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variation is the character of crude drug used, but even with the same drug the medicinal prepara- tions may vary considerably according to the man- ner in which they are made. Thus, the official fiuid extracts were found to be invariably weaker, rela- tively, than the tinctures, indicating an incomplete extraction of the drug. So called tinctures pre- pared from fluid extracts are correspondingly weak ; physician- >hould insist upon getting the genuine instead of such imitation tinctures. The strength of the alcohol used in making the prepara- tions has an important bearing upon their keeping qualities ; some of the special preparations made with comparatively dilute alcohol were found to be especially liable to deterioration. The bulletin closes with a discussion 01 two somewhat widely used specialties, digalen and digi- puratum. The tone of the bulletin is throughout moderate and conservative, and the author, a man of considerable clinical experience, clearly recog- nizes which part of the problems are the proper subjects for laboratory investigation, and which parts can only be decided clinically. SUPR.AREN.-XL INSUFFICIENCY IX INFEC- TIOUS DISEASES. Again attention is called by Coniby {Archives de medecine des enfants, January) to suprarenal insufficiency, frequent in the infectious diseases of childhood, particularly in the so called malignant types of scarlet fever and diphtheria. Formerly myocarditis and cardiac collapse were incriminated, Can You Buy Viagra Over The Counter In Canada likewise bulbar manifestations, but following the writings of Sergent, it was recognized that the asthenia, the weak pulse, the hypothermy, and the white line all pointed to suprarenal insufficiency. There is consequently much necessity for the study of the condition of the suprarenal capsules, both clinically and at autopsy, in cases of infectious diseases. Moizard, some time since, classified cases of suprarenal insufficiency by setting forth the prin- cipal symptoms. The asthenia frequently attains an extreme degree; the limbs are cold, and livid and present a marked cyanosis ; the heart beats are weak and the sounds dull : the arterial pressure fall? at least ten points ; vomiting is frequent, sometime.^ incoercible in character ; the abdominal pain may occasionally lead one to suspect appendicular in- flammation ; while the nervous disturbances an. variable, consisting of agitation, delirium, menin- gitic state, and coma. All these symptoms may develop suddenly and terminate in death, and, according to Moizard, the most common cause of sudden death in the infec- tious diseases is suprarenal insufficiency. General- ly speaking, however, the alarming condition rapid- ly disappears and the affection pursues its normal course. These facts should be Can You Buy Viagra Over The Counter In Canada known, because, Can You Buy Viagra Over The Counter In Canada when in presence of acute manifestations of this type, rapid action must be taken, and by proper treatment their gravity is decreased. If suprarenal insufficiency arises during the progress of diph- theria, Comby advises combining suprarenal opo- therapy with serotherapy. If syphilis is also pres- ent, suprarenal opotherapy may be associated with mercurial treatment. In the other infectious dis- eases, where no specific medication exists, opother- apy should be begun from the beginning of the symptoms of suprarenal insufficiency. Adrenalin may be given by the mouth, or, if the hypodermic method is used, i c.c. of a i to 1,000 solution is added to fifty grammes of normal salt solution and injected into the subcutaneous tissue. As this medi- cation is inoffensive, it can be continued daily until the accidents of suprarenal insufficiency have Can You Buy Viagra Over The Counter In Canada dis- appeared. ABSCESS OF THE ILIAC LYMPH NODES. Abscesses of the iliac lymph nodes require a com- plex classification, which is based both upon their primary site and their origin. The most interesting cases, those really meriting the denomination of iliac abscess, develop Can You Buy Viagra Over The Counter In Canada in the cellular tissue which spreads between the iliac fascia and peritonaeum, and should always be considered as developing in the lymph nodes. Bonvoisin (These de Paris, 1910) has recently studied those cases of lymphatic abscess which, in appearance primary, give rise to uncertainty in diagnosis and prognosis. It is to be recalled that the external iliac lymph nodes receive the lymph- atics of the pelvic organs, so that if the lower limb April 22, igjl.] EDITORIAL ARTICLES. 791 is normal, without ulceration or wound, ii is most likely in the pelvis that the causative lesion of the process is to be sought for. According to Bon- voisin, the uterus is practically the only organ responsible for lymphatic infection and post partum or post abortum infection is nearly exclusively the cause. In cases of primary iliac lymphatic abscess all digestive symptoms are wanting and movement of the coxofemoral joint is possible. It is above Pou- part's ligament that the abscess projects and spon- taneously opens. Rupture of the abscess into the intestine is most infrequent, likewise ulceration of the iliac vessels. Consequently it would appear that the prognosis is good, which is quite the con- trary to that of other pus collections in the iliac fossae. These abscesses should be opened and drained before fluctuation ha? been detected.