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use of antitoxin was begun. In 1894 there were 14.- 088 ounces of whiskey consumed in the hospital. In 1895 an d tne fi'' st real viagra shop Iour months of 1896, there were 18,- 240 ounces of whiskey consumed. In 1894, with 700 cases of diphtheria and 259 of scarlet fever, there was an average daily attendance of 59.38 patients, giving a daily consumption of alcohol per patient of .65 ounce, or viagra trial generic about two-thirds of an ounce. In 1895 and 1896 to May 1st, there were 1,099 cases of diphtheria and 274 of scarlet fever, with an average daily attendance of 85.8, giving a daily consumption of alcoholic stimu- lants per patient of .43 real viagra shop ounce, considerably less than one-half of an ounce. It appears, then, that there has been less alcoholic stimulation since the introduction of antitoxin instead of an increased amount as ob- served by Dr. Winters. It was stated by the writer of the paper two weeks ago that during the past year there has prevailed in the hospital a new type of uncontrollable diarrhoea. Here again Dr. Winters' observations are at variance with those of the rest of the attending staff. In the fifty two cases which I have had occasion to analyze this evening, a slight diarrhoea viagra trial generic is mentioned in just three. There has been but one severe case of diarrhoea dur- ing the past winter a case of colitis which lasted for some weeks, the patient finally recovering. I should say that we have had more real viagra shop trouble with consti- pation of the bowels than with diarrhoea. Frequently when a rise of temperature would make us appre- hensive of a complication such as broncho-pneumo- nia or otitis media, a close of laxative salts or an ene- ma would bring the temperature down to normal. The ward charts of perhaps a majority of the cases show a record of laxatives ordered by the resident physician. It has been stated by Dr. Winters on more than one occasion that he had observed a peculiar type of bron- cho-pneumonia during the past year in the hospital, and that there was much suppression of urine and an increased amount of albuminuria, with other signs of renal disease. It has seemed to the rest of us that the broncho-pneumonia was quite of the usual type so commonly seen in the infectious diseases of child- hood. Suppression of urine has occurred with about the usual frequency and has generally been relieved by local applications and the use of diuretics. Al- buminuria has perhaps been noted somewhat more often, owing possibly to the more careful examination of the urine, but it has seldom been accompanied with casts or other evidence of serious involvement of the kidneys. Cardiac weakness has not been observed more frequently than in former years. Post-diphthe- ritic paralysis, with the exception of temporary par- 900 MEDICAL RECORD. [June 20, 1S96 esis of the palatal muscles, has been noteworthy by its absence. I can recall but one case in the past six- teen months in which serious paralysis occurred. In that case the respiratory real viagra shop muscles were involved and the patient died. It has been stated that since the introduction of an- titoxin, cases of a milder type have been admitted to the hospital, many of them having no clinical evidence of viagra trial generic diphtheria. In my opinion, cases admitted to the hospital during the past sixteen months have been fully real viagra shop as severe as in the year 1894; the records show that in that year over one-third of the patients had no membrane in the throat or only a small patch on the tonsils. I remember that in the spring and autumn months of 1894 it was with difficulty that I could find patients to show students the characteristic diph- theritic deposit in the throat. In commenting upon the present mortality of intu- bated cases in the Willard Parker Hospital seventy- two per cent., Dr. Winters stated that a former resident of the Willard Parker Hospital reported a mortality of but fifty per cent, without antitoxin in laryngeal cases. Note the two classes of cases com- pared" by him, intubated cases under antitoxin com- pared with laryngeal cases without antitoxin, laryn- geal cases including both operated and non-operated real viagra shop cases. Not even Dr. White, the resident real viagra shop physician referred to, and whom all know : to be a most skilful operator, claimed to have saved fifty per cent, of intu- bated cases without antitoxin. The percentage of mor- tality as given by him was eighty-five per cent., which viagra trial generic are the proper figures to be compared with the present percentage of seventy-two. In order to show the fatal effects of even a small dose of antitoxin, Dr. Winters cited the case of a child who had been exposed to diphtheria in Bellevue Hospital, had been given an immunizing dose of viagra trial generic the serum, and had been sent to its home in Brooklyn, where it died viagra trial generic shortly afterward, presumably from the effects of the antitoxin, as it did not develop diphtheria. The facts of the case are as follows : The patient, Elsie Biershank, four years old, of 200 Freeman Street, Brooklyn, was admitted to the first division of Bellevue Hospital, April 3, 1896, with a history of convulsions. During her stay in the hospital she had occasional convulsive attacks. Another child in the same ward having developed diphtheria, viagra trial generic it was deemed advisable to immunize the other children. This was done, but the supply of viagra trial generic real viagra shop antitoxin not being sufficient it was given to those most exposed. Elsie Biershank was one of the children who received no serum, and was discharged before a fresh supply could be ob- tained. This is the statement made to me viagra trial generic at the close of the meeting two weeks ago by Dr. E. H. Wright, the house physician of the first division of Bellevue Hospital. The further history of the case is as fol- lows: The patient was discharged and remained well until April 29, when, alter exposure to cold, she was taken with dyspneea. Dr. J. A. Jenkins, of 271 Jeffer- son Avenue, Brooklyn, was called and made the diag-