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governments, including our own, would do well to follow its example. It is futile to think of inducing our people to subsist on rice Buy Nortriptyline Online or on any exclusively vegetable diet, and to argue that such a diet ma>- possibly prevent typhoid fever will never save an American or an English army from devastation by that disease. THE INSANE IN THE STATE OF NEW YORK. Whoever is in danger of underrating the impor- tance, the magnitude, or the varied character of the problems connected with the care of the insane in so large a community as that Nortriptyline 25mg of the State of New York is likely to be set right if he will read the Tivclfth Annual Report of the State Charities Aid Association to the State Commission in Lunacy, re- cently issued. Buy Nortriptyline It is fortunate for the insane that such an enlightened organization is influential in their management. It appears from the report that on October i, 1904, there were 25,019 inmates in the fourteen reg- ular State hospitals, 844 in the two State hospitals for Nortriptyline 10mg the criminal insane, and 998 in the twenty-three licensed private asylums, making a total of 26,861, EDITORIAL ARTICLES. a number greater by 927 than the total at the corre- sponding date in the preceding year. Probably this . increment represents approximately the annual in- crease of insanity in the State. In spite of the pres- ent rigid inspection to which immigrants are sub- jected, it is not unlikely that much of the increase is due to the landing of insane persons from foreign countries. Though in this matter as in all others the State of New York has to bear the brunt of the evil of undesirable immigration, the association does not think it wise for the State to undertake to sup- plement the national inspection service. The prospective establishment of a reception hos- pital for the insane in the city of New York, au- thorized by recent legislation, is highly favored in the report. " It now remains," we read, " for the city of New York to do its share toward the estab- lishment of this hospital by acquiring by purchase or otherwise sufficient and suitable lands convenient- ly located within the borough of Manhattan." Such a hospital, it is properly pointed out, would furnish a timely refuge for persons whose mental impair- ment might be only temporary if they could meet with appropriate treatment without the delay inci- dent to a formal commitment ; would, bv its out patient department, accomplish a great deal in the home treatment of individuals in danger of lasting insanity; and would furnish opportunities far su- perior to those now available for the clinical teach- ing of psychiatry. The report deals with many other features of the work of caring systematically and humanely for the insane, but we have not space for their consideration at present. We cannot, however, refrain from ex- pressing our gratification at the appreciative terms in which the report speaks of Dr. Nortriptyline 25 Mg Peterson and Dr. Macdonald, who recently resigned, the one from the State Commission in Lunacy and the other from the superintendency of the city asylums. EPILEPTIC STUTTERING. It is well Order Nortriptyline Online known that stuttering is often accom- panied by convulsive contortions of the face, also that in some instances convulsive movements of other parts of the body are evoked by the stut- terer's attempts to speak. It is known, too, that epilepsy and the stuttering defect of speech may both Nortriptyline 25 affect an individual without any manifest connection with each other. But it seems to be true that in certain cases there is a relation be- tween stuttering and epilepsy. The relation varies in different instances, and some Generic Nortriptyline of the variations have lately been made the subject of an interesting article b}' M. Fere, of the Bicetre {Rcvuc de medecine, February). Sometimes, says M. Fere, habitual stuttering is intensified after an epileptic fit, or a recrudes- cence of the defect of speech may be the only manifestation of an epileptic crisis, the actual con- vulsion and loss of consciousness failing Nortriptyline 10 Mg to ap- pear. Cheap Nortriptyline More rarely it is only in connection with an Nortriptyline Mg epileptic paroxysm that the stuttering occurs, preceding it, following it, or taking its place, in which last mentioned case it is a true manifesta- tion of epilepsy and deserves to be ranked as such. When stuttering follows an epileptic attack, it should be looked upon as a continuation of the nervous discharge or as a result of the exhaus- tion consequent upon the paroxysm.

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