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died of it. We do not possess a single scientific proof that a case of diphtheria was ever prevented by the immunizing process. "2d. Children, who during the first sickness have been treated with large doses of serum, have a short time after acquired diphtheria anew. They were not rendered immune either by their sickness or by the largest doses of the antitoxin. 3d. In a large number of cases, children have been treated on the first or second day of their illness with the fullest dose of the antitoxin, and have died. " .(th. It is certain 100mg viagra levitra that a large part of those who 100mg viagra levitra have died, notwithstanding the serum treatment, did not die from tl tsof 100mg viagra levitra a mixed infection, but directly from the specific effects of Loeffler's bacillus. 5th. Heart and other post-diphtherial paralyses are also seen in early and fully treated cases, and occur as often as they did before the serum treatment. 6th. Of generic viagra 20mg a fever fall by crisis in the first twenty-four . and of a pronounced antipyretic effect of the serum, most observers have seen nothing or next to nothing. "7th. The separation of 100mg viagra levitra the membranes follows in Min favorably in the customary manner; but often there is an extension of the local pi and a renewal of the already separated menu during and after the serum treatment. "8th. The burden of proof lies with Behring and his coworkers. The world eagerly and only too willingly received this proof. We know that the former extrav- agant promises are out of the question ; but we should be grateful to have it demonstrated that the serum can reduce the mortality by even one per cent. As yet we generic viagra 20mg have not the slightest basis on which to found an ex- pectation that fewer children will die in the future of this disease on account of the serum treatment." One of the strongest arguments against the anti- toxin 100mg viagra levitra treatment of diphtheria is the attitude of those who are living in hospitals and watching its results, who formerly were earnest advocates of the treatment, and who, after experience, have from conviction be- come opposed to it. Dr. William M. Welch (Municipal Hospital, Phila- delphia), who has injected over three hundred patients, stated to me that he would not have antitoxin used on himself if he had diphtheria; that if his children had diphtheria of any type, he would not allow them to be injected: and if left to act independently and from his own conviction, lie would never inject an- other patient. Dr. Steinsieck (North Brothers Island Hospital) says he would not have antitoxin used on himself; that recently he has thought it all over as to what he would do in case his children had diphtheria, and he has decided he would not have them injected with antitoxin, no matter how severe or what the form of the disease might be. Dr. Warmuth, Dr. Tyler, and Dr. Bern is, of the Municipal Hospital, Philadelphia, were believers in antitoxin, and are now opposed to it. Dr. Hardin, of Washington, and Dr. Levy, of Rich- mond, came to the Willard Parker Hospital thorough believers in antitoxin, and are now opposed to it. Dr. Warmuth (Municipal generic viagra 20mg Hospital, Philadelphia) had diphtheria and refused to have antitoxin used on himself. Dr. Levy and Dr. Hess, generic viagra 20mg of the Willard Parker Hos- generic viagra 20mg pital, had diphtheria and refused to have antitoxin. Not one of the nurses of the staff of these hospitals would have antitoxin used on themselves for immuniz- ing purposes. Variot states that the doctors and nurses of the 100mg viagra levitra Trousseau Hospital (Paris) would not have antitoxin used for immunizing purposes, though one of the doc- tors had a severe diphtheria. It has been said that I have been prejudiced against the use of antitoxin. My impressions with reference to the use of antitoxin were gained first in the autumn of 1S94, when I saw Dr. Halliday come under treatment at the Willard Parker Hospital. He was brought to us as soon as the diagnosis of diphtheria was made, partly for isolation and partly to get the benefit of the antitoxin. He had an uncomplicated, but severe, diphtheria, involving most of the throat. He was a strong, healthy young man of perfect habits. He was given antitoxin as generic viagra 20mg generic viagra 20mg soon as admitted given the full dosage, I understand and in addition, every other possible treatment, of course, that could be sug- generic viagra 20mg gested. At the end of two weeks and one day he died of a straight, uncomplicated diphtheria, the antitoxin not having had the slightest influence on a single symptom from beginning to end. This made me won- d< 1. for the man seemed to have every possible chance to be saved by this specific. I was so impressed by it that I went to Dr. A. L. Loomis, and talked over the matter generic viagra 20mg with him on three different occasions. He wanted me to come out then and express my opinion, but I said: " No: there is a possibility that I am mis- taken, and I do not wish to deprive any one of the use 1 'f it." In that autumn only five patients with diphtheria were treated with antitoxin. Four out of the five died, and the fifth was desperately ill. He had a peculiarly long and tedious convalescence. It was these five June 20, 1896] MEDICAL RECORD.