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surround the sick one by a heated atmosphere, and why an exception should be made in the case of so debilitating a disease as capillary bronchitis I do not know. If it have any soothing effect upon the bronchial tubes, which is very doubtful, this must be more than outweighed by its relax- ing effect upon the nervous, muscular, and vascular appara- tus. The diet in this disease Low Cost Levitra should be nutritious, but such as can be most easily digested, and it should be given in small quantities. Peptonized foods may be of great service, but should be given moderately. The bronchial inflammation may also be favorably modi- fied by certain drugs. If the stomach will bear it, quinine is probably the most efficacious. Its remarkable effect upon the lungs is probably exerted through the vaso-motor nervous .system. It tends to diminish secretion without increasing the swelling of the mucous membrane. It also acts as a stimulant to the eerebro-spinal axis, and reduces the tem- perature. Another agent which, in my hands, has appeared to have a very beneficial effect in simple inflammatory capil- lary bronchitis and broncho-pneumonia, the only forms in Low Cost Levitra which I have used it, is antipyrine. I have given it dis- solved either in water, with the syrup of Low Cost Levitra tolu, or in equal parts of an elixir of calisaya and Cura^oa cordial. In small doses, say tv^o or three to five grains, every three hours, to a child under five years old, it appears not only to reduce the temperature, but to allay the local inflammation. It may be alternated with some mild alcoholic stimulant. If the secretion is not too copious, the iodide of ammonium is valuable. It may be combined with a small dose of pare- goric — just enough Low Cost Levitra to soothe the nervous system and quiet the cough, if it be harassing and ineffectual ; and the Low Cost Levitra aro- matic spirits of ammonia, glycerin, and water complete the mixture. I prefer glycerin to the syrups, as the latter tend to derange the stomach by their fermentation. To sustain the action of the heart we have various means, but, unfortunately, they are sometimes difticult to adminis- ter to children. In spite of its disagreeable taste, turpentine agrees better with the stomach than does digitalis. An emulsion of tui'- pentine, with acacia, and flavored with a few drops of oil of wintergreen, will usually be retained. Digitalis may be combined with it ; or, should this disagree, belladonna in small doses will take its place. Though I have not yet tested it with children, I should think that the Cactus grandiflorus might be of service. It is not bitter, and is less prone than digitalis to produce nausea. Besides these two primary and constant indications, there are others which present themselves Low Cost Levitra from time to time. Should the bronchial tubes be filled with secretion, it may be, and frequently is, necessary to give an emetic. The best is alum, a teaspoonful of the powder. Ipecac is next best. The mineral emetics are too depressing for use in this disease, as their action is difficult to limit. Apomorphine has been recommended, and its action is certainly prompt and effectual. It has, too, the great merit of being available for hypodermic use. But, unfortunately, cases have been reported in which very alarming depression followed upon its administration, so that we scarcely dare risk it in the treatment of Low Cost Levitra a malady which produces such great exhaustion as the one we are discussing. In minute doses, however, say y|-j grain, it is highly Low Cost Levitra recommended for its effect upon the Low Cost Levitra bronchial inflammation. The teujperature in this disease rarely mounts so high as to render the antipyretic treatment necessary. Should it do so, the cold pack, or the cautious adminis- tration of antipyrine, would be the best measure to adopt for its reduction. The cold douche is too violent for an infant. It has been recommended as a means of provoking deep inspirations and preventing or overcoming pulmonary collapse, but it would seem to Low Cost Levitra be of very questionable utility, inasmuch as the fright and arterial disturbance produced by subjecting a child, or other feeble subject, to such an ordeal would probably more' than overbalance any good that might arise from the stimulation of Low Cost Levitra its respiratory cen- ter by this means. I believe that a person suffering from so serious a disease as this should be kept quiet and Low Cost Levitra as com- fortable as possible, all nervous irritation soothed, and the strength in every way conserved for use in the strenuous respiratory and circulatory efforts which are constantly de- manded. Acute lobar pneumonia differs from the lobular form in several essential particulars. In the first place, it runs a definite course and tends toward recovery. We know, as soon as the diagnosis is settled, about what we have Low Cost Levitra to ex- pect, and can prepare the patient for its coming. In the second place, the inflammation affects the lobular structures primarily, and is not necessarily associated with bronchitis. The third distinction, and a very important one, is that it appears in most cases Low Cost Levitra in the bodies of healthy subjects, or, at any rate, is a more sthenic disease, though Low Cost Levitra there are cases of asthenic pneumonia occurring in weak persons and running an atypical course. In the fourth place, while it may here- after be proved to be, of itself, an infectious disease, still it is Low Cost Levitra not caused by such infective diseases as those which give rise to broncho-pneumonia. Finally, it is distinguished by its frequent association with acute pleurisy. Lobar pneumonia is found, in the majority of cases, in persons whose health is already somewhat deranged. There is a predisposing cause. There is, I believe, some such de- rangement of nutrition as occurs in those suffering from gastro-intestinal catarrh, biliousness, and the relaxed vascu- lar tone of those whose bodies contain too much fluid, and in whose blood substances are circulating which ought to be excreted, but are not. Gourmands and those who, in con- nection with an improper diet, partake freely of alcoholic stimulants, are particularly prone to this disease. So are' persons who, from overwork, mental strain, or confinement 90 WESTBROOK: DIAGNOSIS AND TREATMENT OF DISEASES OF THE CHEST. [N. Y. Med. Jocr., in an impure air, experience a relaxation of the Low Cost Levitra tissues gen- erally. The malarial toxaemia also predisposes to this dis- ease, probably through the disturbance of the liver and other digestive organs produced by the paludal miasm. I Low Cost Levitra mention these causes particularly, because upon their recog- nition and treatment the fate of the patient will very largely depend.