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and there buy cheap cipro is no indication whatever purchase cipro online of cardiac
mischief. Experience has taught that endocard-
itis, and even insufficiency of the aortic valve, are
frequently found in persons in whom the)' had
not been suspected during life.
The preceding considerations lead to the two
following conclusions: (o) That the heart in a
number of women cipro price during pregnancy and the
puerperium is subject to hypertrophy, which may
become permanent and pathologically affect the
valves; and (b) that latent cardiac disease of
rheumatic and other origin may first come to the
front during pregnancy or in and after labor.
If we only admit that cipro online pharmacy cardiac disease in general
is, under certain conditions, capable of producing
mental disorders of a typical nature, then buy cipro online could
not puerperal insanity, in some obscure cases at
least, be brought in connection with either a la-
^Dreysel, Miinchener medicinisehe Abhandlung n 1891.
"Pepper, Text-Book of Medicine, 1894, Vol, ii. p. 279.
'^Th. Parvin, /. c, p. 420.
'^Osler, /. c, pp. 702 cipro online and 712.
July 27, 1901.]
JACKSON: EXAMINATION FOR KIDNEY DISEASE.
159
tent or previously diagnosticated affection of the
heart ?
In cases of puerperal insanity where a diseased cipro 250mg
condition of the heart was certainly known to
exist, the cardiac affection, so far as I can judge
from the literature, has never been given any im-
portance in connection with the coincident puer-
peral psychosis. To cite an example : In his re-
cently published Clinical Lectures, Kraepelin"
describes three typical cases of puerperal insanity, in
one of which there was a history of apoplexy cipro 250 three
years cipro order previous to pregnancy, and in another there
were signs of an enlarged heart with an apical
presystolic murmur. Yet he passes these data
by without any further comment.
Cardiac disturbances of any kind might be
oftener discovered in cases of puerperal insanity
if more attention were paid to the condition of
the heart in obstetric practice, and thus, perhaps,
indirectly contribute to the study of mental mani-
festations in relation to cardiac disease.
THE OPHTHALMOSCOPIC EXAMINA-
TION FOR KIDNEY DISEASE.*
By EDWARD JACKSON, A. M., M. D.,
OPHTHALMOLOGIST TO THE ARAPAHOE COUNTY HOSPITAL,
DENVER, COLORADO.
In cases of renal disease the ophthalmoscopic
examination follows closely in importance the
clinical and microscopical examinations of the
urine. Noticeable changes are found in fifty per
cent, of such cases ; and distinct albuminuric
retinitis occurs in not cipro hc less than ten per cent. In
these latter cases the ophthalmoscopic appear-
ances are easily recognized, are as pathognomonic of
the general disease buy cipro as any set of symptoms known
in medicine, and have the most definite prog-
nostic significance. Of the men showing this
symptom in Haab's Clinic, all died within two
j'ears. Belt, in 419 collected cases, found that
seventy-two per cent, were dead at price of cipro the end of
the first year, and ninety per cent, at the end of
the second year. A symptom of such frequency
and such significance is worth looking for, and it
should be looked for repeatedly, for some of its
most characteristic appearances are transient.
To look for it thoroughly requires cost of cipro the use of a
mydriatic. The patient usually presents a small
senile pupil. The most characteristic changes
are apt to be in or near the macula, a region hard
to examine thoroughly without the use of a cipro cheap my-
driatic, even in young eyes. If the patient is in purchase cipro
bed, the cipro 250 mg difficulty is still further increased, and
also the need for buying cipro online the mj'driatic. But these pa-
"Einfiihrung in cipro cost die psycltiatrische Klinik. Leipsic, 1901, p. cipro 500mg 135.
•Read before the Colorado State Medical Society, June 19, 1901.
tients are suffering a progressive loss of vision.
If you put atropine in the eye, it takes two weeks
to get over it. The atropine impairs the sight,
and by two weeks the progress of the disease will
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