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tending to so high a figure as seventy-five per cent. The swelling associated with the presence of membrane subsides within twenty - four hours. The broncho- pneumonia does not so frequently supervene. In laryngeal diphtheria antitoxin has been a decided aid. He does not advise it viagra cheap real as a preventive measure. The clinical is equal to the bacteriological test. Rec- ords show that deleterious results come mostly from its use in health. We should wait until a reasonable diagnosis of the presence of diphtheria can be made before using antitoxin. Dr. Larrabee said there was no longer viagra cheap real a germ theory, but a germ fact. It is only during germ ac- tivity that we have disease. It is surprising that we have viagra 50 pill thought of immunizing against a disease which dqes not immunize against itself. Antitoxins, if prop- erly prepared, should arrest the disease in its progress. He has seen four children die who would not have died had they not used antitoxin. On the other hand, he had seen twelve patients recover from stenosis under its use who would have died without it. The fatality in reported cases of sudden death by injection of air cannot be explained. He has observed a sudden and inexplicable anuria in such cases. That hetero- geneous toxins or ptomains are present, he thought was shown by the rashes often produced. Ocular in- spection should cause us to exclude turbid-appearing serum. Septic matter should be removed from the throat, as it is when the antitoxin is not used. The blood can be fortified against destruction as in former days by the muriate-of-iron tincture given viagra 50 pill internally, and it should be applied to the throat externallv. Dr. W. B. Parks, of Atlanta, said that most of the diphtheria in Atlanta is follicular tonsillitis and patients get well without antitoxin. Dr. Rosenthal, of Philadelphia, said the latest viagra 50 pill report by Dr. Billings, of New York, shows that after antitoxin is used viagra cheap real the blood is not altered. Individu- ally, he has never seen abscess or other bad effect. His injections are made with the utmost antiseptic care in the interscapular spaces, sealing the puncture with iodoform collodion. He believed that antitoxin possesses great viagra 50 pill powers, viagra 50 pill but against the Klebs-Loeffler bacillus alone. If there is compound or mixed in- fection, then we must use other remedies, and the tincture of the chloride of iron is the best drug he knows of. Since using antitoxin he can remove the intubation tube much sooner than formerly. Bacterio- logic investigations have their necessity, but bacteriol- ogy is not everything. Dr. Ross, of Kohamo, Ind., said he never had seen, out of about fifty injections, any local signs of irrita- tion and only once an erythema. Not a patient of his was lost, nor was a patient lost in his city in about two hundred cases, while those on whom it was not used furnished a number of deaths. Dr. Gray, of Connecticut, said that in Bridgeport he has seen about seventy patients viagra 50 pill treated ; twenty-eight of his viagra cheap real own, out of which number only one died. Better results were obtained from initial doses of one or two thousand units than from the small doses of a few cubic viagra 50 pill centimetres. Recovery was rapid in all the cases, excepting the one resulting fatally. Dr. Tomlinson, of Michigan, said it was very grat- ifying to him that, having defended the treatment at last year's meeting, so much viagra 50 pill could now be said in its favor. Even if antitoxin has killed a few, it has cured thousands, and he would give it up on this ac- count no sooner than he would discard cocaine be- cause death has resulted from its use. Dr. Bell, of Atlanta, spoke of the use of antitoxin in the New York Infant Asylum as showing conclu- sive!}' during his time of service that an antitoxic effect was produced. These children stand compara- tive large doses of iron. He viagra cheap real believed in using anti- toxin for its immunizing effects when the bacilli were found in the throat. Dr. Garrison, of Illinois, said two-thirds of the population in her town had had antitoxin injections made for supposed diphtheria, but the bacillus was never to be found and there were no deaths. Dr. Baker spoke of his experience at the Willard Parker, where he observed one hundred and fifty cases, but he saw no results which could not have been ob- tained without antitoxin. He thought two years more would be required before we can speak finally as to the value of antitoxin. Dr. Wilson, of Ohio, spoke of a severe epidemic in which he lost his cases until he began using anti- toxin. Then a series of sixty cases recovered. Those who refused to use antitoxin in his town were the ones who lost most of the patients that succumbed. Dr. Kuite, of Pennsylvania, said he believes that a true attack of diphtheria does immunize; hence the argument which has been used is fallacious. Dr. Klebs said we have different forms of immu- nity. Recurrences in diphtheria do take place, but not so often as in pneumonia. We cannot compare 780 MEDICAL RECORD. [May viagra 50 pill 30, 1896 different infectious diseases with each other. Many of the children in a family in which diphtheria exists may show bacilli in the nose or throat, viagra 50 pill and without any injection may never become diphtheritic. These bacilli may be highly infectious to others, but do no