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January ist, +; February 3d, — ; negative in two months, supplemented by a course of mercury. IV. Primary lesion, September, 1910; followed by sec- ondaries. Treatment : Calomel inunctions and, December -Vth, 0.6 gramme alkaline solution of salvarsan, intramus- cularly; Wassermann reaction, November 12th, -\ — |- ; Jan- uary 31st, — ; negative in two and one half months. V'. Infection not determined. Secondaries in October. 1910. Treatment: January 14, 191 1. 0.5 gramme intra- venously; February 8th, 0.5 gramme intravenously. Ser- um reaction: Viagra Order Uk January 1st, -f ; January 26th, -\ — |- ; Februarx 15th, weak -!- ; iNlarch nth, — ; April nth, — ; negative in two and one half months with two intravenous injections. VI. Initial lesion, December, 1910. Treatment, mercury by mouth (30 capsules) and, February 6, ign, 0.5 gramme salvarsan, intravenously; serum reaction on ^larch 3d, -j-; .\pril, — ; negative reaction two months after salvarsan treatment preceded by a course of Viagra Order Uk mercury internally. VII. Initial lesion, December. 1910. Secondaries si.x weeks later. Treatment, fifty pills; sixteen mercurial in- jections; March 3, ign, 0.42 granmie salvarsan, intra- venously ; March 24th, 0.4 gramme, intravenously ; serum reaction: March 2d. -| — |- ; April 15th, — ; negative six weeks after first salvarsan treatment VIII. Of peculiar interest as bearing on the perma- nency of the effects of the remedy are two cases which I have observed since May and June, 1910, respectively. The first was Viagra Order Uk a patient with severe rupial lesions of the face, neck, and arms developing within the first nine months of infection, for which he had taken mercurial pills for several months. On May 19th I gave him an in- tramuscular injection of 0.3 gramme alkaline solution. At the end of thirty-nine days cicatrization was complete, and he has had no clinical relapse to date. His serum reaction on the day of treatment was -^ — |- ; June 2d, -\ — \- : December 2d, weak -f ; February nth, very weak + J April 6th, — ; a period of almost nine months in which gradual diminution in the strength of the reaction took place. IX. The second case was one of multiple chancres of the lips and secondary eruption. Previous treatment : two grains mercury salicylate hypodermically. On J-une 2d received 0.3 gramme alkaline solution intragluteally. In ten days all visible symptoms were gone, and up to Viagra Order Uk *he present he has suffered no Viagra Order Uk relapse. His reaction on the day of treatment was -| — \- : October 23d, — ; Feb- ruary 14th, — . These two cases are striking illustrations of the intensi\e therapeutical properties of the drug even in Viagra Order Uk minmium doses. I have watched the serum reaction in cases treat- ed with mercury Viagra Order Uk in which the drug was adminis- ■tered in the most Viagra Order Uk approved method by hypodermic use and Viagra Order Uk by inunctions, alternating the one with the other, and with an occasional course given inter- nally, and have not found it possible to obtain such a rapid change in the reaction. By way of illustration the following cases are cited : Physician, infected November, 1909. From January 15th to March 2, lyio, nrnioiiidide. one quarter grain. three times daily. From March 2d Viagra Order Uk to June 24th, ninety- seven inunctions; a rest of a month, and then fifteen in- jections Viagra Order Uk of mercury salicylate, from one grain to one and one quarter grains. A Wassermann examination made one month later was still strongly positive. Physician, infected .April, ignq. Injections from May to September, 1910, of mercury bichloride, one quarter grain, three times a week, alternating with salicylate of mercury, from three quarters to one and a half grain, every five to seven days. His Wassermann reaction was still positive after four months of intensive treatment. .\fter one month's rest this was Viagra Order Uk followed by eighteen in- jections of salicylate, one and a half grain to two grains. and his Wassermann reaction became 4- in March, igio. .\nother series of injections was begun and with internal treatment and periods of rest continued to the beginnin'; iif ion. While under medication or as soon as discon- tinued he has presented mucous membrane and cutaneon-- relapses and has never given a clean negative reaction in the two years he has been treated. In another patient, whose infection dates back Viagra Order Uk to No- vember, 1908, w-ho had had almost continuous treatment, liy mouth and by injections, the serum reaction was still strongly positive Alarch I, ign. He had also recurrences several times during this period. It can therefore be stated pretty certainly that salvarsan materially shortens the time in which a negative Wassermann reaction can be obtained, and the statements that it is only a symptomatic remedy are not true, for its effect on the spirocliKtse and the complement fi.xing jxjwers of the blood can only be interpreted as a specific action. -Abundant evidence is at hand from the work done during the past year that the clinical symp- toms as well as the Wassermann reaction yield more rapidl)- to the drug alone or to a combination with mercury than to mercury alone. It must be remembered that all of the earlier experiments with the drug were made with Viagra Order Uk single doses, and that only in the past few months has the more intensive method been emjiloyed. Viagra Order Uk We are hardly yet in a position to make Viagra Order Uk any positive assertions regarding the time required to influence the reaction. It has also been demonstrated that the drug is more potent in bringing about a change in the serological reaction in Viagra Order Uk the early stage of the disease than at any other time and it is just here that a note of warning should perhaps be sounded. Even though all clinical manifestations disappear at this stage, the patient should be kept under continuous ob- servation for at least a year and the treatment con- trolled Viagra Order Uk by repeated Wassermann examinations. Otherwise, a feeling of false security may be en- gendered and patients may regard themselves cured, only later on to have a relapse on the part of the nervous system. I arii often consulted by patients who had acquired the infection several years before, in whom the Wassermann reaction is strongly positive, but who are without other mani- festations of the disease. Such patients desire to take the treatment for the purpose of insuring themselves against relapses. Are we justified here in administering the drug or in promising the pa- tient that the subsequent treatment will be mate- rially shortened? No matter what treatment is employed in these cases the Wassermann reaction