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ative Widal by no means excludes paratyphus infection (the author refers of course to clumping the paratyphus B). When true cholera is simulated viagra indien the prognosis is grave, but subnormal temperature does not necessarily aggravate the prognosis. Sudden onset with diarrhea and vomiting suggests a choleriform infection as well as acute poisoning. Colitis seems to be always present in all paratyphus B infections. The clinical types vary much. viagra indien In one case local symptoms predominate and we see acute gastroenteritis and cholera-like symptoms, pseudo-dysentery, etc. In another, ordinary typhoid is simulated by a combination of local and general symp- toms. In a third type we see an extensive bacterio-tox- emia — a sepsis with metastasis throughout the body. Deutsche medizinische Wochenschrift. July 15, 1915. Dihydromorphin and Diacetyldihydromorphin. — Kolb has been testing these morphin derivatives as sub- stitutes for morphin. He first sought to learn the dose of hydrated morphin, and made use of how many viagra can you take operated goiter patients for this viagra indien purpose. In this way he found that with hydrated morphin twice the dose of ordinary mor- phin is required. In regards to quality of action this appeared to be the same in hypodermic exhibition but hydrated morphin cannot well be given by mouth for it has a marked tendency to cause vomiting. In fact it could well be used as an emetic, were it not for the fact that its action was both slow and distressing. It no doubt acts by causing pylorospasm in a much highei- degree than does morphine. In the protracted use hy- podermically of hydrated morphin there was no de- mand for an increased dosage; in other words it is not habit forming. As is well known diacetylmorphin is heroin, and the author also tested hydrated heroin. This is well tolerated both by the mouth and hypodermically under conditions: viagra indien i.e. up to a certain viagra indien dosage vomiting is rare — as rare as with morphin ; above that dose, however, it begins to be common. Hydrated heroin, like hydrated morphin, is not a habit-forming drug. The two drugs have been used throughout to fill the indications for morphin. Angina Pectoris and Raynaud's Disease. — Schott of Nauheim states that war has introduced new clinical pictures of diseases. This is true especially of diseases of the circulatory system, with or without a nervous component. Infections, febrile affections, attack men who have been undergoing incredible hardships. A soldier, aged 37, had a clean record in most respects. He had always drank considerable beer. A mason by trade, his hands and feet had never been cold during the winter. He bore the hardships of war well. His work was driving a munition wagon and the dust given off from the explosives was irritating to the air passages and at last became a hardship. He con- stantly coughed, sneezed and spat up mucus tinged by the yellow and green explosive material. His fingers now began to show the symptoms of beginning Ray- naud's disease. The troop surgeon allowed him to stop at intervals to warm his hands, but nothing was of any benefit and when blebs developed on his fingers and he could no longer feel anything he was laid off permanently. Examined in the Reserve Hospital he was found to be well nourished, weighing 176. There was no fever. The lesions were limited to the fingers and hands and the toes. The .T-ray showed that the bony skeleton was still intact. The nervous system was normal, aside from the sensory disturbances in the ex- tremities. In about three weeks thoracic symptoms de- veloped. The patient was found to have the lungs which characterize stone cutters and other workers in dust and this was explained by his trade of mason. The state of the heart and vessels was highly com- plicated and repeated examinations were made before a diagnosis could be reached. Both the radial and ankle pulse were at times imperceptible and there was a marked asj-mmetry. A full radial on one side would be associated with absent radial on the other. The cardiac finds also showed irregularity. The area of dullness, the heart sounds, etc., were inconstant. As the composition of the explosive was a secret no exact information could be obtained about a possible chronic intoxication. Picric acid could be excluded through the spectroscopic finds in the blood. It was finally as- sumed that nitrites were in part the offending agent and it was shown that nitrobenzoic acid formed from nitrotoluol was able to cause the syndrome from which the patient suffered. Some of the symptoms, such as precordial pain on climbing stairs could be summed up as stenocardia, due apparently to beginning arterio- sclerosis. These viagra indien yielded to nitroglycerin and diuretin. Arteriosclerotic angina was, however, associated with the vasomotor or functional type. The same combina- tion of the functional and organic was also evident in the Raynaud's disease. The extreme instability of the heart, aorta and arteries, as to form and function, seemed to be a direct result of the chronic intoxication ; but Schott, despite his e.xperience in circulatory path- ology had never before seen such manifestations. Tonsillar Extract in the Treatment of Diabetes. — G. B. Farmachidis concludes on the basis of animal ex- periments and clinical observation that an extract of the faucial tonsil named by him "glycolytic amygdalin" has viagra indien a definite therapeutic value in simple glycosuria and in diabetes mellitus. The extract is administered by mouth. — Ri forma Mcdica. Cardiac Stimulants and the Coronary Arteries. — Sakai and Saneyoski find that toxic doses of strophanthin pro- duce a contraction of the coronary arteries, but that moderate or therapeutic doses have no such effect. Likewise therapeutic doses of caffeine and diuretin cause no coronary constriction ; on the contrary they produce, although not constantly, a dilatation of the coronary arteries. — Arckir fur rxpcriinetitrlU- Patlio- logie niid Pliarmakolor/tc 4i(}