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on the eighth day. On the tenth day there was sup- pression of urine, and the child died of uremic con- vulsions. Case II. J. C , aged generic viagra free two and one-half years. Had been ill several days; membrane on tonsils and pharynx; severe dyspncea showed generic viagra free invasion of larynx. The child had rickets, and was anaemic; the cervical glands were much swollen, and his body was covered with large sores, supposed to be pemphigus. Intuba- tion gave relief to dyspncea. On the fourth day I re- moved the tube: three hours later I was called to re- qo8 MEDICAL RECORD. [June 20, 1896 insert generic viagra free it. The following day broncho-pneumonia was generic viagra free diagnosed and treated. The pneumonia resolved ; the tube was removed on the tenth day and the child made a good recovery. This was the worst case I ever saw, and recovery was little viagra sold prescription short of miraculous. HI. R. S , aged two years. Membrane on tonsils and palate; larnygeal obstruction became so severe that intubation was done. The tube was re- moved on the fourth day; dyspncea gradually sub- sided, and the child was well on the twelfth day. I\". J. A , aged three and one-half years. Had been ill three days without medical care; pseudo- membrane on tonsils and pharynx; glands of neck much swollen; dyspncea severe. The same night I saw the child it almost died from laryngeal obstruc- tion. Intubation was done, the tube being removed on the fifth day. Twelve hours later it again became necessary to intubate. The tube was removed on the eighth day ; recovery was complete. Forty-two of the sixty-five cases treated without antitoxin were of a severe form, while twenty-three I considered mild in character. Eleven patients were viagra sold prescription intubated, with four viagra sold prescription deaths. Of the total number of sixy-five cases treated without antitoxin there were eleven deaths, giving a mortality of seventeen per cent. Five deaths occurred in children between the ages of six months and two years, two between two and four years ; one was five years, one six, and two ten. When I began the use of antitoxin I had implicit faith in its remedial effects, but careful observation of the cases just enumerated convinced me that antitoxin does not exert the slightest favorable influence on the course of diphtheria. In fact, it is my opinion that the antitoxin patients who recovered had a more pro- tracted convalescence, the anaemia especially being more marked and less amenable to treatment than in those who recovered without antitoxin. igvaQVBSs of IVledicttl Science. Painful Temporary Paralyses in Children. Dr. Brunon discusses painful temporary paralysis occur- ring in young children. Out of twenty-two viagra sold prescription cases two had paralysis of the lower extremities, all others hav- ing the arm only involved [British generic viagra free Medical Journal). In all there was an absolutely sudden onset, sometimes following the slightest traumatism; often no cause was observed. The paralysis is complete from the generic viagra free onset; amelioration is gradual. The child screams when the slightest examination is attempted. No ana- tomical lesion is found except occasional creaking of the joints. Recovery takes place in from twenty-four hours to a week. Most generic viagra free authors take the view that there are in such cases anatomical lesions such as sub- luxation, stretching or twisting of ligaments. Brunon believes with Chassaignac that in the cases in question any idea of fracture, disl . or tearing of liga- . may be dismissed, .is no deformity, ecchymosis, or interrupted movement of joints can be found. A differential diagnosis is needed between this and the formoi paralysisdue to partial dislocation of the head of the radius, a pathognomonic sign of the latter being the impossibility of supination. In the cases under consideration all hung limply by the side and could be freely flexed, pronated, or supinated. The initial lesion may be an injury to ligaments, but examination fails to localize the injury. Pain is general from shoulder to finger tips. The condition appears to be clue to a reflex inhibitory action, i which other exam- ples are numerous and which affords a rational ex- planation of the paralysis. An intellectual factor, the memory of the initial pain, explains the persistent crying of the child, 1 of being touched. is no pain when the child is not handled. Much de- pends on the influence of suggestion made by those in charge of the child. Blood Changes in Syphilis in Relation to Ther- apy. Dr. Reiss has studied the hematic changes ob- served in a number of syphilitic patients who were under systematic mercurial treatment. generic viagra free Two hundred cases in all were observed, and in most of these sub- cutaneous injections of sublimate were administered. The results of his investigations have been published in the Deutsche Medizinal-Zeitiing, March 2. 1S96, and may be briefly summarized as follows: The red-blood corpuscles are diminished in number even in the ear- lier stages of primary generic viagra free syphilis. When viagra sold prescription the cutaneous manifestations appear this diminution becomes more marked and gradually increases as the disease ad- vances. Even after treatment has been begun this corpuscular decrease continues for a certain length of time. The number of leucocytes remains unchanged