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of the foot and extended. The temperature was septic and on consultation Dr. Fiske amputated the limb at the point of selection, in the thigh, antero-posterior flap. The femoral artery was found atheromatous. Before the operation the urine contained 7.5 per cent, of sugar, five days afterward only 2.5 per cent., and within a few weeks the sugar had disappeared entirely viagra united-pharmacy and the man's health had become better than it had been in years. In Dr. Powell's paper read before a meeting of the New York State Medical Society it appeared that in eleven cases viagra united-pharmacy of amputation viagra united-pharmacy for diabetic gan- grene t\\e patients died. The more dangerous cases were those in which the urine contained albumin in addition to sugar. Dr. Fiske also presented a woman, aged sixty-one, viagra united-pharmacy whose online viagra sell breast he had amputated for ulcerating carci- noma a year ago. Her urine had contained more than two per cent, of sugar and sugar was still present, but the breast had healed favorably and there had been no recurrence of carcinoma. The pectoral muscles and axillary and clavicular glands were removed with the breast. Intestinal Fistula ; Suture Dr. E. M. Foote presented a boy, sixteen years of age, who had had a fistula in the right groin for two years. At first it had discharged pus, then faeces. The history was some- what indefinite. Dr. Foote closed the opening in the intestine eighteen days ago by incision in the loin. Union had been complete. Separation of Epiphysis of Head of Humerus. Dr. John viagra united-pharmacy B. Walker presented a boy, three years old, who had been brought to him while the shoulder was enormously swollen, and with a history of having fallen. Motion was obtained just below online viagra sell the tuber- osity; no crepitus. He made a diagnosis of separa- tion of the epiphysis. The child now had almost perfect use of the arm. Plastic Operation for Restoration of the Ear. Dr. IS. F. Curtis presented a man advanced in years, illustrating the online viagra sell result of an attempt viagra united-pharmacy to restore the ear by plastic operation after its removal for epithelioma. Only the online viagra sell lobe of the ear had been left. An extensive flap of integument had been raised from the neck and gauze placed beneath it: then the lower attachment was di\ ided and the flap, attached bv a pedicle above, was turned viagra united-pharmacy over, modelled somewhat in imitation of the normal ear, and attached by sutures. The result had been fairly good, but in spite of the size of the May 30, 1S96] MEDICAL RECORD. ?S 7 flap it had shrunken so much as to permit of but little further shaping. He hoped to overcome its viagra united-pharmacy tendency to droop by a online viagra sell further minor operation. Skin grafts had left the wound in online viagra sell the neck nearly of the appear- ance of the surrounding integument. Discussion viagra united-pharmacy on the cases being in order. The Chair- man said Dr. Fiske's case reminded him of one of cellulitis of the hand in which the complaint had started from a small wound and had run a very obsti- nate course. Finally sugar was discovered in the urine, which cleared up the case; they amputated the arm just below the elbow with good result, and the patient was still living in fairly good health, although the urine was not free from sugar. Dr. Lilienthal said he had amputated the breast in sl young woman whose urine contained five per cent. of sugar, and, although the wound healed primarily, yet there was no reduction in the amount of viagra united-pharmacy sugar. It had been his observation that in amputation of the .thigh for gangrene the sugar disappeared from the urine, but why it should disappear in such cases and not after amputation of the breast, he was unable to ^explain. Dr. John Erdmann, commenting on Dr. Walker's case of separation online viagra sell of the epiphysis of the head of the humerus, said he once read a paper on some cases in all of which he was able to make out some motion and to feel the bicepital groove. Multiple Calculi of the Prostate Dr. L. Bolton Bangs read the paper. By calculi of the prostate was .meant those which formed within the body of this gland from material furnished by the gland exclu- sively viagra united-pharmacy material which did not come from the urinary tract and viagra united-pharmacy primarily had no admixture of urinary salts. They formed insidiously, grew slowly, and occupied a sac which they painlessly made for themselves within the tissue of the prostate. They were usually multi- ple; under certain conditions two or more might amal- gamate and form a stone of considerable size. They were found during midlife, but were said to exist even during childhood. Under the head of prostatic calculi the text-books had recorded many interesting cases, but some of these were not such, strictly speak- ing, and online viagra sell should have been described as urethral calculi. As many as three hundred had been found. As viagra united-pharmacy a rule they did not cause symptoms except after erosion into the bladder or urethra, when the mass had at- tained considerable size. They were not infrequently met with at autopsy in considerable numbers and size in persons who had had no symptoms during life. In these days of castration for enlarged prostate, the viagra united-pharmacy pos- sibility of a mistake in diagnosis should be borne in .mind. The theory of viagra united-pharmacy the formation of prostatic calculi was that they started in the minute concretions which were found microscopically in a large proportion of prostates examined after death. Some observers re-