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 |   Related post: slightly suspicious. With the history of the water as known, few men would have been bold enough to condemn the water as dangerous before the outbreak oc- curred. The inference drawn from the outbreak is that we can not exert too much care or exact too high a standard with our public water supplies. The quality of the Pedlar water had been passed upon by several specialists of undoubted competency and had been pronounced safe, and in this opinion the speaker concurred. The sole lapse from the conditions imposed for safety was that at intervals lasting only a few hours, occurring proTsably three or four times a month, chlorine was cut off and yet during these brief intervals the bacilli which in the untreated water but rarely reached the intake, seems to have gotten by and caused infection. Vol. X No. 10 SHALLENBERGER: NERVOUS MANIFESTATIONS 797 SURGERY, GYNECOLOGY, OBSTETRICS AND GENITO-URINARY DISEASES GYNECOLOGIC ORIGIN OF NERVOUS MANIFESTATIONS* By W. F. SHALLENBERGER. A.M., M.D., Associate Iv Avelox Professor of Gynecology, Emory University (Atlanta Medical College), Atlanta, Ga. Nervous manifestations as an accom- paniment of gynecologic conditions are ex- tremely common. The problems presented by these cases are often manifold and dif- ficult. The question arises, are we deal- ing with a pure functional neurosis, an organic nervous disorder, or is the nerv- ousness more or less the outgrowth of the gynecologic condition? The proper man- agement of the case Avelox 40 Mg depends upon this de- termination. Pelvic symptoms are fre- quent in women with functional neuroses and the women becoming consciously aware of functions that are normally only sensed by Avelox 400 Mg Tablet the subconsciousness, may im- agine that they are the victims of all sorts of "female troubles." Such patients are not gynecologic and their attention should be led away from the pelvis. Local treat- ments, operations, etc., will, as a rule, work nothing but harm to them. On the other hand, it is frequently very difficult to determine, with absolute assur- ance, that the pelvis is perfectly clear. Pelvic adhesions, which are a common source of pain and discomfort, are often not to be made out. A careful history and a thorough study of the patient will be helpful. The assistance of a neurologist may be necessary. The possibility of an organic nervous lesion must always be kept in mind. Women are more prone to nervous dis- orders or neuroses than men. The clien- tele of the average neurologist is composed largely of women. These neuroses mani- fest themselves most frequently during the period of sexual activity, between puberty and the menopause. They are not commonly met with at the extremes of life. During her sexual life a Avelox Moxifloxacin 400 Mg woman is constantly passing through a monthly cycle in which her entire organism par- ticipates, — an ebb and flow of her vitality. Menstruation is not a local phenomenon but a systemic phenomenon with local manifestations. There is a close and im- portant relationship between the endo- crine system and menstruation ; and de- i-angement of many of the glands of this system is accompanied by nervous symp- toms more or less marked. Therefore, it is Purchase Avelox Online small wonder that the nervous equilib- rium of many women is upset at the time of the menstrual period. Havelock Ellis calls attention to the fact that a number of investigators have found that among women criminals and suicides the acts were in the great majority of cases com- mitted during the menstrual period. He also states that among insane women the insane impulse becomes more marked dur- ing menstruation, and he says that: "These facts of morbid psychology are very significant; they emphasize the fact that even in the healthiest woman a worm, however harmless and unperceived, gnaws periodically at the roots of her life." That derangement of the endocrine sys- tem may be the important factor in the production of nervous symptoms in con- nection with various other gynecologic conditions may be true, but, in many cases, the pelvic condition, per se, is primarily responsible. That gynecologic conditions are a frequent source of nervous mani- festations can not be denied. The intens- ity of the nervous symptoms depends not so much upon the extent of the lesion as upon the nervous organization and sta- bility of the patient. A most extensive condition with uterine displacement and adherent adnexa, such as we often see in colored women, may exist with few if any symptoms in this race, whereas a minor and insignificant pelvic affection may com- pletely undermine the nervous reserve force of a more highly organized white woman. It is somewhat of a mooted ques- tion just how the nervous symptoms are produced. The neurologists have gotten away from the idea that it is a simple re- flex phenomenon. The effect of pelvic dis- ease may be and probably is largely psychic Related links: What Is Dilantin, Benicar Hct Generic, Atorvastatin 40 Mg, Order Tylenol 3, Noroxin 400mg, Keppra Xr Coupon, Seroquel 100 Mg, Cheap Accutane, buy cheap cytotec, Order Clonidine
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