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may be studied independently of those of the rest of the cardiovascular system. One function of the arteries usually overlooked is their ability to pass blood on into is viagra covered by medicare the veins by means of peristalsis. From the days of Hippocrates and of Morgagni abnormal pulsation of the abdominal aorta has puzzled clinicians. Although the pathology of this condition is still veiled in obscurity, Brunton be- lieves that Morgagni was right in ascribing it to nervous irritation. This is probably produced re- September 11, 1915] MEDICAL RECORD. 445 flexly through the solar plexus by some irritation in the stomach or duodenum and occurs especially in cases in which there is a suspicion of ulcer. A pulsating aorta is to be differentiated from aneurysm by the fact that in the former the pulsa- tion is only in one direction while in the latter the pulsation is in all directions. Abnormally great pulsation is also observed in other arteries, as the innominate, subclavian, and carotid. A frequent throbbing of the large arteries is a common accompaniment of exophthalmic goiter. Brunton believes that the throbbing of the carotids in this disease is due not only to longitudinal elongation but also to lateral expansion and is a manifestation of hyperthyroidism. The throbbing of the carotid on one side in migraine shows that the condition depends partly viagra perdorimi at least upon the nervous system, although the possibility of a tox- emic element cannot be excluded. Functional disturbances of the arterial system due to dilatation, as seen in blushing and in the flushes of the menopause, are less common and of less importance than those due to arterial contrac- tion. One of the most characteristic of these occurs in migraine which has been strdied exhaustively in his own case by Brunton. He finds that the causa- tion of migraine is twofold: (1) a toxemia from the liver is viagra covered by medicare or intestines, and (2) a local cause, such as eyestrain, dental caries, or nasal or aural irri- tation. Other conditions caused by arterial con- traction occur in the acroasphyxia of various de- grees of severity, its most pronounced type being Raynaud's disease. There is no longer any ques- tion, he thinks, that angina pectoris is primarily caused by vascular spasm. So also is the "angina abdominis" thus named by Baccelli but previously described by Brunton and about the same time by Huchard as "angina pectoris pseudogastrique." The point is emphasized that in many cases the symp- toms of vascular spasm occur although the vessels affected are healthy. As the arteries become less elastic with age the tendency to constriction viagra perdorimi fre- quently becomes less marked. But the effects of atheroma may exaggerate the symptoms caused by actual spasm. THE PROPHYLAXIS OF MUMPS. Epidemic parotitis has always been regarded as rather of a negligible quantity among the infectious diseases because of its general harmlessness, and it is probably on is viagra covered by medicare account of this attitude that so little is known about its etiology and treatment. It is true that, in children at least, it is a comparatively trivial is viagra covered by medicare affection and very rarely accompanied by more than a transient discomfort, but in institutions it is apt to occur in epidemics which occasion a great deal of annoyance to the managers and an ex- cessive amount of work to the meager nursing staff. We have no treatment worthy the name, and isola- tion as a prophylactic measure is made difficult by the long period of incubation. As a rule one attack of mumps confers a complete and lasting immunity upon the individual, and it is therefore reasonable to suppose that such a person carries in his blood antibodies against the infectious agent. Working on this theory Hess (Am. Jour. Dis. of Children, 1915, x, 99) has recently been in- jecting the viagra perdorimi blood of immunes into children who had been exposed to the infection. His results are in- teresting for in no instance did parotitis develop in a child thus protected. From six to eight cubic centimeters were obtained from a vein of the donor with a syringe and immediately injected intramus- cularly. The procedui'e viagra perdorimi was, of course, guarded by the Wassermann reaction and in no case was there any rise of temperature or local viagra perdorimi reaction. He found it possible to use as donors patients in whom the swelling had not subsided and the long period of in- cubation permitted inoculation some time after the exposure. Blood injected in this way should not cause trouble because of incompatibility and the whole process seems to be devoid of danger. It should prove of value, especially in orphan asylums and similar institutions, where a large number of susceptible persons are collected. A DISSERTATION ON THE DIAPER. That the dignity of medical science should conde- scend to a discussion of the correct application of the diaper would seem strange were it not for the usurpation of this function by knowing aunts and wiser nurses, who have really retarded the evolu- tion of this important perquisite of the nursery. The time has apparently arrived for a radical dress reform in this most elementary of all garments. From time immemorial infants have protested loud-