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A correct diagnosis usually narrows the treat- ment endep 10mg down to a very few agents, and it is merely a matter of expedience which particular method of therapeutics we employ in any given case. Admit- ting for the sake of argument that it was difficult, nay, even impossible, to arrive at a correct diag- nosis during the acute stage of the disease ; what, then, are our order endep chances during the chronic stage? Again, we must bear in mind that the patient dur- ing the chronic stage is no longer suffering from the acute disease ; but rather from some changes that have taken place in the economy, as endep 10 the result of the acute condition. In other words, the symp- toms have entirely changed. Hence we speak of symptomatic treatment, meaning therebv the ameli- oration of the various symptoms as they mav be complained of by the patient. If we give this so- called symptomatic treatment a passing notice, we must admit the absurdity of endep tablets it and our inability to do better. Here we have a patient whose whole -system has been more or less changed by the proc- esses of disease and repair, whose manifestations and interpretations are anything but normal. Let us take, for instance, the neurasthenic, the hysteric, and the hypochondriac. If we were to administer treatment according to the interpretations of their feelings, our already overcrowded therapeutic ar- mamentarium would certainly be inadequate and our results even more chaotic than they are now. In refutation it might lie said that these three condi- tions are not truly buy endep online disease conditions, bvU rather psychic conditions ; let us bear in mind that the man or women who thinks he or she is sick, and is not, is sick indeed. I venture to say there endep 25 mg is not a single symptom or manifestation of disease without some underlying cause. The first step in therapeutics is to remove the cause, for no matter how often or how much we may treat the symptoms, imles the underlying cause is removed, the same symptoms must again appear, though changed through the administration of our symptomatic treatment. It is the cause of the symp- toms, and endep tablets 10mg not the symptoms themselves, that require our attention. To make it more clear, let us suppose a patient complaining of nothing more buy cheap endep than a head- ache, which may be due to toxemia from intestinal origin, derangement of the gastric functions, changes in the circulatory system, changes in the kidneys, defects of the visual apparatus, frontal sinus disease, nasal or middle ear lesions, uterine lesions, intra- 626 GEYSER: endep 10 tablets DIAGNOSIS OF CHROXIC CONDITIONS. cranial tumors, congestion or anemia of the brain or its coverings, syphilitic changes, constipation, and a host of psychical impressions. Certainly, with even a slight purchase endep online thought upon the subject, we must become convinced that a cause must be dis- endep 25mg covered and removed before any real benefit can be expected endep 25 from our therapeutic applications. As has been stated, in chronic diseases we are more often endep 50 suffering from some obscure cause and the symptom complex is frequently referable to some undiscovered lesion bringing forth rather re- flex manifestations than directly associated condi- tions. Pain is an expression of some interference with a sensory nerve, central or peripheral. With- buy endep out the intervention of a nerve of sensation there could be no sensory impression. Paralysis, or motor inability, necessitates the interference with the func- tion of a motor nerve, either the nerve itself cen- trally or peripherally, or joint and purchase endep muscle changes preventing the motor nerve from carrying out its physiological function. Changes in tissues or organs in general are pre- sided over, not by order endep online the sensory or the motor nerves, but by that third system of nerves, the sympathetic. All growth and repair of tissue generic endep is under the direct control of the sympathetic system. All injuries, traumatic, chemical, or biological, aside from the pain, loss or increase of motion, are under the direct influence of the sympathetic nervous system. It is this system that takes cognizance of the changes which endep 50mg have taken place and, under its control through the vasoconstrictors and dilators, the proc- ess of repair is more or less perfectly carried out. THE AUTONOMIC OR SYMPATHETIC SYSTEM. For our purpose and for the sake of brevity we will make no special distinction between the sympa- thetic proper, the bulbar, and the sacral subdivi- sions. Neither is it advisable to consider in too much detail the anatomy of this system, but only so much of it as is really necessary for the elucida- tion of the problem of spinal reflex diagnosis. The sympathetic nervous system is intimately connected with the cerebrospinal system, endep 10 mg though it differs from it in many ways, especially in its peripheraj distribution.

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