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of the motor centres to be noticed, with some loss of muscular sensibility. Such persons find a difficulty in sitting still, and the ordinary co-ordinated movements are exaggerated so that they move rapidly and continue walking and running up-stairs without feeling tired. When sitting down, a viagra cheap free constant shifting of position, or agitated chair-rocking, and general fidgetiness may viagra cheap free be noticed. Their only complaint at first is a disagree- able feeling in the epigastrium, probably due to hy- peresthesia. It will be found on inquiry that this display of energy is not being compensated for with food and rest. On the contrary it will be found that the usual sleeping-hours are reduced to three or four, or very commonly there is complete insomnia. They have no appetite for food, and take only viagra cheap free a little, per- viagra cheap free haps, to relieve viagra cheap free the uncomfortable feeling at the epi- gastrium. Such a condition of affairs precedes many cases of mental disintegration, and is familiar viagra cheap free in a more exaggerated form as the early stage of general paralysis and viagra cheap free acute mania. If at this stage the patient comes under a phy- sician's notice, and can be persuaded to alter his or her mode of living by adopting the only rational measures that lead to recovery, rest and food, the end may be averted. Unfortunately this advice is too often disregarded, and as the inevitable re- action sets in, recourse is had to the various so- called "nerve tonics" "to hx themselves up" too often alcohol, morphine, or cocaine. These are no better than spurs to a jaded horse. Nature has her revenge, and after a certain time, according to the strength of the individual, the reserve is exhausted and there is a progressive depression of the nervous system, spreading from the higher nervous centres downward. All work becomes impossible; a settled melancholy succeeds the previous exaltation; the presence of intimate friends and even of nearest rela- tives becomes a burden ; various forms of emotional weakness, with hysterical disturbances manifest them- selves; muscular weakness with fibrillary twitchings, cardiac weakness with fainting, are some of the symp- toms of prostrate nervous system. This is a bare outline of the condition with which we are all familiar under the name of nervous pros- tration. The progress of events may be rapid or slow, according to circumstances. When it extends over some time, the symptoms displayed are more numerous and often difficult to account for. They have been described very fully by Dr. Beard. It is only my object to emphasize by reference to the dynamic laws of cheap viagra nyc the system, how inevitable the reaction is, and how impossible it is to impede the downfall so long as the exciting causes con- tinue to operate. In a lane proportion of cases, as the result of an extended rest, tile normal equilib- rium is re-established and the patient returns to his or her usual occupation. This means that a consider- able rest has to be taken, extending in some cases to a couple of years or more. Every Altantic liner leaving New York has some of these afflicted ones on board. Most of them are men who viagra cheap free have shattered their energies in business. Their very natural excuse is that "time' is money, that opportunities 1 annot be thrown away, and that money would be lost through not pushing busi- ness." That is true enough; but they do not seem to consider the time lost in Europe recuperating their health, the opportunities cheap viagra nyc for pushing business that are then lost, and the increased expenditure incidental to travelling. It is quite open to doubt whether they do not in the end suffer a loss all round. There are some unfortunate cases in which the normal equilibrium is never re-established, and a permanent unstable condi- tion of the nervous cheap viagra nyc system results. The same law applies to all forms of nervous ex- haustion, whether it be that resulting from the general exercise of faculties in business, or the excessive use of any one department of the nervous system. Com- mon examples are seen in the overtaxing of children, especially girls in school, too much attention being given to mental development during a period which should be largely devoted to physical growth ; or some- times there is an excess of exercise in both directions. Another form is seen in people of leisure and intel- lectual attainments, who do too much abstract think- ing and self-analysis. Others read too much im- aginative literature, especially poetry to excess, and hear too much music, pursuing whatever gives the largest emotional element. The resulting exhaustion can be observed in the gradual deterioration of their taste, which undergoes a gradual decline, seeking for satisfaction finally in the literature of the French de- cadent school and also in the continual complaint of "ennui" and "boredom." In reference to this form the following law laid viagra cheap free down by Alexander Bain 1 is of interest. "Every emotion whatsoever both exercises and exhausts some one portion of the physical framework of mind. Cer- tain circles of the brain, certain muscles and or- ganic processes are involved in each case, and these are liable to weariness after a time, while by repose they become charged with new vigor. Hence any de- partment that has been severely drawn upon ceases to support the associated mental condition, and every de- partment that has been long dormant is ready to burst forth on application of the proper stimulus."' Dr. Beard attributes the tendency to cheap viagra nyc nervous exhaus- tion viagra cheap free to two causes more than to any other cheap viagra nyc ; first, the nine- teenth-century competitive feeling, and secondly, the stimulus given to the nervous system by electrical dis- charge in dry conditions cheap viagra nyc of the atmosphere, when con- duction in the air is cheap viagra nyc diminished. The second is probably more operative in America than is generally supposed. As regards medicinal treatment, he places ergot and the bromides in the first rank, and they are certainly very useful in the stage of excitement. Arsenic he also regards as a very useful remedy in some forms of neurasthenia, as it diminishes sensibility and reflex irritability. There are great obstacles in the way of devising methods of treatment in some of these conditions. The judicious selection of methods is fraught with difficulty to the physician, viagra cheap free and it sometimes requires a considerable amount of tact and ingenuity on his part to divert the energies into other channels. Considerable space