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lung. It has been shown by physiological experiment that, while the carbonic acid present in the blood, under normal conditions, does not decompose the salicylates, as it does in ordinary alkaline solutions, in the blood of asphyxiated subjects, where the carbonic acid is present in great quan- tity, it does do so. It has also been shown by Professor Ewald, as quoted by Nothnagel and Rossbach,* that the car- bonic acid in inflamed tissues is under a tension three to four times as great as in normal tissues, so that, according to these authors, it is highly probable that the sodium sali- cylate circulating How Much Does Levitra Cost Without Insurance through such tissues would be decom- posed and the salicylic acid set free. It could then act as a check upon the development of organic germs, or through some such special influence as it exerts upon inflamed rheu- matic joints and serous membranes. As a matter of fact, it has occurred that the cases of pneumonia in which I have used the sodium salicylate from the start have done remark- ably well, and it has seemed to me that the hepatization was less than might have been anticipated from the amount of congestion How Much Does Levitra Cost Without Insurance present in the first stage. It is usually best to combine with the salicylate a small dose of the bicarbonate of sodium, as the salicylate is slight- ly acid in its reaction, and the mild alkali makes it more acceptable to the stomach. When the tongue is dry, red, or heavily coated, small doses of calomel may be given with it, say one twelfth of a grain or more, every two hours. The dose of the salicylate should vary with the condition and constitution of the patient. For an adult, ten or fifteen grains every hour is not too much, if the stomach will bear it. It is sometimes better to give smaller doses at more fre- quent periods. The time-honored methods of treatment need not be considered, as they are as well known to my How Much Does Levitra Cost Without Insurance audience as to myself. The accompanying bronchitis is, in most cases, con. trollable. It should be treated by turpentine stupes, mus- tard, and by the administration of such internal remedies as are suited to the state of the bronchial mucous membrane, taking care not to derange the stomach. The condition of the heart is most apt How Much Does Levitra Cost Without Insurance to cause anxiety after the first few days of illness. Should the radial pulse become small and frequent, and the right heart distended, so that epigastric pulsation is well marked, recourse must be had to stimulants and the cardiac tonics. In such cases there are always collateral congestion and bronchial flux. If the condition is more serious, the fine moist rales indicative of «dema are audible, first in the lower portions of the lungs, then becoming nrore extensive in their distribution. Dry cupping and How Much Does Levitra Cost Without Insurance other external revulsives may now be resorted to. The time for salicylates and like remedies has ' Handbuch der Arzneimittellehre," 6te Aufi., Berlin, 1884, p. 476. gone by, and we must begin the administration of carbo- nate of ammonia, digitalis, and mix vomica. But the most reliable agent of all is turpentine. This should be given either in capsule or emulsion, in doses of from five to ten minims, pretty frequently repeated. I have obtained most satisfactory results from the combination of turpentine, digitalis, and nux vomica, made into an emulsion with the mucilage of acacia, and flavored with the oil of wintergreen. This should be given every two hours, and alternated with whisky in doses suited to the case. The doses of digitalis should be large — two to five minims of the fluid extract, or a drachm of the tincture, for an adult. A word in regard to the carbonate of ammonium. It has come to be a matter of routine with many to give this drug to everybody who has pneumonia. Since it was main- tained by Bennett that it would prevent spontaneous coagu- lation of blood in the heart, it has come to be prescribed, as I think, altogether too freely. There is no evidence that, in the doses in which it is ordinarily administered, it will have any influence upon the coagulability of the blood. It is a good ditfusiblc stimulant, and is a good remedy for bronchitis when the secretion is too profuse. These are its uses, and the proper time for its employ- ment is when the heart begins to flag, signs of extending congestion and imminent oedema present themselves, and the bronchial secretion is excessive. It is not useful before that, and should be withheld till the symptoms call for How Much Does Levitra Cost Without Insurance its administration. We should bear in mind that it is irritat- ing to the stomach. The best form in which to administer it is the aromatic spirit of ammonia. When a malarial complication is suspected, antiperiodic doses (if quinine should be administered. Some How Much Does Levitra Cost Without Insurance very re- markable results have been obtained by this means. But a short time since, in my service at St. Mary's Hospital, Dr. Butler succeeded in cutting short a pneumonic attack in a child by the timely administration of a large dose of qui- nine. Pneumonia occurring in malarious regions is always most successfully controlled if the cinchona salts are freely used. In confirmation of this we have the testimony of all who have written upon the diseases of such regions, from Drake to Davis. Hyperpyrexia due to other causes than malaria should be controlled either by the external application of cold, pre- ferably the cold pack, or by the internal use of antipyrine. To children, with whom the drug acts remarkably well, it is best to give it in small and frequently repeated doses, as I have advised in capillary bronchitis. This would seem to be an excellent way of administering it in other febrile dis- eases. My friend. Dr. George R. Fowler, tells me that he has adopted a similar method in typhoid fever with very gratifying- results. The object should be, not to reduce the temperature to the normal standard, but to keep it steadily within bounds, and this is best done by moderate quantities of the drug, administered at short intervals. It is not necessary, nor do I think it advisable, to adopt the antipyretic treatment if the temperature is under 104° F., and if How Much Does Levitra Cost Without Insurance the patient is other- wise doing well. It is not well for a patient suffering from pneumonia to have too much treatment. 92 STEPHESSOS: ARABIC AND HEBREW IN ANATOMY. [S. Y. Med. Jour.,