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epileptic attack, the dog all of a sudden, without any provocation, "straightens itself upon its feet, the hair disheveled, its looks angry, the eyes injected and brilliant ; it directs its looks toward any point, although there is nothing to attract its attention ; it stiffens, and with neck stretched, the ani- mal is ready to jump : it advances and retreats suc- cessively : it barks with rage and struggles furiously, grinding its teeth, jumping abruptly to c^tch its ini- agjnary enemy ; it then shakes its head from side to side, the teeth close together, as if readv to tear its prey. Little by little it becomes calmer, again gazes, growling, in the same direction, then is reassured entirely." Magnan declares that "this delirious attack, so suddenly developed, explains the precocious delirium of absinthe drunkards. . . . Under the influ- ence of small doses of the essence of absinthe, the dog stops suddenly, stupefied, the head lowered, the tail hanging Zofran 4 down, the appearance dejected, a stran- ger to all that is going on. It is in a condition of {>clit iiiol." In the acute form of absinthism, vertigo and nau- sea are prominent svmptoms. besides the effects of the alcohol. According to Amory, the immediate effects of absinthe are epileptic convulsions and nervous debility. One overdose of absinthe will pro- duce epileptic convulsions. When absinthe is given to animals in small doses, it causes giddiness and muscular jerking. In large doses it produces epi- leptic convulsions, and also delirium and hallucina- tions. This delirium develops very suddenly-, and the hallucinations cause appearances of fright and agitation. In man the giddiness and muscular jerk- ing are not so marked as in animals. They might be even unnoticed if one were not on the lookout for them. The trembling and giddiness which appear might be thought to be due to alcohol alone. But where there is complete intoxication there are epileptic seizures which are not caused by alcohol. Marcc, Trousseau, Fidoux, and Motet have de- termined that a small dose of absinthe will cause vertigo, Iv Zofran muscular disorders, Odt Zofran and convulsive move- Zofran 8mg ments. In a stronger dose it causes attitks of epi- lepsy more or less violent. The attack of insanity of the absinthe drinker is very similar to that Zofran Buy produced by alcohol, but, in addition, according to Magnan, there are often epi- leptic seizures, and Cost Zofran the hallucinations are very sud- den in the onset and quickly reach their acme. In certain experiments, the administration of this drug was followed by diminished reflexes and a condition of depression. In acute, as well as chronic intoxication, Zofran Mg after the stage of depression and dimin- ished reflexes, violent epileptiform convulsions oc- curred, and a distinct increase of reflex irritability. Amory gives a comparative table of the temporary and permanent effects of absinthe with those of alco- holic beverages generally, Zofran 8 Mg founded on the experi- ments conducted by Magnan and himself: Absinthe. Animal perfectly well Ondansetron Zofran for fifteen minutes, at the least, after the -ngestion, with the exception of a few muscular twitchings and a slighr uneasiness. Muscular agitation, com- mencing in the anterior portion of the body. No paralysis. Epileptiform convulsions and rigidity, resulting in a speedy death. No apparent lesion, ex- cept perhaps a slight cer- ebral congest'on, show- ing the cause of death to be intoxication by the poison. Alcohol. In a very few minutes symptoms of inebriation, resulting in torpor. Paralysis, commencing in posterior extremities, and then extending to the anterior. Paralysis of both poste- rior and anterior ex- tremities in succession. No convulsions. Stupor, coma, resolution, and a gradual death. Lesions of the brain and of the alimentary canal ; gastritis and enteritis might have supervened, had the animals lived long enough for their de- velopment. Differentia! and characteristic signs wdiich govern the ])ositive diagnosis between the effects of alcohol and absinthe are epileptic attacks, vertigo, early hal- lucinations, delirium, and inconscient delirium which sometimes follow the attack. Simple alcoholic delirium is far slower of develop- ment. The use of absinthe produces convulsive manifestations almost immediately. The epilepti- form attacks in most cases of simple alcoholism re- quire a certain time — some years — for preparation of the brain before they manifest themselves. Absinthe ■'convulsions are an exact reproduction of the epilep- tic cvcle : tonic convulsions, followed by clonic ones, rapid and short at first, then more and more slow and distant, ending in rest." The delirious attacks of absinthe develop sud- denly, just as "after the administration of certain poisons, of hyoscyamus, belladonna, or stramonium, and this rapidity in the Zofran Cost development of the intellec- tual disturbances is one of the distinctive charac- teristics distinguishing the action of absinthe and that of alcohol." Robinovitch says that in the case of the absintheur "the whole clinical tableau of alcoholic poisoning seems to be condensed, so to speak, within the short- 572 MEDICAL RECORD. [Oct. 13, 1906 est possible space of time. The excitation of the senses, the delirium, the muscular cramps, the dizzi- ness, vertigo, and finally the true epileptic convul- sions set in, and follow one another in rapid suc- cession. Where years are necessary for alcoholic morbid changes to be expressed clinically by epilep- tiform attacks, one year or even less, suffices to bring about true epileptic attacks by the Zofran Odt abuse of absinthe." Absinthism differs in various ways from alcohol- ism. In the former are manifested hallucinations and terrible dreams, enfeeblement of the intellect, and stupor, all of which may develop rapidly with- out any muscular tremor. If this tremor does exist, it is usually confined to the upper extremities. Ab- sintheurs are restless at night. They suffer from nightmare, nausea, lack of appetite, vomiting, mental dullness, and sometimes delirium or mania. Mental deterioration progresses. The power of concentra- tion of memory is impaired, and the patient loses his will power. He becomes indifferent to the wel- fare of both himself and his familv and friends. In- stead of the simple muscular tremor of delirium tre- mens, as is seen in the alcoholic, the epileptic fit is seen in the absinthe drinker. The fit recurs from time to time. If the habit is overcome during the early stages the fits cease. But Zofran 4 Mg if the indulgence is continued the intellect is permanently deranged and paralysis and death result. The morbid changes which develop vary according to the individual pre- disposition. Sometimes the fits are more like an at- tack of hysteria. .-Vbsintheurs have hallucinations of sight and hearing which do not represent a con- dition like delirium tremens. The victims of this habit become absolute physical and moral wrecks. Lanceraux says that chronic absinthism has devel- oped at the end of eight, ten, or twelve months in young women, or even girls from eighteen to twentv years of age. Cirrhotic degeneration of the liver, kidnevs. and heart is one of the effects of chronic Zofran 4mg alcoholism. Muscular tremor and Zofran Ondansetron incoordination are marked. The chronic form of alcoholism differs from that of absinthism, as has been said, mainly in respect to the epileptoid attacks and the earlv development of general paralysis : C.autier says also' by the frequency of hyperesthesia in the iliac fossae especially. In general the effects of absinthe are like those of alcohol, but in the former they develop much earlier, Price Of Zofran and are of a severer nature. In absinthism there is also a more striking disturbance of the nervous system. The writer takes this opportunity to acknowledge her great indebtedness to the many original investi- gators in the subject treated of in this paper. Their work has been freely consulted and quoted in this brief review. 39 East Twenty-Ninth Street. Acute Yellow Atrophy of the Liver in Pregnancy.— G. Acconci states that acute yellow atrophy of the liver is rare in pregnancy, and is gonorally fatal both to mother and Zofran Iv Zofran Price fetus. The etiology is obscure, but the author con- cludes, from the study of two cases observed by him, that there is no specific cause, but that any of the factors that produce it in the male may act in pregnancy as well. It may also be the result of an autointo.xication of severe type due to the pregnant condition. It may come on as thi aggravation of a slight icterus or may be a morbid entity. Pregnancy generally affects unfavorably any anatomical lesion of the 8 Mg Zofran liver. The same toxin that affects the mother may injure or destroy the fetus. The symptotns generally come on insidiously rather early in pregnancy and advance to a condition of stupor in which the fetus is delivered. The patient continues in a deep coma until death releases her. — Annali di Ostclricia c Ginecologia, March, 1906. ROENTGENOGRAPHY OF THE STOMACH. By M.\X EIMHDR>^. .M D . avd ]L. G. COLE, .M.D., NEW YORK. RiEDER,' Holzknecht,- Williams,^ and Hulst^ have recently succeeded in taking good roentgenographs of the stomach. The method consists Cost Of Zofran in giving the patient, when the stomach is entirely or partly Fig. 1. — -\'-ray photograph of stomach (negative) of Dr. B., taken in standing position. The greater curvature extends just to the navel empty, a pint of milk into which one ounce of sub-

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