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two days before her first cclainptic convulsion. Also that albumin was practically absent before this date. From the beginning of Buy Cheap Vpxl Mrs. X.'s pregnancy a faint trace of serum albumin could be obtained, but could only be demonstrated by salting the urine and then boil- ing with acetic acid. Upon November 12th the albumin jumped to 5.5 per cent. In the last week in July you will observe occurred the first decided danger signal in the urinary nitrogen. At this time, although Mrs. X. was passing between 50 and 60 ounces of water, the uranalysis at two examinations showed a high ammonia and undetermined nitrogen and a low urea nitrogen. The symptoms of toxremia were at this time more pro- nounced. It was at this date that I was consulted re- garding the prognosis and treatment, and I advised the induction of premature labor. The family, how- ever, chose an expectant treatment. No ca^ts were found in the urine until the Novem- ber examinations, the urine being examined regularly every two weeks. Up to the beginning of November there was no oedema whatever, or other signs of a ne- phritic condition, other than the faint trace of albftnin. A marked change occurred during the first part of November. Within a day or so the whole picture changed. Large amount of albumin was found in the urine, together with many hyaline and granular casts. •There was marked oedema of the extremities and face. After this had continued for a week or so convulsions occurred, followed by artificial emptying of the uterus. After the emptying of the uterus, the patient gained rapidly, all signs of the toxKmia disappeared, and she now has but a trace of albumin with a few casts. This case of Mrs. X. is an excellent illustration of the vaUie of the changes in the urinary nitrogen, giving us the first danger signal, the first red flag Buy Vpxl of trouble ahead. A low urea nitrogen and high ammonia and undetermined nitrogen, together with exacerbation of the clinical symptoms of toxzemia, ift the last week Vpxl Online in July was (in my opinion) a suffi- cient warning of impending disaster. It will be Cheap Vpxl Order Vpxl Online noted that up to this time there were no casts and practically no albumin as danger signals, that apart from the faulty urinan,- nitrogen the urine was what we term normal in pregnancy. Mrs. X. Buy Vpxl Online partially reacted under treatment from this July attack, but November 12th, three months afterwards, suddenly had marked nephritic symptoms, 5.5 per cent, albu- min, abundant casts, and cedema, and two days later all but lost her life from eclampsia. The clinical and chemical data in this case of IMrs. X. are, I believe, most valuable, and I commend' them to the careful consideration of the members of this society. 50 E.\ST Thirty-fourth Street. THE CEREBRAL LOCALIZATION OF APHASIA AND ITS CLASSIFICATION ON AN ANATOMICAL BASIS.* Bv Charles L. Dana, M. D., LL. D., New York. The discussion aroused by Marie is the exciting cause, no doubt, of this present article, but I must claim this merit, that the views here presented, and the facts upon which they are based, were mostly • Rend before the .American Aasoclntlon of Physicians. prepared three years ago, Purchase Vpxl Online so that, in so far as I agrt< with the distinguished observer, it is a matter of independently reaching Purchase Vpxl similar conclusions. I have long felt the relative uselessness of the old classifications of aphasia in the practical teach- ing of students. The theory, indeed, is simple and licautiful, and the didactic lecture is an easy luece of diagrammatic exposition. But to make a stiiden. tniderstand that a patient who cannot speak a word has a " sensory " aphasia, or a patient who cannot speak, but who also cannot read, or write, or understand very well, is afTected with " motor " aphasia, is very difficult. And the usual conclusion of a lecture on the average case is that most aphasia is ■■ mixed," leaving the patient, the Order Vpxl student, and the situation in about the same condition. The Clinical Diagnosis. — This being the case, I have sought for some simpler way of teach- ing aphasia practically to students. In describ-j ing other morbid conditions of the brain teach the student to make first a clinical diag^j nosis, then an anatomical or localizing diagnosis^ and, finally, a pathological diagnosis. I have beer making the experiment of applying this method to aphasia. To establish the Generic Vpxl clinical diagnosis, we first determine that an aphasia, or defect of lan-j

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