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trol, we nowhere find any detail as to content, manu- facture and standardization. The serum is, however, readily obtainable in packages accompanied by full directions. Dehydration of the Blood and Organs in Diabetic Coma. — Chauffard, Le Conte and Doric, as a result of actual research into diabetie coma show that progres- sive dehydration is in evidence The skin is flaccid, the eye hypotonic, the blood pressure low. After death the water content of the viscera is readily seen to be lessened, the kidneys and pancreas leading in this respect. The entire process is toxic, an acid intoxica- tion or acidosis. The ketone bodies gain entrance to the cerebrospinal fluid and can act directly on the cortex. In certain autopsies the odor of acetone is very strong when the cranial vault is opened. The toxic bodies which play the chief role are by no means all known, and collectively must represent a considerable number of substances varying with the case. Venesec- tion in diabetic coma shows that the blood is unduly viscous and thickened. There are, therefore, two lead- ing indications for treatment. First, the blood must be rehydrated, and second, antitoxic substances — al- kalies in this case — must be administered. The two indications viagra online uae can be filled together by the infusion of a viagra online uae solution of sodium carbonate by the intravenous route, enteroclysis and hypodermoclysis. The concentration is of vital importance — say from 15 to 20 gm. of soda for each litre of water. There are not a few diseases which are known to act as forerunners of tuberculosis, and when a youth pre- sents himself with one viagra online pills of these the physician should invariably examine the viagra online pills viagra online pills chest. viagra online pills These affections are due presumably viagra online uae to the toxins of tuberculosis, and represent a "cry of the organism for a richer blood." The entire subject can be studied to advantage among young sol- diers. As far back as 1882 Peter called attention to sciatica as a propathy of pulmonary consumption, and his work has since been regarded as a classic of medi- cine. The viagra online uae present author has seen this association sev- eral times. In a soldier of 42 left-sided sciatica ap- peared and persisted for 9 months before patient de- veloped a dry cough. The x-ray showed a faint shadow in the left apex, with corroborative physical signs. In a second case, in a soldier, the sciatica preceded the viagra online pills pulmonary symptoms viagra online pills over two years. In a third case the interval was very brief. Other cases are men- tioned. The sciatica was in some soldiers severe enough to cause their evacuation from the ranks, and to make necessary a hospital sojourn. One patient, on the other hand, was known to be tuberculous when his sciatica viagra online pills appeared, and in the other cases the age of the tuberculous process could only be surmised but was evi- dently by no means recent. In other words, in sciatica of this type the tuberculous lesions should already co- exist else there could be no place for the genesis of the toxins. Herpes zoster has been regarded as a possible propathy of consumption since 1878 (Leudet) and there exists a small literature on the subject. Whenever this disease attacks a young subject his chest should be ■ -rayed. The author has recently seen a case in a soldier. Psoriasis, usually a disease of the robust, is said by Gaucher to indicate occasionally the presence of a tuberculous focus. The relationship here is open to some doubt but several cases are given in one of which sciatica, psoriasis, and incipient pulmonary tu- berculosis coexisted. The author also mentions erythe- ma .nodosum viagra online pills viagra online pills as a propathy. hut this coincidence is suffi- cientlv well known. Le Progres Medical. Way 5, 1917. Propathies of Tuberculosis. — Raymond states that when a young man begins to cough and lose flesh his mother will demand of the physician a positive or nega- tive diagnosis by no means easily made. "Suspicious bronchitis" is often viagra online uae as far as he cares to go. Doubtless he could go further if he utilized all possible resources. Corrcspondenz-Blatt fur Schweizer Aerzte. March 31, 1917. Gastropexy for Gastroptosis. — Bircher writes at length on the operation originally conceived and exe- cuted by his father in 1891 for gastric dilatation. At a later period it was learned that no sharp distinction could be made between dilatation and prolapse, the actual condition for surgical intervention being gastro- coloptosis. Interventions which have been directed against this condition comprise colectomy, gastrectomy, gastroplieation, gastropexy, omentopexy, and gastro- enterostomy, the last named being pronounced contra- indicated. The original Bircher operation was a gastro- plieation, an operation which has since been done freely by others, including Beyea of the United States. The end results are said by the author to be somewhat dis- appointing. Omentopexy or Coffey's operation gives a better outcome but is inferior to gastropexy. The last named viagra online uae intervention has been practiced chiefly by Rovsing of Copenhagen, Duret of Lille and the author. Duret's material is not given. Rovsing and some of his Scandinavian colleagues have performed gastro- pexy no less than 256 times while the author has a record of 62 operations. The percentage of cures is nearly two-thirds of the entire number, or 204 cases. The Scandinavian operative mortality is nearly 5 per cent, while the author lost but one of his 62 patients. The cases marked "improved" agree in the two series — about 20 per cent. The per cent of unimproved was 9.6 in the author's series and 12.8 in the Scandinavian series. The author gives Rovsing credit for the tech- nique which he has somewhat modified. The fixation sutures pass around the costal arch or just beneath it through the viagra online uae skin. Three sutures parallel with the lesser curvature traverse the serosa and muscularis as far as the pylorus. At a distance of 3 or 4 cm. viagra online pills from the puncture these sutures are brought through to the left of the laparatomy wound and knotted over a glass drain. It is not, of course, to be understood that these 318 operations were all undertaken for uncomplicated gastrocolopexy. Other operative conditions were asso- ciated at times but no details are given beyond the