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he would name water and calomel. The hydropath, who was looked upon with disfavor in the past, has taught us much of the value of water. Lavage should not be ignored. The adult can overdrink and expel the water of his own volition, but the child's stomach must be washed. Turpeth mineral is an excellent emetic 100mg viagra cost in laryngitic stenosis. Opium should be withdrawn from the list of useful drugs. Syrups should be ruled out entirely. Conservatism is most of all necessary viagra trial voucher at the bedside of the baby. Antitoxin must be applied early. Most cases reported are in reality those of follicular ton- sillitis. Dr. Klebs, late of Munich, spoke briefly, but viagra trial voucher re- served most of his remarks for the general discussion upon the antitoxin question. Dr. Larrabee said that when a non-absorbable emetic was necessary, turpeth mineral was the best one to use, partly because of the small dose required. 778 MEDICAL RECORD. [May 30, 1896 Alcohol should be omitted from infantile therapeutics, because depression must of necessity follow. Feeding . or viagra trial voucher food stimulation is much better. Dr. Cotton said the subjects of the papers read touched every practitioner closely and opened up a wide field for discussion. Dr. Elmer Lee, of Chicago, read a paper entitled The Fallacy of the Claims Made for Antitoxin as a Treatment for Diphtheria. The history of the origin and the clinical use of antitoxin was briefly entered into, and reference was made to the discovery in 1884 by Pasteur of the hydrophobia treatment, from which it was shown that the 100mg viagra cost improvement in the percent- age of death due to the 100mg viagra cost treatment consisted not in a bet- ter understanding of the process, but in the greater dilution of the Pasteur lymph. It was shown that an analogous condition has been the experience of clini- cians with reference to the use of antitoxin. The stronger the antitoxin, the greater the danger. The explanation given concerning the reason for the early use of antitoxin is entirely dependent upon the rela- tive strength of the patient to withstand the assault upon the system made by the introduction of extraneous poisonous matter. Diphtheria is classified by the au- thor into true clinical diphtheria and diphtheria of the bacteriologic laboratory, a distinction which did not exist previous to the present stage of bacteriology. The first class is diagnosticated by the clinician at the bedside, while the second depends chiefly upon the findings of the culture tubes within the laboratory. The bacteriologist affirms that the throat manifesta- tions are paramount in importance, contrary to the experience of clinical observations. Systemic poison- ing, owing to lowered vitality, are essential factors in the causation of diphtheria. The special pathologic change in the fauces is considered by the author to be of secondary importance. The use of antitoxin as a curative agent is empirical rather than scientific, owing to the utter impossibility of measuring the exact chemic action which takes pace within the blood. It is seriously questioned whether it is possible to suc- cessfully neutralize a toxaemia by the introduction of a foreign viagra trial voucher substance which has 100mg viagra cost no natural place in the human economy. The proposition agrees with the supposed effect based upon the theory of cotttraria cmtraribus curantur, but is utterly inconsistent with natural physiologic reasoning. The difficulty of de- termining the exact value of a therapeutic agent makes it next to impossible to put absolute reliance in sta- tistical tables furnished by the sponsors of antitoxin treatment. If the cases were all of similar character, and the treatment could be classified by control ex- periments, the conclusions would approach reliability. As it is, it must ever remain largely a question of personal experience and faith as to the value of the curative influence of special drugs and preparations. Very much is done to increase the belief in the effi- cacy of antitoxin by the modern secular press, viagra trial voucher the family of the patient frequently requesting and almost demanding that antitoxin should viagra trial voucher be used, the posi- tion of the viagra trial voucher physician being dependent upon the im- pressions iii.uk- by the inaccurate statements of news- papers. The value of the treatment is thus prejudiced in its favor, which sometimes throws a shadow across a conservative judgment as to the true effects. Un- doubtedly fatal results have occurred, but in each in- stance some special plea has saved the treatment from condemnation. The use 100mg viagra cost of antitoxin, therefore, goes on, owing to the seductive claims which were pub- lished at the outset and which the profession has not had the experience necessary nor the courage to 100mg viagra cost correct. The careful records of the Willard Parker Hospital furnish sufficient evidence upon which to base a fair judgment as to the value of antitoxin. It is shown from this hospital that the claims of the foreign path- ologic investigators have failed of being substantiated. 100mg viagra cost When all the facts, based upon a cooler judgment, are taken into consideration, the clinical experience of the whole profession renders it necessary to proceed fur- ther in the use of antitoxin with caution. It is true that diphtheria when treated by antitoxin has ap- peared to be favorably influenced, but the claim that it is a reliable and safe treatment is far from being established. A little time is still required in which to enable the profession to sift the facts and determine viagra trial voucher the place of antitoxin in therapeutics. Already the chief promoters who favor antitoxin for the cure of diphtheria are rapidly receding from the position that antitoxin is also a preventive of the disease. It is almost certain 100mg viagra cost that the ensuing year will witness a return to former methods of treating diphtheria, judg-