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Atrophy of the Malpighian tufts is more frequent in the small kidneys. Deposits of urate of soda are found in the pyramids of some atrophied kidneys, especially with gout. These various changes constitute the lesions of chronic dif- fuse nephritis, the most common form of kidney-disease. avapro cost The clinical symptoms and the condition of the urine vary with the extent and manner in which these lesions are developed. Al- bumen and casts in the urine, oedema of the face and legs, or general anasarca, nausea, diarrhoea, loss of vision, convulsions, and coma, are the symptoms with which all physicians are familiar. The tendency of avapro generic alternative the disease is to a constantly avapro 75 mg -increasing impairment of the functions of the kidney, but life and com- parative health may be prolonged for many years. Ill, Chjonic Parenchymatous Nephritis. — This condition of the kidney is met with in the course of severe and exhausting diseases. Every physician knows that in typhus fever, in py- aemia, in pneumonia, in cholera, in yellow fever, in avapro coupon alcoholism, and in other severe constitutional diseases, the urine of some patients will contain albumen and casts. If the patient recov- ers, the symptoms of renal disease also disappear. EECENT CONTRIBUTIONS, ETC. 255 avapro alternatives In tliese cases the kidneys are found to be of normal size, or slightly larger. They are neither congested nor anaemic. The cortex is opaque and yellowish white, tlie markings of the straight and convoluted tubes are lost, or may be nearly per- fect. The pyramids appear normal, or their papillae are a little whiter than nsual. The Malpighian tufts and vessels are un- changed. In the convoluted tubes the epithelium may appear normal, or may be swollen so as to nearly fill the tubes, and appear stiffer and more opaque than usual. In the straight tubes of the cortex, the epithelial cells are granular, sometimes broken down, and detached so as partly to fill the tubes. In the straight tubes of the pyramids the epithelial cells are gran- ular, detached from the basement-membrane, sometimes glued together by hyaline-cast matter. In some of these tubes, and in TIenle's loops, there are hyaline casts. Whether this lesion is to be regarded as a parenchymatous inflammation or degeneration is, in the present state of our knowledge, hardly to be decided. Akt. IY. — A Synopsis of avapro coupons Recent Contributions to Mental Science in Great Britain. — Treatment of Insanity. — Cold Applications hi Cerebral Rheumatism. — Locomotor Ataxia. — Epilepsy. — Hydrophobia. — Dextral Preemi- nence. — Dr. Richardson's Discourses. By George E. Day, M. D., F. K. S. The West Eiding Lunatic Asylum Reports contain three articles on the Treatment of Insanity, viz. : " On Artificial Feeding of the Insane," by Dr. Lawrence ; " On the Treat- ment of Insanity by the Hypodermic Injection of Morphia," by Dr. Ward ; and " On Ergot of Rye in the Treatment of Mental Diseases," by Dr. Fox. Dr. Lawrence begins with a summary of the various causes that lead insane patients to refuse food. These are : 1. Delir- ium of a fanciful or absurd character, as the idea that they cannot pay for it, that they do not deserve it, that they are dead, and do not need it, that there are serpents in the stom- ach that must be killed by starvation, etc. ; 2. order avapro online Organic dis- 256 RECENT CONTEIBUTIOlSrS TO ease of the stomacli or liver; and 3. Perversity, stupidity, and sncli extreme helplessness that they cannot even swallow what is put into their avapro discount card mouths. The characteristic symptoms of want of food are briefly but avapro avalide clearly given. The most marked symptom is the dis- agreeable fetor which the breath acquires. It is something so peculiarly sui generis, and so distinct from the fetid breath which marks ordinary dyspeptic derangements, that it can be easily recognized buy cheap avapro by all who have perceived it for a limited number of times. It arises, doubtless, from the altered state of the secretions of the mouth and stomach. The mouth be- comes clammy, the teeth become foul, and, in the worst cases, are covered with sordes ; the tongue is coated with a thick white fur of old epithelium ; little saliva enters the mouth, avapro recall and what does so is allowed to escape by avapro price the lips. The offensiveness of the breath soon. disappears in most cases, if a regular avapro generic name and sufficient supply of nourishment is admin- nistered, without the aid of medicine at all — a circumstance which shows that it mainly arises from the want of food, and consequent state of the mouth, and the body generally, in which the avapro vs diovan wasting process far outstrips and exceeds the renew- ing ; but so marked and constant is it that, in the avapro classification case of newly-admitted patients, about whom no losartan vs avapro very definite in- formation can be obtained, it may be taken as a good guide as to wdiether the patient requires to be artificially fed or not. When moral influences — persuasions, entreaties, avapro 10 mg com- mands, bribes, threats, etc. — have failed in inducing a refrac- tory patient to take food, the order avapro spoon or the feeding-jug is to be tried, and the way in which the latter is most efiectually employed — by laying the patient on his back, and compelling avapro tablet him to swallow one mouthful after another by compressing

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