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room subject. Dr. V.\x Arsdale remarked that it was an easy matter to remove these growths by operation, and the results were entirely satisfactory. Dr. Erdmann said that these growths were often seen near the internal condyle, but the case presented was interesting because of the exostosis on the outer aspect. The patient desired cheap viagra max to have them removed because of the inconvenience which they occasioned. Elephantiasis of the Vulva, with Report of a Case. — Dr. W. Duff Bullard read a paper on this subject which will appear in a future online viagra herbal.com issue. Dr. W. B. Coley said that the case was a most re- markable one. The question of etiology seemed to him especially important and interesting. He did not think the causation by the filaria sanguinis could be ruled out here. The fact that the disease developed shortly after bathing would seem to be very strong evidence that the cause might have been the filaria, as bathing was one of the modes by which the filaria was introduced into the system. Dr. B. F. Curtis said that one or two cases of filaria associated with elephantiasis of the lower extremities in males had been at St. Luke's Hospital. The pres- ence of the filaria had been demonstrated in these cases only after repeated and most careful examination. In many cheap viagra max cases in this country elephantiasis developed in connection with chronic inflammatory conditions. He recalled one case of chronic ulcer of the leg and necro- sis of the tibia, in which a typical elephantiasis of the skin cheap viagra max online viagra herbal.com was engrafted upon the first condition. At the urgent request of the patient he had amputated the limb above the knee. In such cases the elephantiasis was evidently due to chronic inflammation and obstruc- tion of the lymphatics. In cases of filaria observed in this country, the persons had at some previous time lived in the tropics. Dr. Carl E. Pfister said that online viagra herbal.com he had seen a good deal of elephantiasis in India, Japan, and China. There is very little elephantiasis in South America. He recalled a very interesting case cheap viagra max of elephantiasis of the penis in an English soldier, following the removal of a chain of infected inguinal glands. That was the only case of elephantiasis that he had seen in India among the white cheap viagra max population. He had seen elephan- tiasis of the scrotum in two white persons. ®orrespandence. OUR LONDON LETTER. CFn r Special Correspondent.) THE BRADSHAW lecture — PERFORATION OF STOMACH BY ULCERS — MEDICAL COUNCIL — MR. HORSLEy'S REPORT SCHOOL cheap viagra max OF TROPICAL MEDICINE; COM- MITTEE AND STAFF DISPUTE — SIR W. BROADBENT's VERDICT — THE " CHRISTIAN SCIENCE " CASE DEATH OF DR. CLEVELAND. London, December q, i8c8. The Bradshaw lecture was delivered at the Royal Col- lege of Surgeons on Wednesday by Mr. Pickering Pick, who took for his subject " The Union of Wounds." He remarked that, while many hold that repair is in- compatible with inflammation, others regard that proc- ess as essential to healing. No doubt Hunter believed that wounds may heal without inflammation, and at the present day this view is expressed by Roser. But so online viagra herbal.com many surgeons and pathologists oppose this notion that it seems clear that the word is differently inter- preted. There will be no agreement until the previ- ous question of a definition is settled. Mr. Pick divides the several modes of union into only two classes, those without and those with suppu- ration ; online viagra herbal.com and the latter he regards as merely a modi- fication of the other. Primary adhesion as taught in 960 MEDICAL RECORD. [December 31, 1898 some text-books he online viagra herbal.com discards as untenable, the cases so described being merely those in which the inflamma- tory process is at a minimum. He pointed out the close analogy between the processes of union by first and second intention. In both there are inflammation and exudation; in both the material exuded, though differing in amount, forms the bond of union. In the second class of cases there is the same process with the conversion of the exudation into granulations and in the superficial layers. The cells degenerate into pus cells. This is due to prolonged or excessive irri- tation produced by micro-organisms. Those who hold