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caused degeneration of the arteries at the origin of the nerve, sometimes there is Non Prescription Viagra Canada a fractured rib. and sometimes there may be a toxremia complicating a gra\e disease like typhoid fever or chronic nephri- tis. In these cases the annoying spasm often proves very intractable, is exceedingly exhausting, and not infrequently contributes materially toward a fatal re- sult. Here such simple measures as taking a sf>oc)n- ful of sugar, drinking a glass of water, or holding the breath often fail. The first thing which should be done is to apply a large, strong mustard paste to the epigastrium, until the skin is reddened. If this does not afford relief the next thing to be done is to give a hypodermatic injection of one fourth of a grain of sulphate of morphine and one Non Prescription Viagra Canada one hun- dred and fiftieth of a grain Non Prescription Viagra Canada of sulphate of atropine. These drugs impair the excitability of the nerve, diminish the muscular spasm, and often prove ef- fective. Sometimes morphine is contraindicated. Other remedies, which may then be considered are numerous, but less useful. Among them ma\' be mentioned ipecac, which is useful if the stomach is overloaded, as happens occasionally with chil- dren. Spirits of chloroform may be given in doses of twenty or thirty drops, repeated every hour. The tincture of belladonna, in doses of Non Prescription Viagra Canada five drops every four hours, is sometimes Non Prescription Viagra Canada useful, Xitroglycerin, in doses of Non Prescription Viagra Canada one one hundredth of a grain, repeated every hour or every two hours, is beneficial in soine cases. Finally, it is sometimes worth while to em- ploy inhalations of nitrite of amyl. Ether, musk, and camphor may be tried in desperate cases. Dr. Herman Friedel, of Stapleton, remarks: The treatment depends on the cause of the dis- order. In milder cases, forced sneezing, gargling with water, or repeating the following process a luimber of times is all that is necessary : Sit erect and take full inspiration, and while holding the breath bend forward slowly until chest meets the knees : resume erect position and slowly exhale the breath. In gastric or intestinal irritation, lavage or a hy- podermic injection of an emetic dose of apomor- phine, 1/20 to i;'io grain, will stop it. Apormorphine hydrochloride gr. i/io; Distilled water ti\_x ; Sip:.: Inject hypoderniically. or Spirits of chloroform 5ss : Spirits of camphor 5ss ; Compound tincture of lavender, to make 5ss. M. Sig. : One dose. Where hiccough comes on after meals and is due to indigestion, the treatment depends on the Non Prescription Viagra Canada con- dition of the stomach, which must be Non Prescription Viagra Canada corrected. Since atropine has the power to relax spasm due to some local cause connected Non Prescription Viagra Canada with a muscle or its supplying nerve, it is serviceable in hiccough where the irritation is peripheral; atropine 1/120 to 1/60 grain each dose, Non Prescription Viagra Canada or 1/20 grain in the day. Chloral is the standard remedy in all forms of severe spasmodic disorders; twenty grains repeated in an hour. In obstinate hiccough, especially of centric irri- tation, forty grains of sodium or potassium bromide and twenty n)inims of tincture of deodorized opium in four to eight ounces of starch water should be injected into the rectum. A few inhalations of ether cr a fine spray on the epigastrium mav check an attack. In the hiccough of typhoid fever, musk, ten grains, by the rectum is very good. In uraemia, the cause is a nitrogenous product which fails to be adequately excreted by the dis- eased kidneys : therefore the indications are restric- tion of the diet, venesection, and by vicarious elimi- nation by channels other than the kidney. Diaphoresis by hot packs, hydragogue cathartics, lavage of stomach, and venesection, unless the blond pressure is low, and replacement of blood removed by saline infusion, are some of the methods to be resorted to. Dr. Beicrley R. Tucker, Non Prescription Viagra Canada of Richmond, J'a., says: Mild hiccough often is a simple reflex phenome- non occurring after a slight indigestion, fullness of the stomach, the drinking. of cold substances, and exercise immediately after eating, or the cause may not be traceable. These cases yield promptly to such simple treatment as taking a deep inhalation and holding the breath, or drinking eight or ten swallows of water Non Prescription Viagra Canada in succession, or lying down on the back with the thorax propped up and the head thrown back, or taking some carminative sub- stance like spirits of chloroform, or steady pres- sure over the lower part of the chest, limiting the movement of the diaphragm. Hiccough occurs in typhoid, .Vddison's disease, and in such general states as alcoholism, haemorrhage, uraemia, diabetes, and gout, also in shock following anaesthesia or surgical operation, and after syncope. When any of these conditions obtain, if they are vigorously treated, the hiccough usually disappears. At times the symptom of hiccough itself is .so important that its especial treatment becomes paramount, for even the patient's life may be in danger. In treating the symptom itself we may try the simpler means first. but these are usually of but little avail in severe cases. In these cases pilocarpine hydrochloride in OUR READERS' DISCUSSIOXS. doses of one fifth grain is sometimes of value or a Dr. II. B. Biscoiv, of Kciv York, says: seventy-fifth to a one-hundredth of a grain of hyo- Dietary treatment. Advise your patient to eat seine, or bromides may be given by the. mouth or slowly, carefully masticating the food, not to over- bowel. A hypodermic of morphine and atropine gat, and especially not to take large quantities of will sometimes check an attack. Probably the most n^jds at meals. Exclude all indigestible food efficient medicinal remedy is extract of musk given stuilfs.