51 50 11 5 Venta De Levitra Generico En Mexico 15 29 December 35 50 45 -28 9 23J These temperature records seem Venta De Levitra Generico En Mexico to show that this local- ity is particularly favorable as a winter climate. Venta De Levitra Generico En Mexico The cold is not so great as to interfere with out-door exercise, and yet intense enough to secure a dry atmosphere during the major part of the time. The Venta De Levitra Generico En Mexico combination reads: dryness, purity of air, without marked diurnal variations of the ther- mometer. The western blizzards are unknown, and, although at times the winds are high, yet it does not blow so violent- ly as in certain western districts, while the accommoda- tions are most satisfactory. My records, it is true, show that occasionally days occurred which were not satisfactory — but they were very few. For instance, in 1883 it rained once in January; in 1885 there were four days of rain. In February of 1883 there were two days in which there was some rain, and in December about a similar record prevailed. The month of March, so disagreeable in other latitudes, is here about the same as December, growing warmer to- ward April. In 1883 there were only six days of high winds, and in 1885 only three. In the first year, March July 3, 1886. OOSKERT: A CASE OF IMPERFORATE ANUS. showed there fourteen beautiful days, and the other years fifteen. Lastly, when April is somewhat advanced, the in- valid can retrace Venta De Levitra Generico En Mexico his steps homeward. Cold climates suit some healthy persons better than warm, while with others the reverse is true. It is well to take this into account. I incline to think that — individual peculiarities Venta De Levitra Generico En Mexico aside — more benefit can be derived from the cold. The characteristics of the Venta De Levitra Generico En Mexico summer climate need no comment at my hands ; the fly-nuisance is reduced to a minimum by the last of June, and the insect practically vanishes as a plague by the mid- die of July. I think there are more rainy days in the Blue Mountain region than in the St. Regis, but the woods dry rapidly and the rains are seldom long continued, excepting in September, which in its latter weeks may be rainy. It may also be argued that air is mechanically cleansed by rain and snow, as it is chemically purified by ozone. Rain, as it were, washes out the atmosphere and carries with it to the ground not only its solid particles, but also its carbonic acid and ammonia, so that, unless in exceptional seasons, when rain is long continued, the unpleasantness may be salutary. If I were to indicate in closing a few observations based on the character of cases which one should select in which to send the patients away from home, it might justly seem as though I could say nothing new on this trite theme. It is a matter of painful experience that persons spend time and money and become exiles from home only to fall victims on the pathway to their El Dorado. In the com- plex clinical picture so many etiological and clinical factors appear that it is 'impossible to consider them briefly. The element in prognosis from the standpoint of pathology is the division of the pulmonary tissue involved and the locali- zation of the disease to a small area. For, even if breaking down of the lung occurs, the limited area involved becomes a prominent prognostic symptom. The eases most suitable for climatic treatment seem to me to be those in which the lungs are thickened and the vesicular structure not consolidated. In such cases, with or without bronchial catarrh, advantage can be sought from the climate cure — even in hereditary and tubercular phthisis — and I would include in this group cases in which limited local softening has occurred. The patients sent from home must be capable of living out of doors, and this precept often will determine whether one shall choose for a patient a cool, cold, or warm climate, the sea voyage, or the sea- shore. It would seem that, since chronic bronchitis is often so favorably modified by the sea air, a sea voyage may benefit those cases of phthisis in which the element of catarrhal bronchitis is a prominent factor. At sea the dampness and the high winds do not seem so unfavorable as on the sea-coast, and it is proverbial how the insular cli- mate of small islands (otherwise suitably situated) may often benefit chronic bronchitis. But it should be borne in mind that, when it is deemed undesirable to send a patient away from home, much benefit may be obtained by suitable attention to domestic hygiene. At home, with proper expenditure in securing appropriate heating and ventilation, with a suitably arranged dietary, one of the prime factors in the treatment of this scourge. one can often secure superior results, and one is tempted to severe reflections upon the misuse of the climate cure.