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can be obtained if the drug is given in capsule form by mouth. At first twenty grains in four capsules of five grains each can be given, followed by a five grain capsule every four hours. j. Forchheimer's treatment of the vasomotor paralysis with caffeine sodium bensoate. — While at the present time opinion diflrers on the vaso- motor paralysis being the positive element in cardiac failure, the late Dr. F. Forchheimer insists that the toxic albuminoids developed in the course of pneumonia, whether from the pneumococci or from the intestinal tract, are the elements that paralyze the vasomotor centre in the medulla. Forchheimer states : Safest Way To Buy Cialis Online "I do not hesitate to say that with a healthy heart, vasomotor paralysis is a com- mon cause of pneumonic death in so far as the cardiovascular apparatus is concerned, and it goes without saying that this mode of death may occur irrespective of the health or disease of the heart." lie holds that the efliect is due to splanchnic par- alysis. He recognizes the effect as follows : in- creased heart rate, fall in the blood pressure, asso- ciated with marked tympanitis, signs of collapse, pulse irregularity, cerebral anemia, delirium, rest- lessness, and death. To meet this condition, he asserts that caffeine meets the indication better than any other drug because of its power to stimulate the vasomotor centres. It always sustains the blood pressure unless there is some organic lesion. He recommends the double salt of cafl'eine sodium benzoate in doses of three to five grains every four hours hypodermi- cally. Personally, while not wholly satisfied that the vasomotor paralysis is the essential cause of heart failure, in preference to dilatation of the right heart, the present consensus favoring the latter, I do absolutely recommend the use of caffeine as ad- vised as soon as indicated. It is a drug of inestim- able value in pneumonia. 6. The writer's advocated treatment. — This em- braces all the essentially good features of all the plans mentioned, each case being considered in- dividually and the plan modified accordingly. Faith is placed in the use of serum in Type I, if it can be obtained ; in optochin, or Safest Way To Buy Cialis Online quinine and urea hydro- chloride as outlined ; in camphor when toxemia is very marked ; and in caffeine sodium benzoate, and digitalis by mouth or hypodermically as sheet anchors, thiocol or cresote carbonate being used with associated bronchitis. In detail the following points in the treatment are important: absohite rest in the recumbent pos- ition, in the proper temperature, according to age and condition ; careful attention to the intestinal tract ; very careful feeding, including milk, cereals, fruit juice, egg, and limitation of the protein ele- ments ; following the chill, for the first twenty-four, thirty-six or forty-eight hours, administration of the dosimetric thirty granule : Aconitine hydrobromide, gr. 1/800 Digitalin gr. 1/64 Strychnine arsenate, gr. 1/128 This is given to the aged or asthenic patients. To the robust or sthenic Safest Way To Buy Cialis Online type the defervescent compound granule may be given. Aconitine hydrobromide, gr. 1/800 Digitalin gr. 1/64 Veratrine hydrochloride gr. 1/128 Ihese formulas for many years had the endorse- ment of the late Dr. Francis Delafield, of New York, and are now used by thousands of able practitioners throughout the country. They promptly reduce and control the circulator}^ dis- equilibrium. These remedies are used at first half hourly, and later at hourly intervals. For the toxemia, quinine, optochin, or camphor, as outlined, are given, the quinine intramuscularly, the camphor subcutaneously and the optochin by mouth. Digi- talis, tincture or powder, is given early. Strychnine sulphate, 0.025 grain, may be used for the vasomotor effect. For severe pain, small doses of morphine sulphate subcutaneously. For sleep or for restless- ness, heroinehydrochloride, 1/12 grain, pro re nata. A word regarding digitalis, the sheet anchor in the protection of the heart in pneumonia. Alfred E. Cohn, at the Rockefeller Institute, recently proved that the drug positively acts beneficially in the fever state. Therefore, in pneumonia it is wise to begin the administration of digitalis early in the course of the disease, the purpose being not to produce immediate effects upon the heart, but to put the patient in such a condition that later, when the need arises, physiological digitalis eifects Safest Way To Buy Cialis Online may quickly be obtained by the use of moderate doses by the mouth, subcutaneotisly, or intramuscularly. To accomplish this Cohn's method is advocated. If the case is seen early, 0.5 gram of the drug is given by mouth on the first and also on the second day. It is given again, in the same amounts, on the fifth and sixth days. No more is given unless indica- tions arise. Of course it is understood, that these are adult doses, and based on the Cary Eggleston's method of administration. If the patient is seen late in the disease, say oti the third or fourth days, I gram is given in the first twenty-four hours, then wait one day, and on the two subsequent days, 0.5 gram on each, is given. Should fibrillation or flut- ter develop, or should the rate unexpectedly rise, the drug is freely used. Safest Way To Buy Cialis Online Cole recommends the product digipuratum because of its accuracy of standardiza- tion. Personally, I am very partial to this product in liquid form for intramuscular Safest Way To Buy Cialis Online use. It is obvious that the diet is important. Nourish- Safest Way To Buy Cialis Online ment must be given in simple fonn — milk, cereals, fruit juices, with milk sugar — at regular intervals of two hours throughout the day, in amounts of six to eight ounces taken through a tube with the patient recumbent. Orangeade sweetened with milk sugar is both grateful and nutritious. Avoid producing flatulence. 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