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the iodine solution. Continue until a slight flomax cr irritation of the skin supervenes, then interrupt the treatment a few days and apply an indifferent salve, when the treatment may be recommenced. — Kerley. Scrofuloderma and Lupus. — g. Zinci. oxidi, Amyli pulv aa J oz. Vaselini aibi i oz. Hyd. oleatis, 5 per cent i oz. Acidi salicylici gr. .\x. Ichthyolis TTi^ xx. 01. lavendulae q. sufF. M. Fiat ung. coloratuni. — Brooke. Scabies. — B . Creoline 5 parts. Vaseline 100 " Mix. Use with friction, once every day, over the flomax tamsulosin parts affected. , — -LOLLIS. Psoriasis. — ^. Ethylate of sodium gram. 20 Olive oil " 80 Frictions. — Gamberini. Ulcers, Itch, Psoriasis, Eczema, Pruritus. — B. Resorcinol (resorcinand iodoform com- pound) gram. 5 Venetian talc. " 20 Use as powder. Bielajew. 766 MEDICAL RECORD. [December 9, 1893 ©orrcspo xiAcnce, OUR LONDON LETTER. (From our Special Correspondent.) FUNERAL OF SIR ANDREW CLARK PRESIDENCY OF THE ROYAL COLLEGE OF PHYSICIANS ROVAL MEDICAL AND CHIRURGICAL SOCIETY MEDICAL SOCIETY OF LONDON STRANGULATION OF TESTICLE NEPHRECTOMY IN HY- DRONEPHROSIS — PREVALENCE alternative to flomax OF INFECTIOUS DISEASES. London, November i8, 1893. Sir Andrew Clark has been buried a week to-day. During that period his life, work, and death have been the chief topics of conversation wherever medical men met. The service cost of flomax in Westminster Abbey was most impos- ing. flomax women To his immediate friends and relatives, with all its sad solemnity, it could not but be some source of consolation that such a crowded assembly, composed largely of his professional brethren, should have been gathered together in the great abbey to bid farewell to the honored dead. A great multitude thronging the old cathedral and what is flomax extending along the route of the proces- sion, was a testimony to the esteem in which he was held, and an honor almost unique for a physician to attain to. The scene in the little churchyard near the deceased's country-house, though shorn of the pomp of the abbey service, was none the less affecting. With a simple ser- vice the body was committed to the grave, in the presence of the many friends and colleagues who had followed to take their part in the last offices of respect for the es- teemed and beloved dead. R. L P. It was not in human nature to refrain from specula- tion as to flomax for women the presidency of the College of Physicians. It will be a difficult thing to succeed Sir Andrew Clark. The college, indeed, numbers in its ranks many who, for some reason or other, are worthy of its highest honor, and capable of discharging all the duties of the position. Consequently many names have been discussed and their several qualifications canvassed. Among these, perhaps. Dr. Russell Reynolds may be thought to combine most of the qualities to be desired. An election of this kind is, however, often most uncertain. On Tuesday, the 14th inst., the chair was taken at the Royal Medical and Chirurgical Society by Dr. Church. At the previous meeting, as I have reported, the session was opened by a vote of sympathy with the family of Sir Andrew Clark, their president, on his serious price of flomax illness. At this, the succeeding meeting, the first business was a resolution e.xpressing the sense of irreparable loss sus- tained by the society, and sympathy with Lady Clark and the family in their bereavement. Dr. Church paid a touching tribute to the memory of the late president, and related the course taken by the council under the sad circumstances ; for no president has previously died in office, although the society has been established more than eighty years. Consequently there was no precedent for the officers. Their action was quite approved. On Monday last (13th inst.) the President, Dr. Bris- towe, opened the meeting with a few touching remarks on the loss sustained by the death of Sir Andrew Clark, after which Mr. Owen related a case of strangulation of the testicle by axial rotation of the cord, and urged the propriety of removing the organ in these cases. Mr. Bland Sutton then read a paper on the indications for nephrectomy in hydronephrosis. Observing that hy- dronephrosis is mostly due to obstruction, he insisted that this must be incomplete or temporary, or otherwise rapid atrophy would ensue rather than dilatation. As a rule, he said, it ran a latent course. When unilateral the di- agnosis might be difficult, but when bilateral the inter- missions might alternate. In the latter case the only symptoms might be frequent micturition until the kidney substance was reduced below the physiological needs, whereupon ursemia suddenly appeared. Though hydro- nephrosis remained unperceived until very large, should flomax online suppuration occur symptoms immediately called atten- tion to it. It is necessary to distinguish this condition from primary pyonephrosis, which is seldom large and is mostly associated with calculus, calling for nephrotomy rather than nephrectomy- As to hydronephosis suppu- rating, Mr. Sutton remarked that when very large it often came into close contact with the colon, the walls being so thin that osmosis could take place. He objected to as- piration for diagnosis, as it flomax cost exposed the patient to dan- ger and was often misleading. Mr. .\lban Doran advocated delay of operation- when associated with floating kidney, and related a case in which the condition subsided of itself He could not admit that real atrophy necessarily occurred, as he had specimens showing the kidney substance normal. Mr. H. Morris observed that the original cause of ob- struction was not always found, as it might disappear during or after the forming of the hydronephrosis ; he pointed out, too, obstruction of the ureter low down did not necessarily cause dilatation right up to the kidney, as a pouch was sometimes formed and might press on the tube higher up, as an aneurism might do. He recognized a thin-walled variety which collapsed on tapping, and a second kind in which there was hypertrophy of the kid- ney substance, so that when the generic for flomax calices were laid open they were seen to be thick walled and separated by fibrous septa ; and this was specially likely to occur when one kidney atrophied or was removed while its fellow was undergoing dilatation. He thought that such organs should sometimes be dealt with as if they were solid tu- mors. Cholera has left us, but small-pox and scarlet fever still prevail. The former has lately spread a good deal in different jxirts of England. The difficulty of providing hospitals for infectious diseases continues and has been mentioned in Parliament. Diphtheria has extended. A serious epidemic has oc- curred in Essex, and another flomax in women outbreak is reported at Ox- ted, in Surrey. Influenza is again appearing ; at Birmingham and Black- burn it is very rife, although it is said the type is not se- vere. Here in London many mild cases are met with, but the prostration which succeeds the attack is often very great. A RESPONSE FROM DEMILT DISPENSARY. To THE Editor of the Medical Record. Sir: In your flomax alternative editorial of November 25 th on "Doctors and Dispensary Hoards" you question the truth of my statement that dispensaries managed in whole or in part by medical men are the worst in the city. I might easily offer proof of my assertion ; but to specify instances would be unwise and would not settle the question. I am con- vinced that should a fair-minded committee of medical men investigate the management and work of all the dis- pensaries, they would reach the conclusion that a manag- ing board of laymen in close touch with the faculty is the most efficient in carrying out the design of such institu- tions. This policy was adopted in the organization of the Demilt Dispensary, forty years ago, at the suggestion of a father in disjiensary and hospital management. We generic of flomax have found the advice so sound and its results so satisfac- tory to our medical staff that we commend it to other institutions. I know well that " there are plenty of phy- sicians who possess both professional knowledge and busi- ness capacity." This fact does not have any bearing upon my assertion, which was that the best management is an exclusively lay board, and the worst a mixed lay and medical board. In passing, let me point out one advan- tage of the lay system ; flomax generic the fact that under it appoint- ments are uninfluenced by questions of medical i)olitics or medical school prejudice; the appointing officials are not subjected to the pressure brought to bear upon doctors acting in such a capacity. Surely no more convincing proof can be asked of the esteem in which the lay board of the Demilt is held than the list of eminent physicians December 9, 1893] MEDICAL RECORD. 767 who flomax 0.4 have served it in the past, and the professional stand- ing of those on its staff to- day. The managers have failed to discover that " the Demilt Dispensary, which used flomax price to stand in good repute among the profession has lost much, if not all, of its prestige through the narrowness of its managers. ' ' Mr. Editor, "we flomax 0.4 mg trust that you have facts to sustain this remarkable statement." We regret that the proofs should have been withheld. We, at flomax prices least, have never been aware of the ex- istence of any of the "friction" apparently common elsewhere. I doubt whether two sets of men have e\-er worked together more harmoniously than have our man- agers and physicians. Occasional disagreements have arisen, as they will in any live organization ; but, consid-

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