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Inspector-General Arthur Anderson, C.B., M.D., died on April 26th, in the eighty-second year of his age. He entered the army in 1838, and served in the Crimea, China, and India. He obtained a number of distinctions, had been principal medical officer of Ben- viagra generic 100 gal, and eventually served in the same office at Netley Hospital, after which he retired. Deputy Inspector-General of Hospitals and Fleets J. Flanagan died on April 30th, aged sixty-one. This officer had been some time retired. OUR BFRLIN LETTER. (From our Special Correspondent.) THE viagra generic 100 LANGERHANS AFFAIR CONGRESS FOR INTERNAL MEDICINE TETANY AND RICKETS LUMBAR PUNC- TURE DIABETIC ACUTISSIMUS A NEW ARTERIAL PHENOMENON A CASE OF LEPROSY A Ml COURT OF HONOR. Berlin, May 16, 1896. The quiet which had settled upon the scientific world here during the holidays was suddenly disturbed by the case of Langerhans. The misfortune which fell upon Professor Langerhans, to lose his son immedi- ately after having himself administered by way of viagra pharmacy cost prophylaxis an injection of diphtheria antitoxin, has been so widely published in the daily press all over the world that then' remains little to add to the sad tale. The general impression here is that the sorelv afflicted father acted rashly in publishing the statement that his son's death was due to viagra pharmacy cost viagra pharmacy cost the antitoxin before there had been an autopsy to determine viagra generic 100 the cause of death. But neither the autopsy nor the examination of the serum nor that of the horse from which it had been taken gave any evidence that death was due to the antitoxin, and while the cause will remain a mys- tery the antitoxin treatment of diphtheria viagra pharmacy cost has received no setback. In the Congress for Internal Medicine, which closed about two weeks ago in Wiesbaden, a number of new questions were brought to the front. Herr Cassel read a paper on the relation between tetany and rachitis. Among six thousand cases at viagra pharmacy cost the polyclinic he had sixty of tetany, all in nursing infants, and in thirty- two of these there were also symptoms of rickets. In most of these the evidences of the disease were only slightly marked, but in two of them there was laryn- gismus stridulus. The speaker could see viagra pharmacy cost no evidence from these cases that there was any causal relation be- tween tetany and rachitis, and he had never seen any improvement whatever as regards tetany in the result from antirachitic treatment. He regarded tetany as an independent affection caused by unhygienic conditions. In severe cases he found benefit to result from pro- longed baths (twenty minutes) in water at a tempera- ture of 28 -30 R. (96-99 F.), from small doses of chloral hydrate, and especially from an improvement in the hygienic surroundings of the little patients a direction in which, in Berlin, there is room for much to be done. Cassel's theory received confirmation from the fact that he had never seen tetany among the children of those in the upper classes. Those who took part in viagra pharmacy cost the discussion did not agree with the author as to the origin of tetany, for they thought that the relation between that and rickets could not be denied. It was suggested that the dis- ease might possibly arise from an auto-intoxication by toxins formed in the gastro-intestinal canal of the patient. Heubner thought laryngismus stridulus and tetany were in no sense identical affections, the latter not being a specific affection, but one that might be excited by any irritation of the cerebral cortex, just as are spasms viagra generic 100 of the extremities. The speaker had often seen general convulsions and even true epilepsy viagra pharmacy cost follow laryngismus stridulus. In the same meeting the operation of spinal or lum- bar puncture was warml\ r and justly praised. Albert Fraenkel, of viagra generic 100 the Urban Hospital, reported a case in which the diagnosis of tuberculous meningitis viagra generic 100 was made by means of spinal puncture, and Stadelmarm and Fiirbringer reported, a number of other cases in which a correct viagra generic 100 diagnosis was arrived at as a result of this operation. Fraenkel advised that the fluid so ob- tained be treated in the centrifuge and the sediment be examined for tubercle bacilli. There are cases of quite advanced tuberculous meningitis in which there are absolutely no severe symptoms, neither headache, nor vomiting, nor retardation of the pulse, and the speaker referred to one in which a purulent exudate was found on the surface of the brain, and yet the pa- tient, twenty-four hours before his death, was appar- ently in perfect health and was walking in his garden. Stadelmann said that in his case he was enabled to determine the pneumonic nature of the meningitis by finding FraenkeFs diplococcus in the exudate. Thera- peutically also, lumbar puncture was of value, as it had resulted in the disappearance of the headache. From this interesting discussion the conclusion was arrived at that lumbar puncture was the only means for determining with certainty the diagnosis in a case of doubtful exudative or purulent meningitis. Benda and Stadelmann also reported an interesting case. It was that of a woman, twenty-three years old, who was perfectly well one week before her death. She was taken with severe abdominal pains, glycosuria (five per cent.) and acetonuria, and finally fell into May 30, 1896] MEDICAL RECORD. 791