Possibly, the striking improvement that occasionally takes place in apparently hopeless demented katatonics, improvement so marked that they are able to accept a limited amount of responsibility in daily life, once more leads to errors in the classification of recoveries. It is probable that acute articular rheumatism and perhaps endocarditis, are commoner in choreic patients than in patients with other affections, yet three-fourths of the cases of chorea have ueitlier rheumatism nor endocarditis. I think that evidence goes to show that the poison is retained in the mucous membrane longer than is generally considered to be the case.

The jaundice rapidly cleared up, there was no drainage from the wound, and the urine and stools soon became normal.


On opening the thorax, five of the dorsal vertebrae were found covered on the right side by an oblong cyst containing pulpy matter of an atheromatous appearance and consistence. I merely submit this as a suggestion, but would meanwhile remark that the arteries in which inorganic or anaemic murmurs are of most common occurrence, happen to be precisely those from which several large branches arise within a small space: namely, the subclavians, carotids, and abdominal aorta. This fact may explain, in part at least, why patients with kidney disease have, as a rule, actually been made worse by the In my work at Nauheim during the past three years I have observed a number of cases referred for the cure, in whom various grades of nephritis were present. Accordingly, an individual local authority, instead of attempting by themselves to provide the trained medical skill and scientific laboratories necessary for effective committee to discover and keep in touch with all available sanatoria, either in the immediate locality or at a distance." Whether sanatoria and dispensaries, which are essentially curative institutions, should be provided and maintained, either' What the clause renlly means is, I presume, that compulsory notification per se is of little or no administrative value; that compulsory notification should not become merely a means of collecting statistics, but that it must be followed by and conjoined with effective means for preventing the spread of the disease. Thorough ablution, change every article of dress, and allow twentyfour hours or more to elapse before attending to any case of mid wifery. If it is diagnosed early, before tht re is much destruction of the arterial coats and surrounding structures, the cure is often practically complete. The brief period of an interndt, no small part of which must be spent in learning to observe, is far too short to qualify any one for writing on all the diseases of children, and a new edition of his Traite des Maladies des Enfans, which contains three hundred pages more than the former one; but this addition consists of the opinions, worthless as well as valuable, of all who have written on the subject within the last seven years, not of the results of the author's greater experience and maturer them may be termed an instinct. Following removal of the tumor, a shock-like state with marked hypotension is common, generally thought to be due to epinephrine lack. In view of these facts, the kidney function in, and the treatment of, pernicious anzemia require reconsideration. The walls and ceiling should be dry rubbed or lime washed, and the floor should be washed with some disinfecting liquid. Even the means of prevention must be but imperfectly understood until we arrive at a more accurate knowledge of the nature of the disease, and of the circumstances under which it takes its rise. Thigh, fractured the external malleolus and astragalus, and caused great extravasation into the textures of the leg and foot. Most of these are patients who have kidney trouble at the same time. If his rest be broken, it will not be by either of these. Tavo Yariefies of hemorrhage in newly-born babies are met with; or injuries, such as forceps or long-continued pressure on the head not caused by any apparent injury during birth.

Of their previous habits of life, we can speak with more accuracy, as unhappily but few men-of-war sailors are to "at" be found who are not addicted to the vice of drunkenness; and on board of the John Adams, a half dozen temperate individuals probably could not have been selected from the entire crew, if officers and apprentice-boys were excluded. In the interval of a pain, I made an endeavour to press back the tumour, and fancy that I succeeded to some extent, as on the recurrence of the pain the head came down on my fingers, and upon their withdrawal the vertex cleared the pubic arch, and our troubles were Upon passing the finger into the vagina, the tumour was found occupying its original position, apparently unaltered in size or shape, and painless upon free pressure. Decomposition of foodstuffs is not, therefore, an essential element in causing death. It has occurred to an invalid correspondent to ask whether something can not be done to prevent the awful waste of patients' time that goes on in the ante chambers of the leading London medical practitioners. Two or three are taken for a dose every other night at bed-time. The medullary sheaths were wonderfully I consider that the microscopic appearances of the muscle indicate that its substance was undergoing degeneration as the result of the action of some toxic substance in the blood, possibly absorbed from the intestine, and that this degeneration Avas followed by proliferation and remarkable enlargement of the sarcolemma nuclei, these acting in fact as phagocytes and The change which was present in the nuclei in this case occurs to a certain extent in some other pathological states of muscles, but I have never seen it even approaching such a degree as in this case.

The holes are unsupported, making the tube liable to kinking. If, in making these explorations of either valve, the stethoscope be placed half over the dull portion and half over the thin resonant edge of the lung, the object will be sufficiently answered (walgreens). It is noteworthy that, even among the Greeks, the word palastra came to mean a school, and that the most highly educated of modern peoples, the Germans, designate the highest of their secondary schools by the term gymnasium. Page Version 1.05