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rapidly followed by atrophy, while, as a rule, sensory symptoms are absent. The changes in electrical re- action are similar in these two conditions, the reac- tion of degeneration, while in monoplegia or hemi- plegia of central origin the electrical reaction is normal or increased. After speaking of pain in neu- ritis, together with trophic changes, the author said it may be difficult in viagra online 4rx some cases to decide viagra online 4rx whether the lesion producing the paralysis is in ths nerve trunk, cord, or brain, but a definite decision can almost in- variably be reached by a critical electrical examina- tion. When a person awakes with paralysis of one side of the face, the friends speak of it as a stroke, meaning a cerebral apoplexy, but clinical experience shows that isolated facial paralysis of cranial origin is ex- ceedingly rare. Not so when there is also hemi- plegia. In simple facial paralysis of central origin, the upper branches of the facial nerve are rarely paralyzed, only the lower face showing palsy. The nerves continue to react to faradism, usually quanti- tative increase being present. In peripheral facial paralysis all branches are affected, the patient is unable to close the eye or raise the forehead, and the faradic irritability is either diminished or lost within two best viagra dosage weeks. It is not necessary to confuse the practitioner by speaking of change in polar reac- tion, for in general it is sufficient to compare the electrical irritability to the faradic current viagra online 4rx on the two sides; best viagra dosage if it is diminished or absent on the paralyzed side it indicates reaction of degeneration. If the viagra online 4rx gal- vanic reaction be tested, the normal condition should give greater response on cathodal closure than on an- odal closure, and greater response on cathodal closure than viagra online 4rx on cathodal opening. A reverse of this indicates viagra online 4rx reaction of degeneration (R. D.). Reaction of degen- eration is conclusive proof of a lesion of some severity at the nucleus or in the course of the nerve trunk. This test is also important in prognosis. One rarely sees atrophy of the muscles in paralysis of the facial nerve, whereas in peripheral paralysis of the extremities atrophy is not at all uncommon. Pain is an obtrusive symptom in the latter when there is degenerative neuritis. Cases of paralysis of the peripheral nerves without a wound can be classed in three categories slight, medium, and severe. The first form usually gets well in about fourteen days; the second, with partial reaction of degeneration, in about two months ; viagra online 4rx the severe form, w ith complete reaction of degeneration, in from three to nine months. Dr. Leszynsky thinks this period can be shortened in the two latter classes by electrical treatment begun two or three weeks after the onset. Patients usually think the benefit is in proportion to the strength of the current and its duration, but this is a mistake. In palsy due to division of a nerve, suture is called for at the earliest moment. Electricity, to be of diag- nostic value, must here be used early, since after two or three weeks one cannot say whether viagra online 4rx the reaction is due to division or to neuritis. The paper was discussed by Dr. H. W. Berg and Dr. L. F. Bishop, both of whom have been unable to arrive at a conclusion as to the therapeutic value of electricity in cases of peripheral paralysis. Dr. Les- zynsky, however, has no doubt on this point. In dispensaries it is most used in anterior poliomyelitis of infants, where its beneficial results are less ap- parent than in paralysis of peripheral origin. Dr. Thomas H. Manley presented a woman and a sarcomatous tumor weighing a pound and a half, which he removed from her lower jaw viagra online 4rx at a second operation. He also showed a portion of gangrenous intestine which he removed by resection some days after his subject was kicked in the lumbar region by a horse. June 13, 1896] MEDICAL ghempmtic Hints. Myxoedema. The first case of this disease which was treated by thyroid, beginning in April, 1891, and continuing till the present time, is to-day free from swellings, the skin is soft and moist, the hair has grown in again, and best viagra dosage the woman leads an active life, taking, however, each week three or four grams of thy- roid extract. George Murray {British Medical Jour- nal*). Ozaena. best viagra dosage R Pure glycerin - j0 Borax 20 Distilled water ^ S. Used as a nasal spray two or three times a day. Nouveaux Remides. Diabetes. R Arseniate of soda mgm. .002 best viagra dosage Carbonate of lithium cgm. . 1 5 Codeine " .02 Powder of theriac " ,25 Dry and powdered extract of quinquina " .40 For one powder. Make thirty. One before the first break- fast and the dinner. \. Robin. Spasmodic Asthma 1$ Tinct. lobelke setherese iti xv. Spirit, xtheris iri xx.