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Proben thinks it is seldom necessary to make vene- section, it being sufficient to use rectal injections or venous transfusion of saline solution. He out- lined the histories of three or more cases illustrating adverse results from the use of pilocarpine in his early experience. Each of the three patients had ura-mic toxaemia from chronic Bright's disease, and as other measures had failed, he tried injection of one- fifth of a grain of pilocarpine, and in all the same result was soon noticed. The drug exerted all viagra trust rx of its inflence upon the heart muscle, producing tumul- tuous action, venous stagnation, collapse, cedema, clammy sweat. Death soon followed. In one in- stance atropine was used to neutralize the effect of the pilocarpine, but without avail. He also recalled that, when interne in a city hospital, pilocarpine was sometimes used and caused cardiac failure. It is established that pilocarpine is a marked cardiac depressant, dangerous to use in uraemia, and its use should be restricted to other conditions than Bright's disease. The author related a case of eclampsia before and after delivery, with almost complete suppression of urine with one hundred per cent, viagra trust rx albumin. He in- jected two quarts of saline solution into the vein of the arm, with the result that in twenty-four hours the woman passed one hundred and nine ounces of urine. There is no means more effectual for stimulat- ing kidney secretion. Pilocarpine in Scarlatinal Nephritis. Dr. J. Lewis Smith opened the discussion. His generic viagra less attention was first called to pilocarpine many years ago by the re- mark of a gentleman distinguished in the profession 872 MEDICAL RECORD. [June 13, 1S96 that he would never use it again because it was likely to produce fatal bronchorrhcea. Soon after this. Dr. Smith was called to see a child generic viagra less in consultation by a physician who had given it one dose of pilocarpine for transudation of serum following scarlatina. The child was breathing with the utmost dyspnoea, the chest was full of very coarse rales, a condition which might be called bronchorrhcea, evidently due to the pilocarpine. The child died. Although pilocarpine is efficacious beyond all other remedies in producing urination and perspira- tion, yet Dr. Smith has not used generic viagra less it in hospital pauper adults, with anaemia attending their dropsical accumu- lations in Blight's disease, lest its depressing effects viagra trust rx should prove fatal. His record books, however, con- tain the histories of two children with dropsical ac- cumulations depending on scarlatinal Bright's disease in which pilocarpine given internally in doses of one- thirty-second of a generic viagra less grain has been efficacious in saving life, and this experience inspired the hope that a way may be found of using it, say in small doses or guarded by some other drug, by which its beneficial effects can be secured without its dangerously de- pressing effects. Dr. J. Blake White said his experience with pilo- carpine has been more favorable than Dr. Proben's. He employs it in generic viagra less smaller doses, and usually in con- nection with some viagra trust rx cardiac stimulant, as strychnine or digitalis. To a child he gives not more than one- thirty-second of a grain, to an adult one-twelfth to one-sixth of a grain by the stomach, never more than one-sixth hypodermatically. He doubts whether the pulmonary and cerebral oedema in the cases of Barker and Saenger were due to the pilocarpine, as they are apt to occur in the usual course of the disease. Chil- dren are especially tolerant of pilocarpine. Careful examination should viagra trust rx be made of the circulatory system in order to exclude heart disease, etc. In some closing remarks generic viagra less Dr. Proben said that while (edema is a frequent cause of death in Bright's disease, yet as it comes on so rapidly after admin- istering the pilocarpine, he must attribute it to the action of this drug. Authorities are agreed that it is generic viagra less best to administer the pilocarpine hypodermati- cally. The crystallized form alone is reliable. Ja- borandi contains other alkaloids which are more or [( >s antagonistic. Diagnosis of Paralysis of Peripheral Origin, and the Value of Electricity as an Essential Element in Differential Diagnosis, Prognosis, and Treatment. Dr. William M. Leszynsky read the second paper of the evening. It was based on a study of nearly four hunched cases of peripheral paralysis which have come underthe writer's observation during the last ten years. For want of time, his remarks were confined chiefly to facial paralysis and paralysis involving the brachial plexus, these being the more common forms se n by the practitioner. It is not uncommon for paralysis of peripheral origin to be mistaken for dis- ease of the brain or cord, and naturally there is cha- grin when spontaneous recovery takes place in a few- weeks or months after giving an unfavorable prog- nosis. The most common cause of peripheral paralysis is trauma, direct or by pressure during sleep; then come refrigeration, lead poisonings, and constitutional dis- eases syphilis, gout, etc. Paralysis affecting a num- ber of muscles in the same extremity, when due to a lesion of the trunk of the nerve viagra trust rx or nerves, is always of flaccid type, affecting muscles in the distribution of those nerves; frequently there is loss of sensibility and of irritability in greater or less degree, lesion of the anterior horn of the generic viagra less cord as in poliomyelitis, weakened or paralyzed viagra trust rx muscular groups which are functionally ociated; the paralysis is of flaccid type, but is