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orrhagic seplicjemia) of an Generic Cialis Price Comparison epizootic disease caused by one and the same microorganism which was indistinguishable from the foregoing. Cows are well known to be subject to frequent febrile disturbances, evidently of infectious origin and, being subject to distemper infection, it requires no great stretch of the imagination to understand how a wave of bovine infection, which need only afifect a cow here and there, could result in the dis- tribittion of enough of the bacilli to cause epidemics of poliomyelitis among children, especially when the weather or room temperature to which the house- hold supply of milk was subjected was high enough to permit multiplication of any infection contained therein. As a saproph\tc in general. — Now. as shown, the poliomyelitis bacillus is capable of saprophytic exist- ence, and, therefore, could undoubtedly grow in many food substances. Pearson supposed that an outbreak of poliomyelitis Generic Cialis Price Comparison among Eskimo dogs, which he reported, Generic Cialis Price Comparison might have arisen froin the semiputrid fish which, at the time, formed their sole diet. There is a curious stateiuent in the literature, on poliomyelitis in Australia, to the effect that the dis- trict in which the disease first appeared in that country was that in which "phosphate" had just been used extensively, and for the first time, as a fertilizer. Direct transmission. — As to whether direct con- tagion from one person to another is an important Generic Cialis Price Comparison factor in the spread of poliomyelitis, I think it may be said that it is not, since it is well recognized that cases do not develop in the way which such a sup- position would entail. Generic Cialis Price Comparison In the City Department of Health's report on the 1916 epidemic, of the 8,635 families in which poliomyelitis developed, 8,287 (ninety-six per cent.) had one case only, although the total number of children in these families amounted to 24,883. The report states: "The in- vestigation showed that, in nearly all instances where more than one case occurred in a family, the onsets were so close as to suggest simultaneous in- fection (3). CONCLUSIONS. "It is demonstrated that the organism Generic Cialis Price Comparison isolated from the nerve centres of cases of poliomyelitis (in- cluding the "streptococcus" described by various observers ) is a pleomorphic bacillus of the distemper group, which varies in characteristics much as the various, supposedly different, members of the group do from one another" . . . "It seems very probable that, while contact cases of poliomyelitis may occur, either by direct trans- mission of the germ from animal to man, or from man to man, the great mass of cases which comprise epidemics are caused by milk borne contagion" (4). Doctor Ixosenow (5) now states that he finds that his "streptococcus" will produce the bacillus form, and Doctor Bristol (6) working with one of Flex- ner's cultures, obtained from the Rockefeller Insti- tute, developed from the "globoid bodies" bacilli such as I described. Bristol concludes : "From these studies I venture to suggest the possibility that the organism of poliomyelitis is a pleomorphic bacillus (often indistinguishable however, from a true coccus), and that it may be closely related to the large group of so called bipolar bacilli, or pasteur- ella." . . . "Based on this assumption, the mode of spread may be considered analogous to that demonstrated for all forms of pasteurellosis in animals, namely: directly, by contact with the secretions or excretions of an infected individual (either diseased or a healthy 'carrier') ; mdirectly, by the carriage of the .specific organisms by insects, or possibly in dust, un- cooked food, or drink." This is practically the same conclusion which I advanced some six months previously. REFERENCES. 1. GREELEY and JOHNSON: An Epizootic of Poliomyelitis Among Dogs, Medical Record. November 17, 1917. 2. New York State Journal of Medicine, December, 1917. Generic Cialis Price Comparison 3. Tlie Epidctiiic of Polio- myelitis in New York City in 1916, published by the Department of Health, New York City, 1917, p. 121. 4. GREELEY: Journal of Laboratory and Clinical Medicine, July, 1917. 5. American Journal of Public Health, December, 1917. 6. Journal of Medical Research. January, igiS. RELATION OF Generic Cialis Price Comparison INDUSTRIAL HYGIENE TO GENERAL PRACTICE.* By Louis I. Harris, M. Generic Cialis Price Comparison D.. New York, Director, Bureau of Preventable Diseases, Department of Health: Special Lecturer, Department of Bacteriology and Hygiene, New York University and Bellevue Medical College. No matter how greatly machinery is improved by the inventions of our mechanical experts, the guiding human hand remains indispensable to its proper operation. And yet, while no end of ex- pense is incurred by factory owners in the main- tenance and repair of machinery, their elYorts and expenditures to conserve the strength and lives of the workers upon whose creative powers their wealth and welfare as that of the nation depend, have been Generic Cialis Price Comparison absurdly trivial. In making this indictment we leave out of the reckoning all purely sentimental and hu- manitarian considerations, and view it merely from the economic standpoint as evidence that there is less regard for the human factor in industrial man- :igement than there is for machinery and equipment. Paradoxicallv, war, which is destructive of human life, has done much to awaken the country at large, and business men in particular, to the immediate necessity of conserving and guarding the lives and health of the industrial army. Splendid, wise and "Paper read before Harlem Medical Association, Generic Cialis Price Comparison January 2, 1918.