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years of age. Of the author's private patients op- erated upon during the past five years, forty-six per cent, were children. Buy Pantoprazole Online In children the histological, anatomical, and physiological conditions invite, and the habits incite appendicitis. The solitary glands and follicles of Lieberkiihn furnish abundant lymph- oid structure, more susceptible to morbid processes in the development of childhood than in maturity. The proportionate size of the appendix to the colon in the child is greater than in the adult. Its posi- tion, with the colon high and the appendix hanging, favors more its becoming a receptacle for the con- tents of the colon. Violence of action, Order Pantoprazole the infant in crying, the child in rope jumping, and other sudden impulsive movements, serve as additional injury, or force the contents, pf the colon into the appendix lumen. Localization of the tenderness in a dis- tressed baby may be quite difficult, but one need not consider ectopic rupture, renal calculi, or obstruc- tion from malignancy. The acute attack exhibits distress, restlessness, vomiting, crying, and abdom- inal soreness. So do acute digestive disturbances ; but in the sleeping or restful moments, slight, and then greater, pressure over the abdominal surface, comparing the respective positions, forms the cru- cial test. The cardinal symptom is local tenderness over the appendix. Rectal examination aids the determination. Chronic appendicitis is insidious Buy Cheap Pantoprazole and protracted in its course. It is less frequently suspected, but claims Purchase Protonix a greater number of victims. Violent acute attacks are too often the outcome of the chronic insidious preparation. JOURNAL OF NERVOUS AND MENTAL DISEASE. May. IQIZ. 1. Horace Carncross: Bilateral Supranuclear Palsy of Upper Facial Distribution. 2. Edward Mercer Williams: Intermittent Claudication in Upper Extremities. 3. Edward Buy Protonix Online L. Hanes: Acute Delirium in Psychiatric Practice with Special Reference to So Called Acute Delirious Mania (.Col- lapse Delirium). June, 1912. 4. Joseph Fraf.nkel: Dyspasia Lordotica Progressiva, Dystonia Musculorum Deformans Pantoprazole Online — Tortipelvis. $. W. J. Sweasey Powers: Interestine; Emotional Dream States from Royal Charite Hospital in Berlin. 6. Robert T. Edes: Tumor of Frontal Lobe. i. Bilateral Supranuclear Palsy of the Upper Facial Distribution. Generic Pantoprazole — Carncross presents two cases, one with pathological studies, in support of the contention that palsy in the distribution of the upper branches of the facial nerves may be caused by supranuclear lesions, at the same Purchase Pantoprazole Online time discredit- ing the view that some of the fibres of the seventh nerve are derived from the oculomotor nucleus via the posterior longitudinal bundle. Clinically the two cases were similar, showing evidence of bilat- eral brain lesions, particularly bilateral facial palsy, involving upper as well as lower distributions with- out changes in the electrical reactions of muscles. Post mortem, areas of softening were found, involv- ing both pyramidal tracts in the brain stem, and the nuclei of the seventh nerves were intact, as well as their roots external to the pons. 2. Intermittent Claudication in Upper Ex- tremities. — Williams reports the case of a man of fifty-eight years in whom the symptoms of claudi- cation developed suddenly in the left arm during an attack of influenza, and suggests that the cause may have been Cheap Pantoprazole an infectious endarteritis as reported by Erb. The continuous pain, absence of radial pulse, and the gradual subsidence of all symptoms Order Pantoprazole Online seem to support this view. 4. Dysbasia Lordotica Progressiva, Dystonia Musculorum Deformans — Tortipelvis. — Fraenkel briefly reviews Oppenheim's contribution in which this condition was first Buy Protonix described and named, and reports four cases of a similar nature. According to Oppenheim the characteristics of the condition are deformity about the pelvis and tonic and clonic Protonix Mg myospasms of the musculature of the pelvic girdle, sometimes associated with involvement of other muscles. Attempts to stand or walk excite the spasms, while Cheap Protonix most of the symptoms disappear when the patient is in the recumbent position. The gait is grotesque, and is described as "monkey" or "drom- edary gait." Permanent deformity develops, con- sisting of a marked lordosis of the lower dorsal and upper lumbar vertebrae, with inclination of the pelvis and prominence of the buttocks. Signs of organic disease of the nervous system are absent, though variations in the tendon reflex,es are noted. Oppen- heim Buy Pantoprazole is convinced that the condition has an ana- tomical basis, though it greatly resembles a neurosis. The Purchase Pantoprazole four cases which Fraenkel reports correspond with those of Oppenheim. The course is chronic and progressive, though remissions occur. Transi- ent benefit was obtained in one case by psychother- apy and muscle education, and in another Order Protonix by intra- spinal injections of magnesium sulphate. Fraenkel is inclined to classify the condition among the tics and spasmophilias, and to individualize it by the name "tortipelvis" from its analogy to essential tor- ticollis. 5. Interesting Cases of Emotional Dream State. — -Powers believes that emotional shock as the chief and active cause of dream states has not received sufficient prominence, and sides with those who con- tend that a dream state can develop on a basis of emotional shock without predisposing etiological factors, although this is denied. In three of his cases the dream states were precipitated by emo- tional causes in patients predisposed by alcoholism, hysterical stigmata, or epileptic history ; but in the other case no predisposing factors were present.

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