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' Professor Paw, before the Tenth International Medical Con- gress. Berlin. May 23, 1896] MEDICAL RECORD. provokes our admiration of the labors of Thiroloix Minkowsky, Le'pine, Torup, Valli, Battistini, and oth- ers, who, apparently realizing the difficulties to be over- come and perceiving the causes of past failures, have set to work to overcome them. Their work signal- izes a new departure in the therapeutics of this dis- ease, but the principle they employ is not new; its ex- act analogue is seen in the successful employment of a thyroid extract against myxcedema. The destruction of sugar in the blood of a diabetic animal has been at- tained by other means than by the subcutaneous injec- tion of a pancreatic extract. Pancreatic grafting into the abdominal cavity and into the skeletal muscles has been successfully performed. Reference has already been made to the experiment of Minkowsky, in which he proved " that if a portion of the pancreas (in an ani- mal from which it had been extirpated) was transplanted beneath the peritoneum, the diabetic condition was averted, only to appear when the transplanted organ was removed by a further operation." Professor Schafer, in his address already referred to, says: "A fragment of the gland either from the same or another animal may, in fact, be grafted elsewhere into the per- itoneal cavity or under the skin. Provided the graft- ing be successful and the portion of the gland em- ployed of sufficient size, removal of the pancreas is now no longer followed by the usual symptoms. The animal may, in fact, remain in perfect health. But if at any subsequent time the grafted portion of the pan- creas is removed, diabetes supervenes, and the viagra online report animal dies within a short time, as after primary removal. 1 It is interesting in this connection to note that Thi- roloix, in considering the results of pancreatic grafting, an ingenious device practised by Minkowsky, He"don, and himself (whereby the pancreas in. dogs is brought out of the abdominal cavity and grafted into the mus- cles of the external walls), has modified his former theory and has now adopted Le'pine's conclusion 'that the viagra online report pancreas produces the principal glycolytic ferment which destroys glucose in the blood and thus prevents its reaching the urine.' ;: Schafer, referring to the experiments made by Dr. G. R. Murray on the mon- key, in which after the removal of its thyroid gland all the symptoms of myxcedema viagra online report appeared, and which that observer claimed to have cured by injections of the thyroid juice, says: " He (Murray) does not, however, state how long the animal was kept under observation after treatment and whether the cure was permanent. It is, indeed, scarcely probable that the subcutaneous injection or the taking by the mouth of the order womens viagra thyroid juice would be followed by more than a temporary re- moval of the symptoms. The effects of grafts, howev- er, are to all order womens viagra intents and purposes permanent, and it has been found, as in the case of the pancreas, that re- moval of the graft which has maintained the health of the animal after extirpation of its own thyroid is speedily followed as with primary removal of the or- gan by the usual symptoms of thyroidectomy."' ; Thiroloix proved that " the grafting of the portion of the pancreas, the secreting part of which had been de- stroyed by injection of paraffin along the ducts, is also efficacious in preventing the advent of diabetes after removal of the pancreas." The idea that viagra online report pancreatic grafting can be successfully performed and that the grafts will grow, is not only shown viagra online report by this mass of direct testimony, but is also strongly su^Dorted by analogy; its analogue being thyroid gra> . 'ig for myxcedema.' ' Loc. cit. , p. 342. - Abstract in Medical Record, vol. xlvii., p. 494. 3 Ibid., p. 343. 4 The pathological analogies of pancreatic diabetes and myxce- dema are numerous order womens viagra and order womens viagra striking, the parallelism extending even into the domain order womens viagra of treatment. (1) Both maladies are probably systemic dystrophies superin- Too many successes have attended thyroid grafting, performed by order womens viagra numerous independent and widely sepa- rate observers, to longer viagra online report seriously question its practi- cal value. The mass of concurrent testimony as to its success is ample order womens viagra and conclusive; and, what is more to the point, this success has been achieved not only in the lower animals but also in man. The technique of the operation as performed on the human subject is thus described by Gibson, of Brisbane: "The grafting was done by removing both lobes of an etherized lamb's thyroid, incising them longitudinally and intro- ducing them (1) within the sheath of the pectoral muscle and (2) on another occasion into the child's abdomen. The improvement in the child's condition was remarkable. 1 Thyroid grafting (in man) has been practised with good results in cachexia strumi- priva, in sporadic cretinism, and in myxcedema by Kocher, Horseley, Bircher, and Gibson, of Bris- bane." ' The analogies of pancreatic diabetes and myxcedema are so numerous and impressive as to render it proba- ble that the ultimate technique of pancreatic grafting in man will be similar to that observed in thyroid grafting as described above. ' Grafts of the pancreas and of the thyroid gland maj- or may not grow. If the former result ensues, the symptoms of diabetes and myxcedema respectively viagra online report are ameliorated for a time, or " the animal may, in fact, re- main in viagra online report perfect health" (Schafer). But Schifi long ago pointed out, an observation since