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Syphilis is common : we meet it under many masks and in many unsuspected persons, but write this down as axiomatic, that if symptoms occur in a person you would least suspect, suspect that per- son until the diagnosis is certain. I am often struck with the great fear some family physicians fee! when the diagnosis of syphilis is made ; they wish at once to suppress the truth ratlier than realize that a frank knowledge leads to careful and per- sistent treatment. It may in fact be the ounce of precaution. T am sure T state the fact moderately April PRICE: FUXCTIOXAL NERVOUS DISEASES 729 when I say that )w neurologist of block all gambling sites for free am? experience in diagnosticating brain and cord diseases would pay the slightest heed to the statement that there was no histor}- of infection, and this applies with double force to women, who often do not know of casino gambling in jacksonville florida its pres- ence, and if they do are apt to prevaricate even more than men. Remember that borderlands 2 sanctuary gambling machines a negative Was- sermann reaction does not eliminate the question ; a positive test settles it in my opinion. Syphilis of the nervous system does not involve the nerve tissue, but the bloodvessels, membranes, and connective tissue (mesoblastic tissues), the im- pairment of the nervous, online gambling an appreciation of legal issues being secondary. It is not alwa\s curable; does best under most careful, gambling casino in orlando florida gen- eral, and antispecific treatment. I am wedded to the hypodermic use of mercury and when necessary extremely large doses of the iodides, well casino gambling in florida diluted with water. Hydrotherapeu- tics and all forms of physiotherapeutics are valuable aids. Its treatment is a broad subject, too broad to stop and consider here. 11:5 \\'est Chestnut Street. ETIOLOGY OF THE FUNCTIONAL NERVOUS DISEASES.* By G. E. Price, M. D., Philadelphia. The three great functional neuroses, hysteria, neurasthenia, and hypochondria, differ radically in their nature and symptomatology, although they have why is the state of massachusetts suddenly interested in casino gambling in common many predisposing and exciting causes. Neurasthenia, the fatigue neurosis, is character- ized by exhaustion and imperfect nutrition of the nerve centres. Experimentally, it has been shown by Hodge, Lugaro, and ohio casino gambling addiction casino gambling age uk others, that the exhausted ganglion cells of animals present definite changes. The nucleus is decreased in size, irregular in out- line, and reacts abnormally to dark stains, while the cell protoplasm becomes shrunken and vacuo- lated. These changes are not destructive, the cells returning to the normal condition after rest, although their recovery is slow. Neurasthenia is not a condition which arises spontaneously, but can always be traced to an underlying cause. Either the individual has inherited a nervous system defi- cient in strength which readily succumbs to the stress of life's vicissitudes, or else we find that a sound nervous system has been greatly overtaxed. Inherent weakness of the nervous system is present in the majority of cases as the result of a neuropath'c liercditv. Direct heredity, the parents being neu- rasthenic, is in mv experience, not as common as iidirect heredity. Insanitv or nervous disease of the parents, consanguinity, alcoholism, illness of the mother while carrying the child, or conception oc- curring when the parents were well advanced in years, are recognized predisposing factors. Exciting causes are numerous and varied. Ex- haustion may follow prolonged mental or phvsical overwork without sufficient sleep and nourishment. Long continued worry and anxietv are often com- bined with overwork and greatly reinforce the ■Riad htforc Hk- K-nsiiitrton Branch of iIk- Philadelphia County Medical Society. March 3, 1911. harmful effect of the latter. Alcoholic and sexual excesses contribute their quota of cases, and in many instances all of these factors are operative in a given case. Neurasthenia often follows a pro- longed and exhausting illness or free spells to stop gambling may accompan_\ and be the result of a chronic kidney, pelvic, gas- rric, or other visceral disease ("neurasthenia symp- tomatica" _). Trauma is responsible for a large online gambling usa 2013 group of cases, every physician being familiar with the so called "traumatic neurosis." Profound men- tal shock unaccompanied by ph\sical injury may cause neurasthenic symptoms. Another group of cases are gambling casino in san antonio texas the result of some form of constant reflex irritation ("reflex neurosis"), of which eye strain may casino gambling addiction stories be given as a type. Autointoxication from the products of imperfect metabolism is assigned as a cause, but this condition, I believe, is more often the result of the exhaustion than a causative factor. The literature written upon the question and the ar- guments that have been advanced online gambling usa 2012 pro and con re- call fallsview casino gambling addiction free gambling spells that work the query "Does the constitution follow the flag or the flag the constitution"? Neurasthenia affects males more than females, and is a disorder of adult life, occurring at free gambling games online no download the full tide of life's struggles and responsibilities. It is rarely seen in free gambling helpline uk old age and seldom occurs before the age of twenty, although one enthusiastic neurologist recently reported what he believed to be a case of neurasthenia in an infant of two years. Americans are more prone to the disease than their phlegmatic cousins of England and Germany, although how any of the latter race escape the ex- haustion psychosis while mastering the intricacies of their language is difficult of explanation. He- brews, especially of Russian birth or descent, are also very liable to neurasthenia. Neurasthenia must not be confounded with the prodromal symptoms of the various psychoses to which Dercum has applied the term "neurasthe- noid." They are not the result of chronic fatigue, and have only a superficial resemblance to the svmp- toms of true neurasthenic states. The term "psychasthenia" has of recent years been applied to cases of neurasthenia presenting •.narked cerebral symptoms. These patients invari- ably have a neuropathic or psychopathic heredity. Hysteria. The nature of hysteria is still a de- batable subject, and our understanding of the cause has not progressed as far as our knowledge of the symptoms. Thus Charcot, to whom we are indebt- ed for an illuminating exposition of the manifesta- tions of hysteria, says: "Hysterical are those phv- sical and mental processes of extraordinary charac- ter and strength, which may be online gambling usa players brought into being by ideas." Janet considers hysteria to be the result of a .splitting ofT or separating of certain elements of consciousness from the total consciousness. .-\t the present time, the ideas of Babinski and Freud are attracting the most attention ; Babinski considers that the symptoms of hysteria are induced only bv suggestion and auto-suggestion and removable bv

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