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is eflfected by pressure (action of the heart by hy- draulic pressure), that of the venous blood by Is It Safe To Buy Viagra In Mexico suc- tion, and that of the capillaries by both pressure and suction. The heart sets the blood in motion, the vessels distribute it, but the sanguineousness of a part of •Rtad at the mecti.ig of the New Vork Academy of Medicine. .April 20, 191 1. 88o PFAHLER: GASTRIC PERISTALSIS IN STOMACH CARCINOMA. the body depends less on its vascularity than on the number and extent of its capillaries. Such extent is variable, and the fluid motion in the capillaries is regulated by a nervous system, the susceptibility of which is subject to great variations. Each muscle is both a pressure and a suction pump. which exerts an effect upon the distribution of the blood, especially in the capillaries and in the dis- tribution of fluids in the tissues. Relaxed tissues absorb fluids more readily ; a fact which accounts for the obstinate hreniorrhages ex atoiiia. post par- Is It Safe To Buy Viagra In Mexico tuin haemorrhages, and climacteric hremorrhages which resist treatment, but are controlled when the tonus of the abdominal muscles has been reestab- lished by means of proper bandaging. The same applies to chronic diarrhoea caused by atonia gas- trica, which will resist all medication and dietetic rules until the cause — the atony — has been over- come. The uniformly distributed pressure when an ad- hesive plaster belt is applied to the abdominal wall has not only the efl:ect of acting on the tonus of the abdominal muscles, and thus indirectlv on the circulation, but it also exerts a direct influence on the circulation. I should like to write more exhaus- tively on this subject; but I will confine myself to the relation of a case which demonstrates very well the relation of atonia gastrica to circulation. .^n elderly gentleman suffered for several years from attacks of \ertigo and unconsciousness. Almost daily, sometimes hourly, and even at shorter intervals, the alarm- ing symptoms appeared. The frequency of the pulse was from 27 to 31 beats in the minute ; only every second con- traction of the heart caused pulsation. All the physicians who saw the case diagnosticated, quite correctly, myocarditic affection and treated him accordingly, but without success. The enormously distended belly of the patient had at first not been taken into consideration until Dr. Groddeck paid attention to it. The reduction of the size of the belly, although it did not cure the diseased myocardium, was followed by cessation of the attacks of vertigo and un- consciousness. The size and the weight of the belly hav- ing been reduced, the work of the heart was materially relieved to such an extent that even the imperfect contrac- tions were sufficient to fill the brain with the necessary quantum of blood. It is sometimes of more importance in cases of heart disease to examine the abdomen than to distinguish the fine points of the auscultatory symptoms. I oniv beg to convince you that when you meet again with cases of dyspnoea and pulmonary hiemor" rhage caused by heart affection, to apply the ab- dominal belt, and you will, in some cases at least, observe a most remarkable relief. 172 Le.xi.n"gton Avenue. CINEM.^TOGRAPHIC DEMOXSTR.-\TION OF NOR- MAL GASTRIC PERISTALSIS, AND THE PART THESE WAVES PLAY IX THE DIAGNOSIS OF CARCINOMA OF THE STOMACH.* By Geokge E. Pfahler, M. D., Philadelphia, Pa. Through the courtesy of Professor Rieder, and Dr. Rosenthal anrl Dr. Kastle, of Munich,' I am privileged to demonstrate to you a cinematographic film made by them about two years ago showing normal gastric peristalsis. They first made thirteen separate plates while the subject held the breath or •Read, with a lantern demonstration, before the College of Physi- cians of Philadelphia. April %, 191 1. ^Zeilsclirift fiir Rbntgenkunde utid Radium Forschung, xii, 19. in about twenty seconds. These separate plates were then reduced to a cinematographic film which by means of repetition gives a fair idea of the normal gastric peristalsis. This is not true cinematographic reproduction, the rate of exposure being too slow, but these gen- tlemen, who are pioneers in this field, deserve great credit for Is It Safe To Buy Viagra In Mexico the remarkable degree of success already obtained. Biorontgenography, as they call it, is the only method by which these movements can be dem- onstrated to an audience and by which a permanent record can be Is It Safe To Buy Viagra In Mexico made. In this cinematographic film which I demonstrate to you a single wave has been recorded from its origin to its termination at the pylorus. Cole, of Xew York, has recently succeeded in producing a cinematographic eft'ect by making a series of sepa- rate e.xposures and then arranging them so that a wave effect can be followed through to the pylorus without really attempting to make them in the time required for an actual wave to pass. Is It Safe To Buy Viagra In Mexico By courtesy of Dr. Cole I am privileged to demonstrate to you two films showing the effect of pylorus obstruction. Caldwell has recently- shown that actual bio- rontgenography will be a possibility, and while the technique and apparatus are not yet perfected, he will undoubtedly be able to make from ten to twenty exposures a second, which will be the time of true cinematography. In my opinion, a careful fluoroscopic examination gives very much more information than any cine- matographic reproduction at present can possibly give. Cinematographically, one can demonstrate at best only a few of the cycles of waves and usually only one, while, fluoroscopically, one can follow any number of waves, can study the effect of varying degrees of pressure, varying degrees of filling, Is It Safe To Buy Viagra In Mexico and