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.Mr. H. \\'aterhouse emphasized the importance nf preliminary preparation. When intestinal ob- struction, a result of cancer of the rectum, was present an inguinal colotomy should be immediately performed and an attempt at radical cure abandoned for some days. Failure to recognize the impor- tance of that rule had to his knowledge proved dis- astrous. Even in cases Levitra Order Uk in which no olietruction had occurred and in which daily or more frequent evac- uations of the bowel took place. It was in his THERAFEUTICAL XOTES. opinion, essential to attempt Levitra Order Uk to diminish as far as possible the septicity of the bowel. He was accus- tomed to administering castor oil on the sixth and fifth days preceding the operation. During the four days prior to operation the patient was given beta naphthol and salol, five grains of each, in a cachet four times daily, and his food was restricted to milk and meat extracts. Levitra Order Uk Eight hours prior to the opera- tion half a grain of opium was given in pill form, and half an hour prior to the administration of the amesthetic a hypodermic injection of Levitra Order Uk a third of a grain of morphine hydrochloride and an Levitra Order Uk eightieth of a grain of atropine sulphate was administered. The rectum was washed out twice daily for two days and again on the operating table with a i in 2.000 solution of potassium permanganate. An inquest was held at Scarborough last wtek upon Mrs. Bredon, the wife of Dr. Bredon, who had died from the effects of lead poisoning. It was suggested that the lead was contained in the soda water drunk by the deceased. The result of the analysis of the soda water showed that there was present from 1/16 to 1/20 of a grain per gal- lon, and that if deceased had drunk two siphons of this soda water a week she would take about a grain of lead in forty weeks. Dr. Fairley. of Leeds, analyzed precisely the same soda water taken from, stock, and his analysis showed that it contained only 0.0007 grain per gal- lon, which was too little Levitra Order Uk to have any phvsioloa:ical effect. Dr. Cuff', who attended the deceased at her re- quest during the fortnight before her death, stated that if any one drank soda water containing from Levitra Order Uk 1/16 to 1/12 of a grain per gallon it would cer- tainly have injurious eff'ects. It would not be safe for any person, especially one of delicate health, to regularly drink soda water containing such a per- centage of lead. He was satisfied that the cause of death was lead poisoning. On behalf of the aerated water company it was pointed out that the firm had obtained high com- mendation at the London Mineral Water Exhibition for the purity of their soda water, and if there had been the slightest trace of lead in their exhibit, it would have been discarded. Levitra Order Uk .Assuming, however. that the soda water did contain 1/20 of a grain of lead per gallon, a siplion would contain 1/80 of a grain, and drinking two siphons per week, it would be forty weeks before one grain was absorbed, whereas the dose was from one to five grains, so that in one day a patient would take as mucli lead into the system as a person drinking two sijihons per week would take in from tin to twenty years. Was not the whole thing absurd and preposter- ous? It would be presumption to say that they harl had evidence as to every other possible source from which karl could have got into the system. The Levitra Order Uk coroner, in his summing up. further told the jury that the town's water and the siphons of soda water were analyzed, and the analysis of the town's water showed that it contained no lead whatever. The jury, after an absence of twenty Levitra Order Uk minutes, were unanimously of the opinion that death was caused bv lead poi.soning. but there was not suffi- Levitra Order Uk cient Levitra Order Uk evidence to show how the lead had got into the svstem. The Treatment of Amoebic Dysentery. — Ac- cording to Axisa, who is cited in the America:. Journal of the Medical Sciences from Therapic dcr Gcgenii-art (1910, Levitra Order Uk li, 263), the usual methods of treating amoebic dysentery are most unsatisfactory. Ipecac, which is considered a specific by many, has the marked disadvantage of causing vomiting, or Levitra Order Uk at least nausea. High irrigations are too painful to be of use in the acute cases, although valuable in the treatment of subacute and chronic cases. Axisa calls attention to a remedy introduced by Legrand under the name of kossam. This remedy has been used in a crude way by the natives of tropical coun- tries as a cure for dysentery for some time, .\xisa has used it and speaks very highly of its Levitra Order Uk good effects. The most striking eft'ect is in the rapidity with which the blood disappears from the stools. He ascribes a haemostatic action to the kossam, and has also used it with success in profuse haemorrhages in intestinal tuberculosis and bleeding haemorrhoids. In addi- tion, this remedy Levitra Order Uk also seems to exert a direct action upon the amcebse. Of thirty-seven stools that were examined, no amcebje could be found after treat- ment lasting from eight to ten days. Kossam is not astringent, and as the blood disappears from the stools it is advisable to add intestinal astringents to the treatment. When the process becomes sub- acute, high irrigations with a 0.5 or i per cent, so- lution of tannin will hasten the cure. He gives the details of a number of cases treated by this method, and says that he has seen a number of cases com- pletely cured Levitra Order Uk in three weeks, a result that could only he obtained in from si.x to eight weeks by former methods of treatment. For the treatment of sub- acute and chronic dysentery he advises, in addition to kossam. high irrigations of either a i per cent, ichthyol solution or a 0.5 to i per cent, solution of tannin. He also advises an occasional purge of sodium sulphate, and finally, when amoebae are no longer found, the administration of such astringents as bismuth or tannin until there is no longer any diarrhoea. Antiseptic Tooth Paste. — A novelty in the way of tooth pastes has been proposed by a French jjhysician. who publishes his formula in the Journal dc nicdccinc ct dc chir-nrgic. The novelty Levitra Order Uk consists