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spite of all directions, some men, knowing they must take three doses, will get back in line for an- other dose. Thus no difficulty is experienced, even with the short lived memory of colored troopers joker poker slot machine cheats : for trikresol leaves a white spot for several weeks, and it is impossible to mistake the number of doses received. The cleaning up process is conducted in a line and may be as rapid as desirable. The needle holder is sterilized and the needles as they are boiled are removed from joker poker slot machine games the water with the boiled clamp and dropped point down in the holes ; the bases, projecting above the surface, are readily accessible without the machine poker gratuit avec joker necessity of handling. The vaccine am- poules are kei)t in a i to 500 mercuric chloride so- lution, joker poker machine strategy removed, and dried as needed, and, after shaking, scrritclied with a file and broken at the neck; the sterile needle is then inserted into the am- poule and the .syringe filled ; the use of the vaccine from the original container eliminates one source of infection, while the small opening minimizes dust contamination, which is a factor where so many persons are constantly moving. By means of this equipment, two medical officers, assisted by four men, and one jeux machine poker avec joker gratuit noncommissioned officer in charge of records, have been able to maintain an average of between four and five doses to the minute for an hour or more ; it has made the vaccination of from 150 to 300 men (a not unusual dailv occurrence) a mere incident instead of a rather formidable task. 3. Industrial Phosphorus Poisoning. — Ivy states, as a free joker poker slot machines result of his investigations, that the facts all point to a local infection of the jaw bone by the phosphortis through diseased teeth as the essential factor in necrosis. In view of the results of observations on 177 persons for periods ranging from six months to two and a half years, it is justi- fiable to conckide that the measures of inspection and prophylaxis in operation at the present time are effectual in the prevention of necrosis in persons employed in the manufacture of matches from white phosphorus, and that the substitution of other free joker poker slot machine games machine poker gratuit joker less satisfactory materials is unnecessary. 5. Gallstones. — Mayo recalls the fact that ten years ago wc heard a great deal about "innocent gallstones," which meant that gallstones existed without symptoms and that their presence was not suspected until post mortem examination brought them to light. We cannot now escape the convic- tion that the gallstones did cause symptoms and that we as diagnosticians, and not the gallstones, were "innocent." In the early history of our knowl- edge concerning gallstone disease, the diagnosis was not often made until secondary complications and infections had brought about marked local signs and symptoms, or until Nature hung out the yellow flag of jaundice. The mysteries of the dis- ease have, however, been gradually dispelled by operative interference, which has given us patho- machine poker avec joker gratuit logical information of the early stages. It has been stated by good authorities, Naunyn, and others, that gallstones are present in 10 per cent, of the human race, and this conclusion has apparently been substantiated by the post mortem material ob- tained from large hospitals, old ladies' homes, alms- houses, etc. As regards the presence of gallstones without double joker poker slot machine symptoms : The symptoms may not be recognized as coming from gallstones, but if gall- stones are accidentally found during the course of operation for other causes, and the history is retaken in the light of these findings, it will usually be found that symptoms were present but were not differentiated from the symptoms of the disease for which the original operation was undertaken. Mayo has been impressed with this fact on finding undiagnosticated gallstones in operating on women for pelvic trouble. After the recovery joker poker slot machine tips of the pa- tient he has nearly always been able to elicit a satis- factory history, (lallstones are hi-lo double up joker poker slot machine originall}- formed in the gallbladder, although later in the disease, be- cause of obstruction and infection in the common and hepatic ducts, secondary stones may form in the liver ducts ; but Mayo has never seen hepatic duct stones without evidence that the original disease had its source in an infection of the gallbladder or common duct, and the common duct involvement was almost always secondary to the gallbladder dis- ease. The symptoms of gallstones depend on the PITH OF CURREXT LITERATURE. location of the stones, and here the anatomy of the gallbladder plays an important part. The cystic duct is not continuous with the neck of the gallbladder, but is elevated on its inner side ; the neck forms a little pouch which overlaps the duct on its outer surface. It is in this situation, the socalled "pelvis'" of the gallbladder, that stones are so often joker poker online gratis im- pacted. Eighty-six per cent, of all cases of pan- creatic disease are complicated with gallstones. The disease is more frequent in women. Ninety per cent, of married women who have gallstones have borne children, and 90 per cent, of machine a sous gratuit poker avec joker these women identify the beginning of the symptoms with some particular pregnancy. Quiescent gallstones often become active during pregnancy, and in a number of instances Mayo has been obliged to operate for the relief of rapidly recurring colics, obstruction with infection, or to remove stones which had been forced down into the common duct during the pregnant state. Recovery w'as always speedy, and in no cases did the operation cause the spontaneous termination of the pregnancy. In direct opposition to the opinions of Continental surgeons, Mayo maintains that: i. In operating before gross changes joker poker pinball machine parts are manifest the danger is minimized and the mortality is small. 2. In operating early an incision longer than is necessary to introduce the hand for exploration is not often required, and pro- longed convalescence and the danger of hernia are avoided. 3. In early operations it is not necessary to remove the gallbladder, and this valuable organ is saved. 4. Early operation relieves the patient before deeply seated infections occur which neces- sitate drainage of the liver ducts. 6. Hookworm Disease. — Strosnider asks the following questions, before giving details concern- ing the thymol treatment: i. May not many cases of neurasthenia and hysteria be attributable to liookworm disease? 2. Could not such perversions, among hookworm patients, as disobedience, profan- ity, lying, stealing, drinking, forging, and sexua! perversions be attributable to hookworm disease, provided recovery followed cure of the hookworms? 3. Is not chlorosis in many cases a result of uncin- ariasis ? 4. Is it not probable that a number of cases of defective eyes and cars, and diseased tonsils and adenoids could be attributed to the same cause? 5. Is it not true that many abortions and miscarriages can be attributed to anaemia resulting from hook- worm disease? 6. Does not observation show that, as Dr. Nicholson of Onslow County says. wherea.s the average eclampsia with first child slot machine mega poker joker free in the United States is i to 250, in women suffering with hook- worm disease the average is i joker poker slot machine to 50? 7. Is it not probable that many women die from shock during lal)or as a result of jeux poker joker machine gratuit hookworm disease? 8. Is it not a fact that, as a result of this disease, many women cannot furnish sufficient milk to nourish their babies? 9. Is it not a fact that hookworm dis- ease is the cause of more amenorrhica. dvsmenor- ihrea, and scanty and irregular menstruations, than any other disease in our South? 10. Is it not a fact that machine a sous poker joker gratuit a hookworm patient, pregnant, quite often suf- fers with a severe dropsy, and often after dcliverv may run an irregular temperature for some fime and fail to react to tonics or quinine? MEDICAL RECORD April S. igii. 1. Posture as an Aid in the Diagnosis and Treatment of

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