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red in color (leather color) and are covered with a small black crust. The one near the chin is surrounded by a vesicular zone about two inches in width ; the surround- ing tissues are firm to the touch. The posterior pustule situated near the ear on the neck is somewhat larger and it exudes a clear fluid in fair amount." — Bellevue Hospital Record. Blood examination on the 26th : white cells 32,- 000: polys, 8.17; mononuclear sixteen per cent. On the 25th he was given ten c.c. of Eichhorn's serum, antianthrax (the precipitated product) ; this was repeated every twelve hours for three doses. On the 27th he was given forty c.c. of the nonprecipitated antianthrax serum. The patient died on the 27th. Horse manure, used for fertilizing on the grounds where the patient was employed, and also the shaving brush used Buy Brand Name Levitra Online by the patient, were examined by Doc- tor Norris, of Bellevue Hospital, but no anthrax bacilli could be isolated from them. Case VIII.— G., Brooklyn, male, dry goods clerk. Pa- tient bought a new brush May 29, 1917, and shaved himself. A furuncle developed on the right cheek Thursday the 31st. It became swollen and he called a physician, who applied hot applications without any relief. A second phy- sician was called and he sent the patient to the Jewish Hospital. Brooklyn Here, wide excision operation was performed with phenol injection and application. Eich- horn's antianthrax serum was also given. The patient re- covered. The brush was examined by the bacteriologist of the City Health Department, but no Buy Brand Name Levitra Online anthrax bacilli could be isolated from it. Case IX.— S.. male, fifty years old, worked in Endi- cott tannery. On June 25, 1917, patient noticed a furuncle on left neck. The same day he shaved and cut off thp furuncle. The lesion became enlarged to one-third inch diameter, and he reported to the plant physician the next day. On examination the pustule was elevated, brown- leather color, centre somewhat depressed, and but slightly crusted ; one could raise the pustule from the subcutaneous fascial and it felt like a hard nodular infiltrated mass (button like). Tissue, surrounding was somewhat edema- tous, and very slightly reddish. The patient had no fever and the pulse was not affected. Diagnosis was made and confirmed microscopically. Doctor Dudley performed the usual operation, without injecting any serum. Patient re- covered. Case X. — P., Glovcrsville, eighteen years old. Lesion was on the neck. Was treated Buy Brand Name Levitra Online by Doctor Ellithorp who made wide excision and injected autogenous vaccine sub- cutaneously. Patient recovered. C.\sr XL — M., New York city, thirty-five years old, Buy Brand Name Levitra Online clothing operator. He noticed a stiff neck Sunday morn- ing, September 5. 1917. The next Buy Brand Name Levitra Online day he noticed a furuncle under the chin and there was a swelling which extended to right cervical glands. Two physicians were called in and they painted the lesion with iodine. The next day a third physician was called and he sent the patient to Mt. .Sinai Hospital. The patient was operated on and accord- ing to the house surgeon, the incision was made one inch around the pustule and the wound was covered with pow- dered mercury bichloride. Fifty c.c. of antianthrax Eich- horn's scrum was injected every twelve hours, three doses. Patient died Thursday night. Case XII. — G., Ephrath, N. Y., worked at a Johns- town tannery; male, forty-five years old. Had pustule on face. Doctor Beebe Buy Brand Name Levitra Online made wide excision of pustule which he followed by a daily application of fuming nitric acid for six days, gave sfimulating doses of quinine three times a day, and painted the area surrounding the Buy Brand Name Levitra Online wound with a tincture of iodine. Patient recovered. Case XIII. — K., male aged sixty-four years, hide han- dler on boats and dock. Patient noticed pimple on right cheek on February 18, 1917; it became larger and the surrounding area became edematous. He called on Doctor Kohlman, who described the lesion as a small pustule with vesicles on the edges with a slight oozing Buy Brand Name Levitra Online straw colored llnid ; central area, slightly depressed, was of dark brown color with dark crust. The patient's temperature was 99.5° F. February 20th in the morning, and 100° F. at night on the 2ist; temperature was 102° to 103°, 22nd 1033/5°, then went down by lysis and became normal on tlie nth day. Doctor Kohlman excised w-ound, making the incision one inch from pustule and applied Dakin's solution to the wound. He injected subcutaneously plain stock horse serum for seven consecutive days. Patient made an un- eventful recovery. Case XIV. — J. B., longshoreman, Manhattan, male, thirty years of age. Lesion on neck. Noticed pimple on neck November 14, 1917; went to a dispensary; w-as diag- nosed as "infected neck": lanced and drained. On No- vember 16, extensive edema set in; ambulance was called; was taken to Bellevue Hospital. Diagnosis of anthrax was made bacteriologically. Nothing could be done for the pa- tient and he died the same day. The Buy Brand Name Levitra Online wife of the patient described to Buy Brand Name Levitra Online lue a typical anthrax pustule but no diagnosis was made at the clinic. Diagnosis. — Buy Brand Name Levitra Online A characteristic anthrax pustule can- not be mistaken for any other lesion. However, physicians that have never seen a case before will easily make a wrong diagnosis and may take it for furuncle, carbuncle, cellulitis, erysipelas, malignant carbuncle, or malignant edema. In a large city like New York where only twenty-five cases were re- ported in three years, you can make up your mind that all its 4,000 physicians are not in a position to see a case. Therefore many of the diagnoses were made at autopsy. On the other hand, some patient working at hides will walk into a physician's office with the diagnosis all made. Early diagnosis is of great importance because the treatment is so very different from other conditions, with which it may be confused. Wherever there is any doubt, bacteriological examination should be resorted to. and without delay. The research laboratory of the Health Department will gladlv make the examina- SCHWARTZ: ANTHRAX. li7i tion, or else it can be made at the physician's office. A little of the oozing serum, from beneath the cen- tral crust can be smearcfl on a cover glass and stained with any of the anilines, watery, or alcoholic solutions and examined under the microscope. Dur- ing the first few days, the bacilli are more readily found than later on. Sometimes, the first manifesta-