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Grant told Dr. Winters that his experience with it had convinced him of its uselessness and of its injurious- ness in certain directions. It would appear from the above that neither of these two young physicians had had any experience with diphtheria previous to the introduction of the serum treatment. Such evidence as this can hardly outweigh that of such men as von Ranke, Baginsky, Heubner, Widerhoefer, 25mg viagra cost Roux, Bokai, and many others who, after an experience of from ten to twenty years in the treatment of diphtheria with 1 Wiener medizinische Wochenschrift, 1S95, pp. 1S5, 246, 257, 291, 336- 902 MEDICAL RECORD. [June 20, 1S96 the older methods, have now pronounced unanimously in favor of antitoxin. Dr. Winters quoted one other European authority, Variot, whom 25mg viagra cost he called a " firm believer in antitoxin," but who had, with greater experience, come to doubt its value. If Dr. Winters will turn to the Journal ,lc Clinique et de buy viagra jordan Thkrapeutique Infantile, 1895, No. 9, he will see that even as early as March, 1895, Variot was inclined to dwell upon the untoward effects of anti- toxin, rather than upon its curative powers. Variot there ascribes to antitoxin various hurtful effects, such as excessive elevation of temperature, increased pulse rate, weakness of the heart, and arhythmia. The last number of the Index Medicus, 25mg viagra cost issued a few days ago, shows that Variot has continued to dwell upon the un- favorable side of the serum treatment. The following are some of the titles of papers written by him during the year 1895, buy viagra jordan and published in the French journal referred to above : 1. Are we justified in employing the diphtheritic serum for immunizing purposes in man? p. 181. 2. Observations on the new formation of diphthe- ritic membrane after injections of serum, p. 241. 3. Remarks on cases of diphtheria associated with buy viagra jordan tuberculosis, treated bv serum and followed buy viagra jordan by death, p. 2S1. 4. L'selessness of diphtheritic serum in sixteen cases of toxic diphtheria followed by death, p. 381. 5. Remarks on the pathogenesis and diagnosis of the eruptions following upon injections of serum, p. 8St. There are several more titles of papers, which I shall forbear reading, not one of which indicates a favorable attitude toward antitoxin. Variot could never have been justly called a " firm believer in anti- toxin." In buy viagra jordan fact, I should have included him among the opponents of antitoxin had it not better suited my argument to bring his name in at this place. Dr. Winters mentioned two continental hospitals as having been visited by him, but, if 1 remember rightly, his observations extended only to the out-patient de- partment of those hospitals. In Berlin he was much impressed with the methods by which all patients with slight affections of the throat applying to the hospital for treatment were promptly sent into the wards of the hospital, to be there subjected to the ad- ministration of antitoxin. In buy viagra jordan Paris he again noted the loose? methods of administration of one of the great children's hospitals, by which children with no clini- cal evidence of diphtheria were allowed to pass into the hospital, to be there included as real cases of diph- theria and treated as such. It does not appear that Dr. Winters passed any considerable time within the wards of any of 25mg viagra cost the great continental hospitals, in order to judge for himself whether or not the statistics of redui ed mortality, of 25mg viagra cost which we have heard so much, had been honestly compiled. I may note in passing that Dr. Winters, though he admits that in every part of the world the use of antitoxin has been followed by an apparent reduction in the mortality of diphtheria, claims that if such reduction be really due to the specific action of the serum it should be uniform \ where. As he gives no reasons in support of this contention, I would simply ask "Why?" In his paper of two weeks ago Dr. Winters stated that all the earlier claims for antitoxin had been abandoned. A very 25mg viagra cost short sean h of the medical liter- ature of the last few months would convince Dr. Winters that directly the contrary is the case. I shall cite a few only of the- recent writings on the subject, taking them from such widely separated places as Massai husetts, England, Germany, and Japan. Dr. J. II. McCollom,' of the Boston City buy viagra jordan Hospital, in an address in February last, at the Boston City Wed. anil Surg. Jour., February 13, 1S96, p. Hospital Club, gave a re'sume' of the experience in his hospital during the previous year. He stated that, under the serum treatment there had been but 96 deaths of buy viagra jordan S44 patients treated, or a mortality of n per cent., as compared with 40 per cent, in previous years. Of 79 patients intubated only 36 had died, a mortality of 45 per cent. In the previous year of 86 intubated patients 74 had died, a mortality of 86 per cent. He stated also that there was a great change for 25mg viagra cost the better in the appearance of the diphtheria wards, due to the favorable effect of antitoxin on the patients. His whole address was enthusiastic in praise of the new remedy. Turning now to England, we have the report of the Metropolitan Asylums Board. Although this report