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are engorged. Hemorrhages are always present. Since we have a definite species of bacterium to deal with in this affection, it is imperative that we show whether the germ or its toxin is at work, nr both. It viagra dosage instructions has been established by experiments and clinical observation that, whatever exotoxin tliere may be, it is a negligible quantity and of no great toxicity. Nor is the endotoxin very toxic. I have succeeded in liberating the endotoxin, and found that the viagra dosage instructions product of viagra per femra a suspension of a virulent virus, of which 0.1 c.c. did bring a monkey down in six days, would kill a rabbit of 900 gm. only when in- jected with 15 c.c. Clinically we have cerebral symptoms of a mild type, which viagra dosage instructions are due to a hyper- emia, and not excessive toxemia. And lastly, the cytological findings in the blood and spinal fluid of cases of poliomyelitis are so typi- cal that for a time those were thought to be the criterion of the affection. The blood presents quite early in the disease a leucocytosis, with a predomi- nance of mononuclears. The spinal fluid in the early stage is clear, and contains 85 per cent, or more lymphocytes. The cell count may range anywhere from 30 to 900 cells per cubic millimeter; its globulin content is increased, and its reducing prop- erty of Fehling's solution is intense. I, therefore, conclude that: 1. Landry's paralysis is a clinical entity with varying pathological changes. These may be primarily in the peripheral nerves, and confined to them, or they may be myelitic only, and again neurocellular. 2. Poliomyelitis is a pathological entity with varying symptom complexes. There may be flaccid paralyses, with muscle atrophy, or spastic paralysis, or cranial nerve involvement, viagra per femra also ataxias and tremors, or mixed types. BIBLIOGRAPHY. Westphal: Archiv far Psychiatrie und Ncrven- kranklicitcn, Bd. VI. Eisenlohr: Virchow's Archiv. Bd. 73: Centralhlatt fur Ncrvenheilkundc, 1883, and Deutsche medizinische Wochenschrift, 1890. Oppenheim: Lehrbuch der Nervenkrankheiten, 1908. Chantemesse and Ramond: viagra per femra Revue Neurologique, 1898. Baumgarten : Berliner klinische Wochenschrift, 1895. Curschmann: Verhandlungen viagra dosage instructions des Congresses fuer innere Medizin, Wiesbaden, 188G. Centanni : Ziegler's Beitraege, Bd. VIII. Remmlinger : Societe de Biologie, 1896. Oettinger and Marinesco: Scmuine medicate, 1896. Marie and Marinesco: Semaine medicale, 1895. Bailey and Ewing: New York Medical Journal, 1896. Buzzard: Brai)i, 1903 and 1907. Courmont and Bonne: Archives de Neurologic, 1899. Hunter: Review of Neurology and Psychiatry, 1906. Hun: New York Medical Journal, 1891. Girandeau-Levy : Revue Neurologique, 1898. Goebel: Mihichener mcd. Wochenschrift. 1898. Burghardt: Charite-Annalen, XXII, 1897. Lugaro: Pathologische Anatomie, Flatau, Minor und Jacobsohn, 1904. Wappenschmidt: Zeitschrift fiir Nervenheilkundt ; Bd. XVI, 1900. Walker: British Medical Journal, 1895. Pfeiffer: Brain. Vol. XXXV, 1913. Mosny and Moutier: Archives de Medecine Experi- meutale, 19T1. Fisher: Landry's Paralysis, Joiir. Am. Med. Assn., 1914. 121.5 Park Avenue. MEDICAL COLLEGES RESPONSIBLE FOR MANY SPIRIT AND DRUG ADDICTS. By T. D. CROTHERS, M.D., ilARTFORD, CONN. It has been observed that some professors of thera- peutics who enthusiastically praise opium, its alka- loids, cocaine, and coal tar derivatives for their good effects, are literally training a certain number viagra dosage instructions of students to become addicts in the future. Sta- tistical studies of inebriates and drug takers, par- ticularly among the medical profession, viagra dosage instructions indicate that a certain number began to drink and take drugs during the time of medical training. Years ago this was more common than at present. The 438 MEDICAL RECORD.