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[September 18, 1915 have higher capacities against diseases of the lungs than either the skin or the intestine. On the other hand, this does not mean that the skin and intestine have no powders against diseases of the lungs. The night sweats of phthisis, viagra generico in italia the burning skin and sweat of the crisis of pneumonia seemingly nega- tive this. Leaving the first question in abeyance, what evi- dence is there viagra generico in italia of interchangeable or assisting powers in the skin, the intestine, and the nose? Crude savages and our ablest physicians alike pay attention to the condition of the skin and bowels in cases of fever, and prescribe accordingly. According to viagra generico in italia writers of textbooks on diseases of the skin, attention to the bowels is the most eflfica- cious method of treatment in almost all of these complaints. Confirmation of these ideas is found in my experi- ments on tuberculosis. If a tuberculosis derelict is put under treatment, one of the earliest signs of improvement is in the skin, which loses its muddy appearance. Especially is this noticeable in the conjunctiva. It explains viagra paypal bestellen the use of poultices, blisters, putting the feet in mustard and hot water in cases of colds, and a thousand and one old-fashioned but effective home remedies, as also many drugs. Having practised among Chinese, their belief in blisters has often struck me. The correctness of their opinions can, however, be shown experimen- tally. In an advanced case of malignant disease of the breast, which had been operated on to its utmost limits and afterwards .r-rayed, there were in addition to the enormous growth numerous ul- cerated scars. The patient was blistered over a healthy area. The fluid obtained mixed with saline solution was injected into the subcutaneous tissue. The cancer was unaffected, but the ulcerations showed marked and rapid signs of healing over, be- fore the patient's death. There is no wish in this paper to prove anything. It may possibly assist clinical physicians. The number of side issues is enormous. With the ex- citement and duties of the war it is difficult to write even in this sketchy manner. Hotel de l'Alliance, hopital militaire 37a, Dieppe, France. SYPHILITIC ARTHRITIS. By H. C. stein, M.D., NEW YORK. viagra generico in italia ASSISTANT SURGEON DISPENSARY AND HOSPITAL FOR DEFORMI- TIES AND JOINT DISEASES. Syphilis is responsible for about 20 per cent, of chronic joint diseases. Fifteen per cent, of joint cases seen at the Hospital for Deformities and Joint Diseases give a positive Wassermann test, and as the Wassermann is positive in only 80 per cent, of syphilis, we should infer that about 20 per cent, of cases of chronic joint conditions have their origin from syphilitic infection. Joint lesions are among the chief manifestations of syphilis. According to von Huppel, 56 per cent, of congenital syphilitics develop arthritis, and a large percentage in the ac- quired form. Many cases of suppurative bone and joint conditions of childhood are luetic in origin. Owing to its frequency and the rapid improve- ment obtainable with specific treatment, the neces- sity for an early correct diagnosis viagra generico in italia is imperative. Yet, this group of cases is very often, if not in the majority of cases, incorrectly diagnosed by general practitioners. We see in this hospital daily, patients suffering from syphilitic arthritis who have been treated by various physicians and in various hos- pitals for years as suffering from rheumatism, rheumatic arthritis, tuberculous joints, Potts' and hip disease, viagra paypal bestellen viagra paypal bestellen malignancy, etc., without improvement. The reason for so frequent failures of diagnosis viagra generico in italia in these cases is that the subject has not been suffi- ciently understood, and its frequency not realized until the viagra paypal bestellen Wassermann test came into use. The literature on the subject is very scant. The text books dismiss it very briefly. There is hardly any mention made of it in the medical schools. The neuropathic Charcot joint occurring in tabes, the various bone manifestations as the localized periostitis, the local and diffuse hypertrophic os- teitis, osteomyelitis, and epiphysitis, are well de- scribed and understood, and will, therefore, be omit- ted from this paper. Syphilis is capable of viagra paypal bestellen producing almost every form of arthritis. These may be primary in the joint, or secondary to adjacent bone lesions. The form primary in joint are the arthralgias, acute, subacute and chronic simple synovitis, and gum- matous synovitis. The secondary types result from neighboring bone lesions, as periostitis, osteitis, osteomyelitis, viagra generico in italia or epiphysitis, causng either a sym- pathetic synovitis, gummatous, or fibrous arthritis. The classification of the various types is arbitrary and is made as to their clinical occurrence; certain forms are characteristic at certain ages ; some are characteristic of viagra paypal bestellen hereditary syphilis, and others of the acquired form.