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Fiji 4.— Showing the apparatus in position, except the bellows and an oxygen tank. normal rate and the entire circulation in good con- dition.* I wish, however, to state expressly that our test by which we gauge the value of apparatus or of man- ual methods of artificial respiration is a severe one. It presupposes that we always have to deal with vic- tims whose respiratory mechanism is completely paralyzed and viagra bulk buy cannot be reached by any reflex viagra pill buy stimu- lation. But there can be no doubt that the vitality *To my mind the apparatus which is here described is practically the most efficient one for the execution of artificial respiration in cases of emergency. It is abso- lutely reliable; it is very easy to handle and is compara- tively inexpensive. My statements which are here made are based upon personal viagra bulk buy observations. I have, of course, very few opportunities of testing viagra bulk buy it upon human beings. I hardly need to state that I have no other motive for pleading for the introduction viagra pill buy of this apparatus into medical and Samaritan practice than a scientific and a humanitarian interest. The manufacturers are spend- ing: immense sums of money for advertising and popu- larization of their machines. Their agents have no other means of demonstrating the possible usefulness of their respective apparatus than by showing its action upon a rubber bag; I need not discuss here the un- reliableness of any of these demonstrations,; neither do I need to discuss the inefficiency of the evidence derived from testimonies of some physicians. of the nervous system of many victims, although they actually show no respiration, is not yet com- pletely abolished and may therefore still be capable of recuperating sooner or later and of responding to some stimulation. In such cases even methods of artificial viagra bulk buy respiration of moderate efficiency may sometimes be capable of sustaining the life of the individual for a certain period, at least, until an efficient apparatus is procured. Furthermore surely there are cases in which the application for a few minutes only of even inefficient apparatus or methods may support the failing respiratory mech- anism and thus help to restore the life of the victim. It is therefore proper to advise that in the absence of reliable and efficient apparatus for artificial respiration any type which is just at hand ought to be used viagra pill buy — provided the viagra bulk buy apparatus does not possess the two above-mentioned dangerous elements, name- ly, the automatically regulating inspiration and expiration and the special provision for expira- tion by means of suction. However, it is rather probable that in most in- stances no kind of apparatus for artificial respira- tion will be at hand when an accident has happened. It ought therefore to be the rule that in each and viagra bulk buy every case a manual method of artificial respiration must be instituted immediately on discovery of an individual who shows no spontaneous respiration. As we have seen above, both methods which are now in vogue, namely, that of Sylvester and of Schafer, may prolong, to some degree, the life of curarized animals. On the other hand, it was found that the viagra bulk buy life of curarized animals was viagra pill buy sustained longer by using the Schafer method than by the method of Sylvester. But we must keep in mind that all these methods, simple as they may appear, re- quire some experience for their proper execution. I shall therefore suggest that in rendering first-aid to accident cases the method of immediate choice should be the one for which there is an operator present who possesses special experience in just that method. In other words, the Sylvester method should be given the viagra pill buy preference if the men who are to render the first-aid are more experienced in this method than in that of Schafer; one is capable of rendering better aid with a method with which he is familiar than with one which he has never used before. However, I shall here go on record, as I did before in the report of the mentioned commis- sions, that generally the Schafer method is prefer- able to that viagra pill buy of the Sylvester method. In using the prone or Schafer method I wish to remind here of the remark made to me by Professor Schafer several years ago and which I have quoted above, namely, that "if he were now confronted with the task of resuscitation he would kneel astride over the subject and perform the simple motions of horse- back riding without employing his hands and arms at all." This simple manner of employing the prone method could be readily combined with the use of the author's pharyngeal insufflation apparatus, and the operator who is performing the Schafer method could at the same time manipulate with one hand the respiratory valve and with the other hand regu- late, when viagra bulk buy necessary, the T-tube. But the operator must learn to move the ring of the valve to the left (expiration) synchronously ivith throwing his body doumward upon the individual and to move his July 7, 1917.1 MEDICAL RECORD. thumb to the light (inspiration) simultaneously with the raising of his body from the individual. We have so far discussed the present methods of resuscitation from the point of view of artificial respiration. But life viagra bulk buy depends at least as much upon the proper circulation as it depends upon an efficient respiration, and here we must confess that for the present viagra pill buy we have no method which would act resus- citatingly upon the circulation, at least no method which could in any way be compared with the meth- ods at our disposal for the performance of artificial