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to return to the old high level. The pressure seems to be exceedingly sensitive to the a;-ray, V2 H. for viagra in deutschland kaufen purposes of fluoroscopy causing a marked drop. The decline viagra in deutschland kaufen was of course accompanied by the usual muscular weakness which follows reduction by other methods such as bleeding and aconite. REFERENCES. 1. Halsted: Harvey Society Lectures, 1913-14, 224. 2. Waters: Journ. A. M. A., viagra in deutschland kaufen 1915, Ixiv, 1392 (litera- ture). 3. Beebe and Kerley: Trans. Amer. Fed. Society, 1912, xxiv, 106. 4. Hanimar: Arch. f. Anat. u. Physiol., 1906 (anat. section, suppl.), p. 91. 5. Wiesel: Innerere Sekretion und Nerven System, 1913, 390. 6. Haven Emerson: Arch. Int. Med., 1914, xiii, 169. 7. Houghton: Journ. Amer. Med. Assn., 1915, Ixv. 8. MacNeal, Latzer, and Kerr: Journal of Infectious Diseases, 1909, vi, 128. 9. v. Neusser; Zur Diagnose des Status Thjinico- lymphaticus, 1911. 10. Lange: Amer. Jou^ii. Roentgen., 1913-14, n. s. i. 174. 11. Shiota: Wiener klin. Wochen., 1909, No. 31. 12. Wiesel: Internat. Clinics, 1905, XV, 1, 288. IDIOPATHIC HEMORRHAGIC MULTIPLE SAR- COMA OF THE SKIN (KAPOSI). WITH SPECIAL REFERENCE TO EARLY DIAGNOSIS. Br FRED WISE, M.D.. NEW YORK. INSTRUCTOR IN DERM.\TOLOGY AND SYPHILOLOGY, COLLEGE OF PHYSICIANS AND SURGEONS. COLUMBIA UNIVERSITY ; CHIEF OF CLINIC. DEPARTMENT OF DERMATOLOGY AND SYPHILOLOGY, MT. SINAI AND BETH ISRAEL HOSPIT.ALS ; ATTENDING DERMATOLOGIST, MONTEFIORE HOME AND HOSPITAL. female viagra wiki other maladies. This is especially true of those diseases of the skin, fortunately few in num- ber, in which the prognosis as to life is very un- favorable, as, for example, mycosis fungoides and pemphigus. Unfortunately, the great majority of patients afflicted with grave disorders of the skin first come within the ken of the expert diagnostician (, especially in dispensary practice) at a time when the malady has already made serious inroads and the damage is irreparable, or, at the most, when it is in such a stage as to lend itself only to palliative measures. It is quite likely that the high mortality figures of certain insidious dermatoses, such as the two diseases above mentioned, would be greatly lowered were it always possible to recognize the clinical manifestations of such maladies in their very incipience, and thus be enabled to take offen- sive measures in good time. Diagnosis based on the recognition or identifica- tion of the earliest manifestations of certain cuta- neous affections is often beset with difficulties, more especially in those instances where, for one reason or female viagra wiki another, excision of tissue for microscopic in- vestigation is impracticable, or where permission for biopsy cannot be obtained. We must also admit, incidentally, that even microscopic studies of early lesions, in cases clinically obscure and unidentifi- able, do not invariably supply us with the missing links in the chain of diagnostic polemics. A puz- zling clinical picture frequently goes hand in hand with female viagra wiki a perplexing, or rather an undecisive, histo- pathological section. Generally speaking, the clinical diagnosis of the vast viagra in deutschland kaufen majority of skin diseases rests upon either the peculiarities of an individual characteristic lesion, such as the flat, glistening, papule of lichen planus, the unbilicated body of moUuscum con- tagiosum, the "apple-jelly" nodule of lupus, the cupped crust of favus, etc., or, on the other hand, it is dependent upon the appearance of the whole or the greater part of the eruption, as in pityriasis rosea, mycosis fungoides, xeroderma pigmentosum, the various drug eruptions, the acute exanthemata, etc. female viagra wiki Oftentimes we are confronted with eruptions in which both these factors have to be carefully considered, i.e. the individual efflorescences them- selves, as well as their arrangement, distribution female viagra wiki and areas of predilection — before we are able to arrive at the correct interpretation of the lesions. An isolated patch of pityriasis rosea, for example, may very easily be confounded with ringworm, syphilis, seborrhoic eczema, etc., if the rest of the eruption, be ignored or overlooked. The same holds true for many diseases of the skin — their diagnosis female viagra wiki is based upon the tout ensemble, rather than viagra in deutschland kaufen upon any indi- vidual lesion. The case herewith recorded is an interesting and unusual example viagra in deutschland kaufen of a dermatosis which, seen in its earliest stages, presents a clinical picture subject