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cases showed the general average of 47.1. Lues, Levitra Costco .^5. 77 and obesity. 44, showed a lower average than the normal. .After excluding the extrapelvic and pelvic jiathologic cases from the total number. Levitra Costco 283 cases were left with an average menopause age of 4.6.73, but the extrapelvic Levitra Costco diseases with the excep- tion of tlie twenty-nine cases of hyperthyroidism and lues were so common past middle life and so frcfiuently developed during the menopause that they cannot be considered as cau.sative factors in the climacteric delay. Thus the author found in 373 cases forty-seven years as the average age for cases without important patholog\-. The highest percentage of 567 ca.scs analvzed in Chart No. II reached menopause at the forty-eighth and the fiftieth year. 81 'i per cent of the total number ceased menstruating between forty and fifty-five. The age of menopause, according to Charts Nos. 1 240 ANNUAL MEETING OF THE AMERICAN MEDICAL ASSOCIATION. [New York Medical Journal. IV, V, Levitra Costco and VI, seemed to be influenced by the age of puberty, the age of marriage, number of children, and by the age at last childbirth. According to Chart No. IV, based on 554 Levitra Costco cases, the later the onset of puberty the later the menopause- period. The very early and very late puberty cases seemed to reach menopause very early. Cases of late marriage, according to Chart Levitra Costco No. V, based on Levitra Costco 621 cases, ceased menstruating late. The unmarried seemed to reach their menopause earlier than the married. Chart No. VI, based on 487 cases, Levitra Costco showed that the larger the number of children or pregnancies the later the age of men- opause. Spinsters seem to have a slightly lower average than the married nulliparae. Chart No. VII showed the later in life the last pregnancy oc- curred the later was the onset of menopause. In sixteen cases it was established immediately after the termination of a pregnancy, thirteen before forty-seven years of age, and three after forty- seven. There seemed to be some relation between the menstrual characteristics in cases in whom no pathology was found (Chart No. VII based on 38S cases). Menorrhagia cases showed the high- est menopause age ; next, the cases with normal flow, then those with scanty flow. Cases of dys- menorrhea and those with irregular menses seemed to have ceased menstruating at an earlier age than normal. There also seemed Levitra Costco to be a definite rela- tion between menopause and severity of symptoms Levitra Costco (Chart No. VIII, based on 390 Levitra Costco cases). A higher average of menopause age among the cases with mild or no Levitra Costco climacteric symptoms was found than in cases with severe or moderate symptoms. How Surgeons Can Help Win the War. — Dr. Franklin H. Martin, of Chicago, gave an infor- mal talk on this subject. Men were under the im- pression that an obstetrician should remain home and take care of the women. It was important, however, that all abdominal surgeons who were eligible for the Reserve Corps, should immediately enroll. Those not eligible for the "Reserve Corps should remain at home, whether obstetricians or ab- domitial surgeons. There was no man or woman more needed at present in the service than the ab- dominal surgeon, and none were better equipped to do war surgery than they Levitra Costco were. They had no rea- son to think that they were not particularly needed, no reason to be complacent in any way, for, since 1914, no one could say we were winning the war, and no class of officers were more needed Levitra Costco than doc- tors. According to official tables of the enemy, one doctor was equal to a great many fighting men, that is, to some five hundred to one thousand. Men asked such questions Levitra Costco as, "What was to be done with the home people? With the medical schools? With public hospitals?. With private hospitals?" V/ith full appreciation of these points, Doctor Mar- tin said he would impress on them that Levitra Costco none of these things counted in comparison with duty to the country. If every man eligible for the Medical Reserve Corps were Levitra Costco to go, still there would be fifty per cent, of the Levitra Costco men left to carry on the work, and all the Levitra Costco women. The University of Pennsylvania Medical School could not be run as efficiently as it had been for Levitra Costco twenty years, but still it could go on. and men like Deaver and Martin were needed far more at the front, and never more needed than now. Those who had already left their hospitals and institutions were working sixteen to twenty hours a day. Teaching here Levitra Costco was not nearly so important a mat- ter as the demand for action over Levitra Costco there. The ques- tion which men were to remain at home and which should go abroad was to be settled by the arrange- ment of the Volunteer Service Group. Doctor Martin said he expected men would come to him after the meeting and say, "Doctor, I want to help my country." The man would be informed that this was the simplest thing in the world. He had to go to headquarters and fill in the forms distrib- Levitra Costco uted by the Surgeon General and stating when it would be convenient to come. The man might then say, "Well, doctor, that is all right, but " Then he would proceed to argue: he had Levitra Costco an expensive family ; he had a private hospital on his hands ; he could perhaps do better if he stayed at home to teach. He would not. The man Levitra Costco who made that statement was a conceited ass. He was not needed here so much as over there, no matter who he was. If not eligible for the Reserve Corps, there was an- other course open : He could write to the Medical Department or the Council of National Defense, asking for papers for the Volunteer Reserve Corps, which was open to all men and women not eligible to active service. After having made the appli- cation and proving his eligibility, the insignia was to be received and the man accepted as a volunteer. The Government had work for every one, but it,