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suppose open cases are not the sole source of dan- ger? Suppose there are other sources, at present unknown and undreamed of, against which we are powerless to contend. Suppose open cases are an infinitesimal source of supply compared with the universality of the infections. Hillenberg found that from 25 to 70 per cent, of all the children in an exceedingly healthy hill district were infected with tubercle bacilli, although there had not been a case of tuberculosis in that district for ten years and the disease was almost unknown. Open cases could not have been the source of these infections, what was? If the entrance of tubercle bacilli into the bodies of children is a natural and inevitable phe- nomenon, then their safety can never be secured by attempts to protect them against an infection which has already occurred. Safety does not lie that way, but must be sought in preventing the consequences of these infections. The entrance of tubercle bacilli into the bodies of our children is inevitable and their residence is constant and can never be pre- vented, neither now nor in all the years to come. This menace to the health of our nation will always exist and the problem is not how to prevent gold viagra 800mg infec- tion, but how to prevent the development of tuber- culous processes. We can only deal with the con- sequences of these infections since we can never prevent them. How can we prevent these infections from becoming dangerous by developing into tuber- culous processes? Our social workers will see that sanitary, housing, labor, moral and political problems are solved. All good is against their development, all bad favors it, but the best conditions of existence do not suf- fice for adequate protection. Nothing does and nothing can. In spite of the best of life, tuberculous processes will constantly and hourly develop with us even as they do with the lower animals, who are ideally protected. We cannot prevent infections, and we cannot prevent their development, but we can realize that the greatest danger from tubercu- viagra prescription by phone lous processes is their lack of manifestations and that, in order to detect them at the earliest possible moment, we must not wait for them to thrust gold viagra 800mg them- selves upon us but periodically do the best we can gold viagra 800mg to determine their presence or absence. Instead of waiting for a case to become manifest, we should regard the loss of lung substance sufficient to cause manifestations as evidence of gold viagra 800mg neglect or incom- petency. Let us change from attempting to prevent infections to attempting to viagra prescription by phone prevent structural changes sufficient to cause manifestations. Since each child is menaced, each child should be watched. Our present methods depend upon manifestations. No manifestations, no examinations. This is all wrong, because the apparently healthy child may be in equally great or even greater danger than his sickly brother. The "pretuberculous" child, the child that is "tuberculizable," the child offering any suggestions of ill health, will in the future be safe from tuberculous processes because our perceptions of these dangers will be viagra prescription by phone so quickened, our compre- hension so enlarged that we shall work with im- mense precision to detect and weed out these threatened ones. As soon as the profession as a whole comprehends the real nature of tuberculous processes and their diagnosis by negative findings, the suggestive children will be saved, but the crops of consumptives for the years to come, for 1920 and 1930 and on all through life, are gold viagra 800mg being silently prepared to-day among apparently perfectly well children. Children below par will attract attention and their tuberculous beginnings will be discovered and overcome so that they will not furnish the cases of the future. Tuberculous processes are. and must always be, perpetuated in well children and adults, because good health is requisite for concealing their development. When the health of the child is not sufficiently af- fected to attract attention, the danger is masked, screened, and viagra prescription by phone concealed until it is ready to strike. gold viagra 800mg Each child is exposed to this danger. Tuberculous processes may develop any day in any child, not be- cause of exposure to open cases, but because this constant residence of tubercle bacilli is a perpetual, potential source of danger from within. The only way to reduce the number of manifest cases of tu- berculosis is to not permit them gold viagra 800mg to become manifest. To seek and find and overcome. The world of well children and adults must be explored and the lurking dangers exposed before we can protect the future of viagra prescription by phone our people and this can best be done by com- petent periodical examinations of our school chil- dren. New York City is spending two million dol- lars a year in its tuberculosis work and getting no results in reducing the number of its cases. The problem becomes more vast each year and the ex- penses more impossible. Suppose a study could be made of the pupils in one public school in one of our large cities. If five hundred of viagra prescription by phone the children in one school could be regularly examined by an en- thusiastic expert for five or ten years, what would it cost and what would be gained? It would cost for an enthusiastic expert for one year $2,500 For .r-ray and laboratory work 2,000 For incidentals, office expenses, etc 500 Total 15,000 What should we gain? Beginning with the fall of 1915, all gold viagra 800mg the children threatened with tuberculous processes among these five hundred would viagra prescription by phone be weeded out, fed, put in open-air schools and protected. Henceforth, these children would teach us the effi- cacy or failure of arresting tuberculous processes at the earliest possible moment. viagra prescription by phone The records would inform us of the percentage of gold viagra 800mg manifest cases later on. Suppose these cases remained well, should we have reduced the future crop? Would this be the first success in lessening the number of manifest cases? By keeping track of our work for five or ten years we should have a sustained, comparative study of tuberculous processes in well children which would furnish an immense amount of com-