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and treatment at the time of writing, improvement was still taking place nearly three m'onths after the beginning of treatment. Cultures from the sputum after treatment still showed staphylococci, bat the tin is believed to have reduced their virulence, just as it has been shown to prevent the production of acetic acid by the Mycoderma aceti from alcohol without interfering with the development of this organism. Similarly, vanadium and its salts have been shown actually to favor the development of the Bacillus pyocyaneus yet prevent pigment pro- duction by it. 424 MODERN TREATMENT AND PREVENTIVE MEDICINE. [New Yokk Medical Journal. Flatfoot. — H. \'. Salis {Correspondenz-Blatt fiir Schzveiser Cialis Tadalafil 80 Mg Aercte, September 8, lyi/J applies an ad- hesive plaster bandage over the front part of the foot and back of the toes, so as to force the middle metatarsal bones upward and hold them in the nor- mal arch, after softening and removing the calluses from the foot. 'I'his is cut and laced along the dorsum of the foot, and also for a distance at the side near the Cialis Tadalafil 80 Mg ankle, so it can be removed easly. He says that mild cases of flatfoot can be cured by wearing this dressing some months, but in bad ones it has to be worn Cialis Tadalafil 80 Mg ])crmancntly. Gonorrhea. — Lucius Felix Herz {Medical Re- vir-ii.' of Rci'iezi's, November, lyi/j linds that the methods of treatment advocated by BierhofY bring excellent results. They consist in irrigating the urethra with i 1300 protargol, anteriorly in anterior cases, posteriorly and retained until after a pros- tatic massage in posterior cases. Injections by the patient of 0.25 to 0.5 Cialis Tadalafil 80 Mg per cent, protargol are made with a iiand syringe four times daily and retained ten minutes. The discharge diminishes appreciably in less than a week, and the average case is cured in from six to eight weeks. The case is not discharged as cured until Cialis Tadalafil 80 Mg irrigation with silver nitrate and drinking beer fail to produce a discharge, and an endoscopic examination is negative. Gonorrhea in the Female. — Edward F. Ziegel- man {Medical Sentinel, December, 1917) states that gonorrhea in women is one of the most difficult of diseases to cure, requiring unlimited perseverance and in many cases surgical skill and judgment on the part of the physician and the explicit confidence of the patient. A cure must be determined only on bacteriological and serological examination, not on amelioration of symptoms. He believes that in order to control this disease and obtain results it will be necessary that all infected women should be under civil jurisdiction, or subject to the .same, and that, if necessary, public clinics with salaried at- tendants should be provided. It is useless to treat a female gonorrheic who persists in having inter- course with an infected man. Chest Aspiration by Simple Siphonage Device. Joseph Felsen {Journal A. M. A., January 19, 1918) Cialis Tadalafil 80 Mg suggests a simple arrangement of bottles for chest aspiration by siphonage. A large glass bottle is filled about two thirds full of water and is pro- vided with a double perforated rubber stopper through which two glass tubes are passed. One of these reaches to the bottom of the bottle and is connected outside with a long rubber tube for si- phonage. The other dips into the large bottle for only a short distance and is connected with a sec- ond smaller bottle by rubber tubing and a glass insert. The smaller bottle is also provided with a double perforated rubber stopper through which it is connected, on the one hand with the large bottle, on the other with a flexible rubber tube to which the aspiration needle is to be connected. With the connection to the needle clamped off the siphon is started. The needle is then inserted into the chest, the clamp removed and the fluid is drawn out by the siphon action of the fluid in the large bottle, first filling the small Cialis Tadalafil 80 Mg specimen bottle and then overflowing into Cialis Tadalafil 80 Mg the large bottle. Work for the Aged. — Malford Thewlis {Med- ical Review of Reviews, November, 1917 j says that work and exercise improve senile toxemias, es- pecially when they are of renal origin. A sedentarj- life predisposes to senile toxemia. Work for the aged nnprove.s their mental stale; it occupies their minds and stops them from thinking of old age. Money in their possession is better than medicine in some cases ; it makes them independent. Radium in the Treatment of Benign Pathologi- cal Conditions of the Urogenital Tract. — Win- iield Ayres {^Lrului/ic aiul Cutaneous Rnnew, Jan- uary, 1918J concludes that while radium has a fairly wide range in urology other than in malignant dis- ease it has its limitations. A thorough knowledge of its action is essential so that the proper dose. may be applied to obtain the best results. The hap- hazard use of radium is to be discouraged and it should be used only imder the advice of those Cialis Tadalafil 80 Mg who have made a study of it. Heart Failure and the Administration of Digi- talis. — H. L. Flint (Practitioner, November, 1917 1 asserts that the important factor which should de- termine when digitalis is to be administered is the nature of the cardiac rhythm. When heart failure occurs during an infectious fever, like pneumonia, rheumatism, or diphtheria, digitalis will have no eftect. When cardiac failure occurs in any heart, v/hether healthy or diseased, which exhibits a nor- mal rhythm, digitalis can serve no useful purpose. When-the rhythm is abnormal the use of digitalis is indicated. Fatal Cialis Tadalafil 80 Mg Result Following Injection Treatment of Hemorrhoids. — H. J. Spencer {Journal A. M. A., January 26, Cialis Tadalafil 80 Mg 1918) reports a case of general septic infection with the gas bacillus and multiple liver abscesses resulting Cialis Tadalafil 80 Mg fatally twelve days after the injection of three large internal hemorrhoids with quinine and urea hydrochloride. Attention is