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adapted for digestive and nutritive purposes; as a re- viagra sale shanghai sult, after months or years of such eating, their sys- tems become very poor-ly nourished and germs innu- 8i6 MEDICAL RECORD. [June 6, 1896 merable appear in the alimentary tract. When called to the case the general practitioner has to deal with errors of diet, general malnutrition, innumerable bacteria, defective digestion. Studying the cases in this way. Dr. Porter thought it is comparatively easy to manage them pretty satisfactorily. On general principles he thought a well-regulated mixed diet gives the best results, but in the more aggravated cases his experience has been best with milk diet; prefer- ably buttermilk. With the further aid of so-called antiseptics he thought viagra best doses we could subdue this intestinal fermentation as quickly as could be expected. Dr. H. 1). Chapin thought a more important sub- ject than intestinal fermentation could not be brought before the academy, for he believed that many wast- ing and also germ viagra sale shanghai diseases, including tuberculosis, are at bottom due largely to failure in nutrition, and in restoring nutrition we go a long way toward stamping out the disease. Too great a variety at meals is to be avoided. Many persons who thought they could not take milk thrive best on it when in- structed how to take it. Hot water is also valuable, and many cases of intestinal fermentation can be stopped viagra best doses by rare beef alone. In the summer many acute cases in children require that milk be viagra sale shanghai cut off entirely for a time, giving, perhaps, only water, or egg water, or beef blood. Dr. Chapin thought the value of antiseptic medi- cinal treatment of intestinal fermentation has been largely overestimated. He has tried mercury, salol, naphthol, etc., but has found them of little use in doses short of poisonous effects. The drug which in his hands had been most valuable is the least anti- septic, subnitrate of bismuth. He believed viagra sale shanghai that by simplifying the diet, cutting off fermentative foods, and avoiding nauseous drugs, we get the best results in intestinal fermentation. Dr. H. Power said that during the past five years he has attempted to trace the clinical connection be- tween certain forms of convulsive attacks, including forms of epilepsy and disturbances of the gastroin- testinal tract. He thought he has been able to estab- lish such a connection in many cases. The relation may be through peripheral irritation intestinal ex- citing the central nervous system, or by toxins low- ering the resisting power. Both explanations are important. Following up this idea, he has placed a large number of patients on small doses of bromides and on intestinal antiseptics, such as salol, naphthol, borax, boric acid, etc.; but all of these antiseptics evidently produce disturbance in one way or another, and cannot be continued indefinitely. viagra sale shanghai He thought benefit has route from flooding the system with water with a view to washing out the toxins. Dr. W. viagra sale shanghai 11. Thomson said he has been accustomed tn teach for years that there is a fundamental differ- ence bet viagra sale shanghai anic nervous diseases and functional ous diseases. In the former the patients are never without symptoms; in the viagra sale shanghai latter the}' show no symptoms during the intervals. Examples of func- tion, il nervous diseases are migraine and epilepsy. \ et in the latter, especially, this \ iew does not exclude special structural faults. lie has foi years treated epil< : 1 hiefly as a toxic disorder, on the line of in- testinal antisepsis. The same is true of migraine and of so-called exophthalmic goitre an inappropri- ate name, because the condition may exist without either goitre or exophthalmia. In such cases he be- lieved that the thyroid -land is doing its best to neu- tralize the ptomain in the blood, which has its start- ing-point in the intestine, and that to extirpate it would be about ay sensible as to extirpate the kidney for diabetes mellitus. Referring to Dr. Chapin's statement that bismuth is not an intestinal antiseptic, he thought he must have meant it is not a germicide, for he, Dr. Thomson, has found it the best of intestinal antiseptics and gives the subnitrate of bismuth, from eighty to one hundred and twenty grains daily, in ty- phoid viagra best doses fever. Gastric ulcer is a frequent condition, and in this he gives antiseptics. Dr. Kellogg said he had been impressed by the statement made by nearly all the speakers that they rely chiefly on diet. He himself relies almost exclu- sively on regulation of the diet, and does not viagra best doses believe that intestinal antiseptics are of great value. He thought we have heard too much of hydrochloric acid, and that probably writers have not touched sufficiently on the value of the intestinal mucous membrane as a means of destroying microbes and also of destroying the toxic alkaloids produced by microbes. Professor Chittenden believed there is a gen- eral impression that free hydrochloric acid is abso- lutely essential for fairly vigorous digestion. That is not so. There may be vigorous gastric diges- tion of the proteid matter when all the hydrochloric acid present in viagra sale shanghai the stomach is in the viagra best doses form of viagra sale shanghai com- bined acid. Combined acid has more or less germi- cidal action, though not so much as hydrochloric acid. (Covucspandcuce. OUR LONDON LETTER. (From our Special Correspondent.)