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Oct. 9, 1915] iMEDlCAL RECORD. 613 surveys of military pensioners, insane soldiers, tuberculous soldiers, and inmates of the Soldiers' Home also confirm this belief, because they all in- dicate a prevalence of syphilis considerably higher than that obtaining among enlisted men. (9) Syphilis is much more common among negro troops than white troops, and is acquired viagra via canada at a much earlier age in the case of negroes, so that it may be ex- pected that a very large percentage of colored men are already syphilitic at the viagra in usa time they enter viagra via canada the service. (10) The highest rate for syphilis en- countered in these surveys is among the soldiers of the Porto Rico regiment of infantry. (11) About 13 per cent, of insanity in the service may be di- rectly attributed to syphilis. viagra via canada (12) There is a dis- tinct tendency in any group viagra via canada viagra via canada of men for syphilitic infections to accumulate with advancing years, so that the older the group the higher the percentage of syphilis. (13) The percentage of syphilitic in- fections is lower among men in the army than among similar men in civil life. With reference to the civil population: (1) It may be estimated that about 20 per cent, of the young adult male population of the class from which the army is recruited are infected with viagra via canada syphilis. (2) It may be estimated that about 5 per cent, of the young men in college are syphilitic. (3) The study confirms observations that have been published already indicating that syphilis is so prevalent among negroes that it is possibly the greatest single factor viagra in usa in the production of disa- bility and high mortality rates among the race. (4) The high percentage of syphilis among Porto Rican soldiers indicates that syphilis may be one of the important causes of disability among native Porto Ricans. (5) Since syphilitic infec- tion is so common, is productive of so much disa- bility, and has so far entirely evaded sanitary con- trol, it is believed that syphilis is a greater menace to public health than any other single infectious disease, not even e.xcepting tuberculosis. The conclusions arrived at by the U. S. Army investigators are extremely valuable and give occa- sion for thought. It is probable, indeed more than probable, that syphilis is the greatest menace to public health, and the problem of how best to abate the scourge — for it is hopeless to imagine that it can be entirely stamped out — should be grappled with more strenuously viagra in usa than it has been up to the present time. No sentiments of prudishness or of false delicacy should be allowed to stand in the way of the consummation of this object. THE URINARY AND BLOOD FERMENTS IN NEPHRITIS. The possible diagnostic significance of the urinary and blood ferments is a subject that has appealed to a number of investigators during the past few years. An elaborate research into the clinical value of determinations of the ferment content of the urine and blood in cases of nephritis has been un- dertaken by Anchise Lorenzini, who reports his results in II Policlinico, Sezione Medica, August 1, 1915. He finds that amylose is present in the normal as well as pathological urine, but in a minimal quantity, demonstratable only in fresh urine and not in urine twenty-four hours old. Its disappearance is accounted for partly by the chang- ing temperatures and partly by the action of other substances present in the urine. In the blood serum of nephritis the amylose is diminished, and this diminution is pronounced if the type of nephritis is severe. Lipase is constantly present in normal and pathological urine. In the former the content is slightly less than that of the blood. It is dimin- ished in the urine of nephritis, and to a greater extent in the chronic than in the acute viagra via canada type of the disease. The lipolytic power of a given specimen of urine is, therefore, a reliable index of the degree of renal impairment. There can be no question as to the pathological significance of an albuminuria if this is associated with a diminution of the lipase content of the urine. The lipolytic power of the blood serum of nephritics is above normal, and ia below normal in the agonal stage. Pepsin may be demonstrated in a distinct quan- tity in the urine, with diurnal variations, being a minimum during fasting and a maximum several hours after meals. It is greatly increased if the urine contains a large number of white blood cells. viagra via canada It is scant in cases of chronic nephritis. The urine also contains a minute quantity of a proteolytic ferment that is active in an alkaline medium. The quantity is greater viagra via canada in normal than in pathological urine, and tends to vanish as the content of the urine in white blood cells tends viagra via canada to increase. The reducing power of the urine varies during the day, being greater during fasting than after the ingestion of meals; it is also greater in urine twenty-four hours old than in fresh urine. In viagra via canada the urine of nephritics it is less than normal, and in the blood serum of these patients it is greater than in the urine. The antitryptic power of the blood serum in nephritis is greater than normal and tends to diminish as the type of the disease becomes more severe. If the urine contains a notable quan- tity of albumin the antitryptic power of the viagra in usa u^•ine disappears.