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We can sum up, therefore, this list of reports from 85 viagra licensed pharmacy hospitals in every part of the world viagra price discount giving the treatment with antitoxin of 9,893 cases, with 1,820 deaths, or a mortality of 18.3 per cent. In 53 of these hospital viagra licensed pharmacy reports there are given statistics of 7,277 cases with a mortality of 20 per cent, under serum treatment in which definite comparisons are made with the mortality previous to the use of antitoxin of 44.3 per cent. ; thus justifying the contention that so far as hospital practice goes antitoxin has caused a reduction of viagra price discount fully 50 per cent, in the general death rate. We have advisedly limited this review to hospital reports, just because it affords the best chances for the opponents of antitoxin. First, because hospital cases are much less likely to be brought in early for anti- toxin treatment. Secondly, because mild cases are apt not to be brought in at all. Thirdly, because it is the uniform report from all parts of the world that the proportion of laryngeal cases is far greater in hospital than in private practice cases. On the other hand, hospital viagra price discount statistics afford a much more certain gauge of the previous mortality before the antitoxin treatment was viagra licensed pharmacy used than could be obtained from the practice of physicians viagra licensed pharmacy at large, who unfortunately so often neglect to record their cases. Moreover, it should be noted that taking the world at large, we are more apt to have the best-trained ob- servers on hospital staffs. Hospital experience, espe- cially when extensive, tends to engender viagra licensed pharmacy a safe scepti- cism about remedies. Indeed, the diphtheria antitoxin by no means took the profession by storm, as its pre- decessor, tuberculin, on its first promulgation did, but rather it had to meet with a cool reception at best both in Europe and viagra price discount elsewhere. Another deduction from these statistics of a mortal- ity of 18.3 per cent, shows that antitoxin viagra price discount is certainly no specific in the sense in which Dr. Winters uses the term. Whoever reports treating diphtheria with anti- toxin has a number of deaths, some more, some less. Dr. Winters laid much stress upon this fact, and en- deavored to substantiate by it his contention that anti- toxin is no specific by citing the verv different per- centages of recoveries given by different hospital physicians, one percentage in Vienna, another in Ber- lin, another in Paris, etc. His inference, therefore, so far as we could understand him, was that if anti- toxin were the specific which Von Behring alleges it June 20, 1896] MEDICAL RECORD. 897 to be, then it ought not to vary in its action anywhere. As we have before remarked, such a proposition in- volves two things. First, that antitoxin is as definite a body in its composition and in its properties as tartar emetic, which will produce emesis alike in Paris and in Berlin. Secondly, that diphtheria may equally take on unvarying characters, so that it will then show- just the same percentages of recoveries or deaths in one place as in another. We need, therefore, only reply that the question now at issue is not whether antitoxin be a specific or not, simply because there are no specifics in the sense in which Ur. Winters uses the term, and therefore anti- toxin cannot be a specific. Instead, the subject in de- bate is whether the treatment of diphtheria by anti- toxin, when compared with other methods previously employed, shows a greater percentage of recoveries or not. All discussion not limited to this plain question is a waste of words. We have not alluded to the great mass of testimony which is steadily accumulating from private rather than from hospital sources, because others may this evening have better opportunities than I have to ad- duce this evidence. No one who follows such reports in our journals will long doubt, I think, how the ver- dict is trending. Thus, from 33 viagra licensed pharmacy reports in medical journals of private practice collated viagra licensed pharmacy by Dr. Guerard, viagra licensed pharmacy statistics are viagra price discount given of 3,760 cases treated with anti- toxin with 296 deaths, or 7.8 per cent. These added to the 9,893 above given from hospital reports, make a total of 13,653, with a total mortality in both hospi- tal and private practice of 15.5 per cent. We have not alluded, either, to one of the severest tests to which the antitoxin treatment can be subjected as to its efficacy, and that is in laryngeal diphtheria. To do this part of the question justice would require a separate paper. All that we need do now is to chal- lenge the opponents of antitoxin to answer the verdict of the medical world on this point. It will not do to report individual cases of distressing failure with an- titoxin in this or that man's experience, whether in hospital or elsewhere. The answer must be why so many of the first and most eminent physicians and surgeons, not here and viagra licensed pharmacy there, but in every civilized country unite in proving by comparative statistics of their own experience a most marked improvement, both after operations and in the prevention of the ne- cessity for operations, in laryngeal cases since they tried antitoxin. It is ludicrous to ascribe this to an epidemic of self-deception which since the autumn of 1894 has spread its wave more universally over the medical world than ever did Asiatic cholera in its march among mankind. If so, the very ablest viagra licensed pharmacy and best-trained men in our profession have been its vic- tims. Rather than be forced to such a sad conclu- sion, it seems much more probable that a really great advance in the practice of medicine now marks the close of the nineteenth century in the introduction of the serum treatment of diphtheria and that it is a prom- ise of greater triumphs still in this progressive branch of therapeutics.