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in which rapid improvement followed the onset of an acute infectious disease, and cases have been reported in which complete recovery took place. -86 MEDICAL RECORD. [May 30, 1S96 Dr. Tohn W. Brannan said that in several partic- ulars his observations in connection with this sub- ject did not agree with those of viagra pill spam Dr. Berg. About eight viagra pill spam years ago he saw a young man with a well- marked mitral insufficiency, who, while he had never had rheumatism, www viagra pharmacy gave a history of scarlet fever. Since then he had seen a number of cases in which cardiac lesions developed during the ^ourse of an attack of scarlet fever or shortly afterward. In one case pains in the joints were also present, and these, as well as the violent action of the heart, were readily controlled by the administration of the salicylates. At the pres- ent time there are seventeen cases of scarlet fever in the YVillard Parker Hospital, and among these there are three cases of arthritis. Two of the latter have developed a distinct cardiac murmur since the onset of the arthritis. In all three of these cases the ad- ministration of salicylate of soda has produced a marked improvement in the symptoms. The fever has diminished, the pain is lessened, and the heart mur- mur is fainter. For this reason Dr. Brannan said he was inclined to regard this complication of scarlet fever as rheumatic in character. Dr. Lambert, in reviewing the subject of the bac- teriology of scarlet fever, said that its true etiology is still an open question. Pfeiffer and his adherents claim that the disease is due to a protozoon, while other observers say that it is the result of some form of streptococcus. A special streptococcus has been iso- lated by one investigator. Recently a Russian found a diplococcus present in the blood in thirteen cases of scarlet fever examined by him. He does not claim that this is the cause of scarlet fever, but mentions that he has never been able to find it in other diseases. These few facts, Dr. Lambert said, do not of course indicate the vast amount of work that has been done in this direction ; they simply show that the www viagra pharmacy problem is still unsolved. Dr. Samuel Ketch expressed the opinion that in tuberculous subjects there is a connection between the acute infectious diseases, notably scarlet fever and measles, and www viagra pharmacy the development of tuberculous joint le- sions. He has seen a number of cases which would tend to confirm this view. The speaker said that while he does not believe that scarlet fever is as common a cause of chronic joint disease as the text- books would indicate, viagra pill spam yet he cannot entirely discard the idea that in a tuberculous subject it acts as a trauma in the production of tuberculous joint trouble. Dr. viagra pill spam VV. R. Townsend said that three years ago he saw a case in which the knee-joints became affected early in the course of an attack of scarlet fever. Both knees were swollen and extremely painful. The pa- tient was put on salicylates and made a good re- covery. Dr. S. H. Dessau www viagra pharmacy .said lie has always looked upon these joint affections of scarlet fever as being rheu- matic in character. Two or three such cases have come under his observation, and in every instance re- covery followed the use of antirheumatic remedies. Drs. Judson and Chappell continued the discus- sion. Dr. Berg, in closing, said he did not wish to be understood as saying that cardiac affections, namely, an endocarditis or a pericarditis, may not complicate scarlet fever; if such a complication occurs, it is viagra pill spam probably due viagra pill spam to the action of the streptococcus or mixed infection, just as the polyarthritis itself is, and not to rheumatic poisoning. IK- called Dr. Brannan's attention to the fact that not infrequently cardiac le- sions develop in scarlet-fever patients who never give any symptoms of joint trouble at all. According to his experience, mild cases of polyarthritis occurring in the course of scarlet fever gel well under any viagra pill spam form of treatment, while the severe eases are unaffected bv the salicylates, piperazin, and other antirheumatic remedies. SECTION OX SURGERY. Stated Meeting, May 11, j8q6. B. Farquhar Curtis, M.D., Chairman. Fracture of the Patella Treated by Suture. Dr. Joseph A. Blake presented a young man who had sustained transverse fracture of the patella by muscu- lar effort to save himself from a fall, four weeks ago; treatment followed a week later by suturing the two segments together by wire through transverse incision. A point of interest was the presence of the lateral patel- lar ligament torn from its attachment to the tibia, still attached to the upper fragment of the viagra pill spam patella, lying completely across the broken edge of the latter, and which evidently would have prevented bony union without the cutting operation and removal. Thus far the result had been perfect. A plaster cast was still viagra pill spam worn, laced up on the front of the leg. Diabetic Gangrene; www viagra pharmacy Amputation of Thigh. Dr. Arthur L. Fiske presented a man, sixty-six years of age, who had been cured of varicose ulcers of the www viagra pharmacy leg in 1893. Others developed in 1894. Sugar was found in the urine, gangrene commenced in the sole