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ler with several original observations of consider- able interest. He admits the rarity of true congenital I rculosis, but that it buy suprax does exist he considers proved by the investigations of Johne, Landonzy, and Queyrat. The direct transmission of the bacilli may occur in two different ways; either by infection of the ovum by spermatozoa mingled with bacilli, or by means of the placental circulation. The first-men- tioned he considers purely hypothetical and extremely unlikely in the light of the examinations made by Jani of the healthy genilo-urinary organs of phthisical patients. This observer ex- amined the dried spermatozoa of nine bodies with negative re- sults. In the suprax 100 testicles, he found a few bacilli in five out of eight rase-, and ill the prostate, in four out of six cases. The re- mainder of the genital tract was free from micro-organisms. The passage of the bacilli through the placental circulation the author considers much more plausible. The observations of Koubassoff and others demonstrate the probability of this the- ory, but the indispensable condition of the transmission through this channel is the presence of the bacilli in suprax injections the mother's blood. At its commencement, however, pulmonary phthisis is in most cases a purely local affection, the morbific agents reaching the general circulation only suprax generation after a tedious passage through the lymphatics. The patient may, and not infrequently does, suc- cumb to the morbid process before infection of the blood takes place. The books say very little as to the frequency with which blood infection occurs. To determine this point, other organs besides the hmgs must be examined. The thyreoid gland, from its anatomical features and relations, would appear the most suitable for this purpose, hut. unfortunately, it shows very lit- tle disposition to secondary tuberculosis. Examination of the kidneys affords a safer criterion. In a hundred and forty-one examinations suprax antibiotics of consumptive subjects by the author, tubercular lesions were found in the kidneys in thirty instances — twenty- one per cent. It may reasonably be presumed that the placenta heroines affected secondarily in the same percentage. But do the placental vessels buy suprax online suprax cefixime 400 mg allow of the passage of suprax 400 mg tablet the bacilli ? Jani's observation of a pregnant woman with acute miliary tuberculo- sis, in whom tubercle bacilli were found in all the organs (but none in the placenta or in the foetus), would give a negative answer. On the other hand, the experiments of Landouzy and Martin in inoculating with placentas from phthisical patients afforded positive results. Admitting, theD, that the bacilli pass through the placenta, the umbilical vein becomes charged with them, and hence it is the liver and not the lungs that consti- tutes the site of predilection for these micro-organisms. This theory is supported by Johne's experiments and by Charrin's and Merkel's cases. In Charrin's ease, a phthisical mother gave birth to a foetus of seven months and a half, which lived three days. Tubercular lesions were found in the abdominal organs, especially the liver, but the lungs were found healthy. In Mer- kel's case, the mother, who was consumptive at the time of conception, went to full term, and died two days after delivery. The infant was emaciated at the suprax injection time of its birth, and presented a small grayish-yellow tumor, of the size of a pea, on the arch of the palate. This underwent caseous degeneration and was followed by disease suprax 400mg of the hip joint. The child died while a suckling, in spite of good care aud nursing; at the autopsy the lungs were found intact, but there was a caseous focus on the palatine arch, suprax antibiotic for children involving the bone, and caseous foci were found in the lymphatic glands, in the liver, and in the coxo-femoral articulation. The author concludes, therefore, that, in true congenital tuberculosis, infection takes place through the pla- cental circulation, and that the liver will be found the seat of tubercular foci, while the lungs maybe intact. When the lungs are found diseased and the liver healthy, in all probability the disease is due suprax cefixime tablets to infection after birth. MINOR PARAGRAPHS. THE LIVERPOOL HOSPITAL FOR WOMEN. The Liverpool newspapers contain accounts of suprax cefixime the recent annual meeting of the subscribers to the hospital, by which we learn with regret that the discord among the members of the medical staff has resulted in at least temporary injury to the in- stitution, having impaired its income, reduced the number of patients applying suprax mg for treatment, and led to the resignation of some of its oldest and most efficient officers. Our readers will remember that the dissensions among generic suprax the medical officers cen- tered on the merits and dements of the operation of removal of the uterine annexa. and that a prominent episode was a suit for damages brought against one of the surgeons, Dr. antibiotic suprax Imlach, by a woman who had been a patient order suprax in the hospital. Some of the speeches made at the meeting were very pointed, and the extraor- dinary step was taken ot dropping Dr. Imlach from the staff. It seemed to be the general feeling, however, that no reflection iui that gentleman's professional capability was intended, but that the action taken was the only practicable way out of ani- mosities and dissensions which could not be allayed. We hope that the hospital will not be seriously crippled by this unfortu- nate affair, and we are quite sure that neither Dr. Imlach nor any surgical procedure advocated by him, even if somewhat too zealously, will purchase suprax be found to have been materially affected by it. THE ATTITUDE OF THE suprax tablets PROFESSION BEFORE THE PUBLIC. At a recent meeting of the Academy of Medicine, the presi- dent, Dr. Jacobi, read an address in which he remarked that the influence of the medical profession in promoting sanitary re- forms depended upon its united action and upon the moral and intellectual status of its individual members. Instances were cited in which sanitary abuses had been to some extent cor- rected in consequence of concerted action by the profession, and some marked examples were pointed out of the present need of more work of the sort. A considerable part ot the ad- dress was devoted to the subject of "newspaper advertising" in the way of reports of wonderful operations, etc., by which Feb. 26, 1887 M/XOR PARA GRA PES.— ITEMS. 241 individual physicians and the entire profession were made to appear ridiculous before the public. Dr. Jacobi thought that this abuse bad become much less common after bis allusion to it a year ago or more, but that it was now being revived. Doubtless the newspaper reporter, and not the physician, was to

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