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ciated measure of fright, grief, worry, chagrin, mental or moral strain or shock, the common start- ing points of psychogenic disease, aggravated, of course, by neurotic heredity seem to determine the strength of the peculiar characteristic tendencies that are imparted to and decide the epileptic tj-pe of nervous constitution. Sometimes the maternal instinct in the mother seemed quite lacking but often there was probably only a temporary perversion of this instinct. In some families of several children there was only one pregnancy which was unwelcome and this turned out to be the epileptic child. A defectively devel- oped instinct seems to be contending with the epi- leptic from birth. Constantly struggling with this defective instinct he goes down before it at times of instability of his nervous organization, viagra buy online australia in early life and adolescence easily, but if then escaping viagra buy online australia succumbs at times when his nervous system is racked by a nervous strain, by some disturbing psychic experience 50 mg viagra how long does it last or viagra buy online australia by the continual irritation of a pathological brain condition or other organic trouble. "The rise of the egoistic sentiments and decline of altruistic" in the epileptic indicate only a natural striving for balance, or struggling compensations by his conserving forces for the defect in him of instincts, advantageous to his fellowman. He feels the extra need to think only of himself. Epilepsy is not, properly speaking, directly heritable. The neurotic element supplied by hered- ity would seem to play only a general role in con- ditioning an unnatural feeling of the mother toward her unborn child. Chance existing reasons of environment or circumstance play also their important part at times in such an attitude of mind. It is readily understood why neurotic stock should by affecting instincts play its part in this 50 mg viagra how long does it last cause for the development of the epileptic. Such an explanation makes it clear why the epi- leptic is common to all races, all ages and in the frequency that exists, his determining character- istics viagra buy online australia being the result of a psychic state possible to any woman bearing a child and needing no other Oct. 16, 1915] MEDICAL RECORD. 657 specific complement than could be supplied by her own distorted thoughts, emotions, instincts, and desires. The very interesting views of Freud and the other leaders of the new psychology trace all mani- festations of hysteria to mental processes more or less morbid, in which motives of shame have resulted in repressing the consciousness of certain experiences which thus become unconscious or sub- conscious. In this state they tend to symbolize themselves and hysterical manifestations arise. In the case of 50 mg viagra how long does it last the epileptic the morbid mental process of the mother must work its disturbing efl'ect by influencing the instinct makeup of the child 50 mg viagra how long does it last with which she is pregnant. The subconscious desire or instinct that prompts the convulsion can be regarded as a psychophysio- logical system which becomes dissociated. The dis- sociated system present in the subconscious and coming to the upper strata of consciousness becomes manifested with a very intense sensorimotor energy. It manifests by liberating all the energy it possesses until fatigue and exhaustion set in. Sidis" compares the liberation of a dissociated sys- tem with its overwhelming energy to the eruption of an underground volcano, this liberation giving rise to temporary attacks or seizures by subcon- scious states of the whole field of upper conscious- ness. He says that understanding the energy which the dissociated subconscious system manifests in this way is not surprising that it appears almost supernatural and by the superstitious ascribed to diabolical possessions. Impulsive insanities and psychic epilepsy are recognized already as really being due to this mechanism. A quotation from Sidis in speaking of the threshold and mental systems shows the way to control 50 mg viagra how long does it last an undesired subconscious system. "Dis- sociated systems present impulsiveness, because of lack of associated counteracting systems. The only way to diminish the overpowering inpulsiveness with which the dissociated subconscious systems make an onset in their rush into the personal con- sciousness is to bring about an association with counterbalancing or inhibitory controlling conscious systems, to work the dissociated system into the tissue of the personal, controlling consciousness." When a system is thus brought into consciousness or the whole situation perceived by the patient the seizure vanishes completely. At the present writing it seems that the mani- festations of the epileptic result from the prompt- ings of an instinctive and unconscious wish. This fact would place the epileptic in almost the same category as the hysteric whose manifestations, whether they be paralysis, blindness, or convulsions, are admittedly prompted by an unconscious wish. Psychological treatment of the epileptic seems strongly indicated. REFERENCES. 1. MacRobert: "The Epileptic Type of Nervous Constitution. A Rational Premise for the Future In- vestigation of Epileptic." viagra buy online australia Medical Record, March 6, 1915.