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the first twenty-four hours: Intense redness at the point of application of the reliable generic viagra current, as well as extending to the whole periphery of the urethra, which is ecchy- mosed. In depth these lesions go beyond the limits of the mucous membrane, and if the intensity cf the current has been somewhat elevated and prolonged in- terstitial hemorrhages are to be seen, which seem to Dr. reliable generic viagra Desnos to play a certain role in the genesis of consecutive accidents. Experiments upon dogs, ft cm which the foregoing observations were made, agree with the author's experience reliable generic viagra in man. The moment it be- comes necessary to employ somewhat elevated current strength in order to overcome the stricture in a single sitting, a rapid recurrence of the stri 50mg viagra softtabs ture is noted; but what is especially important is the fact that this new stricture is firm, tense, and non-dilatable, pre- senting, in a word, the features of traumatic stricture, whence the very great resistance to dilatation in ure- thra; which have been electrolyzed. It is by no means the same after the slow method with feeble currents .is in the method of Newman. Here accidents are scarcely known; as to results, they usually are gecd. The writer admits that he has not been so successful as Newman (who claims not to have had a single ac- cident in several hundred cases), having had several non-dilatable strictures following the application of this method. Unfortunatelv it is an extremely slow June 6, 1896] MEDICAL RECORD. 80- method. Ten or twelve days must be reliable generic viagra allowed between the sittings and from twenty to twenty-five applica- tions are often necessary, causing the patient if not the physician to give it up for another method. In discussing the question Dr. Labbe' considered the rap- id method not electrolysis at all, which is a molecular decomposition of the tissues, but a chemicaustic or a true cauterization, while Newman's method seems to act by true electrolysis. [These opinions, coming from observers of known 50mg viagra softtabs ability and care in utterance, must be at least gratifying to the originator of a method of electrolysis on this side of the water whose claims have received little encouragement from leaders in genito- urinary thought among his fellow-countrymen. They should also cause enthusiasts to pause and consider the ultimate results, before giving themselves up wholly 50mg viagra softtabs to the methods advocated by a brilliant and rapid opera- tor who recently spent some time in introducing here his instrument, which we understand is protected by patent and can be purchased at a correspondingly high price. Ed.] Traumatic Intracranial Hemorrhage. Deaths by intracranial hemorrhage, the result of violence (as a blow on the head) are of common occurrence, says a writer in the Boston Medical and Surgical Journal, March 12, 1S96, as is shown by the records of our criminal courts and mortuary statistics. A fall on the head, a blow from a cane or the fist over the tem- poral, parietal, or occipital region, may be soon fol- lowed by dangerous if not fatal symptoms of compres- sion due to hemorrhage, and in many cases there will be 50mg viagra softtabs absence of fracture and other external marks of vio- lence. The bleeding in a large proportion of subjects comes from lacerated branches of the middle menin- geal artery and is between the dura and cranium, re- sulting in a firm clot adherent to the dura; the 50mg viagra softtabs hem- orrhage is due to separation of the dura from the bone in consequence of the blow and laceration of the vessels as they enter the arborescent bony grooves. As diagnostic signs of this lesion we have the pri- mary stunning, then a period of consciousness of vari- reliable generic viagra able duration, then the secondary coma attended by certain localizing symptoms dependent on the region of the cortex implicated. First the motor symptoms that is, motor 50mg viagra softtabs aphasia, from pressure at the bottom then involvement of the face, then of the arm, and rarely of the leg centres.' The dilatation of the pupil on the same side as the lesion is another localizing sign. The indications will not be materially different whether the clot be inside or outside the dura; nor has the modern surgeon any hesitation about the pro- priety of penetrating the dura when there is extrava- sation of blood beneath it. Intracranial hemorrhage due to external violence is still the bugbear of the or- dinary practitioner, who realizes that such cases are generally fatal, and who is still dominated by such views relative to the utility of trephining as were for- merly prevalent and found expression in the declara- tion of Druitt that 'trephining is a last resource, and, it must be confessed, a very desperate one, which mod- ern surgeons become daily more unwilling to resort to." - Even Gross taught 'that the only case in which trephining is really warrantable is " where the extrava- sation is associated with or dependent on the fracture of the skull, complicated with depression or reliable generic viagra serious injury of the soft parts, or where the fracture is situ- ated directly over the course of the middle reliable generic viagra meningeal artery." :i Naturally, an impetus to bolder surgery 50mg viagra softtabs followed Listerism and modern aseptic methods, and trephin- 1 Keen ; Journal of Nervous and Mental Disease, May, 1S94, p. 24. - Druitt : " Modern Surgery." American edition, 1S60. 3 '* System of Surgery." second edition, vol. ii. ing is now generally regarded by the surgeon as im- peratively indicated in most cases where there reliable generic viagra is reason to believe that there is hemorrhage within the skull whether there be fracture or not provided that there are external marks, as contusion, ecchymosis, and swelling, or other definite localizing indications. Wiesmann reliable generic viagra has considered the matter from the point of view of statistics. He states the mortality of non-op- erated cases as 89.1 per cent, and that of operated cases