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the year 1918, the sum of 2.5 Mg Cialis Online $1,000 to be used to de- fray the cost of salvarsan or its equivalent for pa- tients in the communicable stage of syphilis, who have been reported to the Department of Health and are known by the dispensary or hospital to be unable to pay for the drug. This sum, small and inadequate as it is, together with the 2.5 Mg Cialis Online payments vol- untarily made by patients able to pay for their own treatment, will go far to meet the needs of most of the cases ap[)lying for disix-nsary care. It is my opinion that the city ought to make salvarsan, or any other drug which is recognized as a specific for the treatment or cure of any communicable dis- ease, as free to a case of the disease in its com- municable stage as diphtheria antitoxin is to be poor of this city at the present time, under proper certification of the attending physician. Rcgiilntion 6. Records. — .\ complete and adequate rec- ord shall 2.5 Mg Cialis Online be kept of every case of syphilis treated at a dispensary. Such records shall not be open to inspection by the public or to any person other than the representa- tives of the Department of Health of the City of New York, and such persons as may be authorized by law 10 inspect such records. The propriety of such a requirement must be obvious, and as a matter of fact is accepted by those who maintain dispensaries which serve the patients well and have business standards of administration, as well as clinical records adequate and available for study by the physicians in charge. Rci'.iilntii^n 2.5 Mg Cialis Online .". Follow-up 2.5 Mg Cialis Online System. — .\ follow-up system, approved by the Department of Health, to secure regular attendance by patients shall be established and maintained. There are so many ways in which records can be devised and kept, by which this requirement 970 EMERSON: STANDARD METHODS IN VENEREAL DISEASE. [New York Medical Jousnju- would be suitably met, that it is inadvisable to specify the particular kinds of records or procedure to be followed ; but just as 2.5 Mg Cialis Online a physician would be unwilling to be held responsible for the care of a case of typhoid or scarlet fever, without knowing the progress of the disease until cured, or under what conditions the convalescent stage and period of non-communicability were reached, so with syphilis, we feel that a dispensary offering treat- ment should hold itself responsible for keeping track of the patient until he is no longer a menace to the public. Rcf/ulation S. Procedure Governing the Discharge of Patients. — A standard procedure governing the discharge of patients shall be followed. Such standard shall em- brace suitable tests and subsequent persistent observations. Again, in this regulation, provision is made for a method upon which the dispensary and physicians in charge can rely, before considering their responsi- bility at an end with regard to the treatment or rendering a patient presumably safe from a relapse or recrudescence of the disease. Provocative spe- cific treatment and repeated Wassermann test may not prove to be the only or best way of arriving at a conclusion as to cure, but whatever methods are found by the serologists and clinicians as satisfac- tory, should be made uniform in the disease in which the consequences of incomplete treatment are so shocking to the 2.5 Mg Cialis Online individual and his family and so costly to the community. Regulation 9. Dispensaries to Be Open at Least Three (3) Days a Week. — Dispensaries shall be open at least three (3) days a 2.5 Mg Cialis Online week. This regulation requires no particular comment, except to indicate the interest of the Department of Health in what may be considered an adequate serv- ice, if any service at all is offered for the diagnosis and treatment of syphilis. With regard to the regulations for the operation of classes in dispensaries for the treatment of gonor- rhea, they are quite similar, with the exception of Regulation 3. This reads: Regulation .?. 2.5 Mg Cialis Online Urethroscopic and Cystoscopic Work to Be Performed. — Every dispensary shall be provided with facilities for urethroscopic and cystoscopic work, and such facilities shall be regularly employed by the physicians in attendance. This is found to be necessary by those attempting to give a service adequate to the prevention and diagnosis of those extending lesions of gonorrhea which are easily overlooked or treated in a slipshod way, if direct inspection of the urethra and bladder has not been accomplished. In addition to the section of the Sanitary Code above described with its regulations in 2.5 Mg Cialis Online detail, an important new section, with regulations, has been recently adopted, expressing the interest of the Board of Health in a high standard of laboratory facilities for 2.5 Mg Cialis Online the diagnosis of all kinds of communi- cable diseases. It is as follows : Sec. 105. Diagnostic Laboratories Regulated. — No labora- tory offering facilities for the diagnosis of communicable diseases shall be conducted or maintained in the City of New York withotit a permit therefor issued by the Board of Health or otherwise than in accordance with the regu- lations of the said Board. (As adopted by the Board of Hoalfh. Time 28. 1017.") Regulation J. Applications. — Applications for permits to conduct and maintain laboratories offering facilities for the diagnosis of communicable diseases shall be made by the person in charge of the laboratory upon official appli- cation blanks furnished by the Department of Health. Regulation 2. A Duly Qualified Person to Be in Charge.