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seventy-five cases of appendicitis by medical means only and that all the patients had recovered. generic viagra toronto I should be entirely willing to believe the statement of a generic viagra toronto careful physician to the effect that he had treated seventy-five consecutive cases of appendicitis in private practice, and that all his patients had recovered under medical treatment. Such a statement would be in line with my own experience and that of Dr. MacArtney. Dr. Wyeth, I am inclined to believe, does not see in his practice the average case of appendicitis. Those cases buy viagra america which reach the surgeon are the severe and ne- glected ones, and many of them, without doubt, can be treated successfully only by surgical means. I am not blindly opposed to all surgical procedures in this disease, but what I generic viagra toronto do contend for is that, if these cases receive proper medical treatment from the start, very few of them will require surgical treatment. I cannot believe that the statistics referred to by Dr. Wyeth and compiled by Dr. Samuel Lloyd fairly represent the results of medical treatment in private practice in this country. They are so far from my own experience that I am confident some buy viagra america error has been made. The closing statement of Dr. Wyeth's letter is as follows: "It is probable that the propor- tion of cases which recovers under so-called conserva- tive management would number about fifteen in every hundred, which might be increased if it were permitted to include cases which recover from a single attack, but which are subject to repeated seizures (recurring appendicitis)." This statement seems to me abso- lutely absurd ; as well might Dr. Wyeth tell me that not over fifteen per cent of typhoid fever patients recover under medical management. I am sure this statement 792 MEDICAL RECORD. [May 30, 1896 is not founded upon the careful observation of a large number of cases well treated in private generic viagra toronto practice. Hospital cases should not be considered in making up statistics of this disease. Many of them are recur- rent cases, the earlier attacks of which have not 'been properly treated, and the subjects generally are in such poor condition that no treatment can be expected to give the best results. I should not consider a case well treated unless opium in some form (I prefer morphine by the mouth) was given from start to finish in sufficient quantity to completely "mask" the most prominent symptom, which is pain. H. L. Waldo, M.D. Troy, N. Y., May 15, 1S96. i VI eel i cat ?tcms. Contagious Diseases Weekly Statement. Report of cases and deaths from contagious diseases reported to the Sanitary Bureau, Health Department, buy viagra america for the week ending May 23, 1896: Tuberculosis Typhoid fever Scarlet fever Cerebro-spinal meningitis Measles Diphtheria Small-pox Relations of Medical Examining Boards to the State, to the Schools, and to Each Other. Dr. William Warren Potter, of Buffalo, president of the National Confederation of State Medical Examining and Licensing Boards, chose this title as the subject of his annual address at the sixth conference of this body, held at Atlanta, May 4, 1896. He said there were three conditions in medical educational reform on which all progressive physicians could agree namely, first, there must be a better standard of pre- liminaries for entrance to the study of medicine; sec- ond, buy viagra america that four years is little time enough for medical collegiate training; and third, that separate examina- tion by a State board of examiners, none of whom is a teacher in a medical college, is generic viagra toronto a prerequisite for license to practise buy viagra america medicine. It is understood that such examination can be accorded only to a candidate presenting a diploma from a legally registered school. He further stated that a high-school course ought to represent a minimum of academic acquirements, and that an entrance examination should be provided by the State for those not presenting a high-school di- ploma or its equivalent. He did not favor a nation. ;1 examining board, as lias been proposed, but, instead, thought all the States should be encouraged to estab- lish a common minimum level of requirements, below which a physician should not be permitted to practise. Then a State lii ense would possess equal value in all the States. In regard to reciprocity of licensure, Dr. Potter thought it pertinent tor generic viagra toronto those States having generic viagra toronto equal standards in all respects to agree to this ex- change of inter-State courtesy by official endorsement of licenses, but that other questions were of greater