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rhoea twice ; last attack one year ago. Infected with syph- ilis six months ago. Incubation nearly five weeks. Very active secondary lesions began within four weeks, result- ing in deep scars on the body and face, as shown Do I Need A Prescription To Buy Viagra In Canada in the photograph. Was treated at Bellevup Hospital for a few weeks with mercury and potassium iodide, by each of which he was greatly poisoned. Received his first dose of 606 October ist: second, October 26th, and third, December 13th, 0.5 gramme. Temperature rose slowly to 100.6° on the third and fourth days. Returned to normal on the sixth day. No definite change took place in the scars, as was to be expected. The blood test ran as follows : Strong reaction a few days prior to December 12th when Dr. Noguchi referred the case to me. Weak positive De- cember l6th and 27th. Blood pressure has varied between 134 on December 15th. 122 on December i6th and 19th and 137, January 2d. Weight has slowly increased from 14754 pounds on December l6th, to 14954 pounds on Jan- uan.- 2d. The patient says he feels better but there are no clinical signs to mark this progress except the fact that the serum test on January 3d was negative. Eyes and vision, normal. O. S. old hsemorrhagic chorioiditis from below, pigmented haemorrhage near nerve head and ma- cula. Case XV. H. W., referred by the courtesy of Dr. G. I. Miller, single, Russian, clerk, nineteen years old. Ad- mitted. November 27th, to the People's Hospital. Family histon.-. negative. Previous history, negative. Gonor- rhoea four years ago. Present illness, syphilis contracted .ibout eighteen months ago. Clear historj- of secondaries. Treated with the usual mercurial injections, twenty-six in number. Iodide by mouth for fourteen months. Present condition, positive Wassermann reaction. A feeling of malaise and a laryngitis. November 2Qth. 0.25 gramme injected into each buttock. Slight rise of temperature- for three days, never above 101.4°. The Wassermann test declined until it became very weak on December 29th. The laryngitis improved somewhat and the patient's gen- eral feeling of being ill and out of sorts disappeared. The serum test was strong on December 1st. 5th, and 12th, and weak on December igth and 29th. The blood pressure in this patient on admission was 135; varied from 135 to i.^S. His weight has remained practically at about 12754 pounds. Cask XVI. C H., single, U. S.. machinist, thirty-eight years old. .\dmitted to the People's Hospital November 30, 1910, in fair health with a large chancre in the left angle of the mouth involving both lips. Family history, negative. Previous history, negative. Had the usual children's diseases. Uses Do I Need A Prescription To Buy Viagra In Canada tobacco and alcohol to excess. Venereal history : Had gonorrhoea fifteen years ago, also chancroid fourteen years ago. Present history-, was bit- ten on the lip by a prostitute while kissing her. Chancre came about three weeks later, accompanied by very great swelling of the lymph glands on the left side of the neck. The chancre is show-n in the photograph, but the lymph glands are only slightly within view owing to the angle from which the photograph was taken ; 0.5 gramme of 606 was given November 30th. The results were disap- pearance of pain in the chancre within a few hours, soft- ening and loss of pain in the lymph glands within twenty- four hours, and, on the fourth day, the lymph glands had almost entirely disappeared and the chancre had already greatly decreased in size and had begun to heal. Within twenty-four hours the patient was able to eat with more freedom than he had in ten days or so. The blood reac- tion was negative. The spirochjetse were not found in the chancre, because caustic had been used by another physician. In my effort to Do I Need A Prescription To Buy Viagra In Canada get the specimen I probably did not scrape in deeply enough. The spirochsetes travel to the deep parts of the lesion after a caustic. This pa- tient was most ungrateful and did not return for observa tion after December 5th, notwithstanding writteti requests. The serum test was negative on November 29th and De- cember 1st, and almost negative on December 5th. On November 30th patient's weight was 13454 pounds, blood pressure, 124. Case XVII. J. M., widower, U. S., driver, thirty-three years old. .^dmittcd November T4th to the People's Hos- pital. Diagnosis, chancre of the mouth. Family Do I Need A Prescription To Buy Viagra In Canada history, negative, except one brother who died of tuberculosis of the throat. Previous history, excessive smoker and drink- er. Frequent venereal disease. Present illness, chancre noticed nine weeks before admission, followed by rash all over the body. Six weeks ago was treated for a short time with injection of mercury without benefit at the House of Relief for the chancre and lymph glands in the neck. 606 was recommended; injected, November isth, with 0.5 gramme. Improvement in the lesions immediate- ly occurred so that when discharged, November i8th, the lymph glands, which had been one mass, became distinct nodes and the rash began to get paler. This patient was seen twice during the next two Do I Need A Prescription To Buy Viagra In Canada weeks at the clinic of the House of Relief. In that time the chancre had nearly healed and the lymph glands had nearly disappeared from the side of the face and the rash had nearly faded. Sub- sequent to this the patient disappeared so that the final results cannot be stated at this writing. (This patient re- appeared on January 4th in excellent condition, as is shown by the photographs.") The serum test was strong on November 16th, positive on November iSth, and almost negative on November 29th. The blood pressure in this patient was 105 on admission. Varied from 105 to 117 and decreased to 105 on November iRth. His weight re- mained constant at about 133 pounds. (To be concluded.) TYPHOTDAL CHOLECYSTITIS.* By John E. Summers, M. D., Omaha, Neb., Fellow. American .SurRical .Xssocintion ; Member. Western SurRie.il .\ssociotion: SurReon to the Clarkson Memorial, Wise Memorial, and Douglas County Hospitals. Altlioiifjh it harl been known for many years that inflamination of the .crallhladder miijht comph'cate typhoid fever, it was not until iSqo that Gilbert and Girode proved bacteriologically that cholecystitis was in certain cases caused by the typhoid bacillus. Ciishinc: demonstrated bacteriolopfically the preserice of the typhoid barillus in a case of cholecystitis where there was no aiitecedent history of typhoid fever. Most observers are now of the opinion that the typhoid bacillus, in fewer or greater numbers, •Read before the Western Surgical AMocidion, Chicago, Decem- ber 19, 191a.