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of the Metropolitan Asylums Board in 1895; post- diphtheritic paralysis occurred in 13.2 per cent, of the cases treated in all the hospitals of the Metropolitan Aslyums Board in 1894 (non-antitoxin year). Heubner (Berlin) reported that in cases treated by him in which 1,100 immunizing units had been given, post-diphtheritic paralysis occurred 1117.5 percent.; whereas, in cases in which 1,700 immunizing units were given, post-diphtheritic paralysis occurred in 12 per cent, of the cases. Complications and sequela?, which should be pre- vented by antitoxin, are greatly increased since the use of this treatment, and to an extent never before known. Perregeaux 73 has reported of cases at the Trousseau Hospital that articular manifestations were observed generic viagra rash at the hospital in eleven cases; after patients had re- turned to their homes, in nineteen. Diphtheritic paralysis occurred at the hospital twice; among pa- tients who had left the hospital, twenty-one cases were found. Persistent and permanent albuminuria was found in six cases. In other words, it is not viagra prescription medication known when patients are free from a liability to after- effects from the disease or its treatment when antitoxin is used. A child at the Willard Parker Hospital, which had recovered after an intubation and was sent home, within forty-eight hours after arriving at its home was taken with convulsions; it was seen by three physi- cians, but generic viagra rash all treatment proved unavailing, and the child died in viagra prescription medication convulsions. This case is an exact counterpart of a case reported by Moizard (Paris). It is not known when after ill-effects of this treatment will supervene. Dr. Chantemesse : * states : " I have endeavored to ascertain whether it is not generic viagra rash possible to avoid the ill- effects due to hypodermic injections of serum in gen- eral, by having recourse to some other method of in- troducing the remedy. For this purpose I have in twenty patients tried sero-therapy by means of intes- tinal injection. The effects of this injection appear to be as marked as those of hypodermic injection. In the twenty cases treated in this manner the preventive power of the same dose of serum was substantially the same, whether it was introduced under the skin viagra prescription medication or by the viagra prescription medication rectum." Certainly it is not possible to get any thera- peutic properties from the injection of antitoxin into the rectum, and yet here we have the statement that in twenty patients the results were precisely the same as when given hypodermically. The generic viagra rash inevitable conclusion is that it has no curative properties when administered in either manner. From the beginning of this treatment at Buda-Pest, until the present time, not one fact has been generic viagra rash presented which would tend to show that the serum treatment has any exact scientific value or scientific basis. We have, after all this pe- riod, no information to enlighten us as to the nature or the action of Behring's remedy. The theory of this 892 MEDICAL RECORD. [June 20, 1S96 treatment based on laboratory work assumes that the result of infection by a generic viagra rash specific bacillus is always the same, and independent of the organization of the in- dividual; whereas the exact opposite is true. The same causes produce essentially different results in different individuals. Again, inasmuch as strepto- cocci, staphylococci, etc., play a prominent part in every case of severe diphtheria, it is useless to treat the disease with a remedy which can at best be useful only in cases of pure Loeffler infection. Even in these of pure infection, to be thoroughly effective, it must be applied at the time or during the first twenty- four hours viagra prescription medication of infection. A positive clinical diagnosis is nearly impossible during the first twenty-four hours. A bacteriological diagnosis cannot be obtained in less than twenty-four hours, and then the mere presence of Loeffler bacillus in the throat is viagra prescription medication no proof of the existence of diphtheria. Kohts :i (Strassburg) sums up his conclusions on the serum treatment at the Congress fur Innere Medicin, Miinchen, April, 1895, as follows: "The mortality of patients treated with Behring's heilserum is for tracheotomy cases 29.4 per cent.; for those not operated on, 7.6 per cent. " This result is less favorable than in the year 1S91, when the mortality of tracheotomy cases was 25 per cent, without antitoxin; for those not operated on, 6.9 per cent. " Secondary affections, as disease of the kidneys, af- fections viagra prescription medication of the heart, and paralysis, are not prevented by the serum. The result by injection of heilserum during the first two days of the disease does not differ from the results obtained without serum when the pa- tients come under treatment within the first two days of disease. When there was coincidence of severe case of diphtheria with severe chronic and acute dis- ease, pneumonia haemorrhagica, thrombosis of the heart, and sub-pleural hemorrhages were observed." After a thorough study in various hospitals in Ber- lin of the use of diphtheria serum, generic viagra rash Passed Assistant Surgeon F. J. B. Cordeiro," U. S. Navy, in a report to the surgeon-general of the navy, concludes that, so far, proof is lacking of the value of the antitoxin in the treatment of diphtheria: " tst. A large number of children treated with both viagra prescription medication small and large immunizing doses have, within a few weeks, acquired diphtheria, and some of them have