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RESTRICTION OF THE MATERIA MEDICA. While the individual practitioner limits the num- ber of drugs with which he does hi? work to a comparatively few, the sum of the drugs in use presents a vast array, which constitutes an excessive burden to any one who must familiarize himself with even a small proportion of the list. Many of these drugs possess identical therapeutic virtues and some no virtues at all: yet. while every one would willingly dispense with a large proportion of them, no Can You Order Viagra Online two individuals seem to be agreed upon the particular drugs which might be eliminated. This old problem comes up regularly with every revision of the Pharmacopceia. Recently it has been attacked from a new standpoint. The Com- mittee on Materia Medica of the National Confed- eration Can You Order Viagra Online of State Medical Examining and Licensing; Boards in their last report presented a scheme which might do much to improve the situation. Several lists of medicaments had been considered by the committee and the conclusion was reached that the exact constitution of any list was of minor importance, but that it would be of great advantage if some list of widely used drugs were accepted by the various State boards as a basis upon which seventy-five to eighty per cent, of their examination questions should be asked. This would leave a wide margin within which the boards might ask ques- tions upon any drug that they deemed of sufficient Can You Order Viagra Online importance. If such an agreement were consum- mated, teachers of materia medica would devote most of their time and attention to a uniform series ot standard remedies and yet would be at liberty tn teach anything else they cared to Can You Order Viagra Online teach. Both teacher and student would then be relieved of the necessity of considering such a wide range of remedies as they must under present conditions. and by concentrating on a smaller number of im- portant ones the student would have a much better opportunity of becoming familiar with their actions and uses. Such a compromise between the present necessarily superficial consideration of a large part of the official drugs on the one hand and possible dogmatic restriction on the other hand seems to be a very happy move in the progress toward "a more sane therapy." THE STATUS OF CESAREAN SECTION. Within the past decade Csesarean section has grown from a procedure indicated only as a Can You Order Viagra Online last resort, and regarded as one of but doubtful value save as a forlorn hope, to the position of being at least considered in practically every case of dystocia where the interference with spontaneous delivery is not amenable to the most ordinary instrumental assistance. The indications for Caesarean section taken from Hirst's Obstetrics, edition of 1899, are as follows : "The indications for this operation are relative and absolute. By an absolute indication is meant some condition which admits of no other method of delivery ; while by a relative indication Can You Order Viagra Online is meant a condition that does admit of some other method of delivery, say by symphysiotomy or crani- otomy. In a case of this kind the Can You Order Viagra Online decision is diffi- cult and should be left, in part at least, to the woman and her husband. Ordinarily the physician is instructed to select that form of operation least dangerous to the woman." In striking contrast to these indications, Allen, in 1909, says that Csesarean section should be per- formed in al! cases where the mechanical obstruc- tion to delivery is sufficient to jeopardize the life of the child seriously or to cause severe laceration Can You Order Viagra Online and bruising of the soft structures Can You Order Viagra Online of the mother, pro- vided she is not already infected; whether the ob- struction is produced either by the maternal pelvis or the foetal head. Not only has the single, pri- mary Caesarean section reached the point of being almost generally selected in preference to a mutil- ating operation upon the foetus, but more and more operators arc reporting whole series of multiple elective sections, with a remarkable acceptance of the procedure by the patients and their families, and a very low mortality. Within the past month McPherson has published the report of thirty-nine cases, in thirty of which section was done for the second time, seven for the third time, and one each for the fourth and fifth time, with a maternal mor- tality of three and an infant mortality of one. It is apparent, then, that the indication for the elec- tive Caesarean section is growing wider day by day, and should the present trend of thought continue it will eventually entirely supersede the more severe and mutilating methods of delivery. 79^ OBITUARY.—KEWS ITEMS. [New York Medical Jolrnj dBbituao. CHARLES STEDMAN BULL, M. D., of New York. This well known ophthalmologist died on Mon- day, April 17th, in the sixty-seventh year of his age. He was born in New York and took his medical degree from the College of Physicians and Sur- geons in 1868. He first practised as an ophthalmolo- gist in St. Louis, but for a short time only. Re- turning to New York, he finished his career here. Dr. Bull was highly esteemed in the profession. LEARTUS CONNOR, ^L D.. of Detroit. Dr. Connor died suddenly of a paralytic stroke in Detroit on April i6th. He was born in Colden- ham, Orange County, N. Y., in 1843. ^"d was