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to the authenticity of many of the cases of recovery from tuberculous meningitis so far recorded. That these cases constitute an almost infinitesimal pro- portion of the total number of cases nombre generico del viagra en chile of this dis- ease must be admitted, but they provide the one bright ray of hope in stimulating whatever thera- peutic efforts may be at the disposal of the prac- titioner. An example of the few cases referred to above is perceived in the case reported by Ferdinando Fonzo in La Pediatria, May, nombre generico del viagra en chile 1915. The patient was a girl eleven years of age nombre generico del viagra en chile belonging to a tubercu- lous family, who for a year and a half prior to the illness for which she came under observation had suffered frequently from an irregularly remittent fever with occasional chills. The patient was first seen by the author on the seventh day of an attack that was ushered in by a chill, and that was ac- companied by a fever with slight remissions, and during the first few days by a slight cough. On the fifth day of the disease there was first noticed a clouding of consciousness, and there were then manifested involuntary movements of the facial muscles and of the arms and legs, strabismus, and seizures of vomiting. Physical examination re- vealed the characteristic objective signs of menin- gitis. By lumbar puncture there were removed under moderate pressure 40 c.c. of a limpid cerebro- spinal fluid, in which there formed on standing a fibrinous reticulum, and in which on microscopic examination there were detected the typical acid and alcohol-resisting bacilli of Koch. Following the 660 MEDICAL RECORD. [Oct. 16, 1915 performance of lumbar puncture the general con- dition of the patient improved, at the end of six days the sensorium was apparently normal, and fif- teen days after the beginning of the illness the patient was regarded as clinically cured. There can be little doubt that the above case was one of tuberculous meningitis. Fonzo interprets the initial symptoms as the expression of an in- fluenzal infection in a patient harboring a latent best place to buy viagra online reviews 2013 tuberculosis. This period of latency would cor- respond to the first stage in Hamburger's classifica- tion, in which stage there are healed or latent lesions in the lungs or tracheobronchial lymph nodes. The second stage is characterized by the diffusion of the infection from these lymph nodes throughout the entire body, and the third stage by the development of ulcerative lesions in the lungs. According to this conception tuberculous menin- gitis would represent the transition from the first to the second stage. This transition, initiated by whatever cause, whether traumatic or infectious, breaks down the barrier of defence during the first stage. In the case reported by him nombre generico del viagra en chile Fonzo believes that an attack of influenza precipitated the general diffusion of the tuberculous infection. THE TEACHING FUNCTIONS OF BOARDS OF HEALTH. In recent years there has been a great increase of State and city health department pamphlets in- tended for the information of the public. It is en- couraging to note that President-emeritus Eliot of Harvard University is a strong advocate of such work. He says that there is nobody to give Ameri- cans the sort of instruction they need about tuber- culosis, alcoholism, venereal diseases, prostitution and diet, and to give it with authority, except the medical profession and the public health officials (American JourTwX of Public Health or Social Hygiene, September, 1915). This statement is well substantiated by the fact that tuberculosis con- tinues to spread — thus showing that public opinion has not forced adequate control of this disease, al- though its infectiousness has been known and widely taught for a generation past. In regard to alco- holism it has not been brought home to the entire population that the habitual use and above all the abuse of alcoholic beverages reduces the productiove efficiency of the community. There is great room for improvement over the present ignorant way of dealing with habitual drunkards. Public neglect and silence about venereal diseases are no longer justifiable, since recent discoveries have made the diagnosis more certain, and the treatment more effective. Interest should be quite as strong in these as in any other communicable diseases. The proper handling of venereal diseases by the public naturally leads to the question of how the public should treat prostitution. "Recent in- quiries have demonstrated that more than half of the prostitutes in a modern city, or a rural com- munity, are likely to be feeble-minded women." The public needs to be aroused on this subject. The remedies usually suggested, namely, license, regu- lation, and segregation, have failed in Europe and in Asia. It is essential that true information on this subject be given to the public. "The ignorance of the American people concern- ing individual, family, and public hygiene is vast; and its consequences are deeply to be deplored. . . . The ignorance of the American people con- cerning the enjoyable, healthful, and productive use of foods is profound ; and this ignorance results in immense waste, reduced industrial efficiency, un- necessary ill-health, and shortened life." The ordi- nary American eats too much protein. It is a