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A 40-year-old female presents with fever, malaise, with hemispheric signs and symptoms such as 278. Clomiphene citrate is commonly prescribed for (E) Volvulus headache, and sore throat. Physical examination aphasia, apraxia, hemipareisis, hemisensory losses, which reproductive purposefi In addition, a grayish exudate is appreciated (A) Hemorrhagic strokes (B) Oral contraception with a curve greater than 60 degrees. A hysterosalpingography is a useful exam for the (A) Acute herpetic gingivostomatitis (C) Oral corticosteroids evaluation of infertility. Which of the following (B) Acute herpetic pharyngotonsillitis (D) Milwaukee brace does this exam evaluatefi Lithium, an anti-manic medication, is commonly (E) Viral pharyngitis (C) Sperm survival used as a maintenance medication to prevent 289. Which of the following is the name of the clinical (A) Pregnancy (B) Bipolar disorder sign that results in a carpal spasm in response to (B) Ectopic pregnancy (C) Borderline personality disorder 222 A rachitic rosary reduced exercise capacity, and right-sided con presentation and physical examination, which painless red lesions on the palms and soles. Auscultation of the chest of the following is the most likely source of the addition, exudative lesions are observed in the disordersfi Blood cultures are positive and a trans (A) Cardiomyopathy enlarged cardiac silhouette. Echocardiogram (A) Epiglottitis esophageal echocardiogram reveals an oscillating (B) Croup reveals mildly reduced left ventricular function. Which of the following is the clinical term for a (A) Congestive heart failure the following is the most appropriate diagnosisfi
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It seems that no standard either of strength or consistency has yet been established for extracts, and for this reason the physician possessing any kind of facilities for office pharmacy and who can procure the fresh agent should make his own extracts, as those found in the market are wholly unreliable as to strength or consistency. Unless kept thoroughly sealed in glass or porcelain jars and in cool damp place, water evaporates, and the extract deteriorates, becoming hard and inert. Pharmacopoeia has endeavoured to establish a standard of consistency by the term "pilular consistence," but this is no more definite than the term solid extract, as the consistency of a pill mass must depend on the nature and quantity of the powders to be incorporated. The proper way, we think, is to establish it standard of strength representing a definite quantity by weight of the drug fresh green or dried, to commence with, which shall be represented by a definite quantity by weight of the finished extract, which should be always stated on a label upon the container. In this way the druggist or physician could easily ascertain, by weighing, whether evaporation by long keeping or being loosely stoppered, had reduced the product below the standard; in which case, if not otherwise deteriorated sufficient distilled water could be added to bring it up to the required standard of weight and consistency. With the view of establishing a definite standard of strength for solid aqueous extracts we suggest the following typical formulae: Aqueous Extract of Eupatorium Perfoliatum. Put in a large mouth glass or queensware bottle, cover with a thin stratum of glycerin and thoroughly dose with a good cork glazing Hw top and sides of same with hot bees wax. These are made from succulent green plants, which are bruised to a pulp in a mortar, the juice pressed out with a drug press or displaced with the centrifuge and evaporated spontaneously in a warm place. They should be made on the same standard as aqueous extracts from the green plant, 5 lbs. Some largely resinous agents are best treated in this way; but the percentage of alcohol need not be large, not exceeding 25 or 30 per cent. Last but by no means the least objection, the larger the percentage of alcohol used, the less soluble the extract in the fluids of the alimentary tract. The following is offered as a typical formula for a standard hydro-alcoholic extract. Place the drug in a macerating vessel, mix 4 pints of the water with the alcohol, pour over the drugs and macerate for five days, transfer to the centrifuge or a percolator and displace, setting aside the first six pints, continue the displacement with boiling water until two gallons of percolate in all are obtained, evaporate the last percolate by boiling slowly to a half gallon, mix with the first percolate and evaporate on hot water or a steam bath to one pound of extract put in a well stoppered large mouth bottle, covering with a thin stratum of glycerin. As above st,ated, such ext,racts are not desirable because of their insolubility and expense. Those agents containing large quantities of gum and resin are treated in this way under the notion that their medicinal properties are therein contained. The fact is that the gums as a rule are sparingly solvent in alcohol, while the resins only partially represent the therapeutic constituency of such agents. Pharmacopoeia in 1880 introduced officially under the name Abstracta, preparat,ions made by spontaneous evaporation of an alcoholic tincture and adding sufficient sugar of milk so that when dry or powdered the product would be one half the weight of the quantity of drug used. These preparations had been previously made and sold by a drug firm under the name of saccharated powdered extracts. They were thought to be a great improvement over the solid extracts both as a standard strength and therapeutic efficiency, but after an extensive use of them by the profession, for a short time they fell into disfavour, as they could not be kept from solidifying and they were found to be insoluble by the digestive fluids. In place of the above we suggest the following typical formula, the product of which we shall call abstract triturate. This preparation gives the advantage of first the normal powder of the drug, second, extraction and addition to the normal powder such constituencies as yield most readily to a hydro-alcoholic menstruum, and thirdly rapid and perfect solubility by the gastric and intestinal fluids with consequent complete assimilation of the drug, which constitutes the therapeutic disideratum of a pharmaceutical product. A number of vegetable agents contain a fixed oil which is intimately combined with gum-resinous constituents from which the oil cannot be separated without destructive distillation, while the oil resin and gum can be readily obtained in combination and represents a large therapeutic constituency of the drug.
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The seed are an excellent soothing demulcent, stimulating and toning agent to the mucous membrane of the alvine, respiratory and urinary tracts and is valuable for the relief of irritated and inflamed conditions. When needed for the respiratory tract, it relieves irritation and promotes expectoration. When required for the urinary tract it soothes and relieves irritation, but its influence will be more marked when combined with more positive diuretics. After the oil has to a great extent been pressed out of the ground seed, what is left is denominated oil meal. It may be frequently moistened with Lobelia Verbascum and Capsicum combined as desired. Combined with pulverized Ulmus it is a most valuable preparation for the covering of burns. It will do its work without leaving any marks, no difference how deep the wound, wipe off any pus that may be present and remove dead flesh and then cover again with this preparation. Of course, nervines, cathartics, hepatics or alteratives may be added as needed by the constitution. Put this mixture into an earthen crock and add the sulphuric acid very slowly, a few drops at a time, then allow to stand twenty-four hours until all the precipitate has formed and pour off and retain the supernatant fluid only. The Doctor says this is the best thing for burns that he ever used, and that he has had remarkable results with it, having healed some very extensive burns without, ulceration or scar. It contains a volatile oil called Lippiol, the absence of which renders the agent more or less inert. In hot infusion it relieves colds, loosens catarrhal secretions, increases expectoration and relieves soreness of the throat and is excellent in the treatment of la grippe. It quickly allays an irritating cough, and is very useful in acute and chronic bronchitis, whooping cough, catarrhal fever, catarrhal phthisis and night sweats. From incisions made in the bark of this Southern tree flows a nearly transparent aromatic balsam. Combined with Olive Oil or Vaseline it forms an ointment for ringworm, scald head, tetter and other irrita tions of the skin. It rarely fails to cure scabies and is a valuable application for old sores, hemorrhoids and ulcers. The bark is a mildly stimulating agent and may be used freely in gonorrhoea, cystic catarrh, dysentery and diarrhoea. The inner bark of the trunk and roots is a mild, bitter, aromatic, relaxing and very gently stimulating alterative and nervine.
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