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Januschke and M. Masslow conclude that calcium ions in large doses are not capable of counteracting the acute hyperexcitability of the motor centers in the viagra coupon free trial brain, medulla, or spinal cord, or the motor nerve endings in the skeletal muscles. The combination of calcium and bromine ions in acute cases of motor ex- citability is not more effective than the use of bromine alone; nor is calcium bromide more effective than sodium bromide.^ — Zeitschrift fur die gescmte experi- vientelle Medizin. Oct. 2, 1915] MEDICAL RECORD. 581 The Scope and Function of the Medical Depart- ment. — In a viagra expiration paper read before the fifth mid-year meeting of the Medical Section of the American viagra coupon free trial Life Convention Charles F. Coffin pointed out that it was quite apparent that the scope of the med- ical department of viagra expiration a life insurance company was an exceedingly wide one. First, it had its own specific place as a department of the corporate or- ganization. It had its own specific daily duties growing out of its definite work. It was also quite apparent that it had viagra coupon free trial a tolerably definite relation to the actuarial department, an important relation to the legal viagra coupon free trial department, and a vital relation to the agency department. The following extract from a paper read at the St. Paul meeting by Dr. DeVancy was read: "A medical viagra coupon free trial director who confines his duties to merely looking over papers and appointing examiners does not earn his salary, if it is very large. His position is one of trust, requiring judgment, honesty, and unlimited diplomacy. If I were organizing a com- pany, I would select, as medical director, a man who, along with his medical knowledge, possessed ^ood business judgment and marked diplomacy, for his duties are largely executive, requiring these qualifications. A medical director who is not in himself a stimulant to the business of his own com- pany is more or less of a failure. He should be viagra coupon free trial a living, vital, active force in the official staff of the company." He also quoted Mr. Hopp, who said at the San Antonio meeting: "The ultimate object of all activities in the medical department, is the attainment of a favorable mortality experience. Success in that direction rests chiefly upon a care- ful selection of risks and an effective control of medical examiners." As a careful selection of risks, ■so far as the medical department is concerned, be- gins with the duties of the examiners, the efficient control of medical examiners may well claim our consideration as the one great direct responsibility of the medical department; and it is the responsi- hility receiving in the viagra expiration majority of cases the mini- mum of systematic attention. After stating that the duties of a medical director were more onerous by far than is viagra coupon free trial recognized gen- erally the writer quoted Dr. Talbot, who at the New Orleans meeting, said: "As a rule, the best ■examiners for large towns or viagra coupon free trial cities are young men with hospital training, who have not been in prac- tice long enough to have their time fully viagra coupon free trial occupied viagra expiration and whose hospital training offsets the short time they have been in practice," and then went on to ■say that they should be intelligent and well educat- ed, both generally and professionally. They should he appointed only after a careful inspection and only such physicians should ever be appointed as show some aptitude for the work required ; an inter- est in the business of life insurance, and a willing- ness to study its general principles viagra expiration ; a responsive- ness to viagra coupon free trial the needs of the field, a clear conception of his duty to the company, and a genuine confidence in the strength and character of the company in whose service he enlists. The examiner selected must now be trained and this training or special education must be so planned, so applied, and so persistently applied as to produce, as nearly as possible, the ideal to which reference has heretofore been made. In the second place, the medical department had a tolerably definite relation to the actuarial depart- ment. It was further pointed viagra coupon free trial viagra coupon free trial out that the medical department had an important relation to the legal department, and finally attention was drawn to the vital relation of the medical department to the agency department. The medical department and the agency department, or to be more specific, the medical director and the agent were so closely re- lated that each was useless without the other. It was important, it was indispensable that harmony and a spirit of sympathetic cooperation should be established and maintained between these two strategic persons. The agent's work was hard. Competition was keen and not always ethical. The agent, as a rule, was on a commission, not on a salary, and a rejection of an application was, to him, a serious matter. He viagra coupon free trial was subjected to great strain, viagra expiration to much annoyance viagra coupon free trial by the indifference and indecision of his prospects; to discouragements and obstacles before viagra expiration which most of us would retire defeated, if not routed. These were facts which a true medical director would never forget and they furnished a basis for sym- pathy and patience even when the fatal word "de- clined" must be written across the application. The relation between the agent and the medical director must not only viagra expiration be friendly and sympathetic : it must be personal as far as possible. Carelessness in Physical Examinations for Life