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Tuberculosis dispensaries, venereal disease dis- pensaries, and those for the treatment of other communicable diseases, as whooping cough and communicable eye diseases, etc., are included in this group. At the present time all the tuberculosis dis- *Read before the New York Urological Society, October 3, 1917. May 25, 1918.] EMERSON: STANDARD METHODS IN VENEREAL DISEASE. 969 l^ensaries are members of an association which re- quires com]jlian(.e with certain rules for practice and follow up procedure, and they are more nearly standardized than any others in the city. They al- ready comply with the regulations adopted by the Board of Health. There is only one whooping cough dispensary in the city, but we hope that others will be established and that they will be established under conditions somewhat different from others for children. Venereal disease dispensaries come within the meaning of this section. The principles that gov- erned the committee were the principles applying to the sanitary control of communicable diseases, namely, that it is the physician's inevitable responsi- bility to maintain supervision when he is aware of How Much Does A Cialis Prescription Cost the presence of a disease which the patient, in his ordinary mode of life, would communicate to others if not subjected to a certain control. All such cases (all communicable diseases-) must be reported to the Board of Health. .Vfter the report is made, some one must be responsible for the treatment of the condition during the communicable stage of the dis- ease so that tliis stage may be as brief as possible We believe that the jjhysician who is aware of cases of venereal disease is responsible for carrying out such treatment and placing his patients under such conditions that they will be cured, or the disease will be no longer communicable. The regulations as in force are perhai)s familiar to you, but I should like to take them up one by How Much Does A Cialis Prescription Cost one. In the first place, owing to the special char- acter of treatment needed, we have asked that the treatment of syphilis be not spread through all How Much Does A Cialis Prescription Cost classes in dispensaries, but be localized in a special department or in the dcrmatological department. Keyulaiion 1. Treatment of Syphilis ; Special Depart- ment.— The treatment of syphilis, whatevir its tuanifcsta- tions, How Much Does A Cialis Prescription Cost shall be conducted in a special department maintained for such purpose or in the department for der- matology connected with the dispensary or hospital. Pro- vided, however, when the nature of the part affected, such How Much Does A Cialis Prescription Cost as the eye, throat, viscera, etc., necessitates treatment in some other department of the dispensary, treatment may be Riven jointly by the two departments. .\ syphilologist will see the patient and. if neces- sary, call for and receive the benefit of the thera- peutic advice and diagnostic skill of other depart- ments. Rcrnilatlnn 2. Microscopical Examination Required. — Every department for the treatment of syphilis shall make microscopical examinations of all suspected lesions. In many a case, positive diagnosis at the time the jiatient presents himself will save more secondary ca.ses due to How Much Does A Cialis Prescription Cost personal contact than an unlimited number of positive Wassermann tests in the ter- tiary stage of a disease. Immediate diagnosis may save a group of persons in the home or shop from infection the next day. RciiiilatiJii .?. Wassermann Tests. — Laboratory facilities for making Wassermann tests should be provided in every dispensary. If sncli laboratory facilities are not so pro- vided, provision shall be made for the prompt delivery of specimens to the Dcpartmcnl of Health or other approved laboratories where such tests are made. Obviously, it is the duty of the city to put at the service of the patient and of physicians, dispensaricj or hospitals, its own diagnostic laboratory service Regulation ./, Number of Patients to Be Treated. — The number of patients to be treated at a dispensary shall he regulated by the number of physicians in attendance and the equipment and facilities provided in the dispensary. The ma.ximum number of patients treated by a physician shall not exceed ten per hour. Few private physicians would expect to arrive at a well considered diagnosis or satisfy the needs of education and advice for his patient in six minutes, and yet in the practical operation How Much Does A Cialis Prescription Cost of well organized dispensaries, where clerical and nursing assistance and properly coordinated work among the phy- sicians are arranged for, good clinical results and excellent service can be provided if no more than ten patients an hour, including new admissions and revisits, are accepted. Rcfiulalion p. Salvarsan or its Analogues to Be Admin- istered. — In view of the fact that the obligation to render a person affected with an infectious disease innocuous at the earliest possible moment rests on the institution to which the patient has applied for treatment, salvarsan or its analogues, in sufficient quantities and at proper inter- vals shall be administered, with the addition of mercury or other accented means of treatment, to a!l cases of .syphilis. The dispensary managers may properly reply to this : We have no money to purchase the required medicaments with. The city is forcing us to pro- ' vide something we cannot alTord, or which the pa- tients cannot afford to get themselves. Experience in the operation of dispensaries, as for instance the one operated at the Brooklyn Hospital, shows that ninety per cent, of the applicants for treatment of venereal disease are willing to pay the cost of the specific medicines used in the treatment of their diseases. Furthermore, I have included in the budget re(|uests for the Department of Health, for