotherapy is most impor- tant. They should be thoroughly bathed two Spray Nitroglycerin or three times a day and afterward rubbed with alco- hol. .\ftcr this some bland and mildly antiseptic dusting powder, as talcum, may be applied to keep the skin dry. Frequent and gentle massaging is also Ntg Nitroglycerin indicated, as it stimulates cutaneous circulation. Traumatism should be avoided. In severe trophic disturbances, as in Nitroglycerin Spray myelitis, the skin does not tol- erate much irritation. In these cases vigorous massage, hot applications, and hot water bottles should be used with caution. The soiling of the skin from Nitroglycerin Buy urine, sweat, or feces, is to be prevented, if possible, as the moisture predisposes to ulcer formation. The physiological resistance should be increased by proper diet, fresh air, and good hygiene. A low resistance predisposes to ulcer by causing a de- creased Order Nitroglycerin nutrition of the skin and subcutaneous tissues. This is further augmented by pressure, filth, or local stasis. Where this condition Nitroglycerin Cream is ex- treme, severe or Nitroglycerin Tablets even fatal bacterial infection may result after the sore has formed. The bowels should be kept open, and tonics, such as the iron preparations or nu.x vomica, given when indicated. Alteratives may be given, but when the iodides are used, for example Nitroglycerin Iv potassium iodide, the skin must be watched for signs of iodism. as in this condition it is predisposed to bacterial infec- tion, but they should be administered in syphilitic cases together with other antisyphilitic remedies. In cases where bedsores have already formed, the patient should be placed on an air mattress or water bed. Iv Nitroglycerin and no pressure whatever allowed on the sore or adjacent tissues. The previously mentioned measures as hydrotherapy, cleanliness, change of posture, etc., are all to be carried out. In severe cases, where the ulcer spreads rapidly, the patient should be placed in a continuous warm bath. Occa- sional Nitroglycerin Sublingual immersion in water has a stimulating effect on the peripheral circulation. The production of local hyperemia by any method, has this result. -\ttempts at overstimulation, however, both general and local, should be avoided. Local treatment is much the same as in similar conditions, as in chronic leg ulcer, and should be carried out according to the principles of aseptic surgery. If a suspicious red spot is noticed, a large air ring should be used at once to relieve the local pressure. Where the sore has alreadv formed, relief of local pressure is obtained by soft gauze pads and the pneumatic rin? and. when possible, an air mattress or water bed should be nsed also. The ulcer should be cleansed two or three times a day. or oftener if septic. It may be irrigated with normal saline solution, weak iodine or boric acid, or one to 5,000 mercury bichloride solutions, or occasionally with more astringent solutions, as one to 5,000 potassium permanganate or Buy Nitroglycerin one to 10,000 silver nitrate. .Mcohol, tincture of iodine, or other UCK PRIZE DISCUSSIONS. Strong antiseptic should be used with extreme care lest it cause too much irritation. Balsam of Peru is a splendid preparation, both for its stimulating effect on granulation tissue formation and its anti- septic action. Dusting powders, as thymol iodide, acetanilid, boric acid, and iodoform are among those fre- c|uently used for dry dressings. Stimulating oint- ments, as ten per cent, balsam of Peru, ten per cent, ichthyol, or Sl Nitroglycerin mild scarlet red may also be used in some cases. Hot boric dressings may be used in septic cases, but overheating must be guarded against. In sloughing ulcers, it may be necessary to re- move the necrotic tissue by operation or cautery. Small necrotic areas, or areas of unhealthy granu- lation tissue, may be Buy Cheap Nitroglycerin curetted out or cauterized with phenol or nitrate of silver. In large extensive sores, where tissue destruction has been great, it Nitroglycerin Mg may be- come necessary, when the granulations become healthy and infection minimized, to skin graft the raw surface to promote further attempts at Sublingual Nitroglycerin healing,

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