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great rapidity, while the motor impairment may go on very slowly, or vice versa. Not unfrcquently also an almost entire remission of the morbid mental phenomena occurs even when the disease has made considerable progress, without a corre- glucophage price sponding improvement in the motor symptoms. The kind of mental disorder manifested in general paraly- sis not only varies greatly in different cases, but glucophage diabetes changes not unfrcquently in glucophage cost an unexpected way in the same case. tablet glucophage A glucophage xr 500mg con- siderable proportion of the cases are marked very early in the disease by a peculiar joyful exaggeration of every thing con- nected with self, with exalted ideas of the individual's wealth, powers of mind and body, and cost of glucophage importance in the world, and 382 PRACTICAL EELATIOlSrS OF MORBID this may continue until the mental decay and imbecility of the latter stage of the disease come to glucophage buy take its place. This condition of exaltation was once thought to be a test of this form of disease, but longer and glucophage mg closer observation has shown that it does not always cheap glucophage occur ; some cases glucophage online even from the outset being characterized by depression and timidity. In nearly all there is an irregularly progressive imbecility from the outset of the disease to its fatal close. In many there are occasional outbursts of maniacal fury, in many occasional attacks of deep depression. Loss of memory and loss of control over the emotions are very constant. In a few cases delusions of a ter- rific character, accompanied by the most fearful forebodings, and frightful spectres, are present through the greater part of the disease. It is scarcely necessary to say that, through the whole course of the general paralysis, the patient is to be re- garded as irresponsible, and incompetent to transact important business. As a general rule, this class of the insane is not a dangerous one, and acts of violence are not often committed by them. But, especially during the early part of the disease, before it is fully recognized, price of glucophage most disastrous pecuniary trans- actions are often entered into, and the most absurd specula- tions are entered upon, by the unfortunate victim of diseased hope. Inflated with magnificent ideas of his wealth and abili- ties, and elated glucophage sr with the most extravagant expectations, he enters upon business acts which may reduce himself and his family to beggary. That cases of general paralysis, therefore, should very early be placed under proper guardianship is most important, and the diagnosis of the disease by the family physician becomes immensely important. The most sure tests in the glucophage 500mg outset are generic for glucophage as follows : Motor symptoms. Mental symptoms. Paralysis of the muscles of speech. ( very frequent Tremulousness of the muscles of ex- Exalted personal ideas not constant. Change buy glucophage online in the character, " of pupils, ) especially from religious and sedate to profane, indecent, and intemper- ate, very common. MOTOR AND PSYCHICAL SYMPTOMS. 383 Hemiplegia. — "With regard to the association of hemiple- gia with mental misoimdness, there has, imdoubtedly, been a greater diversity of opinion among standard authorities than with regard to any other form of paralysis. Dr. "Watson, speaking of apoplexy, followed by hemiplegia, says : " The mental faculties are in some few instances quite unhurt by the attack ; too frequently, however, they suffer irreparable damage." Niemeyer is of opinion that psychical disturb- ance is frequent, but not constant. Dr. "Wood states that " the mind appears not unfrequently weakened ; the patient is apt to shed tears upon slight occasions, or without any occasion ; the memory is often defective, and words are mis- called, or one substituted for another of a wholly different meaning ; and, in some instances, it is long before the patient recovers the power of speech after having lost it. After a time, however, which varies in different cases from a few months to several years, the apparently wrecked system is often gradually repaired by its own inherent powers, and the patient, though seldom as vigorous in mind or body as before the attack, regains a tolerable share of health, and is able glucophage generic to enter again into the routine of active duties." Dr. Flint, speaking of the mental condition in cases glucophage xr of chronic hemi- plegia, evidently inclines strongly to the opinion that few, if any, cases are unaccompanied ^by mental unsoundness. He says : " The faculties of the mind generally, if not invariably, are more or less impaired." order glucophage Dr. Benjamin "W. McCready published an elaborate article in the New York Journal of 3Iedicine, of September, 1857, taking the ground, which he fortified by observation in a large number of cases, that " any, impairment of mind, as a direct consequence glucophage tablets of apoplexy, after the patient has recovered from its primary effects, must

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