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skin has been dry viagra purple pill for any length of time the epithelial layers are brought together and the mouths of the glands are closed, thus preventing the discharge of se- cretions. This condition is especially present in drops)', when the skin is dry, owing to the subcutaneous effusion acting as an viagra purple pill obstruction to the capillary cir- culation, thus preventing the action of viagra purple pill the sebaceous glands by interfering with their blood supply. Dia- phoresis, therefore, is greatly assisted by anointing the surface viagra purple pill of the body with olive oil. It must be re- membered that diaphoresis cannot be induced when other eliminative organs are in abnormal activity ; con- sequently, diaphoresis should not be attempted while the bowels are under the influence of a viagra purple pill cathartic. One of the best methods of applying moist heat is in the form of the hot pack. The surface of the body is well oiled and the patient is wrapped up in a woollen blanket that has been immersed in boiling water and wrung out as dry as possible ; over this is placed a dry woollen blanket, and over all a linen sheet. Warm diaphoretics should be given internally. Pilocarpine is undoubtedly the most powerful dia- phoretic known, and were it not for certain drawbacks it would be used extensively. generic viagra bestellen Its power is not in- creased by combination, and it is not necessary to as- sist or increase its action by keeping the patient warm; for pilocarpine acts at all times, and it is only necessary to keep the patient from being chilled. Ow- ing to its depressant action on the heart, pilocarpine should be used with great care. viagra purple pill I have given it in doses of from one-eighth to one-fourth of a grain hy- podermatically for dropsy occurring in young or mid- dle-aged persons, without fear. generic viagra bestellen Diuretics are remedies which increase the volume of urine excreted by the kidneys by increasing the general blood pressure, by causing dilatation of the renal arterioles, or by directly irritating the substance of the kidney itself. The condition of the urine should always be considered a guide for the adminis- tration of diuretics. Urine of high specific gravity and normal quantity indicates high living with gouty tendency. Saline di- uretics should be given, the diet regulated, and alco- hol prohibited. Urine of high specific gravity but diminished in quantity, unless due to excessive perspiration, calls for the administration of saline diuretics. The ace- tate or citrate of potassium may be given in twenty to thirty viagra purple pill grain doses. Urine with uric acid deposits indicates a tend- ency to formation of stone. Plenty of pure water should be taken ; liquor potassae in half-drachm doses largely diluted and sometimes the carbonate or citrate of potassium in twenty-grain doses should be given. If bile is present in the urine, promote vicarious action by the skin viagra purple pill and bowels ; also use remedies to act on the liver. Deficiency of solids and quantity due to renal con- gestion occurs in scarlatinal and acute nephritis. The object is to re-establish the normal secretion of urine. Digitalis and the saline diuretics are useful. Deficiency in the quantity of urine in dropsy is very often caused by fluid in the abdomen. This mechanical obstruction must be got viagra purple pill rid of, or else di- uretics will not always act. The turpentine class of diuretics are active renal stimulants, and are very useful in pyelitis, chronic cystitis, and chronic inflammation of the urinary tract. I have great faith in digitalis as a diuretic, generic viagra bestellen especially if combined with calomel or corrosive sublimate. Digitalis produces a free flow of pale urine of low June 27, 1896] MEDICAL RECORD. 923 specific gravity, and its action when once secured is often continued for four or five days, producing con- siderable depression of the system. When calomel is combined with digitalis so as to direct its action to the kidney, it becomes one of the best remedies for chronic Bright's disease, viagra purple pill as it liquefies and absorbs the hyaline material which surrounds the arteries, hard- ening and contracting them, and setting up a slow in- flammatory process, which destroys the glandular structure. In the treatment of chronic renal diseases the specific gravity of the urine is the guide. At first the specific gravity falls to about 1.010, and remains there for a long time, but falls again at generic viagra bestellen the close of the disease. When it falls to 1.006 there is great danger. Calomel increases the watery flow of the urine, but not its solid constituents. One grain of calomel, one grain of squill, and one grain of pulver- ized digitalis make an excellent diuretic pill. If the pulse becomes intermittent the digitalis must be left out. Digitalis is especially indicated in acute ne- phritis; the stimulant diuretics cannot be given, as they intensify the renal congestion. For the prolonged treatment of chronic renal dis- eases I prefer a pill containing one-twenty-fourth of a grain of corrosive sublimate, one grain of digitalis, one grain of squill, and one grain of quinine sulphate; one of these to be taken three times a day. Very often in this condition the arteries are hard and rigid, and there is great danger from the rupture of a blood- vessel owing to the increased arterial tension produced by digitalis. To overcome the bad effects of digitalis upon the arteries, viagra purple pill nitroglycerin in the form of tablets of one-one-hundredth grain each should be given. generic viagra bestellen It may be necessary to increase the dose up to one- fiftieth or to one-twentieth grain, or even to one-tenth grain. Therefore, for the hard incompressible pulse of arterial sclerosis with renal cirrhosis and the cere-