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upon the fringe of it. The importance, not only radiographically, but clinically and operatively, of the use of forced expiration and forced inspiration with or without vertical posture of the patient is manifest. 7. Therapeutics of Sugar. — Sawyer observes that the profession is much indebted to Dr. Goulston for his paper in the British Medical Journal for March i8th, showing forth the good effects of the exhibition of sugar in certain forms of Low Cost Viagra Canada cardiac fail- ure. His therapeutic suggestions rest upon sound physiological foundations, based upon recent ex- perimental research. The writer has used cane sugar freely and fre- quently during the last ten years or so with success in a variety of morbid conditions. In wasting dis- orders, in various forms of antemia, in adynamic varieties of rheumatism, and especially in the neur- asthenic manifestations of neurotic persons, he has found the continued ingestion of cane sugar markedly beneficial, increasing weight and power, and appearing to act not merely as a nutrient but also as a Low Cost Viagra Canada tonic in the best sense of that word — namely, as a very valuable medicine, "the continued administration of which in debilitated and relaxed conditions of the body imparts strength and vigor without producing any sudden excitement," and as a corroborant gently stimulating the vital energies to an aroused action Low Cost Viagra Canada by a kind of mild stimulation, slowly produced and permanent in effect. For an adult he has usually prescribed from a quarter to half a pound of lump cane sugar, to be slowly eaten daily, a lump or two to be taken at odd times through the day or night, but not just before a meal, the patient alwa}'S carrying a little store of the remedy with him, and eating some of it when so Low Cost Viagra Canada disposed. Now we shall have to think of members of the sugar group especially as sustainers and developers Low Cost Viagra Canada of the musculature of the heart, as in failure of com- pensation, and in a large variety of cardiovascular troubles. Our obstetric brethren might find the remedy useful in conditions of uterine atony, say as a particular nutrient during pregnancy. Cane sugar ma) be distinguished from other forms of sugar bv its luminosity in the dark when two lumps are rubbed together. LANCET April I, igii. 1. Ankyiostonia Infection, By A. E. Boycott. 2. Insanity. Low Cost Viagra Canada Melancholia, the Low Cost Viagra Canada Depressive Phase of Man- ic Depressive Insanity, By George M. Robertson. 3. The Diagnosis of Gallstones, By James Sherren. 4. Congenital Abnormity of the Heart : a Case of Cor Triloculare Biatriatum, By Jane 1. Robertson. 5. Slight General Enlargement of the Thyreoid Gland as Found in School Children, By C. W. Hutt. 6. The Fading of Aniline Stained Microscopical Prepa- rations, By Alfred C. Coles. 7. Extensive Blistering Occurring in an Infant ; Diag- nosis of Scurvy, By Stanley Bott. 8. Inhibition of Tumor Growth in Rats and Mice, with a Suggestion for an Ejnpirical Treatment in Man, By Helen S. Grunbaum and Albert S. Grunbaum. 3. Diagnosis of Gallstones. — Sherren briefly states the points he wished to emphasize Low Cost Viagra Canada as follows : I. Attacks of "colic" resembling those due to gall- stones may be the result of movable kidney or • i duodenal ulcer. It may be impossible to make a certain diagnosis without operation. 2. In the ma- jority of patients with gallstones "indigestion" is present for several years before the first attack of colic. This indigestion has certain features which often enable a diagnosis to be made, but is some- times suggestive of gastric or duodenal ulcer. An attempt should be made to recognize the condition early, so that operation may be performed at the ideal time, while the stones are still in the gall- bladder. 5. Enlargement of the Thyreoid Gland in School Children. — Hutt says that the chief ob- ject with which this paper has been written is to call attention to the fact that slight general enlarge- ment of the thyreoid is fairly common in some dis- tricts. The number of cases investigated unfortu- nately does not warrant any very definite conclu- sions. If, however, the investigation should be ex- tended by operations on the subject, made in the course of routine medical inspection of school chil- dren in a fair proportion of Low Cost Viagra Canada districts, an amount nf data might be obtained of sufficient value to aid in the elucidation of the retiological factors. In these cases Low Cost Viagra Canada the enlargement of the thyreoid was not con- nected with such symptoms as anaemia, mental hebe- tude, increase of the pulse rate, fine tremors of the hands, or exophthalmos. A well known textbook on diseases of children states that in these cases of simple bronchocele the thyreoid is sometimes pain- ful and tender. However, the condition in the cases seen by him did not give rise to any pain nor was the gland tender. 7. Blistering Diagnosticated as Scurvy. — Bolt saw a case, while sailing through the Red Sea, of an infant with a huge blister on the left side, ex- tending from the back of the neck to the whole of the surface under the chin, and from above down- ward between imaginary lines round the neck re- spectively, on a level with the angle of the jaw and with the clavicle ; the case resembled one of Low Cost Viagra Canada scald- ing. Smaller blisters developed on other parts; the child was rickety. Later, there were tenderne<^ ever the .shins and subcutaneous haemorrhage^. April 22, 191 1]