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'Hasslor. Ncif Yon- Mfliatl Journal. Average Cost Of Viagra Prescription .VllRilst tj. 1910, overeating, excessive smoking, pulmonary gan- grene, cardiac trouble, and pregnancy. Hiccough is associated in so many and varird conditions that to give a complete list would prove of little practical value, as it may occur in almost any exhausting disease — acute or chronic. Dia- phragmatic inflammation, be it either parietal or pulmonary, is often a serious complication. Hic- coughing in typhoid fever is of ominous import, in- dicating, as a rule, perforation or the onset of peri- tonitis ; it is also regarded as a grave prognostic sign in yellow fever. The remedies to be employed, therefore, depend largely on the cause of the symp- tom. In the larger number of cases of hiccough, a Average Cost Of Viagra Prescription physician is never summoned until all the ancient family remedies have been tried and proved futile. The milder cases are rarely seen by the Average Cost Of Viagra Prescription physici:;n unless they assume a chronic type. .\s a rule, in mild cases, the spasm may be :ir- rested by one of the old fashioned remedies. Whether or not relief is ever due to psychic sug- gestion the writer is unable to state. The follow- ing are the favorite modes of treatment among the laity: The swallowing of ice. salt, lemon juice, vinegar, strong spirituous liquors ; holding the breath a minute or two ; forcible traction on the tongue for several minutes ; Average Cost Of Viagra Prescription and, taking large draughts of water while holding the breath. The last named seems to have the strongest hold on popular favor and incidentally has antiquity to recommend it, for Eryximachus, physician to .Aris- tophanes, is said to have used it whenever his mas- ter ate too much and realized his indiscretion in the hiccough. It is worthy of a trial, however, and may be found of assistance. The trick, as we may call it, is best accomplished by having (he sufferer Average Cost Of Viagra Prescription press the thumbs firmly over the right and left cars, respectively, while the reliever's index fingers sim- ultaneously exert pressure over the nares, thus pre- venting any air entering the respiratory chamber. At the time this pressure is applied over the ears and nares, the patient is ordered to swallow a large draught of water. Two or more trials may be nec- essary before relief is experienced. The writer w^ishes it understood that he does not vouch for this as a positive cure, but is disposed to consider it with much favor in view of his own success in a number of cases. Holding the breath keeps the diaphragm still and forces it tr> rest awhile. Should the foregoing prove futile and the spasm is not relieved, musk, in a dose of five to ten grains in a solution of starch water should be given a thorough trial. In the administration of musk, caution, of course, must be observed. To obtain musk pure is exceedingly diiificult. as most of the musk carried by the pharmacists is either impure or not musk at all. .\nother drawback is the cost of the remedy. It should not be employed more than once or twice, as beyond that its power be- comes almost nil. In case the musk fails, the writer tries other remedies in succession, remember- ing always that none is infallible and that the ])roper one may be ultimately found. It is wise to ascertain certain facts as to the die- tary and the bowel movements of your patients. If there be gastric or intestinal irritation, do not 82S PRESCOLN: -COLD CAUTERY. LNew York Medical Jocrn hcsiiaic lo use an emetic or purge ; in severe cases, clearance of the alimentary tract is imperative, and should not be neglected. In the severe cases any of the following proce- dures may be resorted to with success : Lavage, passing of the oesophageal sound, prolonged pres- sure over the abdomen and epigastrium, forcible traction on the tongue, abdominal massage, con- striction around the lower thorax, cold pack, hot packs, applications Average Cost Of Viagra Prescription of blisters on each side of the cervical spine over the roots of the third, fourth, and fifth nerves. Of the internal remedies, the number is legion and only a trial can Average Cost Of Viagra Prescription prove tlieir worth. The following have been suggested and used: Nitroglycerin, cocaine, spirit of chloroform. codeine, tincture of capsicum, spirit of camphor, tincture of valerian, amyl nitrite, jaborandi, asa- foetida, the bromides, and numerous other drugs. Morphine, hypodermatically, is not of much value, as the effect is shortlived. In event success should follow the use of any certain procedure or drug. the physician is apt to conclude Average Cost Of Viagra Prescription he has discovered the sovereign remedy for the condition. The ex- tent of such misapprehension will probably be shown by his disappointment in his next case. Ether narcosis is always best in cases of hysteri- cal origin, the spasms seldom recurring after re- turn to consciousness. Faradaization or galvanism is very often the last resort and is of no value un- less applied by experienced hands. .A.pplicati( in must always be made over the epigastrium or the phrenic nerves. When the hiccough has persisted to the point of exhaustion and the patient's life is jeopardized, the following must Average Cost Of Viagra Prescription be given by rectum and, if neces- sary, repeated: Potassium bromide 5i : Tincture of opium, 5ss ; Water, to 3viii. The induction of sleep is, generally, attended by a cessation of hiccough.