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both extremities by attendants, while ethyl chloride fright or other emotion. If these do not prove suf- is sprayed over the epigastrium. ficient, we must call in the aid of opium to pro- When hiccough is associated with flatus, a bowel duce sleep, first trying a few doses of nitroglycerin wash .if soapsuds and turpentine combined is often or inhalations of amyl nitrite, the latter remedy cflicacious. or where the distention is great the old acting sometimes almost as a specific in its rapidity fashioned turpentine stupe often works like magic, of action and relief: and in the intervals, if the at- Ccrtain cases, however, resist all treatments, and tacks are of a recurring character, we must have the prognosis is grave indeed. The patient, weak recourse to tonics, internal and external, the warm from exhaustion, more or less cyanosed, with weak- bitters, capsicum, quinine, chirita, ironwood, etc., ened pulse, cold extremities, and worried, anxious pure air, exercise, and cold bathing. When hie- >3^ OUR READERS cough accompanies, or is a symptom of enteropto- sis, a tight binder is the indication, along with ab- dominal massage ; this also applies to hiccough following postoperative procedures for gallstone, gastrojejunostomy, or conditions where adhesions may have formed, creating a tendency to pull or drag upon the diaphragm. In irritable stomachs of hyperacidity a teaspoonful of olive oil will coat the stomach, quiet the spasm, and inhibit acid pro- duction for the time being. In these cases rest after meals is essential, since exercise delays the passage of food from the stomach. Persistent hiccough in newly born infants : The cause here is an excess of rennin, forming large curds in the stomach : another condition occurring in children over three months old is a hyperchlor- hydria, no mucin, and but little ferment in the stomach contents ; no pyloric tumor can be felt — this type is due to muscular incoordination of the muscles of the stomach, the central nervous system having not yet acquired proper control. Much pa- tience on the part of all concerned is essential. The treatment is necessarily a prolonged one. Small quantities of thin food, so as to avoid distention of the stomach, whey, raw meat juice, one ounce every 20 minutes for the first few weeks, slowly in- creasing to two. three or four ounces, adjusted to regular intervals ; milk, citrated to prevent curd- ling. It may be necessary to stop food by the mouth for a time to enable the spasm to subside. Systematic lavage may have to be resorted to, just before feeding, then twice daily" for several weeks, and then once a How Much Does Viagra Cost In Australia day for some weeks longer, using a solution of sodium bicarbonate, two grains to the ounce, through a Jacques How Much Does Viagra Cost In Australia soft catheter, No. 12 or 14. This should be continued for a time after "the hiccough attacks have ceased and the weight is steadily increasing. In hiccough following injuries, incarcerated hernias, and injury to the diaphragin, the treatment, of course, is to the How Much Does Viagra Cost In Australia condition, although these injuries are in the main fatal, nev- ertheless, very large doses of opium, even to the development of toxic symptoms, pin point pupil, etc., do much good. The best general remedy for an emergency is, without doubt, the nitrite group, nitroglycerin and amyl nitrite. The others may be good, but in general efficiency nothing else equals the foregoing wdien you need medication. Dr. A. de Yoanna, of Brooklyn, remarks: This movement is of a purely reflex character, though the spasmodic action be on the diaphra'^m, its point of departure may be on the abdominal or- gans or on the nervous centres. In ordinary cases it comes and goes spontaneously and is a matter of no consequence. It is often seen in children or adults, who have eaten or drunk immoderately or hastily, after long fasting, in diseases of the stom- ach, intestines and liver, and in nervous persons troubled with flatulence. It is an important sign in peritonitis, strangulated hernia, and other intestinal obstruction. We may have it in intermittent fever, How Much Does Viagra Cost In Australia and it is a grave symptom in typhoid. In nervous ])crsons it may be brought on by any excitement and generally disappears with its cause. Treatment. \\'e cannot certainly stop the hic- cough due to peritonitis, perforation, or in any DISCUSSIONS. LNt" VuKK Medicm. Journal. other case in which we need a surgical procedure (if in time), but I would like to call the attention of the profession to a drug which, if given, will stop the worst hiccough due to nervous or other hysterical causes. Five drops in a teaspoonful of any aromatic elixir of tincture of musk, given How Much Does Viagra Cost In Australia once or repeated after five minutes, will produce the magic effect of stopping the hiccough. For the drunkards, try aromatic spirits of ammonia. Dr. M. Ncitstaedter, of Nczv York, zmtes: It is my intention to speak of the Singultus gas- trkiis ncrrosus, and not of the hiccough accompa- nied by organic disease. In ordinarv cases, the drinking of a glass of water in one gulp, so as to hold the respiration in check for a few moments, will suffice. In my cases, where hiccough came five and eight times per minute during waking hours as well as during sleep, the following treat- ment has given uniformly good results : The strap- ping with zinc oxide plaster of the entire abdomen, beginning from the nipple lines of chest down to the pelvic prominences, and wide enough to encircle the abdomen ; in addition, potassium bromide, one gramme, and chloral 0.2 gramme at one dose, three times d^ily; exclusive milk diet and plenty of alka- line water, such as vichj-, not effervescent. Cases that did not yield to any other treatment for weeks have become well within a few days. After How Much Does Viagra Cost In Australia the hiccough subsides, tonics, such as strychnine, nitrate in doses of 0.002 gramme, three times daily, and a bland fluid diet. This should be kept up for fully three How Much Does Viagra Cost In Australia weeks. If, at the end of this time, hic-