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an oculist who reported that patient had a myopia for far vision and he had prescribed glasses accord- ingly. Case VII. — March 12, 1916. M. F. ; male; age fifty; married ; children ; five feet 4 inches in height. Weight four weeks ago, 155 pounds; never weighed more. Never smoked. Drinks : Formerly a little whiskey with his even- ing meal ; since four weeks none at all. Seven years ago he had an attack of pain in his epigas- trium which went through to his back. It lasted four weeks ; two weeks of that time he was laid up in bed. Four weeks ago he had anotlier attack, and the pain has con- tinued since. When he walks half a block he gets the pain, a pressure through the chest, front to back, and must stop and gasp for breath. The pain shoots into his left arm; it feels cold, numb. Last night after drinking a glass of tea with Ordering Cialis Online From Canada lemon he was seized with a sudden compression of the chest, cramplike; had the Ordering Cialis Online From Canada same cramping sensation in the left arm Ordering Cialis Online From Canada ; he did not feel the pressure in the back. When he is at home he is comfortable. When his stomach is empty he can walk a whole block before he gets the pain ; when he has eaten, a walk of half a block brings it on. Appetite good ; but lately he belches much. Break- fast, a glass of milk and a piece of cake; dinner, soup, chicken, stewed prunes, or orange, or baked apple; supper, herring or sardines, farina, or fried eggs, milk; cold water, formerly he drank a glass after each meal, since two weeks none ; he thought it caused him pain. Bov.'els are regular. Once a week he takes a bottle of liq. citrate of magnesia, sometimes an enema. Headache only when he has the pressure. Sleep good ; tongue rather clean. Examination: Epigastrium, nothing abnormal to inspec- tion or palpation; no sensitiveness anywhere; no splashing; water, eight ounces, no splashing, no sound. Liver and spleen in situ normalc. Abdomen : Good panniculus ; noth- ing abnormal otherwise ; no sensitiveness anywhere. Heart: Size normal; sounds normal. Pulse 80, full, forci- ble, indicative of rather high blood pressure. I had in- tended to take his blood pressure a few days later, but he did not return after the last mentioned date. March 13th. Test breakfast, one hour; tube, 25 c. c. .Stomach contents, bread and fluid, well mixed, rather thick. React. : blue litmus -{- React. : Congo -|- React. : Phloroglucin van -f free HCl. 31. Total acidity 54. March 15th. Diagnosis: Angina pectoris. As to stomach: hyper- acidity of the gastric secretion. Treatment: Milk, cereals (except oatmeal), eggs, white bread, and butter. Vichy (Celestin). Medication : Alkaline powder with Ordering Cialis Online From Canada belladonna. In case of constipation, phenolphthalein tablets. ft might perhaps be said that these cases belonged to the category of pseudo angina pectoris (mock angina of Allbutt), of gastric origin, a subdivision elaborated by Huchard (3), and looked upon as not at all serious ; really, only an aggravated form of dyspepsia, and such was the diagnosis made by me and so recorded in my case books until the following case of severest type and ending quickly (as it were) in death came under observation. Case VIII. — May 16, IQ09. Louis K. ; barber; age fifty- two : married ; three children ; five feet seven inches. Greatest weight, 175 to 180 pounds, eight months ago. Smokes three or four cigars a day. Alcohol very rarely. For two months has spells. He is seized with a sharp pain about the prscordium and for Ordering Cialis Online From Canada the time being cannot move; must sit dowti at once. It will pass in a short time. Does not ,go into his arm. At the same time quite a quantity of water conies up into his mouth ; it feels hot, but he does not know whether it is sour. The spells come on two or three times a day, mainly after meals. (That is also the time when he smokes.) Appetite good. Breakfast, oat meal, coffee with milk, two or three rolls ; lunch, two hard boiled eggs, five or six slices of bread and butter, a bottle of milk ■ dinner (6 to 7 p. m.), soup, meat (no red meat), vegetable, salad, coft'ee. Drinks about four or five glasses of cold water a day. Bowels more than regular, two or Ordering Cialis Online From Canada three movements a day ; natural, formed stools. Headaches rarely. Sleep not very good, especially lately. He is very restless in the night. Tongue, coated white coat. Teeth in good shape. Has a bad taste in Ordering Cialis Online From Canada his mouth. Examination: iMay 25. -OiS.] ILLOWAY: GASTRIC SECRETION AND ANGINA PECTORIS. 967 Heart normal in size and sounds. Pulse of fair force, 85 jK-r minute ; occasionally one beat is dropped, sometimes after four beats, tlicn again after fifteen or twenty, alto- gether about two or three per minute. Epigastrium nega- tive. No sensitiveness anywhere. No splashing; water, eight ounces; no splashing; no sound. Liver and spleen m still Hormalc. .Abdoiiien. large panniculus. Nothing al;- normal to inspection or palpation. May 17th. Reported that he started out this morning and had walked but a few blocks and the pain came on, although he had eaten noth- ing. Had to get into a street car and ride down. Test breakfast, one hour ; tube, 100 c. c. Stomach contents, bread and fluid, mainly Ordering Cialis Online From Canada fluid, very little bread ; bread well worked up. All of normal appearance. React, blue litmus -f React. Congo -j- React. : Phloroglucin van -|- free HCl 57. Ordering Cialis Online From Canada Total acidity 83. Diagnosis: As to spells, angina pectoris. As to stotnach, markedly hyperacid gastric secretion and gastrosuccorrhea. 6 p. m. He sent word that he had had three attacks already and had suffered intensely. Directed an alkaline powder with one seventh of a grain of the extract of belladonna, to be taken every four hours. In case he is not relieved, to have half a grain of codeine and one fourth or half a grain to be repeated in forty minutes if necessary. 1-or nausea, aromatic ipirits of ammonia. Diet for the present: Milk only, si.\ to eight ounces every two hours. Stop smoking absolutely. 1 advised him to keep quiet at home, but he per- sisted in going down to his shop. May i8th, 6 p. m. He had a slight spell at 5 a. m. The milk agreed very well with him today. Tomorrow can have some soft Ordering Cialis Online From Canada boiled eggs in addition to the milk, but no bread. Milk and Vichy, half anfl half, before retiring. He took but one codeine tablet last night. Is taking the powders as directed Urine : Appearance, clear, transparent ; color yellow. Ordering Cialis Online From Canada React. blue litmus. — React, red litmus -|- very faint. Sp. Gr. 1.025. React, heat -|-, addition of a few drops of acid renders it transparent again. Sediment, none. Indican, none. May 23. Has had no pain since previous visit. Only when he gets excited does he feel a slight pain. Epigastrium negative. The pu'sc of greater force, somewhat hard. May take a zwieback and have the eggs hard boiled. Mav Ordering Cialis Online From Canada 25th. Had