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fkOCEEDINGS OF SOCIETIES. t.\£» Yon Medical Jovb Psychology, Columbia L'nivcrsily, said that the cialis 20 mg price costco part of Doctor Salmon's paper he might comment on was that referring to education, in urging psychiatrists to take an interest in the early development of chil- ilren and youths. Education should be controlled by those who understood the general principles of edu- cation as well as the possibility of the (levelopment of neurological conditions. It was necessary to make a S])ecial study of children and young people, going outside of clinical experience to get at normal conditions in contrast with the Cialis 20 Mg Price Costco early stages of func- tional diseases. What was needed was not so much rclros])ectivc study of children from the standpoint of the adult who had become neurotic, but psycho- logical study of the child as he developed. There should be first hand observation of children from a [jractical and psychological point of view. Dr. L. Casamajok, of New York, closing the dis- cussion for Doctor Salmon, said that he did not feel •competent to cx|M-ess Doctor.Salmon's views on the subject and could init forward only his own personal ideas and the thoughts which the paper had aroused in him. One point in the di.scussion called for some remark and that was the reference to the "criminal class," and to the "criminal class" developing psy- choses. One ideal of society which had worked a great injustice in life was that all men were born equal ; society knew that all men were not born efjual for it recognized that men dittered in respect to susceptibility to all diseases, but it seemed to have completely neglected the possibility that there might be mental difl'erences and that all' "individuals were not born mentally equal. There was no such thing as a criminal class any more than there was such Cialis 20 Mg Price Costco a thing as a lawyer class, a physician class, or a stenographer class. Crime was a matter purely of the law and so varied in different countries and dif- ferent times. Business methods which were perfect- Cialis 20 Mg Price Costco ly respectable ten years ago were now criminal, but that did not place those who indulged in them in a criminal class ; probably everyone would belong to the criminal class if this were the case. The problem of the criminal was one of individual anomalies of character and conduct, and it was the psychiatrist's Cialis 20 Mg Price Costco work to study the causation of these anomalies. In the criminal one beheld an individual who, from peculiarities of his makeup, or disease of his mind, found himself at variance with the wel- fare of society and became an antisocial being. Ik- was antisocial because he was defective or because he was sick, and his crime was but a symptom of his condition. It was not a question of the so called criminal class becoming insane, but rather one of an individual with a mental defect or a mental disease beconn'ng antisocial to the extent of conllicting with the law — and so a criminal. Regular Mectwg Held May i. iqiy. Tlij President, Dr. FREnMirK Tilnev, in tlie Cliair. A Case of Syringomyelia or Leprous Neuritis. — -Dr. ITyman Climcnko, of New ^'ork. presented this case for ditterontial diagnosis between syringo- mvelia and leprous neuritis. The patient was a man fifty-eight years of age. born in this countrv of American parentage..\ brother died of Cialis 20 Mg Price Costco tubercu- losis. He was rather illiterate, having been hack- ward in school life and with a poor memory. His Ijosture was never erect. The present illness had Its inception thirty-three years ago in some form of infection of the left arm with a secondary infection extending to the right arm. The deformity of the right hand consisted of a flexure at all the inter- jjlialangeal joints; the left might be called a paw hand ;ind there were marked trophic changes of tingernails on the left. Cialis 20 Mg Price Costco There was a scaly ai>- pearance of the skin of both hands. This case, that later will be reported in full, showed symptoms that might easily be attributed to leprous neuritis as well as symjjtoms that would lead to a diagnosis of sy- ringomyelia, which was probably the true one in the ojjinion of Doctor Climenko. Dr. Edward D. Eishkr, of New York, said that he had now a very interesting case of syringo- myelia under observation, but it was not the typical class of which this case of Doctor Climenko's was a type. He wished to ask if tliere was any deviation of the Cialis 20 Mg Price Costco spine. Dr. Walter Timme, of New York, said that some years ago he had the good fortune to be al- lowed to examine a number of cases of leprosy in [iergen, Norway, at the leper hospital, and this case of Doctor Climenko's impressed him as being in some resjiccts similar to Cialis 20 Mg Price Costco some of the cases there. The atrophic condition of the skin, the condition of the extremities, and the few scars on the whole re- sembled types that were undoubtedly leprosy. This case Jackctl the pathognomonic scars on the fingers which were rarely absent in true cases. On the other hand, leprous neuritis was not accompanied • with loss of reflexes as a rule. It w^as difficult to recognize some of these cases without the presence of the germ being demonstrated, so that the diagno- sis was still open. The speaker thought that treat- tncnt with oil of choomulgra might tend to clear U]) some of the symptoms, in the event that it was a case of true leprosy. Dr. ■v\iLLiA>r M. Leszvnskv asked Doctor Tininic if it was likely that a man would have such a condition of the hands for- thirty-three years and not have suffered some progression of the disease if it were due to a Icjirous neuritis. He favored the diagnosis of syringomyelia. Doctor Timme replied that children the disease st.-irting at the age of eight or nine might remain in the same condition until the patient was tifty or sixt\- years of age. The cases usually began with Iiain Cialis 20 Mg Price Costco in the extremities, but this Cialis 20 Mg Price Costco one did not. He iiad seen cases in which the disease had remained >|ii'cscent for decades. Dr. S. P. CiOoniiAK-r said that when he was in Cuba, he visited the leper hospital in Havana and


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