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these facts simply to make it evident that all the visit- ing physicians of the Willard Parker Hospital stand on viagra online availability the same plane with regard to the use of antitoxin. No one of us has any special interest in its use other than to determine its real value in the treatment of diphtheria. All of us, with the single exception of Dr. Winters, have from the beginning been in favor of the thorough trial of the serum treatment, which is still going on in viagra pill ring viagra online availability the Willard Parker Hospital. Having stated the above by way of explanation, I shall now take up the position of Dr. Winters, viagra online availability as shown by his paper read in this academy at the last meeting, with some reference also to his previous expressions on the subject. In doing so, I wish it understood that I am attacking his position, not himself. All the members of the medical board have the greatest friendliness for Dr. Winters, but we believe that he has made a grave mistake, and that he has done great wrong to the hos- pital of which he is one of the attending physicians, and that his words have caused widespread harm among the people of New- York and of the whole country. Before considering the evidence submitted by Dr. Winters in support of his views, let us see whether he entered viagra pill ring upon his observations in the hospital with a mind open to conviction and free from bias. One cannot read the arguments of any of the vigorous op- is of antitoxin without being struck by the fact that they all start with a distrust of the bacteriologi- cal diagnosis of diphtheria and with a reluctance to I the help ottered by the bacteriologists to the clinicians. Dr. Winters is no exception to this rule, and .is Ion- ago as December, [894, it was evident to the other members of our board that he had strong - of viagra online availability the curative power viagra online availability of antitoxin and was red to find it of no value. The systematic use of antitoxin was not begun until January 1st of the following year, and from the very beginning he had no faith in its virtues and was daily proving to himself that he was right in his opinion. He. however, kept ounsel and no one had any inkling of what was to take place on that mi viagra online availability evening of April a year ago. After barely three months of observations on some one hundred and fifty hospital cases. Dr. Win- ter, had viagra online availability decided for all time that antitoxin was abso- lutely without value, and, in addition, produced great harm, even to the extent of causing death in those to whom it was administered. From that time to this he has 1 ome more fixed in his convictions and has con- theni by a personal investigation of the hospi- tals in Europe. I, unfortunately, was not pre the meeting last year, but I have read and reread his vivid descriptions of patients who have died of anti- toxin poisoning in the Willard Parker Hospital. Though I was not present at that meeting, I was pres- ent two weeks ago and I am here to-night. I shall now- take up some of the statements made by Dr. Winters in his last paper first, those bearing on his observations in the Willard Parker Hospital ; and, second, those telating to his visit to Europe last sum- viagra online availability mer. The Character of Dr. Winters' Evidence in the Willard Parker Hospital. The advocates of the use of antitoxin in diphtheria insist that it must be given early in the disease and in adequate viagra pill ring dosage in order to secure efficient action. Dr. Winters claims that even under viagra pill ring these conditions antitoxin does not cure diphtheria. Further, he asserts that it may cause the death of the patient, as shown by the fatal result in mild cases in which it was administered in the Wil- lard Parker Hospital. In proof of these views he cites some twenty-five or thirty cases of diphtheria of favorable prognosis in which it was given on the first, second, or third day of the disease. These cases were taken from the spring months of 1895 and 1896. Lack of time prevented his giving full details of these cases viagra online availability in his paper of two weeks ago, but he gave the following summary or what he called the "gist'' of the cases. The formula ran viagra online availability somewhat as follows: " Patient, M. C , one day sick, small bit of membrane on the tonsil, favorable prognosis, antitoxin injected, death on the fourteenth day." I have taken the records of the hospital and viagra pill ring collect- ed all the cases with fatal termination admitted in the months of January, February, March, and April, in the years 1895 and 1896, in which antitoxin was adminis- tered on the first, second, or third day of the disease. In 1S95 there were nineteen such cases in which anti- toxin was given on the second or third day of the dis- ease. All cases in which treatment was begun on the first clay resulted in recovery. In order to judge of the character of these cases from the standpoint of prognosis, I have first arranged them according to the age of the patient. Of the nineteen patients twelve were two years of age or less, two were between two and three years of age, one was four years old, two were five years old, one was seven years old, and one was forty-five years old. It will thus be seen that of the nineteen patients only five were above the age of three years. Now let us study the lesions in these patients. Twelve of the nineteen had laryngeal steno- sis, requiring intubation or tra heotomy in all ; seven of these twelve had pneumonia in addition. In five of the non-laryngeal cases there was also pneumonia. It thus appears viagra online availability that of the nineteen patients, seventeen had laryngeal stenosis or pneumonia or both. The single adult had impending delirium tremens on en- trance. This description of these cases shows that they cannot be called mild in type nor could a fa- vorable prognosis be given of them. In fact, the rec- ords state distinctly that the prognosis on entrance was good in only six, doubtful in five, viagra online availability unfavorable in eight. Now let us take the fatal viagra online availability cases admitted on the first, second, and third day of the viagra pill ring disease in the early months of 1896 thirty-three in all. These patients averaged even less in age than those of the previous year. Seven were under one year of age, thirteen more were less than two years of age, four were just two years of age. rive more were between two and three years of age, making twenty-nine in all, leaving only four patients over three years of age. The grade of severity of the cases is indicated by the fact that twenty-two patients had laryngeal stenosis