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as usual in the different varieties of orchitis the ap- pearance of one solid voluminous inflammation hence the generic term orchitis. There are undoubt- edly cases in which the testis proper is primarily- affected, the epididymis remaining intact, but these are rare, and even then the immunity of the epididy- mis is not absolute, there being viagra much pill almost always some participation in the pathological process, whether sym- pathetic or direct. In passing the current through the bladder, care should be taken to have the electrode to be placed on the perineum made oblong and narrow- buy viagra edinburgh to fit the parts, that placed above the pubis being about two inches in diameter. The ascending current is preferable. Although the question in which direc- tion the current should be passed, up or clown, viagra much pill in general is still in discussion, the author would say after an experience with electricity of many years that he has found the ascending current detergent, decon- gestive, and dispersive; buy viagra edinburgh the descending current, on the contrary, sthenic, reconstituent, cumulative. The ac- tion of buy viagra edinburgh the galvanic current on the tissues is purely chemical by cataphoresis and it is for this reason that it is destined to render still greater successes than any yet achieved in medicine or surgery. How came this testicle to be tuberculous, there being no tuberculous deposit in any other organ nor any tuberculous history in the family for several gen- erations back? As it is well known that the bacillus of Koch is carried in the mucous membranes of the mouth in health, it must be, according to the evidence furnished in this case, that the same bacillus is stored away in other membranes and organs, where it remains latent and innocuous until the bactericide condition is overcome by general weakness and a porte d'entre'e is found always in the locus minoris resistentiae. The etiology and semeiology of circumscribed tuber- culosis would carry us too far beyond the limits of this paper, which is essentially a clinical one. PSEUDO-MALARIA. By RFC. A. FERGUSSON, M.D., L.R.C.P. Edin., BAKERSFIELD, CAL. "The buy viagra edinburgh term malaria should be limited to a definite disease in which we know- there is a specific infectious origin" (Rotch). My proposition is, that in the genus of diseases called malaria there are two species: (a) A true malaria due to earth-bred protozoa, and (b) A pseudo-malaria due to the presence in the system of toxic metabolites or of ptomaines. For fourteen years it has been my fortune to have under observation the endemic diseases prevalent during the agricultural development of a new country and the growing up of a community. Bakersfield is the county town of Kern County. Kern Valley is the southern portion of the great San Joaquin Valley of California. In a given locality the peculiar conditions of cli- mate, of soil, and of water, the drainage and general sanitation, the manner of living of the inhabitants, and the presence or absence of malaria are the initial factors in the production of the diseases endemic in that locality. The climate of Kern Valley is subtropical, conti- nental, and dry, and, as in all districts away from large bodies of water, the tendency is buy viagra edinburgh to cool winters and hot summers. The rainfall averages five inches a year and occurs during the winter and spring. The mean winter temperature is about 52 F. The mean summer temperature is about 83 F. The annual range is from about 28 F. in December or January to 110 F. in July or August. The variation during the twenty- four hours is from 25- F. to 50 F. The soil is principally a richly fertilized, deep alluvium, annually watered by the waters of Kern River and other mountain streams. The inhabitants are agriculturists or of the usual viagra much pill oc- cupations of a small town, and are mostly immigrants from maritime and temperate continental climates. viagra much pill Previous to the last viagra much pill fifteen years the rich soil had not been brought under cultivation and its energies were not expended in the buy viagra edinburgh growth of cultivated crops, but in rank vegetation ; viagra much pill the land was intersected by sloughs and lakes and sluggish streams overflowing in the spring and drying up in the summer and au- tumn; the inhabitants obtained their drinking-water from these viagra much pill sloughs and streams or surface wells, and lived as viagra much pill only the inhabitants of a newly settled agri- cultural country may live. Under those conditions the most evident endemic disease of the country was due to an earth-born poison which invaded the body by the intermediate agency of the damp miasm and the drinking-water. Clinically this disease presented all the types of intermittent and remittent fevers called malarial. It also occurred as viagra much pill a pernicious, rapidly fatal intoxication, and as a chronic cachexia with degeneration of the blood and tissues, but most frequently it presented itself as a continued remittent fever. This latter type had a most unenviable no- toriety throughout California and was known as "Ba- viagra much pill kersfield"' or " Kern Island" fever. It was a remittent fever of severe type, with disintegration of the red blood corpuscles, and was variously complicated by every morbid condition that may arise from active or passive congestions of any of the internal organs. The most fatal complication was pneumonia. These diseases were due to hrematozoa. In their treatment quinine was the only medicine that could be relied upon. Since 1884 there has been a rapid disappearance of these protozoic diseases. During the past fifteen years there has been a radical change in the physical condi- tions of the country. The soil, naturally well drained by substrata of sand and gravel, has been brought under cultivation and its energies expended in the growth and sustenance of cultivated crops; particu- larly in the production of vast fields of alfalfa (lucern). This plant, like unto the eucalyptus, sends down tre-