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visional diagnosis of syphilis of the tonsil was made, which, happily Toprol Xl Beta Blocker for the patient, who was successfully treated with antisyphilitic remedies, proved to be correct. The patient whose history forms the basis of this report «as sent to me for advice as to the removal of a tumor, apparently malignant, of the left tonsil. He gave the following history: X. Y., aged forty-three years, American, married, and father of a family of health J' children; merchant. Family history good. Previous history excellent. No evidence whatever of syphilis, and knowledge of any symptom suggestive of it denied. AboTit two months before consultation began to notice soreness Generic For Toprol Xl of left side of pharynx. The Metoprolol Tartrate Vs Toprol Xl tonsil began to increase in size, although prior to this time there had never been any trouble with it. Generic Name For Toprol As the en- largement continued the tonsil became inflamed, and finally began to break down, an erosion appearing near thfe centre of its surface. This extended until about half of the tonsil had become involved in a deep, destructive ulcer, with foul interior and everted Toprol Xl Vs Metoprolol Tartrate edges. At the time of Toprol Xl 50 Mg Recall the Generic Name For Toprol Xl consultation the Toprol Xl Vs Generic remnant of the tonsil was indurated, but there was not marked exten- sion of general infiltration outside of it. Several cervi- cal lymph nodes immediately below the tonsil, however, were slightly enlarged and indurated. The rest of the throat was normal. There was moderate pain in deglu- tition and upon palpation. The clinical appearances of this case were highly sug- gestive of sarcoma. Although the family physician was a well-known practitioner of unusual ability and ex- perience, neither he nor myself were able to find the slightest evidence of syphilis after repeated careful ex- aminations. The patient was Toprol Xl 100 Mg a gentleman of excellent intelligence and social position. He was aware of the gravity of the situation and of the danger of the opera- tion necessary for the removal of a malignant tumor of the pharynx, and while professing the utmost willing- ness to aid us by every Toprol Generic Equivalent means in his power positively denied Is Toprol Xl A Beta Blocker the knowledge of having contracted specific dis- ease. In order to arrive at a diagnosis as speedily as possible a fragment of the diseased tissue was removed and sent to Dr. Toprol Xl Generic Recall Eugene Hodenpyl, of the College Is Toprol A Beta Blocker Toprol Xl Coupon of Physicians and Surgeons, New York, and as a matter Metoprolol Vs Toprol Xl of routihe practice based upon the uncertainty of cases of apparent malignant disease of the throat, the patient was placed upon a course of iodide of potassium. The first report of the pathologist expressed a doubt as to the nature of the lesion, although several other micros- copists who saw the specimen considered the case one of sarcoma. A second small fragment was removed and examined about ten days after the first, and this also gave a like negative result. At this time Dr. Hodenpyl suggested that a positive diagnosis might be arrived at by the examination of one of the afi^ected glands. Meanwhile the latter had al- most entirely disappeared. In order to secure enough tissue to make Toprol Xl Generic Name the examination complete, the entire tonsil was removed by means of a cold-wire snare, and the mass thus separated was sent to the pathologists without any reference being made to the change in the condition of the lymph nodes. Again, the general ver- dict was sarcoma, excepting on the part of Toprol Xl Generic Equivalent Dr. Hoden- pyl, whose report was as follows: Pathological Department of College of Physicians and Is^urgeons, November 2G, 1896. Tonsil, X. Y. — The conditions present in this organ are an exact counterpart of those observed in the speei- Doc. 4, lf<97. THERAPEUTICAL NOTES. 771 mens first examined. The Cost Of Toprol Xl lesion is one of a chronic liy- perplastic nature. If it were a polyedral-cell sarcoma (which is a highly malignant variety) we should confi- dently expect a rapid growth in the past weeks. This tonsil did not seem to be greatly enlarged. The condi- tions Toprol Xl Vs Metoprolol observed, moreover, do not exactly resemble an ordinary chronic hyperplasia, in that, besides a consider- able amount of fibrous tissue, giant cells, etc., there is a very unusual number of endothelial cells in the sections, an appearance sometimes found in cases known to be syphilitic. The resemblance of the sections to sarcoma is very striking, but this diagnosis must be excluded on account of the relatively normal size of the tonsil and of the appearance mentioned above. Eugene Hodexpyl. The subsequent history of the case fully confirmed this diagnosis. Under the continued administration of

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