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ous degrees of rigidity of the thorax. The most appropriate way of testing the manual methods of artificial respiration seemed to be to study the vol- ume of inspired and expired cheapest viagra order air of living conscious human beings. By using this method Schafer found that his prone method of artificial respiration gave a much larger volume than the supine or Sylvester method. However, it was soon discov- ered that the normal individual interferes involun- tarily with the inspiration and expiration either by partly closing the glottis and thus reducing the amount of the expiratory and inspiratory air, or the volume of the cheapest viagra order respiratory air is influenced by the unconscious innervation of the respiratory muscles. Ploman" carried out his studies on human beings cheapest viagra order who were previously trained not to participate in the respiration during the execution of any of the methods of artificial respiration. According to him, Schafer's method gives definitely smaller volumina of respired air than the method of Sylvester and its modifications. It seemed, however, that even a pre- vious training was not a sufficient guarantee that the individuals experimented upon do not interfere sometimes unconsciously with the course of the arti- ficial respiration. Lilijenstrand, Wollin, and Nils- son 7 tried to overcome the difficulties by studying the effect of artificial respiration on conscious apneic individuals. The apnea was brought on by a small series of deep respirations, and it is gener- ally assumed that during a state of apnea the in- dividual is completely relaxed and has no desire for breathing. According to these authors the respired air volumina obtained under any of the manual methods of artificial respiration are much smaller than any normal respirations, but they agree with Ploman that Schafer's method gives a still smaller volume. Loewy, one viagra jelly order of the most active investi- gators in this line came out," however, with the claim, based upon experimental studies, that during apnea the individual is not completely relaxed, but, on the contrary, the respiratory muscles are in a state of tonus, which may mean that in this state the individual is rather more ready to react to the stimulations produced by artificial respiration. As mentioned before, the apnea produced in the experiments of Lilijenstrand, Wollin, and Nilsson, and probably also in those of Loewy, were viagra jelly order brought on by a small cheapest viagra order series of respirations. Yandell Hen- derson 8 undertook a critical examination of Schafer's and other methods of artificial respira- tion on students "who experienced after overventi- lating their lungs by two or three minutes of volun- tary forced respiration a lack of desire to breathe (apnea), lasting from 40 to 80 seconds." He found that under these circumstances Schafer's method gives a slightly larger volume than that of Sylvester, especially when Schafer's method is car- ried out with "the arms stretched forward." But even in Henderson's investigations the respiratory volumina obtained under artificial respiration were about one-half or less than the one obtained in normal respirations. However, no matter to which of the various claims greater weight is to be attached, it seems quite evi- dent that the method of measuring the volumina of inspired and expired air is incapable of demonstrat- ing that any of these methods is in a position to keep up the respiration for any length of time when the respiratory mechanism is in a state of complete failure. viagra jelly order It seems that in the end it is not cheapest viagra order the ex- perimental method of measuring the volumina of the respiratory air which influences the contending parties to take sides with one or the other method ; it is again essentially the old method of making claims by statistical data which induces the fol- July 7, 1917] MEDICAL viagra jelly order RECORD. lowers of various methods to consider one or the other method of manual artificial respiration as the more viagra jelly order viagra jelly order efficient procedure to employ in resuscitation of the apparent dead. Curarized Animals. — Several years ago the writer'" introduced a new method of testing whether a certain procedure of artificial respiration is in- deed capable of keeping an individual with complete failure of the normal respiratory mechanism inter- minably, or at least for many hours, alive. The essential factor in this method consists in keeping cheapest viagra order the respiratory muscles of the animal completely paralyzed by means of curare for as many hours as we wish to continue our experiment. The animals are at the same time anesthetized by ether, admin- istered by means of the method of artificial respira- tion which is viagra jelly order undergoing the test. When the method of artificial respiration is inefficient the circula- tion comes sooner or later to a complete standstill. When, however, the method is efficient the circula- tion can be kept practically in a uniformly normal state for many hours, although the animal remains completely paralyzed. At the end of such a suc- cessful experiment spontaneous respiration can fre- quently be restored to normal by means of an in- jection of physostigmin. By means of this method my procedure for arti- ficial respiration, which I am going viagra jelly order to describe later, has been tested on viagra jelly order hundreds of animals. By the same method I have tested the efficiency of the Sylvester method, of the Schafer method, and of the pulmotor which was so much in vogue at that time. Regarding the manual methods my statements can be brief, and are as follows: The longest time the circulation of a curarized viagra jelly order and anesthetized animal could be kept up by the Sylvester method was twelve minutes, even when the tongue was kept pulled out by means of a forceps. The experiments were made on dogs. By the Schafer method, with the anterior extremities stretched forward, the shortest period