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treatments, and it seemed to him that radium was more prompt in getting results and without much constitu- tional reaction. In his experience the combination of radiation with arsenic, as suggested by Morton of New York, was followed by the longest prolongation of life and with the greatest amelioration of the symptoms. Dr. Joseph Almarin Capps of Chicago said that the .x-ray and radium destroyed some substances which were poor in the leucemic viagra pill wikipedia cells. These substances were more or less selective. Dr. Herbert Ziegler Giffin of Rochester, Minn., was glad to hear Dr. Peabody state that it was better tv keep the patient in good general condition than to re- duce the leucemic count to a low point, not above 50,000. He did not use arsenic until after he had used radium. These cases relapsed. One should consider the intrave- nous injection of soluble levitra viagra online radium salts, but so far they had not attempted them. Lung Ventilation. — Dr. C. F. Hoover of Cleveland, Ohio, presented this paper. He viagra pill wikipedia said that the respiratory excursion of the upper thorax was characteristically modified in the levitra viagra online following conditions as shown by clinical and experimental levitra viagra online studies: (a) When the scaleni were paralyzed; levitra viagra online (6) when the intercostal muscles were para- lyzed; (c) when extensibility of the upper lobes were impaired. Respiratory excursions of the lower thoracic cage gave valuable information: (a) on the total lung volume; (6) the degree of obliteration and the degree of distention of the pleural sinus; (c) the relative enlarge- ment of the left and right ventricles levitra viagra online of the heart ; (d) the total enlargement of the heart; (e) enlargement of the pericardial sac; (/) paralysis of the intercostal muscles, paralysis of the diaphragm; (g) differentia- tion between paralysis of the diaphragm and activation of the diaphragm without excursion of the leaf of the diaphragm; (h) the size of the respiratory unit; (i) an explanation of the error of Duchenne's interpretation of the diaphragm which had been accepted at the present time. Dr. A. Jacobi of New York said that Dr. Hoover had alluded to the upper portion of the thorax, but prema- ture ossification of the upper part of the thorax should be considered which resulted in narrowing the upper part of the thorax, giving rise possibly to tuberculosis and emphysema. A number of operations had been per- formed for such an emphysema. He was glad that Dr. Hoover was doing work along this line. levitra viagra online The Significance of the Percentage of Carbon Dioxide in the Alveolar Air levitra viagra online in Pneumonia Patients Who Were Cyanotic. — Dr. R. D. Pearce of Cleveland, Ohio, pre- sented this communication, which was read by Dr. Pearce. He said it was possible to calculate the capac- ity of the dead space and the percentage of CO. in the alveolar air by comparing the percentage of CO. in ex- July 7, 1917 J MFDICAL RECORD. 39 pirations of varying depths, following a normal inspira- tion. The mathematics depend upon the influence which the dead space air exerts as a diluting agent in reducing the percentage of the C0 2 in expirations of different amounts. The method was very accurate and could be easily carried levitra viagra online out in untrained subjects by the use of an apparatus which made the taking of samples practically automatic. The CO, pressure in the alveolar air was found to be lower than normal in some cases suffering with fibrinous pneumonia. In these cases cyanosis was present, but there viagra pill wikipedia was no evidence of cardiac impair- ment, air hunger or acidosis. Patients with massive pneumonia who had no cyanosis had a normal or high percentage of CO, in the alveolar air. The capacity of the dead space in both conditions was less than was ex- pected. An explanation of this phenomena might levitra viagra online be found in the assumption that the pulmonary circulation continued through the consolidated lung after its respi- ratory function had failed. This condition would supply venous blood to the left heart, which, acting as a dilut- ing viagra pill wikipedia agent to the arterial blood, would increase the ten- sion of carbon dioxide and decrease the tension of oxy- gen in the arterial blood. The increase tension of CO : in the blood stimulated the respiratory center with the result that the minute volume of the respiration was in- creased and the levitra viagra online percentage of CO, in the alveolar air viagra pill wikipedia was reduced. The blood passing through the healthy lung had a lower than normal content of CO : to compen- sate for the high content of CO, in the venous blood with which it was mixed in the left heart. However, since the blood which passed through the healthy lung was fully saturated with oxygen no compensatory mech- anism could viagra pill wikipedia be established by which the oxygen content in the mixed blood in the left heart could be brought to a normal oxygen tension. The blood therefore appeared cyanotic. The condition was somewhat analogous to that found in congenital heart disease. Dr. C. H. Hoover of Cleveland, Ohio, asked how much blood was going through the pulmonary circulation and how much in the consolidated area and other parts of the lung that were encroached upon. How much unre- spired blood was poured into the left ventricle? Dr. Samuel J. Meltzer of New York described a method by which the blueness of the blood might be made to disappear by the administration of oxygen in these cases. Clinical and Pathological Features of Bronchiectasis. — Dr. Alfred Stengel of Philadelphia read this paper. There were sixty-three cases reported, thirty-six cylin- drical, eighteen sacculated, and nine cylindrical and saccular. There were two cases, cylindrical, of tumor obstructing treachea or bronchia. One case, cylindrical, of tumor metastasis in the lungs. There was one case of aneurysm, cylindrical and sacculated. Doubtful, five cases, one cylindrical, three sacculated, and one cylindri- cal and sacculated. There were nine cases of broncho-