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worker, as is well known, can often make a satis- factory diagnosis of the presence or absence of leu- cocytosis merely by looking over a stained film. THE " jNIETASTASES " IN ECZEMA. The question of " metastases " arising in eczema, and particularly that of the fatal occurrences in children following the cure of a more or less exten- sive eczema, have often been considered, but never answered. Maille has taken up the matter in his recent thesis entitled La Mart rapide dan>s Veczema chez Venfaiit. The cases of rapid, if not sudden, death in nursing babies afflicted with eczema are frequent, and Martial has observed two instances, while Dupeyrac, in his thesis, relates a large num- ber. Maille has particularly benoquin cream for sale reported those cases which have been followed by autopsy, in order to find a pathogenic explanation, and the facts that he has collected have led him to admit three classes of cases, to which three theories may be attached. In the first benoquin online class he includes eczema followed by lesions of impetigo, in which death was merely the result of a septicaemia whose setiological agent penetrated into the organism through the preexisting cutaneous lesions. This is Hutinel's theory, one which is based on numerous clinical and bacteriological data, and it may be considered as very plausible. In the second class are recorded the autopsies of eczematous children who have died benoquin cream suddenly and presented all the symptoms of a benoquin cream 20 lymphatic condition. Paltauf applies the mechanical theory to these cases and believes that death is due to compression buy benoquin cream of either the vagus, the phrenic, the recurrent, or the sympathetic nerve by an hypertrophied thymus, a theory difficult to understand and for that matter greatly questioned and one to which the facts ob- tained lend no evident confirmation. Lastly, in the third class are included instances of eczema having an internal origin and benoquin monobenzone cream in which death can be e.xplained by Bouchard's theory of toxKmia. Here one is dealing with a tardy nutrition, having as a consequence an incomplete oxidation of food taken and the production of materials incompletely elaborated. As oxidation does not reach its ulti- mate stage and the urea stops at an intermediary phase, the result is that the ingested matters remain in the state of uric acid, leucine, creatin, xanthin, etc., all of which are nondialyzable and very toxic products. These toxic substances especially attack tlie kidneys and the skin and cause death by renal changes, and Maille quotes on this point Brouardel's plirasc : " Death from the kidney is by far the most frc(|uciit of all instances of sudden death." On the strength of this latter theory Maille en- deavors to e.\])lain all the cases of rapid death in eczema, no matter what clinical differences they may present, in some characterized by respiratory or car- diac symptoms, in others by digestive or nervous phenomena. One point of resemblance is to be found in all cases of death from this cause, namely, the processes are comparable to those encountered in uraemia and sometimes in grave icterus. On the other hand, in the majority of cases recorded by the author, an autopsy has shown benoquin 20 that the liver and kidney are frequently benoquin vitiligo increased in size and in a state of congestion when they are not the seat of fatty degeneration. ]\Iicroscopical examination has constantly shown that the hepatic lesions are of long standing, while the renal lesions, either of recent or of old date, are absolutely similar in every respect to those discovered in uraemia or grave icterus. The cutaneous lesion would appear to be merely the final stage of an hepatic and renal insufficiency, and this writer ends by attributing an all important part to digestive autointoxication in the ultimate accidents and preparatory lesions. benoquin price One is usually dealing with a slowl\- developing toxaemia in subjects pre- disposed by their heredity, and their hepatic heredity particularly. A " FINGER PHENOMENON " IN HEMIPLEGIA. Some years ago Striimpell described, under the name of the " tibialis phenomenon." monobenzone benoquin an elevation of the inner border of the foot, with inward rotation of the sole, occurring when a person affected with hemiplegia attempted to flex the leg on the thigh. This is due to contraction of the tibialis anticus, and it is occasionally seen on the sound side. Dr. A. Souques (Bulletins et mcmoircs de la Societe mcdi- cale des hopitanx de Paris, July 4th) expresses the opinion that Striimpell's phenomenon is analogous to one which he has himself re'cently observed, which he calls the " phenomenon of the interossei," or the '■ buy benoquin finger phenomenon," both being dependent on a disturbance of the pyramidal tract. Souques's phenomenon is not present in complete hemiplegia ; there must be some ability to raise buy benoquin online the arm voluntarily, though in some instances passive elevation of the paralyzed limb evokes an approach to it. When the patient raises the arm. the fingers

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