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prehension as to their nature and the problem of the tuberculosis of adults might be solved at the same time. Which is more important, the reduc- tion of the death rate or the reduction of the num- ber of cases? Oct. 16, 1915] MEDICAL RECORD. 659 Medical Record. -4 Weekly Journal of Medicine and Surgery. THOMAS L. STEDMAN, A.M., M.D., Editor. PUBLISHERS WNI. WOOD &. CO., 51 FIFTH AVENUE. See fourth page following reading matter for Rates of Subscription and can you buy viagra over the counter in mexico Information for Contributors and Subscribers. New York, October 16, I9J5. SOME INTERESTING PHENOMENA ASSOCI- ATED WITH MIGRAINE. Migraine is a frequent and interesting disease, and much has been written by various authors in the past concerning its generic viagra order online possible relationship to epilepsy, in which it has practically been proved that clinic- ally migraine and epilepsy are first cousins. But there are many neglected phases of this condition which are surely deserving of wider recognition than they have as yet received. And in a disease which is of such great frequency as hemicrania, this information should be further popularized. In most cases of migraine the manifestations consist of nothing more than recurring periodic headache of a varying degree of severity, often associated with gastric distress, blurring of vision, and scoto- mata, frequently colored. But we know that in some cases we also find that hemianopsia, hemi- paresis, hemiparesthesia, astereognosis, hemiplegia, anesthesia in the distribution of the fifth nerve, ophthalmoplegia, recurrent facial palsy, aphasia, and even mental disturbances may accompany and e.xist as sequelae of the migrainous attack. In the great majority of cases these phenomena of generic viagra order online a focal nature are transitory, and it is believed that they are due to temporary vascular spasm, a theory which is supported by the clinical history of such cases. Now, although migraine is as a rule harmless, J. Ramsey Hunt of New York has recently pointed out {American Journal of the Medwal Sciences, generic viagra order online September, 1915) that paralytic and other persist- ent sequelas of migraine also occur. These perma- nent focal symptoms are rare, but they may be very serious. They include facial palsy, ophthal- moplegia, organic hemiplegia with aphasia, hemian- opsia, and optic atrophy. Before becoming perma- nent, as sometimes rarely occurs, these symptoms reappear in recurrent attacks, each of which is transitory, but at times becoming more and more prolonged until finally a permanent attack may ensue. It is evident that these atacks must have some pathological basis, which probably is essen- tially a vascular spasm. Nor must it be forgotten that vascular accidents, such as hemorrhage and thrombosis, are much more liable to occur in one who, in addition to his migraine paroxysms, is suf- fering from some degree of cerebral arteriosclerosis, than in one whose cerebral blood-vessels are per- fectly normal. In order to make a diagnosis of persistent and other permanent sequelae following migraine, or of what may be called migraine paralysis, one must be certain of a definite clinical history of true, essential, or idiopathic migraine, and of the direct relationship can you buy viagra over the counter in mexico of the paralytic condition to the mi- grainous attack. So-called warning symptoms, generic viagra order online con- sisting of recurrent transient ptosis, diplopia, hemi- anopsia, hemiparesis, aphasia, and Jackonian seiz- ures are not infrequent. Anatomically there is found a disturbance in the region supplying the area in which function has been lost, the patho- logical lesion in the permanent paralyses accom- panying and following migraine consisting of vascular thrombosis (as a rule) or even of vas- cular hemorrhage — in other words, vascular lesions of a permanent nature. In all such cases the blood and spinal fluid should be subjected to a com- plete can you buy viagra over the counter in mexico examination, and syphilis should be excluded as an etiological factor. THE CURABILITY OF TUBERCULOUS MENINGITIS. From time to time there is reported in medical literature a case of complete recovery from a dis- ease in which the diagnosis of tuberculous menin- gitis has been established both clinically and bac- teriologically. The generic viagra order online importance of making a crit- ical analysis of every report of this nature is quite obvious. There can no longer be any question as