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troops in Honolulu. They stay where they land, viz., in the town and its suburbs. The very military hos- pital is canadian viagra supplier located in the so-called " Independence Park," the least fit locality on account of its bad online viagra pakistan malarial reputation, canadian viagra supplier surrounded as it is with morasses, ponds, rice and banana fields. The town of Honolulu repre- sents an old settlement with online viagra pakistan about thirty thousand in- habitants, and is located upon a vast plain between the sea and the adjoining mountains. This plain is a coral field partly covered with alluvial soil washed down from the neighboring hills. On account of its canadian viagra supplier low elevation and of the mountain waters draining into its soil it is practically a morass whose ground water fluctuates with the ocean tides. There is no drainage whatever, either natural or artificial. There is no sewerage, the ground having been soiled with animal products for a century, since the time of Cap- tain Cook, notwithstanding hundreds of millions of dollars made on the place or rather from the place by its inhabitants. Drinking-water is supplied partly from a shallow artesian well sunk in the middle of the town, immediately under the filthy Portuguese quar- ters and cemeteries, from which water is pumped into an elevated reservoir; the principal supply comes from some ponds in a neighboring valley, at about one thou- sand feet altitude. Those ponds are fed by a stream which owes its existence to the rain-water of the sur- rounding mountain slopes, which are utilized as cattle pastures. These are the general facts concerning the local cli- mate of Honolulu, where both malaria and typhoid fever are endemic. There are no pernicious forms that could be compared with those of other tropical countries, but malarial influence is generally felt as a chronic condition by everybody who does not possess a strong natural immunity. Objectively this influence is manifested in the loss of weight, all the symptoms of tropical anaemia, a pale, sick, sallow complexion, etc. ; subjectively it is felt as nervous and muscular debility, rendering long and steady exertion difficult. It is not the temperature but these miasmatic influ- e-ices that render the local Honolulu climate debili- ta.ting and make every pathological process assume asthenic characters. In its pure and acute manifesta- tions this malaria is but seldom intermittent; mostly it is remittent and accompanied by certain typhoid features, on account of which it is called "typhoid malaria." It is unaffected by quinine, but proves very seldom fatal, though it may last several weeks. The sporadic cases of the real typhoid fever, due to the lack of canadian viagra supplier sewerage in town and to the use of animal fertilizers in the country, are far from being so com- mon. In fact, it is not online viagra pakistan any more frequent here than in any part of the American continent under similar conditions. The asthenic character due to the unabat- ing influence of malaria is the only peculiarity it pos- sesses. The question whether canadian viagra supplier the epidemic among the United States troops is real typhoid fever or " typhoid malaria" is not yet settled between the military and local sanitary authorities. It is not settled because in online viagra pakistan reality it is both malaria and typhoid fever, or rather typhoid fever whose course is affected by local malaria. In short, canadian viagra supplier the diagnosis of this epidemic runs thus: online viagra pakistan The germs are imported by the troops themselves and probably are more virulent than those we usually have to deal with in this country. Their virulence is still increased through the debilitated condition of the troops as well as by online viagra pakistan the asthenic influence of local malaria. Inferring from causes, we may say that this and other similar epidemics might have been pre- vented: (i) By paying more attention to the charac- ter of the former occupations of volunteers. (2) By a better organization of the supply service and the adoption of more hygiene in camps and especially on transports. (3) By online viagra pakistan the immediate scattering of troops upon landing in foreign ports, in small detachments over the surrounding country, viz., upon the neighbor- ing hills and plateaus, the sanitary reputation of which, at least for the Hawaiian Islands, is above all suspi- cion. (4) By providing online viagra pakistan camps with pure and healthy canadian viagra supplier drinking-water. These are old truths; but the older they are, the more frequently they have to be repeated. ^«dical items. German University Sttidents have increased in numbers from 10,000 twenty-five years ago to 32,241 last year. The increase is out of all proportion to the population. — Scientific American. The Coming Season in Cairo. — In spite of the absence of the German Emperor, the season promises to be exceptionally good. The principal hotels have already double the number of visitors which they had last November, and most of the dahabiyehs on the Nile have been engaged. Two new hotels will be opened next month, and several existing ones have enlarged their premises during the winter. — London Lancet. Nurses and Women Doctors. — In ah address given at the Royal Free Hospital in London a short time ago, Dr. I. Walter Carr made some exceedingly apt remarks in reference to the extraordinary development of nursing during the last generation, and expressed the fear that there was possibly a danger of its being carried too far in private work, and especially in the homes of the middle classes. The same speaker also touched upon the question of women doctors, online viagra pakistan and dis- cussed their present position. He asked if they were a merely passing fancy, or were destined to take a permanent place in medicine. The question might seem superfluous, in view of the rapid progress they were making, but if the movement became fashionable, and unsuitable women were led to enter the profession, a reaction might easily arise and jeopardize the cause.