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tendance, and even if there is, you should not ig- nore the ruling spirit of the family. You may with safety practically ignore the other people who Viagra Generic Date are present, but be careful not to slight the head of the house. When you have gained the confidence of your lit- tle patient and are ready to examine him, there are a few pointers you should remember when making a physical examination of a child. It is doubtless unnecessary to caution you against putting Viagra Generic Date your naked finger in a child's mouth : always use a spoon or tongue depressor, and thoroughly sterilize it be- fore and after using. Rut never omit the examina- tion of the throat, mouth, and Viagra Generic Date tongue. In auscultating the chest, always use Viagra Generic Date a stetho- scope. A child will usually remain perfectly quiet if you plav that the stethoscope is a telephone, or trumpet. Remember that intestinal Viagra Generic Date gurglings and rattling of mucus in the nose are sometimes mis- taken for bronchial rales. All chest sounds of chil- dren are louder on the right than on the left side. In infants and young children the inspiratory sound can be heard plainly, the exjjiratory being alir.os undistinguishable. When percussing the chest it is well to have the child sitting up if possible. Re- member that a quick respiration — even with soine fever — does not necessarily mean an involvement of the lung: it's the character of the breathing that counts most. It is well to remember that functional murmurs are not uncommon in childhood, and that in infants the apex is outside the line of the nipples and the first sound is equally clear at the arterial and venous orifices. There is no accentuation of the second sound from birth to puberty, .\nasmic nnu-murs are rarely heard in childhood. Do net forget the marked changes that take place in the area of cardiac dulness between the first and twelfth vears of age. Never percuss the heart of a verv sick child, and do not auscult while the child is crying if vou can avoid it. Remember to always carefully palpate the body of a child, and do not forget to warm your hands first. I'.y palpation (ue cati fee! rales, a solid lung, fluid in the chest, the thrill of a roughened heart valve, and many o;her things. Vou will be surprised what you can learn bv the careful palpation of Viagra Generic Date a child's body — the abdo- men, spini'. epithruclilear glands, the liver and spleen, head, joints, etc. When you start out to examine a child let it be thorough ; overlook nothing. It will be easy to ex- amine some children ; in others who have been spoiled, like little Robespierre, the task will not be so easy, even though you are an expert in handling children. There are some children, like Robespierre, who have been spoiled by over indulgent and foolish parents, who will whine and kick and scratch when an}- doctor attenijjts to examine them. They are thoroughly spoiled children and are always hard to hauflle. and they do not improve much as they grow up. They become the neurasthenic, hysteric, wilful, opinionated, fussy, disagreeable, unstable "cranks'" and "grouches" so many of us hav-e to deal with. ( )h ! If parents would have a little more common sense and control over their children ! You must ignore the whims and wishes of such a child as Robespierre and get down to business at once if )-on find that all your efforts to win his friendship and confidence fail. Neither should you yield to the caprice of mam- ma, who may Viagra Generic Date say: "Maybe he will let tiic hold his tongue down," etc. Do your own work, and in cases of a spoiled family pet who cannot be rea- soned with waste no tiine dilly Viagra Generic Date dalling with the child or its parents, but proceed Viagra Generic Date Viagra Generic Date kindly but firmly and deliberately to examine the patient, and rather than submit to any foolishness or interference on the part of the parents you had better quit the case. .\s regards medicine, the up to date doctor is giv- ing less medicine nowadays than formerly, but is giving better medicine. Whoever now prescribes nauseous, repellent medicines injures both himself and his profession and is deficient Viagra Generic Date in one of tlie most simple and essential requirements. To do so is an admission that one is behind the times. .Some people patronize certain irregulars for no better reason than that the children take their medi- cine easily, knowing from experience that an at- tempt to give pills, powders, capsules, or bitter, nau- seous spoonful doses to children who have not been taught obedience, or .spoiled and humored tyrants like Robespierre, whose nurses and mothers have taught them to Viagra Generic Date fear the "doctor" as a "bogey man." means a Viagra Generic Date fight or failure, and a' nervous infliction on the child, parents, and everyone concerned. Under these circumstances, even should the medicine ef- fect a cure, the cure is perhaps worse than the dis- ease. It is the dulv of every physician who believes Viagra Generic Date in the efficacy of drugs (and every one should, and does if he is not fossilized) to sec to it that his little ])atient is able to take easily and retain the medi- cines he prescribes, palatable prescribing being one of the essentials to success in the management of sick children. Viagra Generic Date Do not. however, subordinate efficiency to jiala- tabilitv. Roberts I'.artholow once said, in effect, that the mere ability to prescribe Viagra Generic Date elegant, good tastint; medicines might enable a man to make a good med- ical confectioner, but not necessarily a scientific medical practitioner. Fortunately, power in action and facility in administration can now be combined without Viagra Generic Date de- Januar U'AXDLESS: THEORY OF TRACHOMA. scending to such trivilalities by employing concen- trated preparations of medicaments such as the alkaloids and other active principles, and by their arrangement in such form as to secure facility of administration and precision in action.