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antitoxin prove less efficacious when the cheap viagra compare virulence of the epidemic is pronounced?" The mortality in Paris has been as high as thirty-two per week during some weeks of 1S96. Variot (Paris) states that bacteriology has included a great number of , .ims which previously were not considered as cases of diphtheria. June 20, 1896] MEDICAL RECORD. 891 Von Ranke " (Munich) reports 102 cases; mortality, 18.6 per cent. cheap viagra compare Von Ranke had 162 cases of diph- theria in six months, whereas in the same hospital they have averaged 146 yearly cheap viagra compare during the last seven years. Landau " (Frankenberg) reports 448 cases treated by serum in six months; 100 deaths; mortality, 22.3 per cent. In this same hospital they had averaged 132-! cases per six months for the last fifteen years, whereas during the serum period (from February to July in- clusive) 448 cases were admitted. Rauchfuss (St. Petersburg) reports 10 1 cases treated with serum in four viagra 0.25 mg months; mortality, 34 per cent., previous mortality, 55 per cent.; but he had 101 cases in four months under serum treatment, or at the rate of .303 per year. During the previous twenty-five years they have averaged in this hospital but 142 cases per year. Vierordt" (Heidelberg) reports a mortality of 25.4 percent, in diphtheria treated by serum. Serum treat- ment was begun October viagra 0.25 mg 31st, and in four months he received into the hospital 70 cases of diphtheria. I find from the hospital report that they had received into this hospital during the previous ten months but 56 cases. The interne at the Children's Hospital (Heidel- berg) told me that there was a great influx of cases from the Necker Valley after the serum treatment be- gan. Many apply to the hospital now who on account of viagra 0.25 mg the expense of the serum would not hitherto have applied. During the first cheap viagra compare ten months of 1894, without serum, 56 cases were received into the hospital, and during the succeeding four months, under the influ- ence of serum treatment, 70 cases; and this at a time, as I was personally informed when in Heidelberg, when diphtheria was sporadic and not epidemic. For increase in the number of cases during the serum period it remained for Dr. Ernest Germonig, of Trieste, to outdo all others. Germonig" reports that from the 24th of August, 1894, to the 31st of January, 1895, a period of a little over five months, 362 cases of diphtheria were treated with serum in the Civil Hospital (Trieste). In this hospital they had in 1892 78 cases of diphtheria; in 1893 no cases; the first viagra 0.25 mg eight months of 1894, 149 cases (before serum treatment). In five months and one week (serum treatment), 362 cases. In 75 cases of diphtheria treated with antitoxin in the University College Hospital,'" London, the mor- tality was 28 per cent. Two hundred and forty-five patients treated with antitoxin in the American Urban Hospital," Berlin, gave a mortality of 2S per cent. Kossel" reports 233 cases; 54 deaths; mortality, 23.1 per cent. Some cheap viagra compare of these patients had flecks the size of a cheap viagra compare pinhead on the tonsils; no swollen glands; no fever. Soltmann " (Leipzig) reports 181 cases of diphtheria with the Loeffler bacillus, treated with serum; 44 deaths; mortality, 24.3 percent. Contrast this with Heubner's ,0 statement : "The mortality at my polyclinic (Leipzig), for fifteen years, for children of all ages and throughout the entire year, through severe and mild epidemics, was 22.5 per cent. This experience was with the same population as that from which hospital patients are drawn. Therefore the mortality was higher than it would have been in good private practice." Report after report might be quoted, showing that the mortality at the present time under serum treat- ment ranges from 23 to 28 per cent., and even to 33 viagra 0.25 mg per cent (Copenhagen; and 45 cheap viagra compare per cent. ( New York Foundling Asylum ). Behring promised us that his serum would reduce the mortality to one-tenth of its former rate. If antitoxin is a specific against the toxin of the Loeffler bacillus, the cardiac paralysis, the albumi- nuria, and the paralytic phenomena of cheap viagra compare diphtheria should no longer be seen. Albuminuria occurred in 40.9 per cent, of the cases treated with antitoxin in all the hospitals of the Metropolitan Asylums Board " during 1895. Albuminuria occurred in 24.1 per cent, of the cases in all the hospitals of the Metropolitan Asylums Board in 1894 (non-antitoxin year), and in 25.4 per cent, of the cases in 1892. Soltmann" found albuminuria in 72 per cent, of cases after the injection of antitoxin, which did not have albuminuria before the injection. Post-diphtheritic paralysis occurred in 23.2 per cent, of the cases treated with antitoxin in all the hospitals