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tions." Dr. T. S. K. Morton read a paper upon " Saline Infusion for Hemorrhage, with Reports of a Case of Extra-Uterine Pregnancy and a Case of Stab Wound of the Thorax Apparently generic viagra specs Saved by its Employ- ment." Dr. John S. Miller reported a case of haemo- thorax from a stab wound of an intercostal artery, in which the hemorrhage was controlled by packing the wound with gauze. The Poor in London Hospitals. The following announcement appeared in the society column of the Standard a few days ago: "Upon inquiry at St. George's Hospital last evening, it was ascertained that Mr. Philip Richard Morris, A.R.A., viagra sale tesco who three weeks since underwent an operation, was progressing satis- factorily toward recovery." In a few weeks the col- lection boxes will be sent around London factories and workshops to receive the pence contributed by working men and boys viagra sale tesco in aid of St. George's and other hospitals. The question arises whether these sons of toil know that their charity is being made use of to relieve gentlemen in the position of Mr. Morris, A.R.A. The Medical Times. 936 MEDICAL RECORD. [June viagra sale tesco 27, 1896 The Significance of Pain. In a recent lecture Professor Potain spoke of the value of pain in the diagnosis of disease, and stated that its absence usu- ally made the prognosis more sombre, latent affections being grave because they develop freely without any warning to the patient {New York Medical Times). It is because of the absence of pain that many affections have remained so long obscure and have caused great ravages, such as endocarditis, chronic nephritis, and aroitis. Certain diseases, usually painful, may some- times exist without this symptom; in waking typhoid fever the pain is so slight that the patient can carry on his ordinary vocation until intestinal perforation occurs, causing rapid death. In pleurisy the pain, sometimes so great, may be absent, but the disease is none the less serious on that account. Cases of an- gina pectoris in which there is no pain are the most dangerous. Certain diseases consist only of pain, such as gastralgia and enteralgia; in others pain is the predominant symptom. viagra sale tesco It should, therefore, be studied with the greatest care, and its characteristics fully determined. Its intensity is what naturally strikes the patient, but this is not at all proportion- ate to its cause, and depends upon individual condi- tions. It is well known that certain races are but slightly sensitive to pain and that education plays a great part in this sensitiveness. A reliable physician states that there is at Chantilly a colony of English jockeys who, accustomed to horseback riding, are liable to numerous fractures, but seem viagra sale tesco to feel only slightly the pain caused by them ; while their wives, with but rare exceptions, never utter a cry during de- livery. The viagra sale tesco intensity of pain is of value to the phy- sician only when it is excessive; for instance, an intensely painful spot in the side may indicate gan- grenous pleurisy; the appearance of peritoneal pain in typhoid fever may indicate perforation of the in- testine. The seat of the pain has but little relation to the disease; thus the painful point in pleurisy is nearly always the same, no matter what may be the precise location of the inflammation. The only ex- ception to this is the viagra sale tesco pleuritic pain of tuberculosis. Dorsal and substernal pain ordinarily indicates an affection of the oesophagus, but to make an exact diag- nosis it is necessary to use the sound. Gastric pain indicates the location of the disease, as a general rule, and the patients are not deceived when they complain of pain in the stomach. Disturbance of the biliary passages is generally marked by pain in the right hy- pochondrium to the other. Nephritic colic causes pain along the corresponding ureter. Vesical pain is easily recognized because of the tenesmus which accom- panies it. There are pains, the seat of which is pa- thognomonic, such as angina pectoris, in which it is pre- thoracic and radiates into the left arm, and sometimes into both arms. To this rule, however, there are many exceptions. Hepatic colic may cause pain only in the epigastrium and simulate generic viagra specs gastralgia, while epigastric pain is often related to alterations of the solar plexus, sm h as that due to aneurism of the abdominal aorta. Reflex pain is also an important aid in diagnosis. It is necessary to bear in mind, in this connection, the dorsal pain in gastric affections; the scapulalgia of hepatic colic; the pain in the posterior portion of the deltoid region in diseases of the liver; the irradia- tions of nephritic colic into the testicles and thighs; the brachial and cervical painsof angina pectoris; the costo-xiphoidal pain of diaphragmatic pleurisy and pericarditis. Rectal pain often extends to the thighs, especially in elderly, constipated men, and such pain should always call for a rectal examination. In affec- tions of the colon pain is generic viagra specs generic viagra specs frequently felt in the precor- dial region. Chronic colitis causes the arrest of frecal matter at the bend of the intestine between the trans- verse and descending colon, and the precordial pain arising viagra sale tesco from this is a source of frequent errors in diag- nosis. Of one hundred persons complaining of heart disease, about seventy have some affection of the colon. Ovaritis often gives rise to intercostal pain, and viagra sale tesco when the cause of a persistent neuralgia of this viagra sale tesco region in a woman cannot be found, it is well to viagra sale tesco con- sider the possibility of ovarian trouble. Pain upon pressure gives more precise information to the physi- cian than any other. When this exists at the points of emergence of nerve branches only, it indicates a neuralgia. When it exists along the entire course of the nerve the case is one of neuritis. The absence of pain upon pressure viagra sale tesco in cases of spontaneous pain indi- cates its reflex nature. Femoral Cystocele. viagra sale tesco Dr. Thierier, of Brussels, re- ports a case of this uncommon disease. The patient,