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with complete anuria. The child ultimately recovered. A child of five years was admitted to Crown Prince Rudolph Hospital, 30 Vienna, November 15, 1894, hav- ing been ill two days with uncomplicated diphtheria. Four injections of Behring's serum were given. No- vember 23d the child died viagra chicago buy of paralysis of the heart. Professor Gnandinger, Crown Prince Rudolph Hos- pital, told me personally that he had seen more cases of paralysis of the heart in diphtheria since the use of serum treatment viagra chicago buy than he had seen during the entire eight years of his connection with the Crown Prince Rudolph Hospital. Dr. Hutinel 31 states: " There can be no doubt of the gravity of post-sero-therapic ill-effects, for I have met with two cases of death from this cause in children. The injection of Roux's serum was followed in both cases by albuminuria, anuria, etc." Dr. C. F. W'ithington ** says: " In private practice I had a case in which I had a great deal of anxiety, not to say alarm from the use of antitoxin. It was a case of a lady with diphtheria involving one tonsil. She re- ceived fifteen hundred units of Behring's serum. Two days later the other tonsil began to be involved, with rapidly increasing viagra chicago buy membrane, and she viagra chicago buy again received fifteen hundred units. Four or five days after this she was in a condition of a great deal of gravity for about a week. There was first erythema, then intense urti- caria; then viagra online wikipedia purpura of a great deal of severity involv- ing both legs and severe pains accompanying the course. of the nerves. Her condition was one of high fever, delirium, and great prostration. She is now- convalescing. The gravity of the symptoms referable to antitoxin in this case will cause me in the future to be a little conservative in its use." One of the best practitioners on Staten Island, Dr. Scales, stated to me that he had never in all his ex- perience been so alarmed as he was after an injection of antitoxin viagra online wikipedia in a woman suffering from diphtheria. For six hours after the injection prostration was so ex- treme that he felt she was likely to die at any moment. Vierordt " reports that " in one case of a girl of two and a half years we thought of the possibility of a bad effect from the serum. The child came in with moderately severe diphtheria of the throat. She re- ceived forty-two hundred immunizing units of viagra online wikipedia Beh- ring's serum. There was collapse and stupor. The June 20, viagra online wikipedia 1S96] MEDICAL RECORD. 885 stupor remained till death, which resulted from heart failure. The autopsy revealed several points of hem- orrhage of the mucous membrane of the intestines and the pericardium, and nephritis." Vierordt concluded that the case was not one showing harmful results of the serum, because it could be explained in different ways; but the case is an exact counterpart of numer- viagra online wikipedia ous cases reported by other observers, in which the only explanation of the symptoms was the ill-effects pro- duced by the serum. Dr. Martin J. Fleming, of this city, has reported to me a case of a child, who after an injection of serum had repeated eruptions ; finally eczema appeared, which persisted for two months. There was nothing in the family history or in the child's general condition to ac- count for the eczema, the only cause being the use of antitoxin. At the April (1S95) meeting of this academy I stated that the pneumonia of the antitoxin cases of diphtheria differed from the pneumonia we were in the habit of seeing in diphtheria; that it was a totally different disease from that seen before in the course of diphtheria; that it occurred as a sequela and not as c complication. Dr. J. W. Brannan 3 ' in a report before the Society of Alumni of Bellevue Hospital, has shown viagra chicago buy that pneu- monia was the cause of death in 53.22 per cent, of the fatal cases of diphtheria in the YVillard Parker Hos- pital; whereas, before the antitoxin treatment, pneu- monia was a cause of death in only 16.90 per cent, in this hospital. His report further shows that the aver- age duration of stay in the hospital in fatal cases of pneumonia before antitoxin treatment was two days; but viagra chicago buy since the introduction of antitoxin, the average time of stay in the hospital in fatal cases of pneu- monia was 13.7 days, bearing out the statement made by me in April, 1S95, that the pneumonia of the antitoxin-treated cases occurred as a sequela and not as a complication of the disease. All conditions in the hospital were precisely the same in 1895 as in 1894, with the exception of the addition of the anti- toxin treatment. The enormous increase of pneu- monia as the cause of death in the YVillard Parker Hospital during the antitoxin treatment has no other explanation viagra online wikipedia than the hypodermic injection of serum albumin. These pneumonias viagra online wikipedia are, as I stated in April last, septic pneumonias: clinically they have the stamp of a septic process. In New York and elsewhere it has been claimed in viagra chicago buy defense of the serum that the unfortunate ill effects in the form of high fever and suppurations are due to streptococcus infection; but if this were really the case they should supervene while the morbid affection is in process of evolution in the throat, whereas they usually supervene after the disappearance of all throat lesions. It is now stated that the bad effects which formerly resulted from the use of antitoxin were due to the amount of serum injected, and that with the use of a more concentrated serum there will viagra online wikipedia be less pneu- monia and bad after-effects than formerly. This is a very weak admission. It is an admission that there are bad effects viagra online wikipedia from the serum. Last year it was as-