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fourth and lilth tubes. When such is the case a more (hlute emulsion must be used, as, for instance, an eight, live or even Buy Cialis Using Paypal two per cent, emulsion. It is manifestly impossible to employ successfully in tests a quantity of antigen which is in itself suf- ficient either to effect hemolysis or to fix comjjle- ment. One should never employ a (|uantity larger than one quarter of the largest quantity which is not hemolytic nor antilytic. The question now arises: Is such a quantity of a given antigen sufficient to fix complement in ihe presence of syphilitic serum? To supply an answer it is necessary to perform a third titration, the titration for antigenic i)roperty. Increasing (juanti- ties of the emulsion are mixed with constant quan- tities of known syphilitic serum and of complement, and the mixtures are incubated. Thus there is an O]>portunity provided Buy Cialis Using Paypal for the occuirence of specific fixation. Its occurrence or not is indicated in the usual way. The third titration is represented in Table III. By means of the titrations of the anti- TABLE III. TITRATION OF LIPOID ANTIGEN : 3. FOR ANTIGENIC PROPERTY. Antigen (i% emulsion).. .01 .02 .05 .1 .2 o o o o Antigen (10% emulsion), o o o o o .05 .1 .2 o Salt solution 3 .3 .3 .2 .1 .3 .2 .1 .2 Leutic serum' (2% solu- tion) I .1 .1 .1 .1 .1 .1 I .2 Complement two units in each tube Inculiate for 4 hours at 8° C. Then add 2 units of ambo and I unit of r. b. c. and put into water bath at 40° C. for 30 minutes. At the expiration of that time there should be complete hemoylsis in the ninth tube. There will be various degrees of hemolysis, from complete to none, indicating various degrees of fixation of complement, from none to complete, in the other eight tubes. The smallest quantity of antigen which effects complete complement fixation is the antigenic quantity. gen we determine, first, how much of it may be used and, second, how much is sufficient to eflfect complete complement fixation. How much may be used is de- termined by the hemolytic and antilytic titrations. It is one fourth as much as the largest quantity which is not hemolytic nor antilytic. flow much is suflicient is indicated by the results of the titration for antigenic property. For example, let us suppose that 0.4 Buy Cialis Using Paypal c. c. of the ten per cent, emnlsion is the larg- est quantity which is not hemolytic nor antilytic. It is apparent that one r|uarter Buy Cialis Using Paypal of that quantity, or o. Buy Cialis Using Paypal i c. c. of the ten per cent, emulsion, is the largest ciuan- tity that may be used. Sujjpose that it is found that 0.05 c. c. of the one per Buy Cialis Using Paypal cent, emulsion is sufficent to effect complete com])lement fixation, is, in other words, the antigenic quantity. It is immediately ap- ])aren.t that the quantity which may be safely used is twenty times as great as the (]uantity which suffices Buy Cialis Using Paypal and is therefore eminently suitable for use, allowing, as it does, a large margin of safety. The dose of this particular preparation is, therefore, o.i c. c. of the ten per cent, emulsion. Serum of the patient. — The preparation of the serum of the patient is a very simple matter. It is well to draw from two to five c. c. of blood and it is most conveniently taken, as a rule, from the vein at the bend of the elbow, the median basilic or the median cephalic. The hollow needle which is intro- *A specimen of scrum wliich h.TS given a strongly positive Wasscr- ni.ann reaction, or better, a mixture of several such serums. duced to the vein should, of course, be sterile. The container for the blood may or may not be sterile. If the blood is to be kept for several days before use, or if it is to be sent any distance, it is imperative to keep it in a sterile condition. If, however, it is to be used very soon and may be refrigerated in the meantime, it is not necessary to employ a sterile con- tainer. Nevertheless, if one is always careful to see to it that the specimen is not unnecessarily contami- nated, Buy Cialis Using Paypal he is saved the bother and inconvenience which not infrequently occur to him who handles his specimens carelessly. Sometimes it is extremely difficult to obtain a specimen of blood and the diffi- culty occurs frequently with a sj)ecimen the report upon which is anxiously awaited by the clinician. If such a specimen should spoil as a result of careless handling, the discomfiture of the guilty person is very great. Although as a rule the veins at the bend of the elbow are the easiest to puncture, sometimes, for one cause or another, it is quite impossible to use them. The patient may have had his veins maltreated on prior occasions, so that they have become Buy Cialis Using Paypal throm- bosed. It is often possible then to puncture the in- ternal or long saphenous vein as it passes above the iriternal condyle. The Buy Cialis Using Paypal skin may be scarified and cupped or the finger or ear pricked and the blood collected in a Wright's capsule. When the patient is an infant it is a very easy matter to puncture the superior longitudinal sinus through the anterior fontanelle. The procedure is fraught with very little danger, if properly performed, but is rather terrify- ing to the relatives. A most convenient apparatus is the bleeding tube devised by Dr. Richard M. Taylor (4). He describes it as follows: "The ap- paratus consists simply of a test tube twenty millimetres in diameter and 150 millimetres in Buy Cialis Using Paypal length with a piece of capillary tubing about 70 millimetres long welded to it at right angles at a point Buy Cialis Using Paypal slightly below- the junction of the middle and upper thirds and with the free end of the tubing ground to fit the standard Luer needle. Previous to sterilization, the tube is plugged with cotton in the usual way and a small test tube placed over the Buy Cialis Using Paypal arm and held in position by fitting it snugly over cotton wound about the capillary near its juncture with the large test tube. In this way the entire arm and the inside of the test tube are w-ell protected and may be kept indefinitely Buy Cialis Using Paypal without danger of contamina- tion. The needles, after being thoroughly cleaned, dried and sharpened, are put in small tubes con- taining about one c. c. of liquid paraffin. These are all sterilized in the dry oven. By this method they are kept in excellent condition and the whole ap- paratus is ready for use at any moment. . . . The apparatus has proved so simple and convenient that the laboratory interns employ it exclusively for taking blood for all purposes."