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since her departure. .Although I was unable to determine positively the source of nifection in this case, I think that the possibility of this child having in some way been infected by a healthy diphtheria carrier should be considered. References. 1. Williams. American Journal of Obstetrics. August, 1898. 2. Hirst. A Textbook of Obstetrics, 1909. V .-Xshton. Practice of Gyncccology, igog. (iBur %tiiim' gisrassions. Questions fi:r discussi'jn in tliis del'artment are an- nounced at frequent intervals. So far as they have been decided upon, Cialis Generic Versus Brand Name the further questions are as folloivs: CI'. — Hozi' do you perform circumcision!' (Closed De- cember 75, igio.) Cl'I. — How do you treat obesity ;" (Answers due not later than January 16, 191 1.) evil. — J-JoTju do you treat acute otitis media? (Answers due not later than February 75, IQII.) U'hoezer answers one of these questions in the manner most satisfactory to the editor and his advisers zvill re- ceive a price of $25. No importance whatever zvill be at- tached to literary style, but the award zvill be based solely on the value of the substance of the anszver. It is re- quested (but not required) that the answers be short; if practicable no one answer to contain more than six hun- dred words. All persons will be entitled to compete for the prize whether subscribers or not. This prise zvill not he azvarded to any one person more than once within one year. Every anszccr must be accompanied by the writer's full name and address, both of zvhich we must he at liberty to publish. All papers contributed become the property of the Jour- nal. Our readers are asked to suggest topics for dis- cussion. The price of $25 Cialis Generic Versus Brand Name for the best essay submitted in answer to question CIl' zvas azinrded to Dr. John \V. Pozvers, of Burlitigton. ll'isionsin. ZiJiosc article appeared on page '.?.?'^ "i volume xcii. PRIZE QUESTION CIV. THE TECIIXIQUE FOR PERFORMING VACCINA- TION. t (Onlinucd from xcii. p. t3S9-^ Dr. A. C. Matthews, of Earkille. N. V.. states: \''accination, properly performed, is one of th- most beneficial procedures which our scivnce in- Cialis Generic Versus Brand Name cludes. The odium, which it has undergone and, which, to some extent, it still underg-oes, is most unjust, as the operation itself is not to blame for that criticism which has been visited upon it. Before proceedings to perform vaccination, the Cialis Generic Versus Brand Name doctor must be satisfied as to three vital points, viz : I, that he is himself aseptic; 2, that the field of op- eration is aseptic ; and, 3, that there is no septic con- dition in the patient's blood. Having satisfied him- self as to these three points, the ne.xt step is to de- cide definitely upon a suitable site for the operation. It must always be remembered that vaccination is very likely to leave a noticeable scar and in oper- ating upon females this fact must always be borne in mind. In passing, let me state that in the per- formance of vaccination it is well for the physician to bear in mind that he is certain to encounter more or less objection on the part of relatives, friends, and meddlesome acquaintances. These persons will have long stories to tell to the detriment of the op- eration. Personally, I have had little trouble in breaking through these obstacles and Cialis Generic Versus Brand Name preparing the way to go ahead. I am very well aware that I have digressed somewhat ; but I hope that it may be tol- erated. Now as to a suitable site. I usually choose the outer aspect of the left arm at about the insertion of the deltoid muscle, or the outer aspect of the left leg at the junction of the middle with the upper third. In very young infants, my experience has taught me that it is usually easier to protect the vaccine sore upon Cialis Generic Versus Brand Name the leg than it is upon the arm. As a rule single scarifications are better than multi- ple ones. If more than one scarification is made, they should be at least one inch apart. Technique: The hands of the operator should first be thoroughly cleansed with soap and water, then with alcohol and then thoroughly dried. Next, wash the site to be inoculated with soap and water, dry it, and then wash it with alcohol. Have a capillary tube of pure lymph, some rubber tubing, a needle, and a toothpick flat at one end. Sterilize the needle in an alcohol flame and make about four scratches, one eighth of an inch long, just deep- enough to draw blood. Break off the ends of the capillary tube, insert one end in the rubber tubing, and blow the lymph out upon the broad, flat end of the toothpick : apply this to the scratches and rub it in well for a few Cialis Generic Versus Brand Name minutes. The wound should then be allowed to dry, which usually requires froin fifteen to twenty Cialis Generic Versus Brand Name minutes. It may then be covered with sterilized bandage or isinglass plaster moist- ened in boiled water. If well dried, no dressing is necessary. The limb should not hv washed for twenty-four Cialis Generic Versus Brand Name hours. Dr Jacob Sobe!, of New York, observes: In orrler to perform vaccination successfully and witli the least possible danger to the patient, I al- ways keep in mind the following : Obtain a fresh and effective virus, one previously tested bacterio- logically and by animal experimentation ; such a virus is the glycerinated bovine extract put up in capillary tubes and small vials of different capacity. T use a vial sufficient for ten vaccinations and keep