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portation through the mail as second-class matter. NEW YORK. SATURD.JiY, APRIL 22. 191 1. A NEW SYMPTOM IN SCARLET FEVER. In the February number of the Archives de medecine des enfants, Pastia, of Bucharest, de- scribes a new sign in scarlet fever which, if it is of constant occurrence, will prove of as great diagnos- tic value as Koplik's spots in measles. This sympn tom consists Viagra 100mg Street Price of transverse lines, usually two or three, in the fold of the elbow. They are of a rose red hue at first, but in a few days turn red or wine colored. In the severe cases they are ecchymotic. Between the lines the erythematous eruption char- acteristic of scarlatina is seen. Similar lines have been observed in the axilla in a few cases, but they are of less intense color and of shorter duration in that situation. These lines are visible before the appearance of Viagra 100mg Street Price the rash, remain throughout the eruptive stage, and persist as lines of pigmentation after desquamation is completed. Pastia found this symptom present in ninety-four per cent, of the cases of scarlet fever in the hospital for contagious diseases in Bucharest. As far as his experience goes, it is absent in the other exanthemata and in all forms Viagra 100mg Street Price of drug rash. If the danger of contagion is greatest during the tonsillar stage of the disease and not during the period of desquamation, as was formerly thought, any symptom which will aid in establishinr' the diag- nosis before the appearance of the rash will be of great value in preventing the spread of the infection. DIGITALIS STANDARDIZATION. The necessity of occasionally examining, espe- cially by new methods, some of the commonly ac- cepted views concerning even well known drugs is well illustrated by a bulletin on Di,^itali.'! Standard- ization by Dr. Worth Hale, recently issued by the Public Health and Marine Hospital Service. The author endeavors to trace the origin of certain prevalent beliefs concerning this important drug, and to determine, by experimental methods, to what extent they are valid. Thus, ever since the time of Withering, the view has been quite generally ac- cepted that digitalis leaves gathered from wild growing plants were more potent than those from jjlants growing in the garden : this view has found expression in a number of pharmacopoeias. Hale, using the method of physiological assay adopted by the Hygienic Laboratory, found various American garden grown digitalis leaves to give tinctures more potent than any commercial tinctures available with one exception. He also Viagra 100mg Street Price calls attention to the fact that Allen's English leaves, which prove very active both in the clinic and in the laboratory, are garden grown. He admits that wild growing leaves may at times be more active than cultivated ones, but he doubts whether cultivation has anything to do with it. Another still more widely accepted view, and one which has found expression in most of the pharma- copoeias Viagra 100mg Street Price of the world, as well as in the International Protocol, is that only second year digitalis leaves should be used. Hale states that he has been un- able to trace the origin of this view, but that it is quite old. It is quite possible that in reaching this conclusion authors have confounded various fac- tors. Thus, Tourdes, in 1867, attributed the greater activity of Viagra 100mg Street Price the digitalis at Strassburg partly to the fact that only second year leaves were used ; it now seems probable that the leaves of this region are usually more active than those grown in some other localities. Experimental work by Focke and by Hart had already indicated that first year leaves might be as active as the second year leaves or even more active. Hale obtained similar results, finding the first year leaves to be from twenty-eight to forty per cent, more active than those of the second year. Great emphasis has been laid by Viagra 100mg Street Price many writers and by some pharmacopoeias upon the methods of drying and preserving the leaves. Some believe that the moisture should be rapidly reduced to 1.5 per cent. ; others that the drying- should be Viagra 100mg Street Price done in a vacuum, etc. Hale found that mouldy leaves might lose ninety per cent, of their activity within a few months, but he does not believe it necessary to take the elaborate precautions to reduce the moisture to a minimum recommended by some, and he considers vacuum drying entirely superfluous. These illustrations show that a number of the cur- rently accepted views concerning digitalis are at least open to question; Hale does not advocate changing the present methods, evidently believing 79° EDITORIAL ARTICLES. [New York Medical Jovrxal. that further evidence should be collected. More important than these suggested causes of variations of digitalis leaves are the well established facts that the locality in which the plants grow alters the amount of their active principles ; that this varies with different seasons ; and, more important still, that Viagra 100mg Street Price leaves of the Viagra 100mg Street Price same locality and of the same harvest may vary considerably. The facts make it highly desirable that a uniform method of stand- ardization be adopted, Viagra 100mg Street Price and at present only the phy- siological methods are available. Hale next discusses the causes of the variations of the medicinal preparations of digitalis ; it was found that the commercial tinctures, fluid extracts, tablet triturates, hypodermic tablets, etc., varied by as much as 360 per cent., and that the variations in the case of some of the special preparations were even greater. The most important factor in this