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of an ordinary Buy Famvir Online steam-boiler, and twice as great as the work- ing pressure usually employed. It was to be expected that such a pressure would exercise a very Buy Famvir decided influence upon those exposed to it, but experi- ence proved that the eifect was much less than was antici- pated. Beyond an unpleasant sensation in the ears while passing through the air-lock on entering or leaving the caisson, there was no uncomfortable feeling whatever. It was ob- served, however, that the pulse was accelerated to the extent of about 20 beats per minute, during the Famvir Buy first hour of the so- journ in the caisson, after which it fell to about 20 beats be- low the normal standard. The phenomena resulting Purchase Famvir from the increased pressure were minutely studied by Dr. A. Jaminet, of St. Louis, who has CIRCULATION OF THE BLOOD. 351 published a very interesting monograpli upon the subject/ to which I am indebted for the facts referred to in this connec- tion, so far as they relate to observations at St. Cheap Famvir Louis. It was not until the pressure had reached twenty-four pounds to the square inch, that the workmen began to suffer. The symptoms, which were almost constant, were violent epi- gastric pain, shooting pains in the back and extremities, and coldness and pallor, or, in some cases, lividity of the skin. In a large proportion of cases there was associated with these symptoms a degree of paralysis, most frequently assuming the Famvir Purchase form of paraplegia, but sometimes involving at the same time one or both of the U23per extremities. In a few instances the paralysis remained permanent, but in most cases it passed off in the course of a few days. Some of the patients in whom there was no paralysis were able to resume work on the fol- lowing day. IS^inety-seven cases occurred, with eight deaths. The post- mortem appearances indicated an intense degree of conges- tion of the brain and spinal cord, and, Famciclovir Famvir in some cases, soften- ing. The abdominal viscera were also more or less congested. But what was very remarkable, and contrary to all expecta- tion, was, that at no time during the progress of the work, even when the greatest pressure was attained, was any incon- venience experienced while in the caisson. It was Famvir 500 Mg invariably while the pressure was being lessened in the air-lock, or after emerging into the open air. Hence it would appear that it was not the pressure, but the removal of the pressure, which produced the pathological result. Dr. Jaminet rejects this obvious inference, and considers that the symptoms observed were due entirely to exhaustion caused by excessive tissue- change resulting from increased consumption of oxygen. As this method Order Famvir Online for submarine operations has been adopted by the Brooklyn Bridge Company, and is likely hereafter to be frequently resorted to, it becomes important to determine, if possible, what is the true explanation of the pathological phenomena in question. It appears to me that all the facts of the case point plainly "Physical Effects of Compressed Air." By A. Jaminet, M. D. 352 ciECULATioisr of the blood. to a derangement of the circulation as the chief cause of the symptoms observed. In considering the Famvir 500mg effect of increased atmospheric pressure upon the circulation, it is plain that it will vary according as the vessels interested are located in a part which is soft and compressible, or in a cavity the walls of which are firm and unyielding. In fact, the result in these two cases will be di- rectly opposite. In the first the tendency will be to press the sides of the vessels together and expel the blood they contain, provided it can find any place to escape into where the press- ure is less. In the second case the vessels will be protected from pressure from without, and would be entirely unaf- fected were they not in communication with other vessels exposed to such pressure. Such being the case, however, they will necessarily receive blood from Famvir Online these latter vessels until an equilibrium of pressure is produced. Now, the vessels of the body generally, exclusive of the bones, fall into the first category, while those within the cranio- spinal cavity belong to the second. It follows, therefore, that in a condensed atmosphere a man will have more blood in his brain Famvir 500 and spinal cord than in the normal Famvir Famciclovir state. This accords precisely with the results of the autopsies in the Order Famvir fatal cases recorded by Dr. Jaminet. In every instance the brain and spinal cord were found to be intensely congested. But the pathological results cannot be attributed to this congestion, else they would be developed while in the caisson instead of after leaving it. In fact, the congestion seems to exert no unfavorable influence upon the function of the cerebro-spinal axis, probably because the pressure is so equa- bly distributed. But how does the matter stand when, after Famvir Cost an equilibrium has been established between the vessels of the general system and those of the Famvir 250 Mg cranio-spinal cavity, the pressure is suddenly removed from the former ? Obviously there must be an action the reverse of that we have Purchase Famvir Online just con- sidered, and there must result a reflux tendency from the brain Buy Cheap Famvir and spinal cord toward the general circulation, in order to re- establish the equilibrium. This would Famvir Price oppose the current of blood going from the heart to those parts, and a more or less perfect arrest of the circidation in tlie smaller vessels would

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