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About two generations ago Dr. Oliver Wendell Holmes made a famous list of questions which, a hun- dred years hence, his spirit would like to ask, regard- ing progress in earthly matters. One was, " In fatal disease, is euthanasia as yet a. fait accompli?" So far as gangrenous, perforative, or acutely suppurative appendicitis is concerned, that question will be an- swered as soon as the opium treatment shall be regu- larly adopted. I wonder if Dr. Greene realizes the probable dura- tion of the discussion into which he so light-heartedly enters? I do not wish to alarm him, but when time shall be no more and when all the prophecies are ful- filled, there will still be found the surgeon laboring patiently and prayerfully with his medical brother re- garding appendicitis; and the family practitioner pointing out to the surgeon, gently and with Christian resignation, that two and two equal six. Indeed, viagra women fda some family practitioners seem cultivating a very pretty talent for mathematics. The figures of Dr. MacArtney, 1 of the physician at a meeting of the American Medical Association, quoted (unnamed) by Dr. Wyetlv and of Dr. Waldo 3 amply prove this. I 1 Medical Record, May 2d. '-' Ibid., May 9th. 2 Ibid., May 30th. viagra images pill 8/6 MEDICAL RECORD. viagra women fda [June 13, 1896 never was good at figures myself. Therefore these, with their twenty-four to seventy-five consecutive cases of appendicitis treated medically without a death, fill me with the greater admiration. The statements of these mathematicians refer to di- agnoses in which they evidently believe, and that be- lief must be treated with respect. But what shall be said of viagra images pill Fitz Hektoen ? he who " finds that thirty-five per cent, of all bodies in the dead-room show traces of appendicitis" (Greene). His assertion is not, like theirs, a matter of opinion. He refers to appendices actually seen at autopsies. Hence there can be no doubt, and our respect for him is proportionately deep- ened. Here is a rare spirit viagra women fda a real adept at the gen- tle art of embroidery. As Dr. Greene has reason to remember, the writer is so placed as to have had for many years opportunity to know the facts in demonstrating operative surgery. Observe this quotation from Dr. Senn which Dr. Greene brings in as an argument for his position: "The removal of the appendix should be limited to those cases in which during the first attack symptoms arise which portend danger to life and relapsing ap- pendicitis. Some cases of appendicitis yield to medi- cal treatment, and in a large percentage of such cases the patients remain free from a second attack." This seems to me, after a cautious perusal, quite harmless. The first sentence is a trifle loose in its grammar; but as a statement the whole thing is safe for the young and for family reading. I )rs. Fenger and Lamphear fare rather badly at Dr. Greene's hands the former on the strength of viagra images pill a viagra women fda con- versation a year ago, the latter regarding a paper writ- ten several years back of this day of grace; and both gentlemen he quotes from memory only. However, they need viagra images pill no defence from me. If they have at anv time said anything for which they are now sorrv, I am sure they are glad of it. My own small addition to this controversy is an en- tirely new idea, and is dedicated to the medical statis- ticians aforesaid. It is that we should not regard every case of pain in the right side of the abdomen as being appendicitis. There are at least a dozen other sources of pain there. This novel thought, which must strike them as a bold conception, is offered with diffidence. To Dr. Greene I would present my compliments and the hope that he will viagra women fda not construe anything I have s.iid as meaning that I cut in every case of appendi- citis to which I am called. That would be far from the truth. Robert 11. M. Dawbarn, M.D, I05 W: , -FOI R : M S [ REE t , \l W V June 1 Asepsis in viagra women fda Country Practice. Where it is impos- sible to secure the appliances of a clinical amphithea- tre for an operation, the water used in washing the hands, the seat of the operation, etc.. should be boiled for an hour. All brushes should be boiled. The sur- geon viagra images pill should carry with him antiseptic soap, alcohol, and a solution of sublimate. lie should also carry- handkerchiefs, aprons, bandages, silks, drainage tubes, etc., in a Mehler's sterilizing apparatus. Just before the operation all instruments, cloths, etc., should be boiled again. When possible the room should be wiped up with a damp cloth two hours before the oper- ation, and all curtains, hangings, et< ., 1. -moved. The patient should be bathed, and all washing-utensils, tables, and, in fact, everything to be used, should be carefully viagra women fda cleansed and disinfected. With infinite viagra women fda pains the difficulties of a country practice may be ome and operations may be crowned with viagra women fda suc- cess.- Munch. med. Woch., Nos. 49-51, 189 5.