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variation in Order Cytoxan a splendidly written article based on the ante and post mortem findings of more than two hundred cases at the Massachusetts General Cytoxan Oral Hospital since 1893. He found that in the so called acute glomerular nephritis, a correct clinical diagnosis was the exception, 75 per cent, being wrong; in subacute glomerular nephritis, 50 per cent.: in chronic glomerular nephritis, 11 per cent. ; in chronic interstitial nephritis, 32 Cytoxan Tablets Cyclophosphamide Cytoxan per cent. : and in amyloid disease, 100 per cent. ; this surprising discrepancy, let it be borne in mind, with full clinical and urinary reports in the diag- nostician's hands. In quite a series of cases there was found in the urine at least one quarter of i per cent, of albumin, together with casts of all varieties in large numbers, without any discover- able lesions post mortem. When, in addition to this, there is a series without albumin and with- out casts, or with the latter in very small num- bers, 3'et the gravest of pathological conditions found at the autopsy, we are very much inclined to doubt just how much of these microscopical and chemical changes, when nephritis Cytoxan And Taxotere is Cytoxan Generic present, are due to the nephritis. As Cabot has well said, Iv Cytoxan we may state with propriety that Adriamycin And Cytoxan they may de- pend upon accompanying functional disturbances Cytoxan Cyclophosphamide whose anatomical basis is still unknown and not to the known anatomical lesions which they hap- pen to accompany. The fact of the matter is that a large proportion of physicians are apt to jump to the conclusion, and life insurance com- panies urge them on, that albuminuria means Bright's, while the absence of albuminuria is proof Taxotere Cytoxan positive that the individual is not suiTering from nephritis, both of which conclusions are erron- eous. Albuminuria and nephritis can each appear without the other; for instance, in that chronic progressive disease of the kidney, in which de- structive anatomical lesions are present beyond the possibility of improvement, how common it is to see the albumin appear and disappear with- out discoverable cause ; or, on the other hand- after prolonged and severe exercise, as after a boat race, to find the urine of every member of the crew containing albumin in greater or less proportion. Yet in the former example the lesion is progressive and destructive, while in the latter, while the albumin mav be in large amounts, the tendenc}- is toward prompt and complete recov- ery. Another old Cytoxan Adriamycin time favorite method of examina- Cytoxan And tion which Cabot has the courage to condemn is the estimation of Cytoxan Taxotere the amount of urea. It is im- possible to compute the time lost daily by the Cytoxan And Adriamycin thousands of devotees of this rather useless pro- cedure. Its advocates appear to forget that the amount of urea appearing in the urine depends not only, or, indeed, even primarily, upon the func- tional activity of the kidney, but on the amount of nitrogen taken up by the individual and the catabolism of the entire economy as well. We must know the amount of nitrogen in the food supply of the individual, his power of digestion, and there must also be Buy Cytoxan reckoned with the amount of exercise, sleep, amount of water ingested, pres- ence or absence of fever, vomiting, diarrhoea, cachexia, or heart disease, and any great varia- tion in these factors will completely invalidate the urea estimation. As regards casts, we now know that those of the hyaline and granular variety may be found in small numbers in the urine of healthy adults, while Shattuck has claimed that two thirds of Adriamycin Cytoxan all healthy individuals over fifty years of age show on uranalysis a slight amount of albumin and a few hyaline and granular casts. It would seem from Cabot's studies that all the time honored methods of examining the urine must be relegated to Taxotere And Cytoxan the background as unworthy of credence, or at least unworthy of the reliance formerly accredited them, and in this all of us who have given the subject any attention must reluctantly coincide. It is simply a trend of the times, a swing of the pendulum for the over en- thusiasm of yesterday. It is a warning, of which we have had many of late, that we must not de- velop and rely upon laboratory diagnoses to the exclusion of those formed by the cultivation of the more simple methods of physical examination. A\'e do not decry any scientific laboratory meth- ods, Buy Cytoxan Online nor should the laboratory worker regard cynically the phenomena elicited by careful phys- ical examination. The wise diagnostician will take account of both and give to neither no more than its just due. Local Analgesia. — Captain J. W. Houghton, in the Journal of the Royal Army Medical Corps, for April. 1905, states that in view of the growing timidity in the use of general anjesthesia for oper- ations, and Oral Cytoxan the magnification of the functions of the anjesthetist, a few remarks on a method of local analgesia may be of interest. Although cocaine and the various freezing mixtures have been found useful to obviate pain in minor opera- tions, yet their uses are restricted and utility lim- ited. The local analgesia which has recently

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