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The President, Dr. F. H. Williams, of Boston, in the Chair. Thirty-third Annual Meeting. Held in Atlantic City, N. J., buy silagra uk May 7 and 8, 1918. (Continued from page 443.) The Relation of War Wounds to silagra online Acute Endo- carditis. — Dr. H. T. buy silagra online Karsner, of Cleveland, re- ported that the incidence of silagra cipla acute endocarditis following wounds of the war justified calling at- tention to its bearing on pathology, clinical medi- cine, and surgery. In France, during the early months the surgery was much as is seen in civil life and the great contamination of war wounds was not sufficently considered. In eight months' ex- perience Doctor Karsner said he performed autop- sies on all deaths, eighty-eight in number, occur- ring in a military hospital. At first they were handi- capped by lack of laboratory facilities, but later exact measurements silagra 50 were silagra tablet taken of the weight of organs. Fourteen of the eighty-eight showed le- sions of acute endocarditis following septicemia and pyemia. The organisms responsible were mostly streptococci. Three showed staphylococcus aureus. In one case the perfringens was found in the blood stream at death. These infections fol- lowed multiple extensive wounds, not of buy cheap silagra any par- ticular type, where an attempt silagra price was made to save the injured parts and where the wound was al- lowed to drain pus for weeks. In the effort to save the joint, extensive damage was done to the heart and kidneys. In the later months of the war, an CiTort was made to determine whether the age of the soldier and the length of his term of service had any influence on these conditions. It was found that if the man was less than twenty-seven years of age and had less than twenty-two months service, the kidney weight and the heart weight was normal. The principal factor was the length of service, prolonged service leading cheapest silagra to a great in- crease in the weight of the heart. Dr. W. W. Ford, of Baltimore, stated that in experimental work with the gas bacillus there was a failure of the organism to multiply in the blood stream but if one introduced a young culture into rabbits or guineapigs the animals died. Rapid multiplication of the organism was found at the site of inoculation. Smears of the blood of heart, order silagra online liver, or kidneys showed a Gram positive, encap- sulated organism, or the gas bacillus. No multi- plication was found in the blood stream. The or- ganism was cheap silagra anaerobic and multiplied at the site of inoculation. Trench Fever.— Dr. Eugene L. Opie, of St. Louis, gave the result of his studies by himself and Doctor Strong, Doctor Swift, Doctor MacNeal, and Doctor Pappenheimer. From the beginning of the war, in IQ14, and more in 1915, there had appeared outbreaks of an ill defined fever, observed first by ■Graham, and named trench fever. Studies on the infectivity of the disease were convincing, and it was proved capable of transmission to human be- ings. The disease was characterized by sudden onset, inability to continue work, and paroxysms of fever. It was thought at first to be a modified form of typhoid in inoculated men. Pains in the limbs and skin spots occurred with the fever. The spleen became palpable and there were marked vascular disturbances. The disease might last for several weeks or months. Since it was thought that the disease was transmitted by lice, experiments were made by allowing lice which had bitten trench fever patients to bite healthy persons. The role of lice had been the subject silagra tablets of much discussion, and no steps had been taken order silagra by the British authorities to effect their extermination. Major _ Strong therefore obtained Red Cross funds for an ' investigation, and volunteers, from the American Expeditionary silagra 50 mg Force, offered themselves for exper- imental purposes. The volunteers were subjected to careful physical examination and charts were kept for a week preceding the experiment. Care- ful studies of the urine and feces were made, to exclude possibility of typhoid. Two problems were studied: First, infectivity of the blood, silagra 100 mg and sec- ond, transmission of the disease by lice. Of six- teen men inoculated with infected whole blood, fifteen buy silagra developed trench silagra uk fever. Of five inoculated with clear plasma, all contracted the disease. The corpuscles of the blood, then, did carry the infection. Inoculations of plasma, passed through a Berk- feldt filter, did not cause infection, i. generic silagra e., filtered virus, did not produce the disease. The inocula- tion period was from five to twenty days. The dis- ease was transmitted through three generations subsequent to the first inoculation. The second problem was to determine whether lice transmitted the disease. Of twenty-two volunteers, bitten by infected lice, fourteen developed the disease; eight volunteers, not purchase silagra bitten, did not develop the fever. Lice from trench fever patients were put upon the

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