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the eversion of the foot which means weakness. An everted foot was never made to support nor ever can support the body weight. The reason we have flat feet causing backache is that the whole poise of the body is altered and in the effort to re- lieve the pain in walking the back is strained to such a degree that Viagra Tablet Price In Indian Rupees a resulting backache develops which is relieved simultaneously with the correction of the deformity of the feet. These several conditions in relation to backache, I have briefly summarized that by so doing I may have emphasized the importance of a more careful and thorough examination being made in all such cases. i2t West Fifty-eighth Street. REPORT OF A CASE OF PSYCHOGENETIC CON- VULSIONS, SIMULATING EPILEPSY, IVith Hallucinations and Obsessions. Treated by Sug- gestion.* By H. W. Frink, M. D., New York, Assistant .\ttending Physician in Department of Neurology, Cornell Dispensary. The case here recorded illustrates a class of hys- terical convulsions that shows so great resemblance to true epilepsy that in many instances a differ- Viagra Tablet Price In Indian Rupees ential diagnosis' is by no means easy. Jones (i) remarks that, while in many varieties of fits it is possible to exclude epilepsy, it is hardly ever pos- sible to exclude hysteria from observation of the fit alone, and he urges careful study of the patient in the interval period before one ventures to make the diagnosis of epilepsia vera. He quotes Hoche (2) as saying that it is definitely known that every symptom of a true grand mal fit, from fixed pupils to sphincter relaxation, may occur in psycho- neurotic conditions. Heilbronner (3), Fox (4). Spiller (5), and others have discussed the diffi- culties of diagnosis in such conditions and have em- phasized the fact that many cases which are looked upon as true epilepsy are, in reality, major hys- teria. The enormous dift'erence in the prognosis of epileptic and psvchoneurotic convulsions snould lead us to make' a careful study of every case. Many cases of psychogenetic fits readily yield to therapeutic suggestion, while Freud, Jung, and the Zurich school have presented to us the method of psychoanalysis which has brought about brilliant results in such conditions. Many other cases will of course respond to the older methods of treat- ment. The case here reported had, as will be seen, some of the symptoms that in the ordinary textbook de- scription arc regarded as practically pathognomonic of true epilepsy, while others, such as biting of the tongue and sphincter relaxation, were absent. The hallucinatory symptoms and compulsive ideas would naturally make one suspicious of a psychic aetiology for the convulsions, though epilepsy could not be excluded on their account alone. The Viagra Tablet Price In Indian Rupees result of the treatment leaves no doubt as to the psychoneurotic •Case presented before the Mai'ch 7. 191 1. New York Neurological Society. nature of the condition for it Viagra Tablet Price In Indian Rupees is practically certain that epilepsy is not benefited by psychotherapeutic measures (6). Case. The patient, H. O.. a single woman twenty- three years of age, came to Cornell Dispensary in April, 1910, and was referred to Viagra Tablet Price In Indian Rupees the Psychotherapeutic Clinic by Dr. Brooks. The Viagra Tablet Price In Indian Rupees history obtained at that time was a^ follows: She was born in America of Irish parents. Her father died of tuberculosis and her mother was living and well. There was no history of any nervous disorder in the parents. She had one brother, who was inclined tu be moody, silent, and unsociable, and to act peculiarly at times. She had measles and whooping cougli as a child but no other illnesses except the present one. Her use of tea and coffee was very moderate, and she took no other stimulants. Menstrual history showed nothing ab- normal. Her present illness began while she had whooping coug'.i when she was two and a half years old. She first had at- tacks in which she would become rigid and stare for a few moments and then continue with what she had been doing as if nothing had happened. With these attacks there was no aura and no loss of consciousness. They occurred two or three times a month and as a rule lasted only a few moments, though a few were as long as twenty or thirty minutes. When the patient was four years old she had her first general convulsion and after that time the lesser attacks ceased. The description of the convulsive seizures was Viagra Tablet Price In Indian Rupees as follows : As a rule there were premonitory symptoms con- sisting of feelings of fright and nervousness for several hours before the attack. Then the patient would see a cloud before her and this rapidly changed to a white figure with outstretched arms. The figure would advance as if to seize her and, just as it seemed about to do so, she wou'd be overcome with a great feeling of terror, give one or two loud, inarticulate screams, and pass into unconsciousness. The convulsions began just after the scream. She some- times had an aura of right sided headache. The patient became first pale and then cyanosed. The eyes were open and directed upward or straight in front of her, and the mouth was drawn to one side. The convulsions were gen- eral, sometimes tonic and then clonic, but more often clonic from the start. She would be unconscious during the at- tack and generally slept for an hour after it. The con- vulsions produced frothing at the mouth, but were not as- sociated with biting of the Viagra Tablet Price In Indian Rupees tongue, relaxation of the sphinc- ters, or vomiting. The mother of the patient kept very close watch of her and was always on hand to support her when a fit came on and believed that it was her care that had prevented the patient Viagra Tablet Price In Indian Rupees from ever hurting herself. The only history of injury was this: Four or five years ago the patient was left alone in the house for a short time and when the mother returned the girl was sitting on a sofa with her collar bone broken. She had no idea of how she got there or how the injury occurred. The mother said that the next day the bone was protruding through the skin. I had never seen the patient in an attack. A friend of the patient who had a daughter suffering from true epil-