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823 a store of it is still unabsorbed at the original site of the injection. Ehrlich thinks the possibility of a permanent cure is greater if salvarsan is given in- travenously. Much less pain is experienced, too, when it is introiluced into the vein, provided none of it escapes subcutaneously around the vein from an imperfect entrance of the needle into its lumen. Sometimes the flow of blood through the needle is so free that the operator feels convinced it is e.x- actly in the right position until he sees a swelling under the skin, which shows that there is an escape of lluid, which causes the patient both immediate and subsequent pain. After having treated a few patients intravenously with about half of them exhibiting the before men- tioned difficulty, I decided to try to improve my technique, and herewith submit a plan which is both simple and effective m determining ('/' the floiv of fluid through the needle into the vein is satisfactory. The patient's arm is rendered thorotighly free from infection and ligated so as to block the venous blood. The salvarsan. previously dissolved, is mi.xed with a Insiiiad of the infu hottle" with .1 expensive. jiparatus, as here shown, an ordinary near the bottom may l)f useil and warm, chemically pure, sterile physiological salt so- lution and poured through a filter into an ordinary infusion apparatus. The rubber tube from this is then connected to a "three way aspirating stop cock"; into it is connected a 16 or 18 gauge needle. .Nnother Buy Viagra Online Australia Paypal glass infusion retort, containing warm, sterile jjhysiological salt solution, is connected by a ruljber tube to the third opening in the three way cock- a glass tube being connected near the cock to show by the flow of blood into it when ti)e needle has entered the vein. The air is thoroughly e,x- cluded from the tubes, cock, and needle; the stop cock is turned so as to note the direction of the flow when in different positions, and finally adjusted so as to shut off the salvarsan and leave open the way from the needle to the salt solution. .\ ckimp is placed upon tiie tube leading to the physiological salt solution to prevent its escape while the needle is being introduced. When the needle is thought to be in the vein this clamp is released and the re- tort holding the salt sojution is lowered below the patient's arm. Buy Viagra Online Australia Paypal If blood is seen to flow freely through the glass part of .the tube near the cock, we may assume that the vein has been entered. The ligature around the patient's arm is then removed and the salt solution elevated and allowed to flow to sec if the passage into the vein is free or if a leak occurs from an Buy Viagra Online Australia Paypal imperfect entrance. If no swelling appears arotmd the needle after 50 c.c. of the salt solution have been allowed to flow, the cock may be Buy Viagra Online Australia Paypal so turned as to allow the salvarsan solution to pass into the vein. This is admitted slowly and discontinued if any untoward symptoms should de- velop or a leakage under Buy Viagra Online Australia Paypal the skin appear during the administration. This method prevents any loss of blood and elimi- nates the pain which would follow a subcutaneous escape of the salvarsan solution before the leak was discovered, while the salt solution does not cause pain or leave an induration. .Schreiber and others have previously suggested tiie injection of a physiological salt solution, but the plan 1 have described renders easy this preliminary test anrl there is no danger of displacing the needle while injecting the solutions. If the vein is not prominent, or if several unsuc- cessful attempts at introducing the needle have been experienced, cocaine is injected, an incision made through the skin, and the vein Buy Viagra Online Australia Paypal exposed so that the needle may be accurately inserted. After the sal- varsan has been administered the wound is closed with one or two stitches and covered with a sterile dressing. i he writer has administered one hundreBuy Viagra Online Australia Paypal this country bear out this statement, and yet we find many who still persist in giving the intramuscular injections. Many Buy Viagra Online Australia Paypal authori- ties at first believed this method to be a satisfactory one ; ])ersonaI experience and clinical reports, how- ever, liave convinced most syphilographers that the results were not nearly so trustworthy as when the salvarsan was given in the vein. Kopj), of Munich, writes of lieing discouraged by tile frequent local necrosis following subcutaneous injecti(