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way and not to go into the pathology of the differ- ent forms of ileus, but rather to analyze the cardinal symptoms and findings common flomax 0.4 to all varieties. In a well established case of acute intestinal ob- struction, it matters not from what cause, the car- dinal symptoms are classical and diagnostic. These are collapse, vomiting, tympanites, pain, and obsti- pation. Why do these symptoms occur in occlu- sion? Is it because the poisons of the digestive tube are no longer expelled per rectum? In con- stipation we have this condition, yet we do not have the symptoms we get in ileus. We flomax for women have all seen cases in which there has been no evacuation of the bowels for a week, ten days, or even longer, flomax cr with no symptoms except malaise, headache, dizziness, etc., so that the stoppage of the intestinal contents is not the main factor in producing the conditions characteristic of ileus. Other important changes must be added to give us the symptoms that are present in a complete flomax 0.4 mg occlusion. Three theories have been advanced to explain the symptomatology of ileus. First, that it is (\uz to a reflex generic of flomax action, and to support this theory, the German • Head before the Omiiliu Medical Society, April 0, 1007. clinicians point out the flomax tamsulosin initial slowing of the pulse, followed later by weakening and rapidity, which is caused by a paralysis of the pneumogastric, at the same time producing price of flomax vasomotor troubles, congestion of the abdominal viscera, lowering of the blood pressure, anaemia of the skin and central nervous flomax online systems; in fact,. the symptoms of shock. Second, the infectious theory, the symptoms of which are attributed to the absorption of intestinal bacteria and their products. The exponents of this theory flomax generic cite in proof the changes that are found in the blood of these patients — there nearly always being micro- flomax in women organisms in the circulation. Third, the toxic the- ory, that the symptoms are produced by the absorp- tion of poisons from the intestinal contents, proxi- mately to the obstruction. cost of flomax I believe that all three of these theories play a part. For instance : In a case of internal strangula- tion, the immediate symptoms may be produced by a reflex action, but they are prolonged by the con- tinued absorption of poisons. These poisons are partly due to microbic action, but the principal fac- tor is the absorption of the poisons which are se- creted by the intestines themselves. In the support of this toxic theory, the brilliant experiments of Roger coincide with clinical observa- tions. He has proved conclusively that the intes- tinal secretions are the most poisonous in tiie duo- denum where there are no bacteria nor putrefac- tion, and that the toxicity lessens flomax prices as we pass down the intestinal canal. A significant point is that as the putrefactive process increases, the toxicity les- sens. It is flomax cost a clinical fact that an obstruction in the small intestine is a graver condition than when in the large, and the higher up in the small intestine the graver the symptoms and the more quickly a fatal termination. In an animal if the jejunum is ligated, the animal will die several days sooner flomax alternative than if the sigmoid be tied. In the latter case, the arrested contents is more abundant, putrefaction is more intense, the growth of the microorganisms more active, the sur- face of resorption more extensive. Why. then, is an obstruction in this part of the bowel not more quick- ly fatal? We know clinically that the severity of the symptoms, and the fatality of these cases de- crease in direct proportion to the distance from the pylorus, that the obstruction is located. In the upper portion, for example, if the jejunum is com- pletely occluded, the patient usually dies in forty- eight to seventy-two hours, while if the colon or sig- moid is obstructed, the patient flomax women will live ten flomax price days or longer. Therefore we are brought 1o the conclusion that the colon is a sort of reservoir, where the intestinal contents can stagnate without much absorption oc- curring, and it seems jirobable that the real toxic substances found in the upper part of the small in- testine must, by some unknown means, loose their to.xicity in their passage down the canal. Maury, of New York, published in Surgery, Gyncecology, and generic for flomax Obstetrics for May, 1906, the results of a series of experiments upon dogs, in which gastroenterostomy with ligature was done and the intestine ligated at difTereiit distances from the pylorus. He found that, when the ligature was placed anywhere within 35 cm. alternative to flomax from the pylorus, in each case the dog died before seventy-two hours September 14, 1907.] CONDON: SYMPTOMS OF what is flomax ILEUS.

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