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any considerable extent, are free from occasional attacks of
maniacal excitement, reaching in some cases to intense fury,
and often attended with marked homicidal tendencies. In-
deed, as a whole, the epileptic insane are nearlylif not quite
the most dangerous class, requiring to be managed with the
utmost care and precaution. Outbreaks of violence are more
sudden than in other patients of a similar grade of impair-
ment, and are characterized by peculiar ferocity and deter-
mination. Occasional attacks of depression occur in a large
MOTOR AND PSYCHICAL SYMPTOMS. 389
minority of the cases. Sometimes tliese seem to arise from a
rational appreciation of tlie mifortnnate nature of tlie afflic-
tion. At other times they appear to be the product sunply of
the diseased cerebral action. It is, however, rather to the
cases in which the deviations from the natural conduct are
more purchase hoodia trifling and less j)alpable that the attention of the medi-
cal expert will be more frequently drawn — to the cases where
the mental impairment is more slight, and perhaps more no-
ticeable in the alFective, than in the intellectual element.
When a deed of violence, or an act affecting injuriously the
rights of others, has been committed by an epileptic, an inves-
tigation of the widest character is imperative, a scrutiny which
shall include character, position, cultivation, former habits, in
fact, all the personal elements of the case, and which shall sift
all the concomitants and surroundings of the act, its motives,
and its connection with healthy and natural, or with diseased
and abnormal, mental hoodia p 57 impulses. I^ot only is it true that,
while some epileptics cheap hoodia are sane, others are insane ; but it is
not less true that many epileptics are at one time responsible
agents, at another time wholly irresponsible. ISTever, perhaps,
very far from the dividing line which separates sanity from
unsoundness, they occasionally make sudden and deep incm--
sions into the latter, leaving reason and responsibility behind
them. To determine just where they were when a certain act
was committed, is often a perplexing task ; but, if hoodia buy all the
circumstances are scrutinized, and no element of .the case is
neglected, a satisfactory conclusion can almost always be ar-
rived at.
Chorea. — This disease being general in its character, and
indicating some purchase hoodia online general affection of the nervous system, we
should naturally expect a pretty uniform psychical disturbance
associated with it. Temporary mental imbecility is a very
constant symptom of the disease, and with it a considerable
change in temper and affections is usually present. Attacks
of maniacal excitement too are not uncommon, and may prove
fatal. Ordinarily, however, the psychical and somatic symp-
toms keep pace, and subside together. " The mind fails in
these cases," says Dr. Flint, " from the deficiency of exercise
of the mental faculties." A more rational view of the matter,
390 PRACTICAL EELATIONS, ETC.
however, would seem to refer botli sets of symptoms to disease,
it may be only functional or sympatiietie, of the nervous
centres. Every careful observer of the disease must have
noticed cases, and perhaps it would be fair to say that these
are a majority of the whole, in which some change in the
character, some disturbance of either the intellect or the affec-
tions, or both, precedes the somatic manifestations. Trousseau
recognizes this fact, and asserts that " these prodromata con-
sist in impairment of the intellectual faculties." Again, lie
says, " With very rare exceptions there is more or less im-
pairment of the intellectual faculties." It may be doubted
whether even these hoodia 57 rare exceptions occur ; and in this disease
we have the uniform remarkable association of disordered in-
tellect, increased motility, and paralysis of both motion and
sensibility — for the latter undoubtedly occurs nearly in the
same ratio as the intensity of involuntary movement.
Paralysis Agitans. — This disease, having a very considerable
likeness in some of its features to the preceding, though occur-
ring at a different period of life, and probably differing essen-
tially both in its pathology and its causes, differs also from it in
this, that no mental disturbances occur necessarily or early in
the disease. It is, however, a progressive malady, and if the
patient is not taken off, as is exceedingly common, by some
intercurrent disease, sooner or later more or less mental im-
pairment occurs in the majority of cases. This is usually of
the character of simple dementia, but occasionally some de-
gree of maniacal excitement with delusions may be manifested.
The probability of complication order hoodia with morbid mental phe-
nomena would seem to depend almost entirely upon the dura-
tion of the bodily symptoms, and the progress of the central
lesion, which may be deduced therefrom.
EXTEAOEDINAEY CASE OF HYDKOCELE. 391
Clmbtl |lfr0rtrs fr0m ^ribiih mxii P0spital llratiict.
Aet. I. — Extraordinary Case of Hydrocele. Hj John G.
Meachem, M. D., Kacine, Wisconsin.
Theee years ago I was consulted by a gentleman of
Kenosha County, in this State, in relation to a greatly-en-
larged scrotum. "WTien tlie patient was in the erect position,
the tumor reached to within foui* inches of the knee-joint
(he was five feet ten inches in height), and it was, in
circumference, twenty-three inches. It was the largest at
the beginning of the buy hoodia online lower third, though nearly uniform
in size throughout most of its extent. It was natural in
color, smooth, semi-elastic, but not diaphanous. The penis
was entirely obliterated, having been dragged out of sight,
and presented simply an umbilicated depression at about
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