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changes; 4, absence of objective sensory defect; 5, absence of fibrillary twitching; 6. rather rapid onset of atrophy and weakness. II. Potassium Permanganate as a Haemo- static. — Buckle reports a case in which he used potassium permanganate as a haemostatic. The patient was a Jewish infant, who- when eight days of age was circumcised. Two or three hours later the nurse noticed that the bandage and parts of the diaper were saturated with blood. Buckle, finding the oozing 100 Or 50 Mg Viagra very slight, ordered gauze saturated with hydrogen dioxide to be applied to the bleeding surface. This he had found adequate to control haemorrhage in apparently similar cases. About 7 p. m. he was again called. The bleeding had 'not ceased, though the oozing was just as slight as be- fore. He applied styptic cotton, adrenalin i to 1,000, powdered alum, tannic acid, and solution of silver nitrate, at diflferent times, but without result. The family became so anxious and excited that they took the child to the hospital. There the skin was stitched to the mucous membrane above the glans, in the hope that this would help to check the bleeding; but it did not. In the two days the baby was in the hospital it grew so pale and weak from the loss of blood that the father, not getting much assurance from the surgeons of its recovery, took it "to die at home." as he said. On the fourth day after the circumcision Buckle was called hurriedly. The baby was extremely pale and 100 Or 50 Mg Viagra very feeble. It could not nurse from the breast but when some milk was pressed from the nipple into its mouth it slowly swallowed it. Temperature was subnormal ; pulse and heart beats were so weak and rapid that they could not be counted. Buckle again tried vari- 8q8 I'lTH OF CURRENT LITERATURE. ous styptics, but the result was as disappointing as before. He recalled that on several occasions of slight bleeding from small cuts he used potassium permanganate with good results. He applied pow- dered potassium permanganate to the wound. The oozing immediately ceased and there was no recur- rence of bleeding. 13. Pain after Salvarsan Injection. — Corbus, from his experience, covering 100 cases, has found that the pain and induration after salvarsan injec- tion are due to the sodium hydrate. The directions that accompany the tube of salvarsan advise that a fifteen per cent, solution of sodium hydroxide be used in making the solution alkaline. One can readily see how easy it is to get an excess of sodium hydroxide; even one drop might cause an excess of alkalinity which would not only cause excess of pain, but in an ill nourished individual might cause considerable necrosis. Following the Alt-Lesser technique lie used a four per cent, solution (normal sodium hydroxide), and his success was good in re- gard to pain 100 Or 50 Mg Viagra and induration. Only twice has he observed an abscess. In one case the patient was extremely debilitated, and in the other Corbus had 100 Or 50 Mg Viagra to deal with an excessively fat individual. In each of these cases he believes the abscess was the result of the sodium hydroxide. He now uses a two per cent, solution of sodium hydrate. In this way any excess of alkalinity is more easily avoided, the in- itial pain is lessened, and he finds that uniformly the coagulum formed in the muscles is absorbed, leaving the muscles in a soft, pliable condition ready for a second injection whenever necessary. He first puts the 0.6 gm. of salvarsan in a 25 c.c. graduated cylinder, and dissolves it in 8 or 10 c.c. of hot water. The sodium hydroxide is then added in small quantities until a clear solution is obtained, care being taken not to add any sodium hydrate in excess. Hot water is then added in sufficient quan- tity to bring the total solution up to 20 c.c. ; 10 c.c. of 'this solution are injected deeply into the buttocks on either side. Great care should be used to keep the injected fluid out of the adipose tissue. The sodium hydrate solution should be sterilized before each injection. This is also true of all the glass- ware used. MEDICAL RECORD At'ril 29. igit. 1. Pulmonary Symptoms as Premonitory Signs of Ven- ous Thrombosis, By Lewis A. Conner. 2. Street Sanitation in New York. With Some Sugges- tions for Its Improvement, By WiLLi.\M V.\N Valzah Haves. 3. A Case of Multiple Myeloma with Albumosuria, By Cecil Kent Austin. 4. Drugs in Gastric Therapeutics, By J. W. Weinstein. 100 Or 50 Mg Viagra 5. The Significance of a History of Alcoholic Addiction. By T. D. Crotheks. 6. Short Talks with My Students and Others: Beins Random Suggestions for the Younger Practitioners. By Riii'.KRT H. M. Davvi;.\k.\. I. Pulmonary Symptoms as Premonitory Signs of Venous Thrombosis. — Conner remarks that pulmonary -.yniplonis -.wc. not infrequently, the first indication (.if a beginning venous thrombosis, ])receding often by several days the local evidences of such thrombosis. .Such symptoms are the 100 Or 50 Mg Viagra result of the lodgment in 100 Or 50 Mg Viagra branches of the yiiilmonary artery of emboli derived from the newly formed, friable thrombi in the peripheral veins. These early pulmonary emboli are usually of small size and the symptoms arising from them are frequently slight and transient. The symptoms of pulmonary embolism and infarction by no means always corre- spond to the classical descriptions of them. One or more of the cardinal symptoms are frequently lacking. This 100 Or 50 Mg Viagra is especially true of hemoptysis, 100 Or 50 Mg Viagra