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berry that ozrena often occurs at a period too early in life to warrant the assumption of a preexisting hyper- ' trophy, I would say that ozsena and atrophy are not con- vertible terms. Ozfena is not a disease per se, but a symptom of a number of pathological states. As is well known, it is often present in hypertrophic catarrh. Ozaena in children does not necessarily imply atrophy. In children, too, as in the adult, the transition period cleocin cost from hypertrophy to atrophy may be very brief, the wast- ing occurring rapidly from malnutrition, due to consti- tutional taint or other causes. The congestion or hyper- trophy that precede the stage of complete waste, too, are not always strikingly marked as regards the naked-eye appearances, and are therefore liable to be overlooked. Assuming that atrophy occurs soon after birth, it is possible that it may have been antedated by a catarrh in utero. This is, of course, assumption, but not extrava- gant speculation. That the atrophic is usually preceded by a hyper- trophic stage is rendered highly probable cleocin 100 mg from a number of clinical and pathological facts. If the clinical history is accurately taken, it will often point to a preexisting catarrhal hypertrophic condition. The hypertrophy — that is to say, the swelling — need not necessarily by any means be very pronounced. Why it should in one cleocin cream acne case terminate in fibrosis leading to the formation of the dense, so-called "hypertrophies," or to formation of nasal polypi, and in another case terminate in atrophy, are questions as yet unsolved. The rapidity with which the hypertrophic passes into the atrophic form is proportionate, in all probability, to the possession of some constitutional taint, such as, for example, the congenital or acquired form of syphilis. The early appearance of atrophy in some cases is de- pendent doubtless, too, upon certain modes of life and other conditions which influence the rate of progress in Nov. 20, 1897.; RICE: TREATMENT OF ATROPHIC RHINITIS. 093 eimijle inflammatiou iu general. I liave seen it occur with rapidity after tlie profound impression made upon the nutrition of the parts as the result of acute cleocin suspension systemic disease. If the 2:iatient is not under observation from the out- set, it may be difficult to establish with certainty the clironological relationsliip of the two stages; but, so cleocin iv far as my cleocin 900 mg observation goes, I have never been able to satisfy myself of the independent origin of the atrophic form. The pathological liistory of the cleocin suppositories process cleocin topical gel is, moreover, that of the conversion of hypertropliic changes into those of an atrophic form. In the rhinoscopic picture, in the microscopic section, the processes of hypertrophy and atrophy are found side by side. More than that, the atrophic changes are more pronounced cleocin 2 in situations in which the catarrhal inflammation originally developed. Thus, for example, if the disease originates as a catarrh of an accessory sinus, the atrophy is more pronounced in the latter situation, the nasal mucous membrane proper presenting evidences of simple or hypertrophic catarrhal inflammation. If, on the other hand, cleocin t acne the disease origi- nate in the cleocin tablets nasal fossae, the morbid condition of the sinus, if such exist, is that of simple or hypertrophic inflamma- tion. Finally, as the hypertrophic variety almost always begins in the respiratory portion of the nostril, so in the atrophic form, the region of the inferior meatus, the classical seat of atrophy, is the first to be destroyed. Weighty cleocin oral evidence in support of the position that atrophy is usually preceded by hypertrophy in cases that follow cleocin phosphate catarrhal inflammation is furnished by the buy cleocin t microscope. Here the processes are found side by side in the section, or portions of the membrane show signs of atrophy, while in others, when the disease is less cleocin 600 mg ad- vanced, hypertrophic changes are discovered. The above considerations encourage the belief, I think, that in sclerosis which is the result of intranasal irritation the atrophy is usually preceded by a hjT)er- trophie or congestive stage. I have not elaborated the propositions which form the basis of my remarks tliis morning.* Until they can be successfully overthrown it may be well cleocin topical solution to accept them, provisionally, at least. In the absence of direct histological and clinical proof of such a condition; in view of the rapidity with which, in some cases, the hypertrophic variety passes into the atrophic; in consideration of the many obvious diffi- culties in the way of certain historical data in its favor, and in the light of anatomical investigation, the ques- tion "Is intranasal sclerosis ever ah initio atrophic?" must, for the cleocin t pads present at least, order cleocin online be answered in the nega- tive. cleocin antibiotic

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