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gastric symptoms. So the home atmosphere was one to make her think of stomach disease and fear its con- sequences. viagra for women in hindi While sitting in my office, and while I was writing down viagra for women in hindi her history, I heard periodically about every five rninutes, a rumbling and then when' I tried to observe her, I also noticed that her viagra for women in hindi facial muscles and throat penis after viagra were moving as though in the act of swal- lowing something. Undoubtedly she was swallowing the air which she subsequently belched up. Now it is quite possible that at the onset, the excessive amount of carbon dioxide stretched the cardium and left it patu- lous, thus making it easy to swallow air. In two other eases, in men, this condition was quite distressing. In fact, one subjected himself to an operation without relief and only an inti- mate acquaintance with their life history con- vinced me that the conditions were neurotic. Both are tailors by trade, both have been subjected to thorough physical examinations in many hospitals and by private physicians without disclosing or- ganic lesions. Regurgitation as a neurosis I have seen once, and unless closely observed it will be mistaken for vomiting and serious gastric disease might be mistaken for it. The case of regurgitation that I have in mind is complicated by achylia gastrica. The patient is a conductor. After his evening meals and while on a car small quantities are re- gurgitated and spat out. It is characteristic that this will occur a number of times after a meal, while real vomiting happens only once or twice. This particular patient dates his trouble back to a wedding at which he ate some decayed chicken, after which he felt sick, vomited, etc. It is quite pos- sible that the memory of this event lurks in his subconscious mind and automatically produces this reflex of spitting out morsels of food. This pa- tient's nutrition did not suffer in the least, but usually, if the condition endures viagra for women in hindi for a long time, emaciation sets in and the sufferer begins to look like an advanced consumptive. This by no means exhausts the list of gastric neuroses, but I have discussed enough of them to viagra for women in hindi indicate their variety and viagra for women in hindi their importance. The diagnosis of gastric neurosis should be held in abeyance until a thorough physical examina- tion and a positive exclusion of organic disease di- rectly or indirectly is made. The pre-existence of neurasthenia as a condition of gastric neuroses is not always true, because it may coexist with organic disease of long standing. Indeed, the cause of the neurasthenic symptoms themselves should viagra for women in hindi be looked for. These can usually be found in an inquiry not in the conventional line of history taking, but an inquiry as to the social and personal life of the individual as far back as childhood days. This is important, as it has a direct bearing upon the treat- ment of these very difficult and baffling conditions. I am a firm believer in the Freudian practice of psychoanalysis in the neuroses. The old-time meth- ods of treating these conditions whether gastric, traumatic, or post-operative, have viagra for women in hindi not sufficed. Suggestion through authority and mystic thera- peutics do not produce any lasting results. On the other hand, countersuggestion, reeducation, en- lightenment of the patient as to his condition through an appeal to his own reason or intellectual capacity, have produced better results. Case III completely recovered after a minute explanation of the mechanism of air-swallowing and a sug- gestion that she could overcome it voluntarily. Dr. viagra for women in hindi Williams, in an article on the treatment of traumatic neuroses, says that it is false notions that maintain the neuroses, and that it is by the substitution of these false notions by true ideas that cures are obtained. Psychic treatment, then, is of great importance. Where domestic relations are abnormal, these must be corrected first in order to influence the gastric neurosis. Of the physical and medicinal therapeutics the following have been found of service: Intragastric or extragastric electricity tends to tone up an atonic condition of the stomach, acts as a sedative to a spastic condition. Hydrotherapy, massage, Swedish movements are of great help in nervous anorexia and nervous dyspepsia. Of drugs, iron, arsenic, strychnine, and the hypophosphites, and most important of all, the bromides, have been helpful. Finally, the diet: All the gastric patients do themselves an immense amount of injur>' by dieting themselves, by omitting to eat meat and vegetables, etc. Most of these patients are afraid to eat, and thus forced feeding under proper con- ditions is the best remedy. After such a regime a troublesome anorexia becomes changed to a vora- cious appetite. The fear of food disappears, nor- mal health returns, but unfortunately for many of our patients such a regime is next to impossible. viagra for women in hindi They cannot afford the necessary amount of the diet itself, nor the nursing or private hospital ac- commodations. In few hospitals can ward patients Oct. 2. 1915] viagra for women in hindi MEDICAL RECORD. 567 be treated on the principles of the rest cure. The poor neurotics deser%'e our best efforts — medical, viagra for women in hindi psychic, social, and viagra for women in hindi preventive. 1527 North Franklin Street.