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was brought to bear than one based on religious and anti-scien- tific prejudices. How unfair for Dr. Bucknill to write in this ex 'parte manner, and he a gentleman who, as we understand, has always prided himself on his disingenuousness in scientific contro- versy ! What, too, inderal cost can we say sufiiciently expressive of the feeling which all must have who are acquainted with the fact, when we call to mind that in his paper he does not even allude to the gross con- tradiction inderal online involved in the circumstance that five of the thirteen " government experts " testified that Guiteau was shamming, and the other eight swore with equal positiveness that he was not ? If this is judicial fairness, we prefer some other quality in those who venture to discuss medico-legal questions. But, before this journal can reach Dr. Bucknill, he will have re- ceived the account of the microscopical examination of the assas- sin's brain, and the report of the eminent gentlemen who made it, to the efi'ect that it exhibited evidence of the existence online propranolol of the first stage of general paralysis of the insane. Thus he will have one more difficulty to overcome. propranolol hydrochloride 80 mg for anxiety gtbixtos nnb irtt^ntrn- IJoi^s. Epilepsy and other Chronic Convulsive Diseases ; their Causes, Symptoms, and Troatment. By W. R. Gowers, M. D., F. R. C. P., Assistant Pro- fessor of CHnical Medicine in University College, etc. London : J. buy inderal online being, never obscures it with side issues, and never strains his facts in furtherance of preconceived notions. Of how few books of the sort can this be said ! Were it only for the information to be had from it in regard to the one disease, epilepsy, it would be inderal price invalua- ble to every practitioner of medicine ; but, when in addition we find it to be a book that, from the masterly method of its make-up, no one can read REVIEWS AND LITERARY NOTES. 335 without, unconsciously it may be, taking a lesson in the broad field of clini- cal observation and reasoning, we feel doubly called upon to commend it to all who would add, not only to their .stock of knowledge, but also to their capacity for clinical investigation. inderal mg Since the publication of Landou- zy's work on hysteria, no neurological monograph has appeared, so far as we generic inderal can call to mind, that seems to us to present such wholesome reading as this treatise on epilepsy. We can not point to any noteworthy imper- fection in its pages, and shall simply allude to a few points tbat have en- gaged our attention, regretting that the space at onr command does not allow of an extended analysis. Dr. Gowers continues the use of the term " co-ordinated convulsion " to express the severer of inderal tablets the convulsive attacks usually called hysterical or hysteroid fits, epileptic hysteria, hysteria major, hysterical epilepsy, or hystero-epilepsy ; and certainly it is one that suflaciently characterizes the seizures, while it has no air of solving the purchase propranolol online vexed question of their relation to hysteria and to idiopathic epilepsy. The differential diagnosis of this affection and true epilepsy is given most carefully and satisfactorily. The author has not been able to verify Charcot's statement that in the initial stage of these attacks the tongue may be bitten, nor has he found com- pression of the ovarian region so potent in bringing on the paroxysms, or in cutting them short, as experience at the Salp^triere would point to. While expressing the opinion that it is not desirable to add to the num- ber of diseases and symptoms, already purchase inderal online too great, called after the names of observers — a system of nomenclature, he adds, alike perplexing to students, confusing to workers, and unscientific in principle — Dr. Gowers yet con- trives to pay a graceful tribute to Hughlings Jackson by proposing that the epithet " Jacksonian " should order inderal be applied to the mode of investigation by which Jackson may be said to have inaugurated a new era in the study of epilepsy, rather than to the peculiar form of onset described by that ob- server, and widely termed " Jacksonian epilepsy." In connection with the matter of modes of onset, it may be noted that the author thinks that the evidence that Dr. Hammond's " thalamic epilepsy " depends on a buy cheap inderal morbid process in the optic thalamus is at present too slender to justify the name. As to the general pathology of epilepsy. Dr. Gowers allows the vaso- motor theory to go on in its progress toward desuetude, ranking vascular disturbances only buy propranolol as among the exciting causes of individual seizures, and attributing the underlying cause to a lack of stable resisting power on the part of the cells in which the explosive action takes its origin — in other words, if we interpret him aright, enfeebled inhibition. His discussion of these points is particularly admirable. Many of the histological changes that have been described he is inclined to regard as secondary rather than fundamental, and he doubts if any great significance should be ascribed purchase inderal to the induration of the cornu Amraonis so dwelt upon by Meynert. It is more to the results of experiment and to clinical purchase propranolol facts that wc must look for an explanation of the pathology, he avers, than to pathological anatomy. 26 336 REVIEWS AND LITERARY NOTES. While the cerebral cortex may always be the seat of the irritation that leads to the outbursts, it is doubtful, he thinks, if all the facts quite warrant the conclusion that epilepsy is a disease of the cortex ; the motor buy inderal centers in- volved may be more deeply seated, but, as Burdon Sanderson's researches seem to show, be affected by surface irritation. But we must refrain from following the author further in this enticing direction. About fifty pages are devoted to the matter of treatment, the cheap inderal salient points being, that the bromides order inderal online are entitled to more confidence than all other remedies put together, both to control the paroxysms and to cure the disease permanently ; that their use can be so managed in the great major- ity of cases as to avoid an amount of unfavorable action suflScient to out-

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