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and when the seizures become frequent and the period between attacks short. It is known also that each attack places the epileptic in danger not only directly from the mechanical or internal complica- tions, as for instance, suffocation or cerebral hemor- rhage, but also from external accidents, such as burning, drowning, etc., which easily occur. As regards drug treatment we still consider bromides the best, but the treatment with them should be individualized and based upon the follow- ing principles: It viagra in manila has viagra in manila been established by experi- ments that the administration for a long period of equal doses of bromides and alkalies produces an in- creased retention of the bromine and a simultaneous reduction of the chlorine content in the organism. This retention is the result of insufficient elimina- tion of the bromine ions through the kidneys, which treat the bromine ions and the chlorine ions equally. The volume of the retention depends on the amount of the bromine ions and chlorine ions introduced into our body. The less sodium chloride is admin- istered together with the bromides (especially so- dium bromide) the greater is the accumulation of bromine in our organism, and vice versa. The administration to and the excretion of fluid from the body, our weight, and probably other in- dividual unknown factors promote also this bromine accumulation. The retained bromine remains as bromine ions in the blood serum and tissue fluids, and the osmotic pressure in them remains constant through the elimination of some chlorine ions. These experiments bring to light the antagonism between chlorine and bromine in our body, and es- tablishes the fact that the presence of chlorine ions reduces, and the absence of them increases the effect of bromides. This has brought about the necessity of developing a standardized schedule of dieting in which the amount of salt would be reduced, and has pointed out the viagra in manila principles directing bromide medi- cation in epilepsy. Toulouse and Richard in 1899, and later Balint, Ulrich, and others, made careful observations and investigations on the salt-free diet. This diet con- tained only 2 grams of salt per day viagra natural para mujeres and did not gain popularity and acceptance. After a certain period the patient refused to follow it because it did not taste good, and the viagra in manila physicians discontinued it because the appetite and nutrition of the patient suffered. The patients showed some symptoms of cachexia and became sensitive to bromides and chlorides, that is, the patient had convulsions when a small increase of sodium chloride in the diet was allowed, or he showed intoxication symptoms when a small amount of bromides was added. The regulation of the amount of salt in the diet was resorted to. Such a schedule of dieting con- tained 10-12 grams of salt a day, while the normal content of salt in palatable food contains 20-30 grams. The meals were prepared partially without salt, using it on the table. A combination of so- dium bromide, sodium chloride, and extracts of veg- etable albumin and condiments, known as Sedobrol, was dissolved in warm or hot water and put on the food to make it palatable and to substitute the neces- sary bromide medication. For instance, meat was cooked without salt and when served on the table it was covered with the above solution. Potatoes were boiled without salt, sauerkraut was thoroughly washed before cooking, other vegetables were slightly salted, and the bread contained 0.8 to 0.9 per cent, of sodium chloride. Tablets of this prep- aration made this regime or dieting easy and the treatment of certain cases possible at home. In the treatment of epilepsy we have to bear in mind that all cases of idiopathic origin represent two groups: (1) viagra natural para mujeres Epileptics who are meantally and physically intact and strong; (2) epileptics who are mentally and physically defective and debilitated. In the first group we should start with bromides, 15 grains a day, giving the usual food but eliminat- ing soups or preparing them without salt. Meat, 480 iMEDICAL RECORD. [September 18, 1915 vegetables, and bread are given as usual with salt. In one, two, or three weeks, depending on the in- tensity of the case, this dose should be doubled and continued for a long period (several months). Only exceptionally later is it necessary to viagra in manila resort to 3, 4, or 5 grams a day of the bromides. Soups and vege- tables can be prepared without salt and made palat- able by the addition of Sedobrol. Strong salted foods, such as cheese, ham, and similar things should be avoided. The treatment in cases of epileptic insanity and demented epileptics included in the second group should be directed quite differently, and cannot be successfullj- conducted at home. It is a great mis- take in such cases to strive to reach a period free from the convulsive seizures. Instead of the sup- pressed convulsive attacks there appear the so-called status equivalents, viagra in manila excitement and confusion with hallucinations, which are worse than the motor seiz- ures. It is known also that epileptics with confu- sions and twilight conditions clear up after the convulsive attacks. In such cases one should start with half a gram (8 grains) of bromide salts, con- tinue for several months viagra in manila with this dose and then gradually increasing the dose reach two or three grams a day. When viagra in manila the equivalent symptoms ap- pear one should reduce the dose gradually or give small doses of sodium chloride viagra in manila (2-5 grains or