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is not relieved, but on the contrary is fastened more deeply upon the individual. In reality the neuralgia should be considered merely a symptom resulting from the fundamentally weakened state of the or- ganism. The term should be applied to pain which has, in the main, three characteristics. First, the affected area is more or less constant and how much do trazodone cost restricted. Second, the part of the body which is the seat of the painful sensations is traversed by a sensory nerve trunk, or represents an area fairly well defined by the ana- tomical distribution of a branch of a how much does trazodone cost sensory nerve. Third, the localized pain is subject to exacerbations. These characteristics, it will be observed, may be applied in general to all forms of neuralgia. It will be buy trazodone uk necessary, therefore, to distinguish buy trazodone sleep the neuras- thenic from the profound migrainic, sciatic, and all the other types of neuralgia due to specific lesion of nerve or ganglion, to toxic and infectious agents, to disease of the blood vessels, to defects in the blood or of the body metabolism, or -to any other definite physical disorder. Anremia, rheuinatism. gout, chronic intestinal toxaemia, have an effect on the organism as a whole, thereby buy trazodone hydrochloride lowering the general nervous tone and pro- ducing a neurasthenic condition of varying degree, but we would not call the neuralgia resulting from ar.y of these diseases neurasthenic. The term neu- rasthenic can be applied only when the neurasthenia is the chief or prominent buy trazodone feature of the case, and the specific disease, whatever it may be. is incidental or contributing in a minor way to the general state. Whenever the disease or other agency is strongly operative and the individual is decidedly neurotic, tlie neuralgia is uniformly increased both as to the intensity and disabling quality. This fact renders the diagnosis still more difficult, buy trazodone hcl especially as the clinical picture of the neuralgia, whether neuras- thenic or due to physical ailmcn:. is -practicallv t\v: same. .\ brief reference to painful cniiditions of the feet will be of service in elucidating still further buy trazodone online no prescription the use of the term neurasthenic. If there exists generic trazodone cost an ana- toir.ical generic trazodone 50 mg defect due to injury, strain, or simple re- laxation of the tissues of the arch, and the orthope- dist can correct the pain by support or specially con- structed shoe, buy trazodone online uk then liie metatarsalgia should not be called neurotic. When the pain, however, is not re- lieved and buy trazodone generic ho special anatomical dejiarture from the normal is observable, or when, as sometimes hap- pens, the pain passes u]) into the leg or generic trazodone online thigh, or over to the other foot, then the term neurotic is aji- plicablc. If an anatomical defect is present in what would he called arlequate degree trazodone cost without insurance and a proper sup- port can he worn and yet the neuralgia is not re- lieved, or if hypera^sthesia prexents tlic corrective device being applied, then doubt would certainly ex- ist as to the relative importance nt the local condi- tion and of the inherent neurotic character of the patient. Fortunately an exact dia.gnosis is not so necessary if only the two factors in the case, physical as well as neurotic, are properly recognized. The tangible factor, or material basis for the neuralgia, should in all cases receive most thorough attention, and when the neumtic cheap trazodone element exists this should be iindcrstandingly dealt with. Any one sufficiently familiar with neurasthenic, hysteric, and hypochondric states can usually deter- mine the type of neuralgia which should be termed neurotic. The reasons for making the diagnosis are somewhat subtle and hard to define. This is be- cause in most of the cases there is a more or less subjective or intangible element which bespeaks a central rather than purely peripheral origin of the pain. Generalizing as broadly as possible, buy trazodone 50 mg my own ex- perience trazodone discount coupon has led me to formulate the following char- acteristics as cheap trazodone no prescription diagnostic of the typical neurotic neu- ralgias. First, psychic influences and marked fluc- tuations in the inental state as well as in the body condition produce noticeable variations in the de- gree of pain, relatively greater in the neurotic neu- ralgias than in those due to more definite physical causes. Second, neurotic neuralgia is often charac- terized as being peculiarly difficult to bear ; in other words, it has a mentally disorganizing or generic trazodone hcl demoraliz- ing quality. It is not because the neuralgia is so severe, but it insidiously undermines the will and power of the individual to endure it with patience and fortitude as one would bear ordinary pain of corresponding degree. Third, neurotic neuralgia may be slow and obstinate, but it is invariably cur- able, unless the patient is a profound chronic in- \alid and will not respond to nervous and bodily upbuilding. The setiolog}' of this class of neuralgias may be briefly stated as follows : First, they occur only in the neurasthenic condition or its equivalent, how- ever produced. Second, superimposed upon this condition there is an exciting cause, such as local or general strain, exposure to wind, cold, and wet. a blow or fall, emotional disturbance or mental shock,

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