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saw many cases, resembling Doctor Climenko's that began with symptoms indicative of neuritis. The very extensive trojihic changes, together with the history of onset, ven- strongly suggested those seen in Havana. If this were a Cialis From India Online Pharmacy true .syringomyelia, there ought by this time to he some obtrusive changes on the motor side; however, the type of .sensurv dissociation spoke for Cialis From India Online Pharmacy this diagnosis which he was Cialis From India Online Pharmacy inclined to believe was the true one. Doctor Cr.TMicxKO. closing the discussion, re- I'lied that the spine was deviated. There was also marked nivokvtnia and the \\'assermann reaction. PROCEEDINGS OF SOCIETIES- 479 both lluid and serum, was negative. When first studying the case, it seemed that the diagnosis would prove to be syringomyelia; the peripheral nerve condition as well as the skin, however, might speak for leprous neuritis. The patient had bulbar symptoms, difficulty in swallowing, and nystagmus — all characteristic in the differential diagnosis be- tween this condition and leprous neuritis. The progress was that of syringomyelia and there were other points speaking for this diagnosis. He had hoped that a name for the peculiar deformity this patient presented might be suggested. Cerebral Edema in Scarlet Fever. — Dr. Charles T. SnAi-tPE, of New York, described this condition Cialis From India Online Pharmacy which he had observed in several cases, where it masked the ordinary clinical picture of the disease so that there was some doubt as to the diagnosis. In scarlet fever the Cialis From India Online Pharmacy rash might be atypical and the mental condition marked and grave doubt might arise unless the variation in ty]_>e were recognized. In addition to scarlet fever, edema of the brain sometimes occurred during the course of measles and diphtheria, as well as i)oliomeylitis, the recent epidemic having offered splendid advant- ages for the study of the latter. The primary in- volvement might be that of the central nervous system. The mental symptoms might predoininate from the beginning, or they might not develop for twenty- four to forty-eight hours after the onset and they sometimes persisted for weeks after con- valescence from the infectious disease. There was an interrelationship between the cere- brospinal jjressure and that of Cialis From India Online Pharmacy the cutaneous circu- lation. This relationship was one of inverse Cialis From India Online Pharmacy varia- tion. In the infectious diseases, both during the early and late periods of the illness, marked cere- bral symptoms were frequently noticealjlc, as evidenced by stupor, low, muttering delirium, and slight retraction, possibly edema of the brain, re- lieved by a profuse cutaneous eruption, the out- break of which was a favorable prognostic omen. In the early stages the evidence of edema was to be found in the stupor, retraction of the head, the cephalic cry, the upward retraction of the eyes, muscular twitchings, tache cerebralc, delirium out of all proportion to the temperature, marked Macewen's sign, increased reflexes, and in some rare cases paralysis and a positive Kernig, Babinski, and Oppenheim. The correctness of the diagnosis is proven by lumbar puncture with release of spinal llnid under increased pressure and by the analysis of this fluid. In the later stages, the evidence was to be found in the melancholia and phobias in some cases, while in others there was hyperexcitability. The fact that the condition cleared up with spinal puncture and other appropriate treatment removed the probability that the condition was due to an- other underlying condition, especially when they .subsequently regained and retained normal mental- ity and health. Other evidence of the edema was to l)c lound in the varying degrees of retinitis and congestion and blurring the discs. F.denia of the skin, with infiltration of the tissues by leucocytes, was a feature of scarlet fever. If then, the rash "struck in," as the old expression had it, one might expect to find this edema in that por- tion of the body that had an mterrelationship, as to pressure, with the skin. One might therefore expect, from the clinical evidence, that the cere- brospinal axis would be the part to exhibit this edema : the speaker believed that this occurred. Dr. Lours Casamajor said that when he had had opportunity to see Doctor Sharpe's patients they had recovered, so that none of the delirious features came under his observation. However, there was evidence that these children had formerly suffered from cerebral edema and it was therefore fair to assume that the edema had been a part of the clinical picture. INloreover, the sections showed edema which was (|uite marked and infiltrations, especially in the lymph spaces of the brain, spoke for severe edema accompanying an infectious process. This delirious picture might not always follow edema, though Doctor Sharpe's point was well taken that there was such a clinical picture of a nervous system rash accompanied by infiltration. Pathological Effects of Streptococci from Cases of Poliomyelitis and Other Sources. — Dr. Carroll (t. Bull, of New York, said that prior to Cialis From India Online Pharmacy the recent epidemic it was not believed that polio- myelitis was caused by any organism that could readily be detected in or cultivated from the body fluids or tissues oi" victims of this disease. It had been experimentally established that conditions similar in every respect to poliomyelitis in man could be brought about in monkeys. Furthermore, it had been shown that this condition could be passed from one monkey to another by inoculating these animals with brain emulsions or filtrates. Therefore, the infecting agent was termed a filter- able virus. The recent epidemic, however, stimulated investi- gation on many lines and new conceptions arose as to the etiology. .V streptococcus organism was cultivated from various tissues of poliomyelitis patients; the throat, tonsils, and blood during life: the cerebrospinal fluid, the central nervous system lymph nodes at autopsies. Mathers said Cialis From India Online Pharmacy he had