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251 58 23.IO In the Boston City Hospital the most striking fact is the great increase in the number of cases for the year 1895 1,566 for that year, and only 598 for 1894. The deaths for 1895 are 207 : those for 1894 are super viagra sale 266. The death rate for [895 is 13.21 as against 44.48 for 1S94. It is a curious coincidence that the number of cases for 1S95 is nearly three times that for 1894, while the percentage of deaths is less than one-third of what it was fur 1894. In the Willard Parker Hospital we find no such dis- crepancy in the percentage of deaths. The cases have increased greatly in 1894 and 1895, but the death rate has not been so markedly lowered. In fact, there are three years, viz., iSSS, 1SS9, and 1890, in which the death rate was lower than that of 1895. The death rate thus far this year to May 1st has been 23.10. It was lower than this in 18S9 and 1890. I believe the great interest in diphtheria brought about by the antitoxin treatment may have been a fac- tor in increasing the number of cases at the Willard Parker Hospital. How many of these cases have been of a milder type and thus have affected viagra prescription illegal the death rate, only those who see the cases there know. As a result of our study of the statistics of diphthe- ria, not super viagra sale only in the cities above named but also in many others here and abroad, we find the conditions so different in the super viagra sale early and late period, as we have divided the disease, that any comparison of the death rate of the latter period with the death rate of the former period will be apt to lead one to erroneous con- clusions. REMARKS ON THE RATIONAL TREATMENT OF UTERINE FIBROIDS.' By WALTER B. CHASE, M.D., GYNECOLOGIST TO THE BUSHWICK HOSPITAL, BROOKLYN, N. V. The time at my disposal this evening will not permit of any exhaustive study of fibroma uteri. I shall not therefore enter upon viagra prescription illegal any discussion super viagra sale of the subject, either histologically or etiologically, nor will ques- tions of differentiation from other growths occupv our attention. It is the most frequent of all the benign neoplasms of the uterus coincident with functional activity of the reproductive organs, and while the per- centage of cases in which it becomes viagra prescription illegal a menace to life is small and the mortality attending it still smaller, it is, nevertheless, so frequently a source of annoy- ance, distress, or disability, as to force itself upon the attention of the general practitioner or specialist. For purposes of clinical study uterine fibroma may be divided into two classes: the hard and the soft, or otherwise known as fibroma and myoma. The disease may be diffused or circumscribed, or confined to the corpus or involving the cervix. As to variety I shall divide it as follows, to wit: diffused, submucus, sub- peritoneal, and intramural. Uterine fibroids vary from those of the size of a pea or hickory nut to those of large dimensions, weighing from one hundred to one hundred viagra prescription illegal and fifty pounds. The frequency of symptoms for which the patient seeks relief are in about the following order: first, hemorrhage; second, pressure causing discomfort or pain, super viagra sale either from size or position; third, general impairment of health; and fourth, acute septicaemia from rapid absorption of struc- ture undergoing retrograde metamorphosis. It is not to be assumed that all cases of fibroma re- quire treatment, either surgical or medical. If not large in size and not a source of discomfort, they may produce no symptoms super viagra sale and their presence may not be recognized. It may be laid super viagra sale clown as a prin- ciple of action that interference should be had the same as in ovarian cystoma, before the growth attains great size. The causes which lead to menorrhagia are so nu- merous and so diversified that questions of differen- tiation cannot be entered upon. The diagnosis of fibroma having been constituted, and the variety and extent of the disease settled, the question of treatment will engage our super viagra sale attention. Medical treatment must be tried in a certain pro- portion of cases, for there is a class of patients who will not submit to heroic measures, unless the condi- tion is of great urgency; besides, they are entitled to super viagra sale the benefit which may be derived from systemic medi- 1 Read before the Brooklyn Medical Society, May 15, 1S96. June 6, 1S96] .MEDICAL RECORD. 799 cation. Few drugs exert any curative influence on fibroma. Those worthy of trial in suitable cases are ergot and hydrastis canadensis; both have the power of diminishing the calibre of the uterine blood-vessels, and ergot stimulates contraction of muscular fibres of the uterus. Influence of drugs on the subperitoneal