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lingers short with a tendency to taper. All the teeth in upper jaw are missing. The mammx are large and pendu- lous, reaching to about an inch from the umbilical line. Height is fifty-five inches and the circumference of the head through the occipital protuberance twenty and one half inches. Other measurements are as follows : From acromion to tip of olecranon, twelve inches ; from there to styloid process of ulna, nine ; from sternal notch to symphysis, thirteen ; from anterior superior spine to in- ternal malleolus, twenty-nine on both sides Trileptal 150 Mg ; from heel to great toe, eight; from one anterior superior spine to the other across abdomen, twelve and a half; bitrochanteric across buttocks, eighteen. Perspiration of feet profuse and Trileptal Generic Name offensive. Pupils react to light and accommodation and consensually. A marked tendency to hippus is noticed. The abdominal reflexes are lively, knee and ankle jerks normal. No Babinski. The general sensibility is in- creased so that light pressure gives pain, reminding one of Dercum's disease. The general sensibility is intact. The deep muscular sense, joint sense, postural and soace senses Cost Of Trileptal are intact. Hypotonus is noticed at knees and el- bows. There is no past pointing of any extremity. Barany test is negative. All laboratory tests for blood, serum, cerebrospinal fluid, and urine are negative with the ex- ception of a marked polyuria, the patient passing at a time three to four thousand cubic centimetres in Buy Trileptal Online twenty-four hours. The specific gravity of this urine averages 1015. There is also a marked sugar tolerance, so that 300 grams of glucose on a fasting Order Trileptal Online stomach give no evidence of sugar in the urine. The x ray report showed an increased intra- cranial pressure without any changes at the sella turcica. Organotherapy in all forms and combinations and doses was tried in the treatment of this Tegretol Vs Trileptal patient, but without any notable effect. Analyzing this case, we see that we are dealing primarily with a marked pituitary disturbance which would best be called dyspituitarism, for the patient shows signs of both hyperactivity and hypoactivity of this gland. It is especially worth while noticing the fact that with the establishment of the menses, contrary to the usual rule, the patient began to gain rapidly and tremendously in weight so that in a short while she weighed, as seen above 225 pounds. This may be explained by a lack of activity of the thyroid gland. It is, however, well known that the thyroid increases in its activity at the beginning of menstruation. It may also be argued that the rapid increase Trileptal 150 of adipose may be due to an inactivity of the pituitary, but here, too, the menses would or- dinarily be scanty instead of profuse as they were so that this case does not fit in well with all known theories of Trileptal Cost endocrinology in the correlation of Trileptal 60 Mg glandular activity. It is also worth noticing that with all that increase in weight the patient was rather bright mentally ; she was able to keep up in her class at school and, later, held a rather responsible position. At nine- teen another change took place ; menstruation ceased completely and she developed symptoms that un- doubtedly pointed to pituitary involvement ; again, with the reestablishment of menstruation, which was this time scanty, she lost weight rapidly and mas- sively, an indication probably of thyroidal hyper- activity ; but this time her Trileptal Vs Tegretol psyche also changed and instead of being a useful member of society she became morose, hypochondriacal and even suicidal, and is still this way after four years, with perhaps slight improvement as far as her suicidal impulses are concerned. Of course, one may argue that the nystagmus, the headaches and the increased intracranial pressure, together with Trileptal Acne such changes in the eyegrounds, might be due to a frontal neoplasm, but this theory must be dispensed with, since for the last four years the optic nerves not only have not increased in their pathological changes, but on the contrary seem to have cleared up and her headaches today are not as severe as they were three years ago. Her psyche, too, is somewhat improved. Besides the pituitary, thyroid and ovarian glands, the adrenals seem to be involved : her rapid pulse, as well as the marked disproportion between the systolic and diastolic Trileptal Tablets blood pressure, can be explained only by unbalanced adrenal efficiency. 252 East Broadway. A PLASTER OF PARIS BANDAGE ROLLER. By William H. Bennett, M. D., Atlantic City, N. J., President, Children's Seashore House, Atlantic City, N. J. Every one who has practised the making of plaster of Paris bandages by rubbing Trileptal 450 Mg the plaster in by hand, and rolling a few inches and then rubbing more Purchase Trileptal Online and rolling again, will Trileptal 135 Mg appreciate the value of a simple machine that will fill and roll Order Trileptal them almost as rapidly as Buy Cheap Trileptal a pain Trileptal Coupon bandage can Cheap Trileptal be rolled. At the Children's Seashore House, Atlantic City, about a thousand plaster of Paris bandages are made and used an-

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