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cordal arrangement, etc., which separate it from human forms — the writer believes that difTerences in morphology are of more value in comparative pa- thology than similarities — are probably due to the fact that the cirrhosing substances generated in the intestines of this phalanger — simply had the proper, nice, chemical constitution to set up those reactions in its hver cells which in the end determine the morphological changes of reversion without at the same time stimulating notable fibrous tissue formation. In human cases, on the other hand, such substances afifect the fibrous tissue, not to enter into the question of stimulative or replacement overgrowth, to such Ordering Generic Cialis a degree as to hinder or prevent the recognition of the real nature of the parenchymal changes. Had the moiety of fibrous tissue in this animal's liver increased markedly and contracted, it is conceivable that it could, say in a year, have so compressed, distorted and atrojihied "these "ducts" that the pic- ture would finally have been the same that we now Ordering Generic Cialis commonly see in human Ordering Generic Cialis atrophic cirrhosis and some of whose "ducts" we call ducts. Reviewing and broadly comparing finally the findings in this case and those heretofore reported in human ones, we find that we can confirm Mal- lory's fat inclusions, and report a new and valuable feature consisting in Ordering Generic Cialis the arrangement of the "ducts." Whereas before we depended for positive evidence mainly upon Ackerman's questionably valuable find- ings, and Mallory's and Adami's as to cell charac- teristics, now we have the additional and important one of maintenance in cords and preservation of sinuses to betray the real nature of the "ducts," and we have probably been thus fortunate because we have stumbled across an animal in which the etiological factor did not. produce enough fibrous tissue to destroy this arrangement as it does in hu- man cases. REFERENCES. I. ADAMI and NICHOLLS: Principles of Pathology, 1909, ii, 169, Lea and Febiger, Philadelphia, Pa. 2. JOSEPH Ordering Generic Cialis McFARLAND: Textbook of Pathology. 1910, 2nd edition. 332. W. B. Saunders Com- pany. Philadelphia, Pa. 3. F. Ordering Generic Cialis B. MALLORY: Principles of Path- ological Histology, 1CH4. 515. W. B. Saunders Company, Philadel- phia. Pa. 4. W. G. McCALLUM: A Textbook of Pathology. 1916. 311, W. B. Saunders Company. Philadelphia. Pa. 5. A. O. J. KELLY: Osier's Modern Medicine. 1908. v, 768, Lea and Febiger, Philadel- phia. Pa. 6. William Wood & Co.. New York, loth edition, 727. 7. SCHMAUS and HERXHEIMER: Griindniss der Pathologischen Ariatomte, 1915, 630 and 633. 8. HERBERT FOX: Cirrhosis of the Liver in Wild Animals, New York Medical Journal, December 19. 1914. 242 XnuTii .^ixTV-FiRST Street. TRICHINOSIS. A Group of Twelve Cases. Hv Ordering Generic Cialis James G. Gumming, M. D.. D. P. H.. San Francisco, Cal., Captain. M. O. R. C; Assistant to Department Surgeon, San Francisco. Cat; Ordering Generic Cialis Recent Director. Bureau Communicable Diseases. California State Board of Ordering Generic Cialis Health. The outbreak of trichinosis which occurred at San Rafael, California, presents several interesting points. First, there were twelve cases in a family of thirteen; one memljer, the nine months old infant, escaped infection. Second, the diagnosis was for some time obscure, the attending physician having naturally regarded the cases as suspected typhoid fever. Third, although four of the twelve had severe symptoms, Ordering Generic Cialis there were no deaths. Several members of the family had been sick for about a week before Ordering Generic Cialis the county physician was called. Then. as they were in poor circumstances, he ordered the sick to the county hospital. During the following four days, the remaining members, with the excep- tion of the infant, became ill, and were admitted to the same institution. Owing to the similaritv of the early symptoms in this group of cases to tyi)hoid fever, blood specimens were brought to the labora- tory of the Bureau of Communicable Diseases for the Widal test. When a negative report was made on these specimens, the hospital authorities sug- gested that this bureau make an investigation to; determine the nature of the infection. In studying the hospital records of these cases it was noted that the temperature charts simulated those of typhoid fever; the temperature was high, ranging from loi" to 105° F. in all cases. Case I.^Mrs. A,, the mother of the family, in describ- ing her symptoms, stated that there had been neither head- ache nor backache, there had been no diarrhea, but there was weakness, stiffness, and pain in the limb muscles. She found it difficult to extend her legs and when doing so there \yas some pain. The leg muscles were found to be quite rigid ; there was pain on active and passive motion, and this was marked on pressure, especially over the ex- tensors of the foot and flexors of the thigh. The arms were but moderately involved. The muscle soreness and stiff- ness at about the tenth day of the illness Ordering Generic Cialis were far more ex- tensive than in typhoid fever. The eyelids were moder- ately swollen and Ordering Generic Cialis there was a clean red tongue. rhe symptoms in this group of cases ranged from a mild fever only, in the younger children, to a temperature of 105° to 10(3° F, with marked mus- cular involvement in the older ones. C.\SE II_— T.. age fourteen years, was typical of those most Ordering Generic Cialis 4-12 CUM.UIXG : TRICHINOSIS. (New Yore Medical Jodenal. severely Ordering Generic Cialis affected. At the time of examination, about the