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Another death after seven days of treatment, which was begun on the second day of disease; 6,000 units of antitoxin; child of fifteen months. Case XXL- -Aged seventeen months; admitted October 2d; second day of disease. Prognosis doubt- ful. General swelling and injection of throat; thin necrotic membrane on both tonsils and palate, extend- ing into pharynx; considerable nasal discharge, croup, stenosis, and retraction. Antitoxin, 2,000 units, on admission. Admitted October 2d, 2:30 p.m.; 10:40 p.m., fumigated. October 3d, 1 115 a.m., it became necessary to intu- bate; 10 :2o a.m., tube removed; 10 :5o a.m., intubated; 10:53 a.m., tube coughed up; buy viagra russia 11:10 a.m., intubated; 1 1 :35 a.m., antitoxin, 2,000 units; strychnine, caffeine, nitroglycerin, carbonate of ammonia, whiskey, sponge bath, dry cupping. Temperature at 4 a.m., 102 F. ; 8 a.m., ioy : F. ; 11:30 p.m., io8 c F. October 4th, temperature at 12:20 a.m., 107. 6 F. ; 12:30 a.m., 107.8 F. Died at 12:40 a.m. Several of the following histories are undoubted in- stances of the bad effects of antitoxin on nerve centres : Case XXII. Aged fourteen months; admitted November 6th; illness began November 3d. Small patch of membrane on right tonsil; K. L. B. ; no com- plication. Antitoxin, 1,000 viagra prescription ireland units, on admission. November 9th, slept at intervals quietly, but was very restless when awake. November 10th, extremely restless most of the night; temperature, 104 F. ; sponge bath. November 12th, pulse very weak. November 20th, rash appeared. November 6th, viagra prescription ireland antitoxin, 2,000 units, at 5:30 a.m.; intubated at 1 p.m. Very restless during the day. Respiration, 60 to 70. At 5 p.m., temperature, 105 F. : sponge bath; 8:15 p.m., temperature, 106 F. Child viagra prescription ireland failed to respond to stimulants; temperature be- came more and more elevated, in spite of sponge bath. December 7th, died at 12 :3o a.m. June 20, 1896] MEDICAL RECORD. 881 According to the record this child had almost no illness on admission. It became very restless after first injection of 1,000 units of antitoxin. Restless- ness reappeared in exaggerated form after the injection of antitoxin, 2,000 units, along viagra prescription ireland with high temperature and rapid respiration, until death. Case XXIII. Aged seven months; admitted Feb- ruary 4th; three days sick. Nothing in throat, slight laryngeal symptoms. Clinical note states: "Slight croup, otherwise good condition." February 5th, antitoxin, 2,000 units. February 6th, antitoxin, 2,000 units; 4 a.m., tem- perature, 104.2 F. February nth, temperature suddenly rose and ery- thema appeared in patches over the body. Tempera- ture in evening reached 105. 4 F. February 12th, morning, rash more marked since midnight. " Marked opisthotonos viagra prescription ireland and stiff neck." February 12th, temperature, 106 F. all night. February 14th, glands and right side of the neck swollen. Temperature ranged from 104 to viagra prescription ireland 106 buy viagra russia F. till March 18th, and patient had convulsions during the night. March 19th, child died at 9 p.m. Case XXIV. Aged thirteen months; admitted October 13th; three days sick. Marked swelling and injection, no membrane, croup. Intubated on admis- sion. October 13th, antitoxin, 2,000 units. October 14th, antitoxin, 2,000 units. October 14th, tube coughed up at 4:10 a.m.; had to be reinserted viagra prescription ireland at 8 :3o a.m. October 15th, tube coughed up at 10:30A.M.; in- tubated at 12 ^0 p.m. October 16th, tube coughed up at 7 :io a.m. October 19th, temperature suddenly rose to 104 F. ; temperature remained high but somewhat fluctuating until the 21st, when it reached 105. 4 F., and the baby had slight convulsions. In the afternoon re- spiration became very superficial; patient failed to respond to any stimulants. October 21st, child died at 5 :25 p.m. Case buy viagra russia XXV. Aged fourteen months; admitted Feb- ruary 20th; five days sick. Rather thick patch on right tonsil, cry and breathing croupy, no retraction. ' Patient admitted in croupy condition, not bad enough to require intubation." Prognosis good. Antitoxin, 2,000 units. February 21st, antitoxin, 2,000 units, at 10:15 A - M -; intubated at 2 buy viagra russia : 10 p.m. ; 5 :45 p.m., tube removed.