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litis, and the same in both. From an ordinary lumbago the pains of malignant dis- ease ought to be distinguished by chronieity and rebellious- ness to treatment. A severe lumbago lasting several weeks, defying treatment, and lacking renal characteristics, should excite suspicion of organic spinal disease. From ordinary sciatica the pains differ by their chronici- ty and rebelliousness to treatment, and the fact that they are generally bilateral Cardura Classification and often accompanied by Cardura E10 pains in the distribution of the crural, lumbar, or dorsal nerves ; a double sciatica or continuous bilateral pains should always put one on his guard. Moreover, general weakness of the legs rarely occurs with sciatica. In spinal irritation, spinal tenderness is more apt to be general and exquisite, while the pains of that disease are fugitive, non-neural, and shifting. The history of the patient ought to have much weight in this case. Spinal irritation in adult males is rare. The protean manifesta- tions of hysteria should not mislead a careful clinician in the face of the unmistakable signs of organic disease gen- erally present. Spinal meningitis and pachymeningitis are comparatively rare ailments, and are generally characterized 1>\ non-neural pains and various spasmodic disturbances peculiar to themselves. Intra-spinal growths cause symp- toms very Cardura N10 closely resembling those of the late stage of ver- tebral disease, but the early appearance and rapid progres- sion of paraplegic symptoms, and the absence of a previous protracted stage of neural pains without paraplegia, are suggestive factors in the diagnosis. The history of the case, aside from the absence of ataxia, diminished reflexes, anaesthesias, retarded sensations, and periods of complete freedom from pain, should render a confusion of vertebral disease with posterior spinal sclero- sis well-nigh impossible. Feb. 26, 1887. MACKENZIE: RESPIRATORY VASO-MOTOR NEUROSES. 231 Inflammatory affections of the cord per se, forming the various types of myelitis, should he easily recognized by their almost universal freedom from acute pain, and by the early supervention of real motor and sensory paralyses and the frequency of vesical and rectal disturbances. 18 Cardura Tablets West Twenty-first Street, January 23, 1SS7. Buy Cardura Online A CONTRIBUTION TO THE PATHOLOGY AXI) TREATMENT OF THE RESPIRATORY VASO-MOTOR NEUROSES.* By JOHN NOLAND MACKENZIE, M. D., BALTIMORE. We are at present passing through a revolution of senti- ment in regard to the pathology of certain affections whose external phenomena at least are Cardura Bph chiefly or wholly manifested in the respiratory apparatus, and notably its Cardura For Bph upper segments. Phenomena inexplicable on commonly accepted beliefs have received their fitting explanation in morbid conditions of these structures linked to a disordered state — imperfectly defined it may be — of the vaso-motor sympathetic. Espe- cially is this true of that interesting group of symptoms known as " hay-fever," but for which I think the term coryza vaso-motoria periodica a more appropriate appella- tion. In this paper I shall limit myself strictly to the essen- tially vaso-motor neuroses, and shall not enter upon the Cardura E10p dis- cussion of the purely sensitive and motor reflex. As my views on the subject of the respiratory reflex neuroses, and especially in regard to vaso-motor coryza, differ in many es- sential particulars from those advanced by other observers, and as some of my confreres, who have done me the honor to quote from my writings, have apparently failed to appre- ciate the fundamental ideas underlying my theory of these affections, I will ask your indulgence while I recapitulate, as briefly as possible, the principal articles of my belief. I shall furthermore ask you to refer for a more elaborate state- ment of my case Purchase Cardura to my former communications on the sub- ject of reflex and vaso-motor phenomena. f That portion of the respiratory apparatus known as the naso-bronchial tract is, together Cardura 1 Mg with its appendages Cardura 6 Mg and connections, frequently the seat of certain periodical vascu- lar disturbances in which paroxysmal Cardura 10 Mg explosions of nervous force play a conspicuous part, and which depend, it is rea- sonable to assume, upon some form of Flomax Vs Cardura sympathetic or vaso- motor nerve-irritation. The vascular changes with their as- sociated nervous phenomena may affect the upper respira- t n'\ tract in its entirety, Cardura Vs Flomax either appearing simultaneously or successively in its different segments, or may be chiefly mani- - * Read before the American Laryngological Association, May 29, 1886. f See especially, "Trans, of the American [.aryng. Assoc.," ISS-l, pp. 113 el .so/. Papers on Coryza Vaso-motoria Periodica in "Medical Record," July 19 and Oct. Order Cardura is, 1884; Rhinitis Sympathetica, " Cardura Online Mary- land Med. Journal," April 11, 1886; Origin and Cure ol Cardura Generic Name Coryza Vaso- motoria, etc., " Trans, of the Medico-Cbirurg, Faculty ol Maryland," 1885 ; Review of Morell Cheap Cardura Mackenzie on Hay-Fever, ''Am. Journal of the Med. Sciences," Oct., 1885, pp. 611-528; Production of Rose-Cold by an Artificial Rose, etc., ibid., Jan., 18S6. fested or localized in some individual portion of the tract (nose, pharynx, larynx, bronchial tubes). In the latter case the nasal cavities and the bronchial tubes are most frequent- ly the areas upon which the nervous shock is expended — the two territories Cardura E10p Msds being seemingly held in close reciprocal relationship by virtue of a physiological law of sympathy between the two extremities of a mucous tract. In the one ease a sympathetic coryza results, in the other a sympathetic bronchitis.

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