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Adenoid Vegetation of the Nose. Paint with a tifty-per-cent. solution of resorcin. Six to ten appli- cations usually prove sufficient. Marage. Medical Record A IVeekly Journal of Medicine and Surgery Vol. 49, No. 25. Whole No. 1337. New York, June 20, 1896. $5.00 Per Annum. Single Copies, ioc. vicinal .Articles. CLINICAL OBSERVATIONS UPON THE USE OF ANTITOXIN IN DIPHTHERIA: AND A REPORT OF A PERSONAL INVESTIGA- TION OF THIS TREATMENT IX THE PRINCIPAL FEVER HOSPITALS OF EU- ROPE DURING THE SUMMER OF 1895.* By JOSEPH E. WINTERS, M.D., Since generic viagra janssen Behring's treatment for cialis 20mg viagra generic viagra janssen diphtheria was pro- claimed to the medical profession by Roux at the Buda-Pest congress in 1894, sufficient time has elapsed to warrant our taking a careful analytical review as to what has transpired with reference to it. Behring's antitoxin was given to the world as a specific against the toxins of the diphtheria bacillus. It has no action on the bacillus; this is not destroyed by the antitoxin, it is not rendered less virulent, it is in no way influenced by the treatment. Behring has told us that his remedy has no influ- ence on the poisons of other bacilli. Diphtheria in man scarcely ever occurs from pure infection by the Loeffler bacillus. Almost invariably we find in ad- dition to the specific diphtheria bacillus, streptococci, staphylococci, etc. The poisonous substances of the latter bacilli are in no way influenced by antitoxin. This fact limits very much the application of Beh- ring's treatment to diphtheria in man. The toxin of Loeffler's microbe causes the cardiac paralysis, the al- buminuria, and generic viagra janssen the paralytic phenomena. These were to be prevented by the neutralizing effect of the anti- toxin. If antitoxin is an antidote to the toxin of the Loeffler microbe, cardiac depression, death from car- diac paralysis, albuminuria, and post-diphtheritic par- alysis should all cialis 20mg viagra be prevented by the action of this agent. It was to remedy these manifestations of the disease that Behring gave to the world his antitoxin. Behring told us his treatment to be effective must be applied early in the disease; to get the maximum generic viagra janssen effect, generic viagra janssen toxin and antitoxin must be applied at the same moment and at the same spot. Armand Ruffer 1 states that if you inject toxin on one side of the body and antitoxin on the other side at the same time, fourteen times as much is required to pro- tect the animal ; if there is a delay of one hour, one hundred times as much is required to protect the ani- mal, and if generic viagra janssen there is a delay of cialis 20mg viagra eleven hours five thou- sand times as much is required to protect the animal. In diphtheria in man we can never apply the anti- toxin at the site of infection, nor at the moment of infection. A period necessarily intervenes from the time of infection until there are sufficient symptoms to call attention to the illness, and, as the result of this, there is a great limitation to the application of Beh- ring's remedy to diphtheria in man. Another consideration of prime importance is: if we are to attribute the reported decrease of mortality of cialis 20mg viagra diphtheria to the action of a cialis 20mg viagra specific, this decrease * Read before the New York Academy of Medicine, May 21 , 1896. must be uniform and constant. There must be the same reduction in mortality in all parts of the world where the remedy is applied. For instance, a mor- tality of eight per cent, in Paris and twenty-eight per cent, in London does not mean that the low mortality in the former city is due to the treatment, but that it is due to a difference in the character of the epidemic, and that when Paris is visited by an epidemic of the same severity as the one that exists in London it will have the same mortality in spite of the treat- ment. If there is at work but a single factor, viz., antitoxin, cialis 20mg viagra in the reduction of mortality, that reduction must be below the lowest mortality recorded in the natural history- of the disease in any part of the world, and it must be steadily maintained below this rate in all parts of the world; otherwise, the variations in mortality may be said to be due to the epidemic char- acter of the disease. We find recorded the following divergences in the deaths from diphtheria, owing to differences in the type of the disease: Deaths from Diphtheria. In New York in 1SS4, ..... 1,090 ' " 1887 2.1(17 Again in 1S90, only ...... 1,262 cialis 20mg viagra " 1=94, 2,359