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essentially a spasmodic phenomenon, or whether the bron- chial constriction is due to an engorged condition of the roncous membrane analogous to that seen in vaso-motor Fosamax Mg coryza — a transference, so to speak, of the nasal swelling Fosamax Price Fosamax With Vitamin D to the bronchial tubes — are matters which do not come within the range of the present inquiry. While there are many reasons for belief in the correctness of the latter view, which was Fosamax Plus D advanced by Weber," and which has recently found an eloquent defender in Sir Andrew Clarke, | and while such transference probably does take place in a large number of cases, still it were unwise, in Fosamax With D the present state of our knowl- edge, to eliminate completely the element of spasm as a pos- sible factor in other cases, and to lay down the law that the constriction of the bronchial tubes alleged to be peculiar to this condition can only be brought about by sudden swelling of the mucous membrane. * " Clinical Medicine," New Syd. Soc. Trans., Loudon, 1868, vol. i, p. 619 et seg. f "Traite eleruentaire de pathologic externe," Paris, 1868-69, torn. 3, p. 815. •j: "Trans, of the Med.-Chir. Fac. of Md.," /. c. "Am. Journal of the Med. Sci.," Jan., 1886. * " Ueber Asthma nervosum." See " Tageblatt d. 45 Versainm- lung deutsch. Naturforscher u. Aerzte in Leipzig," 1872, p. 159. | "American Journal of the Med. Sciences," Jan., 1886^ In sim. pie justice to Trousseau, whom some recent writers seem to overlook, it must be stated that he was the first to look upon the peculiar coryza (un loubtedly the hay-fever of the present day) occurring in connection with asthma (see above) as one of the manifestations of that disease, as a part of the asthmatic process, and also the first to suppose that the difficulty in respiration, sometimes associated with urticaria, was " occasioned by an eruptive Fosamax 70 Mg or congestive state of the mucous membrane of the bronchial tubes analogous to the eruption and congestion on the skin." {/>.■;/., vol. ii. p. 2S4.) An interesting feature of a certain proportion of the class of cases we are now discussing is the occasional asso- Fosamax Buy Online ciation of urticaria, asthma, and coryza. And just here I may remark that the relation of asthma to skin affections was familiar long before the days of Trousseau. Thus the illustrious Hoffmann * mentions, as a fact of common ex- perience, that asthma sometimes follows the suppression of a cutaneous rash ; and before him Baglivi f had recom- mended, in such an Fosamax D event, that the patient should sleep with one having the "scabies," that, catching it, he might be relieved of his asthma. It is also related that William of Orange was cured of an inveterate asthma during the running of a sore on the shoulder produced by the famous cannon-ball wound received at the battle of the Boyne. In the condition of affairs that we are discussing, the coryza may precede the asthma and urticaria in time of appearance, disappearing or remaining after their eruption ; or the asthma or urticaria may antedate the attack of co- ryza ; or, finally, instead of Buy Fosamax alternating the one with the other, they may appear simultaneously in the individual. At the last meeting of this association I stated my belief that these phenomena seemingly depend on an imperfectly defined neurosis or vaso-motor influence (possibly some derangement of the cervico-oceipital sympathetic), which is probably the connecting link between these affecti >ns. Now, in attempting to define the reciprocal relationship between this triad of conditions, we may regard the skin essentially as a part of the respiratory tract — as the external organ of respiration. It is only necessary for me to recall the physiological importance of the skin in respiration among some of Fosamax Online the lower animals, and the embarrassment of respiration in man Fosamax 70 from pathological or experimental suppression of the cutaneous function. We may accord- ingly regard this neuro-vascular disturbance of the external surface as a natural symptom of the respiratory vaso-motor neuroses, and assume that, while the relation of asthma and coryza may be explicable by a possible "normal sympathy existing between the two extremities of the internal respira- tory tract, Fosamax 10 Mg both asthma and coryza may be linked to the skin affection by a sympathetic bond which holds in equili- brium and close consent the whole mechanism of the res- piratory function. The principles involved in the foregoing propositions have served as the basis and rules of my practice in this class of affections during the past three years, and with a most gratifying result. In that time between sixty and eighty cases of Fosamax Femur paroxysmal vaso-motor neuroses of the res- piratory tract have come directly or indirectly under my professional observation. Of this number, the nasal pas- sages were most frequently the seat of the vascular Fosamax 70 Mg Weekly disturb- ance, and next in frequency the Price Of Fosamax bronchial tubes and * " Itit exjtcricntia doccmur, a scabie refrojiulsu . . . a tinea capitis male curata . . . nostrum passionem exoriri." F. Hoffmann, " Op. omnia physico-medica," part ii, Sj ix, p. 257, Geneva', 1760. In speak- ing, too, of the symptoms of asthma, he adds, " Mucus per nares ex- cluditur." \ " Alendronate Fosamax Opera omnia med. practica," ed. oetava, Lugduui, 1714, "Prax. med., appendix de asthmate," p. 104. "Es scabie relropuha si asthma tint, cum scabloso dormiendum est, ut "cables revocetur, vel uriicis cedenda cutis." Fosamax Alendronate Feb. 26, 1887.] MACKENZIE: RESPIRATORY VASO-MOTOR NEUROSES. 235 pharynx. Occasionally the affection was more or less clearly localized in the laryngeal cavity, but, according Fosamax 35 Mg to my experience, Fosamax Lawsuit this is an exceptional event. While the sym- pathetic nerve disturhances manifest themselves most fre- quently in the nasal cavities, in a certain proportion of cases the pharynx and larynx appear to be the starting- point of the trouble, and I have traced a number of retiex phenomena, such as asthma, cough, etc., to diseased condi- tions of these structures. The vaso-motor disturbances, both of the pharynx and larynx, are, however, commonly associated with, or preceded by, similar affections of the nasal cavities. In the pharynx and larynx they are char- acterized by an excessive degree of hyperesthesia — the

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