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since they are not excreted in the bile and so can- not reach the parasites ; moreover, any drug that was excreted in the bile in sufficient quantities to kill the fluke would probably kill the host as well. As a matter of fact, we do not know of any Generic Viagra Canada Cost drug which is secreted in the bile or circulates in the blood in sufficient concentration Generic Viagra Canada Cost to act as a verini- cide. Quinine is certainly a protoplasmic poison, and exists in the blood as r.uch, and the same is true of arsenic ; but these do not seem to have any ef- fect on blond sucking parasites. We endeavor to stimulate the secretion of bile, with the idea that toxic substances should Generic Viagra Canada Cost be washed out and their absorption perhaps prevented. For this pur- jiose enonymin may be given three. times a day in pills containing one grain. A marked rise in h.'enioglobin will probably take place under this treat- ment, but this may be due to rest and improved hy- giene. Symptomatic treatment follows the usual lines, and even surgical treatment may have to be invoked. Prophylactic treatment is hardly called for in man, but consists of the administration of common salt with any food likely to be affected. LANCET April 22, Generic Viagra Canada Cost igii. 1. Sensibility of the .Alimentary Canal in Health and Disease (Lecture I), By Autiiuu !•'. hlERTz. 2. Declining Birth Rate, By F. E. Fremaxti.e. 3. Notes on Some Victims of a Recent Railway Acci- dent, with .Special Reference to Cerebral Fat Em- bolism, By RicK.M.\N J. Godlee and G. E. (X \Villi,\ms. 4. Some Ocular and Visual Conditions in Medical Cases, By James Taylor. 5. Direct Bronchoscopy. Value of this Method for the Detection and Removal of Foreign Bodies, By Herijert Tillev. 6. Value of Ionization in Inllamniatory Diseases of the Lower Bowel, By J. Curtis Webb. 7. Ascites Treated by Lymphangeioplasty, By R. .Atkinson Stoxev and Generic Viagra Canada Cost T, Gillm.\n Moorheau. ducc(l by chemical stimulants such as hydrochloric acid, alcohol, glyc- erin, etc., the sensations of fulness and distention in the oesophagus and stomach. 4. Ocular Conditions in Medical Cases. — Tay- lor points out that inequality of the pupils in the young points to troul)le (jf Generic Viagra Canada Cost the cervical sympathetic ; the Argyll Robertson jnipil does not always Generic Viagra Canada Cost mean tabes dorsalis. but sometimes mere neurasthenia, early syphilis, hemiplegia, para[)legia, general pare- sis. Ophthalmoplegia externa ma}' signify neuritis of the sixth nerve or of the third nerve, tuberculous meningitis, postdiphtheritic paralysis, intracranial disease, and hemicrania, also myasthenia. Optic atrophy generally means tabes, sometimes tumors pressing on the optic chiasm. Optic neuritis is usu- ally significant of brain tumor. Neuroretinitis is associated with albuminuria, glycosuria, or retinal thrombosis. Hemiano])ia may occur independently of any other disease. 5. Direct Bronchoscopy. — Tilley states that with the help ol llriining's bronchoscope he has re- moved a splinter of rabbit bone which had been ini- pacted for nearly three years, also a mutton bone impacted for ten days. He gives the following iiints as to the use of the instrument: If a general anaesthetic has been administered, he prefers the patient in the lateral position — left or right accord- ing to circumstances — with the head slightly flexed toward the chest. By this means the Generic Viagra Canada Cost larynx or u|)per end of the oesophagus is brought very much nearer to the operator than when the heafi is QOO PITH OF CURRENT LITERATURE. [New York Medical Journal. Stretched backwards in the dorsal position, and he has a feeling that from the point of view of the anaesthetic it is a safer position for the patient. The surgeon will find it wiser to wear plain glasses or his ordinary spectacles when making the examina- tion, because, even when the patient is under fairly deep anaesthesia, a sudden cough may send a spray of very septic matter into his eye or paralyze his accommodation if cocaine has been freely used to anaesthetize the bronchus. Such a precaution will also protect his eyes from the "stinging" of the exhaled chloroform vapor, which may become a very real grievance during prolonged Generic Viagra Canada Cost anaesthesia. Finally, while it would be idle to suggest that neith- er skill nor practice is necessary for the intelligent use of the bronchoscope in dealing with a very seri- ous and not uncommon accident — viz., the inhala- tion or swallowing of a foreign body — yet it is very true that a little practice, combined with patience and gentleness, should render any surgeon compe- tent to use the bronchoscope with reasonable assur-