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was not surprised to find large numbers of bacteria. but was considerably surprised to find so large a num- ber of perfectly sterile stomach fluids, especially since ( adeac and Bournay have recently asserted that the stomach and intestinal fluids are not destructive of micro-organisms as was formerly supposed, and since the viagra pricing generic assertion is commonlv made by bacteriologists and physiologists that bacteria are not only present in the alimentary canal but are useful in the digestive process. The fact that no bacteria whatever were found at the end of the first hour of digestion in 50.8 per cent, of three hundred and seventy-seven stomach fluids exam- ined, seemed to be all the evidence required to demon- strate the proposition that the normal stomach is able to destroy those microbes which accidentally en- ter it through the mouth and nose, and that microbes play no part in normal stomach digestion. Kiirhoff and Wagner and others were quoted for further con- firmation of this view. The method of chemical examination viagra pricing generic employed by Dr. Kellogg is based chiefly upon that of Hayem and Winter. In comparing the results of 50mg viagra tablets bacteriolog- ical examination with the viagra pricing generic resuks viagra pricing generic of chemical exami- viagra pricing generic nation, he carefully noted the relation of bacteria to: 1, the viagra pricing generic calculated acidity, which represented the 1 unbilled value of free hvdrochloric acid and the com- bined chlorines diminished by the fatty acids present: 2, the acidity; 3, the free hydrochloric acid; 4, the combined chlorine; 5, the coefficient of 50mg viagra tablets starch 50mg viagra tablets di- gestion; 6, the coefficient of salivary secretion ; 7, the coefficients of chlorine liberation; 8, the coefficient of absorption. The viagra pricing generic summary was as follows: Of the one hundred and ninety-one sterile cases eighty-three were eases of hyperpepsia, eighty of hypopepsia, and in twenty-eight the amount of chlorine eliminated was normal. Of the eighty-three cases of hyperpepsia combined chlor- ine was in excess and 50mg viagra tablets free hydrochloric acid was normal or in excess in fifty-five cases; in twelve cases free hy- drochloric acid was deficient and in one it was absent. < lombined chlorine was deficient, or less than 1.55 mil- ligrams per hundred cubic centimetres in sixteen cases. < )f the eighty cases of hypopepsia. hydrochlo- ric acid was deficient in sixty-eight, and normal or in excess in quantity in twelve. It thus appeared that a sterile condition of the stomach fluid might viagra pricing generic exist in hypopepsia as well as hyperpepsia, and it was indeed a somewhat surprising fact that in forty-two per cent, of the sterile cases hypopepsia existed, whereas hyper- pepsia was found in only forty-three per cent, of viagra pricing generic the cases. In forty-eight per cent, of the cases in which bacteria were absent free hydrochloric acid was less than normal in quantity, being below twenty-five mil- ligrams per hundred cubic centimetres of stomach fluid, and in 23.5 per cent, it was absent altogether. It was noticeable that anaerobic germs were found most abundant in cases in which the total acidity, the free hydrochloric acid, the coefficient of liberation, and the coefficient of absorption were the lowest. It ap- peared that the anaerobics flourished better in an acid medium, or rather resisted the influence of the hydro- chloric acid better, than did the aerobic. The coefficient of absorption in the class of anaero- bic infected cases was .38 as compared with .34 in the sterile cases. The author then considered the method of deter- mining the relation of urinary toxicity to the bacteria in the alimentary canal. The normal urotoxic coeffi- cient was .46. In the case of a lady suffering from a severe attack of migraine, stomach infected to a high degree, the urotoxic coefficient was found six times normal. In another case of marked infection, that of a young woman suffering from epilepsy, the urotoxic coefficient, as she was recovering from a series of seiz- ures, was found to be more than double the norma!. He said numerous similar cases could be cited. A fact of considerable importance which his studies have established is that the tests for fermentation heretofore relied upon are of little value. Bacteri- ological examination is the only means by which it is possible to determine accurately the presence or absence of gastric 50mg viagra tablets infection. For combating infection of the stomach the stom- ach tube is certainly the most efficient of all thera- peutic measures, but most important of all is care- ful regulation of the diet. Foods already undergoing fermentation or decomposition must necessarily be avoided, and for a time at least those foods which readily undergo decomposition or fermentation that is, such substances as furnish favorable nutrient media for the development of the micro-organisms found in the stomach. In cases of excessive amount of free hydrochloric 50mg viagra tablets acid, suppression of foods containing ferments and perhaps for a time of foods which encourage the de- velopment of ferments is indicated. He finds a dry farinaceous dietary of greatest service in these cases, contrary to the practice of many others; but care must be taken that the starch so far as possible is con- verted into dextrin. In extreme cases he uses a starch-free dietary, or rather a dietary in which the starch is completely converted 50mg viagra tablets into maltose and com- bined with prepared nuts. Subnitrate and subgal- late of bismuth, charcoal, and sulphur are useful. In hypopepsia and apepsia lavage is of vast service. Well-cooked farinaceous foods are digestible, but meats, butter, cheese, oysters, and fish must be care- fully avoided for a few weeks or months in cases of mild infection. In dilatation of the stomach dry aseptic food should be given ; in gastric catarrh, kumyss, buttermilk, or, better, koumyzoon. Several other measures, including massage, etc., received con- sideration, and illustrative cases were cited. Dr. W. H. Porter was called upon to open the verbal discussion. He said it seemed to him, on look- ing at the subject from a purely practical standpoint, that the etiological factor in intestinal fermentation resolves itself into three conditions: People as a rule eat too much, and eat viagra pricing generic of materia] which is not best