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effort at precise manipulations. In this manner they represent ordinary clinical procedures and the er- rors possible under these circumstances. The test meal employed was a simple one, composed of a cup of tea, one slice of dry bread, and a quarter of-a pound of lean, chopped beef. The extractions were made two and one half hours afterward by separate individuals. The first extraction was made by passing a very flexible tube to a point just be- yond the cardia where, by aspiration, the first con- tents appeared. Only a small quantity was taken for analysis. The second extraction Buy Viagra Online Us Pharmacy by another ex- aminer was made immediately following by pass- ing a more rigid tube well into the cavity of the stomach, a distance of from four to six inches be- yond the point attained by the first tube. Here, also, only a small quantity, sufficient for analysis, was extracted. The manipulations Buy Viagra Online Us Pharmacy employed dif- fered in no manner, either as to care or exactness, from the usual routine procedures in common prac- tice, the only precaution being the selection of cases sufficiently tolerant to admit of examination with- out violent restlessness or retching. The following are the results obtained in a dozen cases of various diagnoses : Free hydrochloride Total acidity 1. Superficial 45 75 Deep . . 20 75 2. Superficial 32 6o Deep . . 42 6o 3. Superficial -54 75 Deep .. -44 80 4. Superficial 8 48 Deep . . 8 48 5. Superficial 30 70 Deep 40 80 6. Superficial 25 75 Deep 20 .75 7. Superficial 25 70 Deep 15 75 8. Superficial 40 85 Deep 55 I05 9. Superficial 25 70 Deep 20 70 ro. Superficial 38 94 Deep 28 92 T I. Superficial 60 108 Deep .so 120 12. Superficial 10 40 Deep 35 These results are submitted irrespective of diag- nosis and without comprehensive analytical com- ment. They simply reveal the possibility for error in ordinary routine work. It will be noted that the greatest difference exists for the free acid. This mav vary from zero to twenty-five points, and is most pronounced in cases of excessive acidity. The possibility for error diminishes in proportion to the degree of acidity, being nil in cases of achylia. Nu- merically, seven cases exhibited the greatest free acidity upon superficial extractions, three upon deep extraction. In the two subacid cases there was very little difference. The total acidity shows very little variation. From these experiments it would appear that too great reliance cannot be placed upon casual gastric analysis. Two examiners may obtain entirely dif- ferent results, dependent upon the consistence of the test, the time of examination, the depth of ex- traction, the rigidity of the tube, and, most im- portant of all, the muscular activity of the organ. I am indebted to my associate. Dr. Charles A. Haffner. for his aid and interest in these examina- tions. 144 East Thirty-eighth Street. yUINlNE AND UREA HYDROCHLORIDE AS A LOCAL ANESTHETIC. By WiNNiFRED Green, M. D., Louisville, Ky. The writer s attention has been Buy Viagra Online Us Pharmacy drawn for some time to quinine and urea hydrochloride as a local anassthetic. It has proved so satisfactory that she wishes to report from her case book the first eight consecutive cases in which this anaesthetic was used and ventures to offer them as fairly representative Buy Viagra Online Us Pharmacy rases of one year's experience which includes work done on the nose, throat, and ear as well as some minor operations on other portions of the body. Case I. A woman, twenty-one years of age. Diag- nosis, hypertrophied tonsils. Twenty-four minutes Buy Viagra Online Us Pharmacy after injecting fifty-five minims of a one per cent, solution of (|uinine and urea hydrochloride into the capsule of the tumor, an amygdalectomy was done. The operation caused Buy Viagra Online Us Pharmacy very little pain and a small amount of bleeding which subsided in a few minutes. Some remaining tags of tissue were clipped away on the second and third days succeeding the initial operation, thus showing anaesthesia to be complete to the end of the third day. Sensation was then gradually restored until the sixth day when it was found to he normal. Induration appeared almost immediately after the injection of the anxsthetic, the area of which extended about one half Buy Viagra Online Us Pharmacy inch on all sides of the