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27 Wam. .^tkeet.
In the study of new diseases or conditions more or less
incidental to cmr rapidly advancing civilization, each onp
should consider it a duty to relate his experience and record
observations from his own point of view, and, as we all
look at a subject from a different standpoint, it would thus
be illumined on all sides and we would not be so liable to
be led astray by Order Atorvastatin Online the narrow conceptions of the specialist
or the broad considerations of the general practitioner.
Attention to the topic now in hand appears to be specially
opportune, as our present knowledge of the matter seems
to be in a more or less confused and unsystematized condi-
tion, followed sometimes by treatment or operations calcu-
lated to increase when they do not benefit the original
trouble. How often are eye muscles cut, nasal passages
bored out, and ovaries removed to alleviate suffering which
would disappear under treatment directed to raising the
tone of the central nervous system and regulating the func-
tions of the stomach, liver, bowels, kidneys, and skin, com-
bined with measures looking toward a more complete oxida-
tion ! Further, it is a question as to whether peripheral irri-
tations long continued, especially in those with inherited
weak central nerve organs, do not produce organic changes
in the spinal cord. Do we appreciate sufficiently how fre-
quently children and persons with inherited low vitality
and instability of the nervous .system are unwisely placed
in positions and under Buy Atorvastatin Online conditions where they break down
and Purchase Atorvastatin become invalids, who under more favorable circum-
stances might have retained a fair degree of health ? Will
not a more accurate pathological knowledge show that many
so-called cases of neurasthenia are due to multiple neuritis
of a mild grade ? These and similar questions can only be
answered by a careful study of our cases and the advance-
ment of pathological science. All we can at present do is
to group certain classes of symptoms which clinically seem
* Read before the Society of the Alumni of Bellevue Hospital,
January 7, 1891.
July Cheap Atorvastatin 25, 1891.]
to have certain relations to diathetic conditions and which
we can in the present state of our knowledge refer only to
lack of nervous force and vitality. " Neurasthenia has been
defined as a nervous weakness or exhaustion often accom-
panied by perverted nerve function." It may be primary,
due to malnutrition, or peripheral irritation. The classi-
fication I have adopted is a Buy Cheap Atorvastatin modification of one suggested
by Dr. L. C. Gray, and brings all cases under three heads :
1, simple; 2, such as are due to suboxidation ; 8, reflex.
The following cases are illustrative of these three forms.
In all the cases some hereditary neurotic or gouty taint
with primary Atorvastatin 80 Mg nervous weakness can be traced, and the ex-
citing causes — such as mental strain, exhausting diseases,
suboxidation, peripheral irritations, with change in the
mode of life — find here a congenial soil for the development
of a train of nervous symptoms which are not produced in
constitutions whose nerve-centers possess a higher tone :
Mrs. K., white, aged thirty-three years, weight 164f pounds,
married, consulted me October 5, 1890.
Family History. — Father dead ; does not know cause Purchase Atorvastatin Online of death
or age at time of death. Mother died at the age of thirty-six,
probably from phthisis ; mother was subject to attacks of spas-
modic pain in stomach. One sister living and well. One brother,
who had St. Vitus's dance when young and is now addicted to
excessive use of alcoholic stimulants.
Personal History. — Had diphtheria three times when a cliild.
At sixteen years of age had typiioid fever, also malarial fever
nine years ago; has been married fifteen years; two children
living, one of a very nervous temperament ; the other was sub-
ject to convulsions while teetiiing; faints frequently. Shortly
after her marriage and after the birth of her first child she
began to have attacks of spasmodic pains in the stomach, which
have recurred at intervals of three or four weeks until about
three months ago, since which time they have not been so fre-
quent, but she says she suffered nearly the Simvastatin Atorvastatin whole summer from
continuous headache. On October 5, 1860, when Generic Atorvastatin I first saw the
patient, she was suffering from severe neuralgic pains in the
left side of the head, for which I administered a Order Atorvastatin hypodermic
injection of half Atorvastatin Tablets a grain of morphine, with the result that the
pain left the head and she began to have severe pain in the left
side, which also passed away soon after. The pain recurred in
the head on October 6th, 7th, and 8th, and I was obliged to ad-
minister morphine again. The neuralgia finally yielded after
the administration of thirty grains of quinine Atorvastatin Buy within three hours

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