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diff --git a/old/18467-8.txt b/old/18467-8.txt new file mode 100644 index 0000000..ca0c826 --- /dev/null +++ b/old/18467-8.txt @@ -0,0 +1,50327 @@ +The Project Gutenberg EBook of The People's Common Sense Medical Adviser +in Plain English, by R. V. Pierce + +This eBook is for the use of anyone anywhere at no cost and with +almost no restrictions whatsoever. You may copy it, give it away or +re-use it under the terms of the Project Gutenberg License included +with this eBook or online at www.gutenberg.org + + +Title: The People's Common Sense Medical Adviser in Plain English + or, Medicine Simplified, 54th ed., One Million, Six Hundred + and Fifty Thousand + +Author: R. V. Pierce + +Release Date: May 28, 2006 [EBook #18467] + +Language: English + +Character set encoding: ISO-8859-1 + +*** START OF THIS PROJECT GUTENBERG EBOOK MEDICAL ADVISOR *** + + + + +Produced by Kevin Handy, John Hagerson and the Online +Distributed Proofreading Team at http://www.pgdp.net + + + + + +[Illustration] + + * * * * * + +THE PEOPLE'S + +COMMON SENSE +MEDICAL ADVISER +IN PLAIN ENGLISH: +OR, +MEDICINE SIMPLIFIED. + + +BY +R.V. PIERCE, M.D. + + +ONE OF THE STAFF OF CONSULTING PHYSICIANS AND SURGEONS +AT THE INVALIDS' HOTEL AND SURGICAL INSTITUTE, AND +PRESIDENT OF THE WORLD'S DISPENSARY +MEDICAL ASSOCIATION. + + +FIFTY-FOURTH EDITION. + +ONE MILLION, SIX HUNDRED AND FIFTY THOUSAND. + +_Carefully Revised by the Author, assisted by his full Staff of +Associate Specialists in Medicine and Surgery, the Faculty of the +Invalids' Hotel and Surgical Institute._ + + * * * * * + +Entered according to Act of Congress, in the year 1895, by the WORLD'S +DISPENSARY MEDICAL ASSOCIATION, In the office of the Librarian of +Congress, at Washington, D.C. + + * * * * * + +TO +MY PATIENTS, +WHO HAVE SOLICITED MY PROFESSIONAL SERVICES, +FROM THEIR HOMES +IN EVERY STATE, CITY, TOWN, AND ALMOST EVERY HAMLET, +WITHIN THE AMERICAN UNION; +ALSO TO THOSE DWELLING IN EUROPE, MEXICO, SOUTH AMERICA, +THE EAST AND WEST INDIES, AND OTHER +FOREIGN LANDS, +I RESPECTFULLY DEDICATE +THIS WORK. + + * * * * * + + + + +TABLE OF CONTENTS + + PREFACE TO THE PRESENT EDITION + PREFACE_TO_THE_FIRST_EDITION + INTRODUCTORY WORDS + + PART I + + CHAPTER I. BIOLOGY + CHAPTER II. PHYSIOLOGICAL ANATOMY. THE BONES. + CHAPTER III. PHYSIOLOGICAL ANATOMY. THE MUSCLES. + CHAPTER IV. PHYSIOLOGICAL ANATOMY. THE DIGESTIVE ORGANS. + CHAPTER V. PHYSIOLOGICAL ANATOMY. ABSORPTION. + CHAPTER VI. PHYSICAL AND VITAL PROPERTIES OF THE BLOOD. + CHAPTER VII. PHYSIOLOGICAL ANATOMY. CIRCULATORY ORGANS. + CHAPTER VIII. PHYSIOLOGICAL ANATOMY. THE ORGANS OF RESPIRATION. + CHAPTER IX. PHYSIOLOGICAL ANATOMY. THE SKIN. + CHAPTER X. PHYSIOLOGICAL ANATOMY. SECRETION. + CHAPTER XI. PHYSIOLOGICAL ANATOMY. EXCRETION. + CHAPTER XII. PHYSIOLOGICAL ANATOMY. THE NERVOUS SYSTEM. + CHAPTER XIII. THE SPECIAL SENSES. SIGHT. + CHAPTER XIV. CEREBRAL PHYSIOLOGY. + CHAPTER XV. THE HUMAN TEMPERAMENTS. + CHAPTER XVI. MARRIAGE. LOVE. + CHAPTER XVII. REPRODUCTION. + + PART II. HYGIENE. + + CHAPTER I. HYGIENE DEFINED.--PURE AIR. + CHAPTER II. FOOD. BEVERAGES. ALCOHOLIC LIQUORS. CLOTHING. + CHAPTER III. PHYSICAL EXERCISE. MENTAL CULTURE. SLEEP. CLEANLINESS. + CHAPTER IV. HYGIENE OF THE REPRODUCTIVE ORGANS. + CHAPTER V. PRACTICAL SUMMARY OF HYGIENE. + + PART III. RATIONAL MEDICINE. + + CHAPTER I. THE PROGRESS OF MEDICINE. + CHAPTER II. REMEDIES FOR DISEASE. + CHAPTER III. BATHS AND MOTION AS REMEDIAL AGENTS. + CHAPTER IV. HYGIENIC TREATMENT OF THE SICK. + + PART IV. DISEASES AND THEIR REMEDIAL TREATMENT. + + INDEX + + FOOTNOTES + + * * * * * + + + + +PREFACE TO THE PRESENT EDITION + +The popular favor with which former editions of this work have been +received has required the production of such a vast number of copies, +that the original electrotype plates from which it has heretofore been +printed, have been completely worn out. + +The book has been re-produced in London, England, where six editions +have already been necessary to supply the demand for it. + +In order to continue its publication to meet the demand which is still +active in this country, it has been necessary, inasmuch as the original +electrotype plates have become worn and useless, to re-set the work +throughout. This has afforded the Author an opportunity to carefully +revise the book and re-write many portions, that it may embody the +latest discoveries and improvements in medicine and surgery. In +performing this labor he has been greatly assisted by contributions and +valuable aid kindly supplied by his staff of associate specialists in +medicine and surgery who constitute the Faculty of the Invalids' Hotel +and Surgical Institute. + +That part of the book treating of Diseases and Their Remedies will be +found to be thoroughly reliable; the prescriptions recommended therein +having all received the sanction and endorsement of medical gentlemen of +rare professional attainments and mature experience. + +THE AUTHOR. + +BUFFALO, N.Y., January, 1895. + + * * * * * + + + + +PREFACE TO THE FIRST EDITION. + +Every family needs a COMMON SENSE MEDICAL ADVISER. The frequent +inquiries from his numerous patients throughout the land, suggested to +the Author the importance and popular demand for a reliable work of this +kind. Consequently, he has been induced to prepare and publish an +extensive dissertation on Physiology, Hygiene, Temperaments, Diseases +and Domestic Remedies. It is for the interest and welfare of _every_ +person, not only to understand the means for the preservation of health, +but also to know what remedies should be employed for the alleviation of +the common ailments of life. + +The frequency of accidents of all kinds, injuries sustained by +machinery, contusions, drowning, poisoning, fainting, etc., and also of +sudden attacks of painful diseases, such as headache, affections of the +heart and nerves, inflammation of the eye, ear and other organs, renders +it necessary that non-professionals should possess sufficient knowledge +to enable them to employ the proper means for speedy relief. To impart +this important information is the aim of the author. + +Moreover, this volume treats of Human Temperaments, not only of their +influence upon mental characteristics and bodily susceptibilities, but +also of their vital and non-vital combinations, which transmit to the +offspring either health, hardihood, and longevity, or feebleness, +disease, and death. It clearly points out those temperaments which are +compatible with each other and harmoniously blend, and also those which, +when united in marriage, result in barrenness, or produce in the +offspring imbecility, deformity, and idiocy. These matters are freely +discussed from original investigations and clinical observations, thus +rendering the work a true and scientific guide to marriage. + +While instruction is imparted for the care of the body, those diseases +(alas how prevalent!) are investigated which are sure to follow as a +consequence of certain abuses, usually committed through ignorance. That +these ills do exist is evident from the fact that the Author is +consulted by multitudes of unfortunate young men and women, who are +desirous of procuring relief from the weaknesses and derangements +incurred by having unwittingly violated physiological laws. + +Although some of these subjects may seem out of place in a work designed +for _every_ member of the family, yet they are presented in a style +which cannot offend the most fastidious, and with a studied avoidance of +all language that can possibly displease the chaste, or disturb the +delicate susceptibilities of persons of either sex. + +This book should not be excluded from the young, for it is eminently +adapted to their wants, and imparts information without which millions +will suffer untold misery. It is a _false_ modesty which debars the +youth of our land from obtaining such information. + +As its title indicates, the Author aims to make this book a useful and +practical Medical Adviser. He proposes to express himself in plain and +simple language, and, so far as possible, to avoid the employment of +technical words, so that all his readers may readily comprehend the +work, and profit by its perusal. Written as it is amid the many cares +attendant upon a practice embracing the treatment of thousands of cases +annually, and therefore containing the fruits of a rich and varied +experience, some excuse exists for any literary imperfections which the +critical reader may observe. + +THE AUTHOR. + +BUFFALO, N.Y., July, 1875. + + * * * * * + + + + +INTRODUCTORY WORDS. + +Health and disease are physical conditions upon which pleasure and pain, +success and failure, depend. Every _individual_ gain increases public +gain. Upon the health of its people is based the prosperity of a nation; +by it every value is increased, every joy enhanced. Life is incomplete +without the enjoyment of healthy organs and faculties, for these give +rise to the delightful sensations of existence. Health is essential to +the accomplishment of every purpose; while sickness thwarts the best +intentions and loftiest aims. We are continually deciding upon those +conditions which are either the source of joy and happiness or which +occasion pain and disease. Prudence requires that we should meet the +foes and obviate the dangers which threaten us, by turning all our +philosophy, science, and art, into practical _common sense_. + +The profession of medicine is no _sinecure_; its labors are constant, +its toils unremitting, its cares unceasing. The physician is expected to +meet the grim monster, "break the jaws of death, and pluck the spoil out +of his teeth." _His_ ear is ever attentive to entreaty, and within his +faithful breast are concealed the disclosures of the suffering. Success +may elate him, as conquest flushes the victor. Honors are lavished upon +the brave soldiers who, in the struggle with the foe, have covered +themselves with glory, and returned victorious from the field of battle; +but how much more brilliant is the achievement of those who overwhelm +disease, that common enemy of mankind, whose victims are numbered by +millions! Is it meritorious in the physician to modestly veil his +discoveries, regardless of their importance? If he have light, why hide +it from the world? Truth should be made as universal and health-giving +as sunlight. We say, give light to all who are in darkness, and a remedy +to the afflicted everywhere. + +We, as a people, are becoming idle, living in luxury and ease, and in +the gratification of artificial wants. Some indulge in the use of food +rendered unwholesome by bad cookery, and think more of gratifying a +morbid appetite than of supplying the body with proper nourishment. +Others devote unnecessary attention to the display of dress and a +genteel figure, yielding themselves completely to the sway of fashion. +Such intemperance in diet and dress manifests itself in the general +appearance of the unfortunate transgressor, and exposes his folly to the +world, with little less precision than certain vices signify their +presence by a tobacco-tainted breath, beer-bloated body, rum-emblazoned +nose, and kindred manifestations. They coddle themselves instead of +practicing self-denial, and appear to think that the chief end of life +is gratification, rather than useful endeavor. + +I purpose to express myself candidly and earnestly on all topics +relating to health, and appeal to the common sense of the reader for +justification. Although it is my aim to simplify the work, and render it +a practical common-sense guide to the farmer, mechanic, mariner, and +day-laborer, yet I trust that it may not prove less acceptable to the +scholar, in its discussion of the problems of Life. Not only does the +method adopted in this volume of treating of the Functions of the Brain +and Nervous System present many new suggestions, in its application to +hygiene, the management of disease, generation and the development and +improvement of man, but the conclusions correspond with the results of +the latest investigations of the world's most distinguished _savants_. +My object is to inculcate the facts of science rather than the theories +of philosophy. + +Unto us are committed important health trusts, which we hold, not merely +in our own behalf, but for the benefit of others. If we discharge the +obligations of our trusteeship, we shall enjoy present strength, +usefulness, and length of days; but if we fail in their performance, +then inefficiency, incapacity, and sickness, will follow, the sequel of +which is pain and death. Let us, then, prove worthy of this generous +commission, that we may enjoy the sweetest of all pleasures, the +delicious fruitage of honest toil and faithful obedience. + + * * * * * + + + + +PART I. + +PHYSIOLOGY. + + + + +CHAPTER I. + +BIOLOGY. + + +In this chapter we propose to consider Life in its primitive +manifestations. _Biology_ is the science of living bodies, or the +science of life. Every organ of a living body has a function to perform, +and _Physiology_ treats of these functions. + +_Function_ means the peculiar action of some particular organ or part. +There can be no vital action without change, and no change without +organs. Every living thing has a structure, and _Anatomy_ treats of the +structures of organized bodies. Several chapters of this work are +devoted to _Physiological Anatomy_, which treats of the human organism +and its functions. + +The beginning of life is called _generation_; its perpetuation, +_reproduction_. By the former function, individual life is insured; by +the latter, it is maintained. Since nutrition sustains life, it has been +pertinently termed _perpetual reproduction_. + +LATENT LIFE is contained in a small globule, a mere atom of matter, in +the sperm-cell. This element is something which, under certain +conditions, develops into a living organism. The entire realm of nature +teems with these interesting phenomena, thus manifesting that admirable +adjustment of internal to external relations, which claims our profound +attention. We are simply humble scholars, waiting on the threshold of +nature's glorious sanctuary, to receive the interpretation of her divine +mysteries. + +Some have conjectured that chemical and physical forces account for all +the phenomena of life, and that organization is not the result of vital +forces. Physical science cannot inform us what the beginning was, or how +vitality is the result of chemical forces; nor can it tell us what +transmutations will occur at the end of organized existence. This +mysterious life-principle eludes the grasp of the profoundest +scientists, and its presence in the world will ever continue to be an +astonishing and indubitable testimony of Divine Power. + +The physical act of generation is accomplished by the union of two +cells; and as this conjugation is known to be so generally indispensable +to the organization of life, we may fairly infer that it is a universal +necessity. Investigations with the microscope have destroyed the +hypothesis of "spontaneous generation." These show us that even the +minutest living forms are derived from a parent organization. + +GENERATION. So long as the vital principle remains in the sperm-cell, it +lies dormant. That part of the cell which contains this principle is +called the _spermatozoön_, which consists of a flattened body, having a +long appendage tapering to the finest point. If it be remembered that a +line is the one-twelfth part of an inch in length, some idea may be +formed of the extreme minuteness of the body of a human spermatozoön, +when we state that it is from 1/800 to 1/600 part of a line, and the +filiform tail 1/50 of a line, in length. This life-atom, which can be +discerned only with a powerful magnifying glass, is perfectly +transparent, and moves about by executing a vibratile motion with its +long appendage. Within this speck of matter are hidden the multifarious +forces which, under certain favorable conditions, result in +organization. Magnify this infinitesimal atom a thousand times, and no +congeries of formative powers is perceived wherewith to work out the +wonders of its existence. Yet it contains the principle, which is the +contribution on the part of the male toward the generation of a new +being. + +The _ovum_ or germ-cell, is the special contribution on the part of the +female for the production of another being. The human ovum, though +larger than the spermatozoön, is also extremely small, measuring not +more than from 1/20 to 1/10 of a line, or from 1/240 to 1/120 of an +inch, in diameter. + +[Illustration: Fig. 1. + +_A_. Human Spermatozoön magnified about 3,800 diameters. +_B_. Vertical and lateral views of spermatozoa of man. +_C, D, E, F._ Development of spermatozoa within the vesicles of evolution. +_G_. Cell of the sponge resembling a spermatozoön. +_H_. Vesicles of evolution from the seminal fluid of the dog in the parent cell +_I_. Single vesicles of different sizes. +_J_. Human spermatozoön forming in its cell. +_K_. Rupture of the cell and escape of the spermatozoön. +] + +The sperm and the germ-cells contain the primary elements of all organic +structures, and both possess the special qualities and conditions by +which they may evolve organic beings. Every cell is composed of minute +grains, within which vital action takes place. The interior of a cell +consists of growing matter; the exterior, of matter which has assumed +its form and is less active. + +When the vital principle is communicated to it, the cell undergoes a +rapid transformation. While this alteration takes place within the cell, +deteriorating changes occur in the cell-wall. Although vital operations +build up these structures, yet the animal and nervous functions are +continually disintegrating, or wasting, them. + +Throughout the animal kingdom, germ-cells present the same external +aspect when carefully examined with the microscope. No difference can be +observed between the cells of the flowers of the oak and those of the +apple, but the cells of the one always produce oak trees, while those of +the other always produce apple trees. The same is true of the germs of +animals, there being not the slightest apparent difference. We are +unable to perceive how one cell should give origin to a dog, while +another exactly like it becomes a man. For aught we know, the ultimate +atoms of these cells are identical in physical character; at least we +have no means of detecting any difference. + +SPECIES. The term species is generally used merely as a convenient name +to designate certain assemblages of individuals having various striking +points of resemblance. Scientific writers, as a rule, no longer hold +that what are usually called _species_ are constantly unvarying and +unchangeable quantities. Recent researches point to the conclusion that +_all species vary more or less_, and, in some instances, that the +variation is so great that the limits of general specific distinctness +are sometimes exceeded. + +Our space will not permit us to do more than merely indicate the two +great fundamental ideas upon which the leading theories of the time +respecting the origin of species are based. These are usually termed the +doctrine of _Special Creation_ and the doctrine of _Evolution_. +According to the doctrine of Special Creation, it is thought that +species are practically immutable productions, each species having a +_specific centre_ where it was originally created, and from which it +spread over a certain area until its further progress was obstructed by +unfavorable conditions. The advocates of the doctrine of Evolution hold, +on the contrary, that species are not permanent and immutable, but that +they are subject to modification, and that "the existing forms of life +are descendants by true generation of pre-existing forms."[1] Most +naturalists are now inclined to admit the general truth of the theory of +evolution, but they differ widely respecting the mode in which it +occurred. + + +THE PROCESS OF GENERATION. + + +The vital _principle_, represented in the _sperm_-cell by a +spermatozoön, must be imparted to a _germ_-cell in order to effect +impregnation. After touching each other, separate them immediately, and +observe the result. If, with the aid of a powerful lens, we directly +examine the spermatozoön, it will be perceived that, for a short time, +it preserves its dimensions and retains all its material aspects. But it +does not long withstand the siege of decay, and, having fulfilled its +destiny, loses its organic characteristics, and begins to shrink. + +If we examine the fertilized germ, we discover unusual activity, the +result of impregnation. Organic processes succeed one another with +wonderful regularity, as if wrought out by inexplicable intelligence. +Here begin the functions which constitute human physiology. + +Generation requires that a spermatozoön be brought into actual contact +with a germ that fecundation may follow. If a spermatic cell, or +spermatozoön, together with several unimpregnated ova, no matter how +near to one another, if not actually touching, be placed on the concave +surface of a watch-crystal, and covered with another crystal, keeping +them warm, and even though the vapor of the ova envelops it, no +impregnation will occur. Place the spermatozoön in contact with an ovum, +and impregnation is instantly and perfectly accomplished. Should this +vitalizing power be termed nerve-force, electricity, heat, or motion? It +is known that these forces may be metamorphosed; for instance, nervous +force may be converted into electricity, electricity into heat, and heat +into motion, thus illustrating their affiliation and capability of +transformation. But nothing is explained respecting the real nature of +the vital principle, if we assert its identity with any of these forces; +for who can reveal the true nature of any of these, or even of matter? + + +ALTERNATE GENERATION. + + +In several insect families, the species is not wholly represented in the +adult individuals of both sexes, or in their development, but, to +complete this series, supplementary individuals, as it were, of one or +of several preceding generations, are required. The son may not resemble +the father, but the grandfather, and in some instances, the likeness +re-appears only in latter generations. Agassiz states: "Alternate +generation was first observed among the Salpae. These are marine +mollusks, without shells, belonging to the family Tunicata. They are +distinguished by the curious peculiarity of being united together in +considerable numbers so as to form long chains, which float in the sea, +the mouth(_m_) however being free in each. + +[Illustration: Fig. 2. ] + +[Illustration: Fig. 3. ] + +"Fig. 2. The individuals thus joined in floating colonies produce eggs; +but in each animal there is generally but one egg formed, which is +developed in the body of the parent, and from which is hatched a little +mollusk. + +"Fig. 3, which remains solitary, and differs in many respects from the +parent. This little animal, on the other hand, does not produce eggs, +but propagates, by a kind of budding, which gives rise to chains already +seen in the body of their parent(a), and these again bring forth +solitary individuals, etc." + +It therefore follows that generation in some animals require? two +different bodies with intermediate ones, by means of which and their +different modes of reproduction, a return to the original stock is +effected. + +UNIVERSALITY OF ANIMALCULAR LIFE.--Living organisms are universally +diffused over every part of the globe. The gentle zephyr wafts from +flower to flower invisible, fructifying atoms, which quicken beauty and +fragrance, giving the promise of a golden fruitage, to gladden and +nourish a dependent world. Nature's own sweet cunning invests all living +things constraining into her service chemical affinities, arranging the +elements and disposing them for her own benefit, in such numberless ways +that we involuntarily exclaim, + + "The course of Nature is the art of God." + +The microscope reveals the fact that matter measuring only 1/120000 of +an inch diameter may be endowed with vitality, and that countless +numbers of animalcules often inhabit a single drop of stagnant water. +These monads do not vary in form, whether in motion or at rest. The life +of one, even, is an inexplicable mystery to the philosopher. Ehrenberg +writes: "Not only in the polar regions is there an uninterrupted +development of active microscopic life, where larger animals cannot +exist, but we find that those minute beings collected in the Antarctic +expedition of Captain James Ross exhibit a remarkable abundance of +unknown, and often most beautiful forms." + +Even the interior of animal bodies is inhabited by animalcules. They +have been found in the blood of the frog and the salmon, and in the +optic fluid of fishes. Organic beings are found in the interior of the +earth, into which the industry of the miner has made extensive +excavations, sunk deep shafts, and thus revealed their forms; likewise, +the smallest fossil organisms form subterranean strata many fathoms +deep. Not only do lakes and inland seas abound with life, but also, from +unknown depths, in volcanic districts, arise thermal springs which +contain living insects. Were we endowed with a microscopic eye, we might +see myriads of ethereal voyagers wafted by on every breeze, as we now +behold drifting clouds of aqueous vapor. While the continents of earth +furnishes evidences of the universality of organic beings, recent +observations prove that "animal life predominates amid the eternal night +of the depths of the liquid ocean." + + +THE ORIGIN OF LIFE. + + +The ancients, rude in many of their ideas, referred the origin of life +to divine determination. The thought was crudely expressed, but well +represented, in the following verse: + + "Then God smites his hands together, + And strikes out a soul as a spark, + Into the organized glory of things. + From the deeps of the dark." + +According to a Greek myth, Prometheus formed a human image from the dust +of the ground, and then, by fire stolen from heaven, animated it with a +living soul. Spontaneous generation once held its sway, and now the idea +of natural evolution is popular. Some believe that the inpenetrable +mystery of life is evolved from the endowments of nature, and build +their imperfect theory on observations of her concrete forms and their +manifestations, to which all our investigations are restricted. But +every function indicates purpose, every organism evinces intelligent +design, and _all_ proclaim a Divine Power. Something cannot come out of +nothing. With reason and philosophy, _chance_ is an impossibility. We, +therefore, accept the display of wisdom in nature as indicative of the +designs of God. Thus "has He written His claims for our profoundest +admiration and homage all over every object that He has made." If you +ask: Is there any advantage in considering the phenomena of nature as +the result of DIVINE VOLITION? we answer, that this belief corresponds +with the universally acknowledged ideas of accountability; for, with a +wise, and efficient Cause, we infer there is an intelligent creation, +and the desire to communicate, guide and bless, is responded to by man, +who loves, obeys, and enjoys. Nothing is gained by attributing to nature +vicegerent forces. Is it not preferable to say that she responds to +intelligent, loving Omnipotence? Our finiteness is illustrated by our +initiation into organized being. Emerging from a rayless atom, too +diminutive for the sight, we gradually develop and advance to the +maturity of those _conscious powers_, the exercise of which furnishes +indubitable evidence of our immortality. We are pervaded with invisible +influences, which, like the needle of the compass trembling on its +pivot, point us to immortality as our ultimate goal, where in the sunny +clime of Love, even in a spiritual realm of joy and happiness, we may +eternally reign with Him who is all in all. + + * * * * * + + + + +CHAPTER II. + +PHYSIOLOGICAL ANATOMY. + +THE BONES. + + +All living bodies are made up of tissues. There is no part, no organ, +however soft and yielding, or hard and resisting, which has not this +peculiarity of structure. The _bones_ of animals, as well as their flesh +and fat, are composed of tissues, and all alike made up of cells. When +viewed under a microscope, each cell is seen to consist of three +distinct parts, a _nucleolus_, or dark spot, in the center of the cell, +around which lies a mass of granules, called the _nucleus;_ and this, in +turn, is surrounded with a delicate, transparent membrane, termed the +_envelope_. Each of the granules composing the nucleus assimilates +nourishment, thereby growing into an independent cell, which possesses a +triple organization similar to that of its parent, and in like manner +reproduces other cells. + +[Illustration: Fig. 4. +Nucleated cell. +From Goeber. +1. Periphery of the +cell, or cell-wall. +2. Nucleus. 3. Nucleolus +in the center.] + +A variety of tissues enters into the composition of an animal structure, +yet their differences are not always distinctly marked, since the +characteristics of some are not unlike those of others. We shall notice, +however, only the more important of the tissues. + +The _Areolar_, or _Connective Tissue_, is a complete network of delicate +fibers, spread over the body, and serves to bind the various organs and +parts together. The fibrous and serous tissues are modifications of the +areolar. + +The _Nervous Tissue_ is of two kinds: The gray, which is pulpy and +granulated, and the white fibrous tissue. The _Adipose Tissue_ is an +extremely thin membrane, composed of closed cells which contain fat. It +is found principally just beneath the skin, giving it a smooth, plump +appearance. + +[Illustration: Fig. 5. +Arrangement of fibers in the +Areolar Tissue. Magnified 135 diameters.] + +The _Cartilaginous Tissue_ consists of nucleated cells, and, with the +exception of bone, is the hardest part of the animal frame. The _Osseous +Tissue_, or bone, is more compact and solid than the cartilaginous, for +it contains a greater quantity of lime. The _Muscular Tissue_ is +composed of bundles of fibers, which are enclosed in a cellular +membrane. + +[Illustration: Fig. 6. +Human Adipose Tissue.] + +Various opinions have been entertained in regard to the formation, or +growth, of bone. Some anatomists have supposed that all bone is formed +in cartilage. But this is not true, for there is an _intra-membranous_, +as well as an _intra-cartilaginous_, formation of bone, as may be seen +in the development of the cranial bones, where the gradual calcification +takes place upon the inner layers of the fibrous coverings. +Intra-cartilaginous deposit is found in the vicinity of the +blood-vessels, within the cartilaginous canals; also, there are certain +points first observed in the shafts of long bones, called _centers of +ossification_. These points are no sooner formed than the cartilage +corpuscles arrange themselves in concentric zones, and, lying in contact +with one another, become very compact. As ossification proceeds, the +cup-shaped cavities are converted into closed interstices of bone, with +extremely thin lamellæ, or layers. These, however, soon increase in +density, and no blood-vessels can be observed within them. + +[Illustration: Fig. 7. +Vertical section of cartilage near the surface of +ossification. _1_. Ordinary appearance of the temporary +cartilage. _1_'. Portion of the same more +highly magnified. _2_. The cells beginning to form +into concentric zones. _2_'. Portion more magnified. +_3_. The ossification is extending in the inter-cellular +spaces, and the rows of cells are seen +resting in the cavities so formed, the nuclei being +more separated than above. _3_'. Portion of the +same more highly magnified.] + +[Illustration: Fig. 8. +Thigh-bone, +sawn open +lengthwise.] + +[Illustration: Fig. 9. +Lower end of the thigh-bone +sawn across, showing its central +cavity.] + +The bony plates form the boundaries of the _Haversian_, or nutritive +canals of the bones. In the _second stage of ossification_, the +cartilage corpuscles are converted into bone. Becoming flattened against +the osseous lamellæ already formed, they crowd upon one another so as to +entirely obliterate the lines that distinguish them; and, simultaneously +with these changes, a calcareous deposit takes place upon their +interior. Bones grow by additions to their ends and surfaces. In the +child, their extremities are separated from the body of the bone by +layer of cartilage, and the cancellated, or cellular structure, which +remains for a time in the interior, represents the early condition of +the ossifying substances. + +The bones contain more earthy matter in their composition than any other +part of the human body, being firm, hard, and of a lime color. They +compose the skeleton or frame work, and, when united by natural +ligaments, form what is known as the _natural_ skeleton; when they are +wired together, they are called an _artificial_ skeleton. The number of +bones in the human body is variously estimated; for those regarded as +single by some anatomists are considered by others to consist of several +distinct pieces. There are two hundred distinct bones in the human +skeleton besides the teeth. These may be divided into those of the Head, +Trunk, Upper Extremities, and Lower Extremities. + +[Illustration: Fig. 10. +The bones of the skull separated. _1_. Frontal, +only half is seen. _2_. Parietal. _3_. Occipital, only +half is seen. _4_. Temporal. _5_. Nasal. _6_. Malar. +_7_. Superior maxillary (upper jaw). _8_. Lachrymal. +_9_. Inferior maxillary (lower jaw). Between +_4_ and _6_ a part of the sphenoid or wedge-shaped +bone, is seen. Another bone assisting to form +the skull, but not here seen, is called the _ethmoid_ +(sieve-like, from being full of holes), and is situated +between the sockets of the eyes, forming the +roof of the nose.] + +THE BONES OF THE HEAD are classed as follows: eight belonging to the +Cranium, and fourteen to the Face. The bones of the Cranium are the +_occipital_, two _parietal_, two _temporal, frontal, sphenoid_, and +_ethmoid_. Those composing the face are, the two _nasal_, two _superior +maxillary,_ two _lachrymal_, two _malar_ two _palate_, two _inferior +turbinated, vomer_, and _inferior maxillary_. The cranial bones are +composed of two dense plates, between which there is, in most places a +cancellated or cellular tissue. The external plate is fibrous, the +internal, compact and vitreous. The skull is nearly oval in form, convex +externally, the bone being much thicker at the base than elsewhere, and +it is, in every respect admirably adapted to resist any injury to which +it may be exposed, thus affording ample protection to the brain +substance which it envelops. The internal surface of the cranium +presents eminences and depressions for lodging the convolutions of the +brain, and numerous furrows for the ramifications of the blood-vessels. +The bones of the cranium are united to one another by ragged edges +called _sutures_, which are quite distinct in the child but which in old +age are nearly effaced. Some authorities suppose that by this +arrangement the cranium is less liable to be fractured by blows; others +think that the sutures allow the growth of these bones, which takes +place by a gradual osseous enlargement at the margins. The bones of the +_Face_ are joined at the lower part and in front of the cranium, and +serve for the attachment of powerful muscles which assist in the process +of mastication. Although the soft parts of the face cover the bony +structure, yet they do not conceal its principal features, or materially +change its proportions. The form of the head and face presents some +remarkable dissimilarities in different races. + +[Illustration: Fig. 11. +_1_. The first bone of the sternum (breast-bone). +_2_. The second bone of the sternum. +_3_. The cartilage of the sternum. _4_. The +first dorsal vertebra (a bone of the spinal +column). _5_. The last dorsal vertebra. _6_. +The first rib. _7_. Its head. _8_. Its neck. _9_. +Its tubercle. _10_. The seventh or last true +rib. _11_. The cartilage of the third rib. _12._ +The floating ribs.] + +[Illustration: Fig. 12. +A vertebra of the neck. _1_. The +body of the vertebra. _2_. The spinal +canal. _4_. The spinous process +cleft at its extremity. _5_. The +transverse process. _7_. The interior +articular process. _8_. The +superior articular process.] + +THE TRUNK has fifty-four bones, which are as follows: The _Os Hyoides_, +the _Sternum_, twenty-four Ribs, twenty-four _vertebræ_ or bones of the +Spinal Column, the _Sacrum_, the _Coccyx_, and two _Ossa Innominata_. +The _Os Hyoides_, situated at the base of the tongue, is the most +isolated bone of the skeleton, and serves for the attachment of muscles. +The _Sternum_, or breast-bone, in a child is composed of six pieces, in +the adult of three, which in old age are consolidated into one bone. The +_Ribs_ are thin, curved bones, being convex externally. There are twelve +on each side, and all are attached to the spinal column. The seven upper +ribs, which are united in front of the sternum, are termed _true_ ribs; +the next three, which are not attached to the sternum, but to one +another are called _false_ ribs; and the last two, which are joined only +to the vertebræ, are designated as _floating_ ribs. The first rib is the +shortest, and they increase in length as far as the eighth, after which +this order is reversed. + +[Illustration: Fig. 13. +_1_. The cartilaginous substance +which connects the bodies of +the vertebræ. _2_. The body of the +vertebra. _3_. The spinous process. +_4,4_. The transverse processes. +_5,5_. The articular processes. +_6,6_. A portion of the bony bridge +which assists in forming the spinal +canal (7).] + +[Illustration: Fig. 14. +Backbone, spinal +column, or vertebral +column. All +animals possessing +such a row of bones +are called _vertebrates_. +Above _b_ are +the cervical (neck) +vertebræ; _b_ to _c_, +dorsal (back) or +chest vertebræ; _c_ +to _d_, lumbar (loins) +vertebræ; _d_ to _e_, sacrum; +_e_ to _f_, coccyx.] + +The _Spinal Column_ or backbone, when viewed from the front presents a +perpendicular appearance, but a side view shows four distinct curves. +The bones composing it are called _vertebræ_. The body part of a +vertebra is light and spongy in texture, having seven projections called +_processes_, four of which are the _articular_ processes, which furnish +surfaces to join the different vertebræ of the spinal column. Two are +called _transverse_, and the remaining one is termed the _spinous_. The +transverse and spinous processes serve for the attachment of the muscles +belonging to the back. All these processes are more compact than the +body of the vertebra, and, when naturally connected, are so arranged as +to form a tube which contains the _medulla spinalis_, or spinal cord. +Between the vertebræ is a highly-elastic, cartilaginous and cushion-like +substance, which freely admits of motion, and allows the spine to bend +as occasion requires. The natural curvatures of the spinal column +diminish the shock produced by falling, running or leaping, which would +otherwise be more directly transmitted to the brain. The ribs at the +sides, the sternum in front, and the twelve dorsal bones of the spinal +column behind, bound the thoracic cavity, which contains the lungs, +heart, and large blood-vessels. + +[Illustration: Fig. 15. +A representation of the pelvic bones. _e_. The +lumbo-sacral joint. 2. The sacrum. _3_. Coccyx. _1,1_. +The innominata. _4,4_. Acetabula.] + +The _Pelvis_ is an open bony structure, consisting of the Os Innominata, +one on either side, and the Sacrum and Coccyx behind. The _Sacrum_, +during childhood, consists of five bones, which in later years unite to +form one bone. It is light and spongy in texture, and the upper surface +articulates with the lowest vertebra, while it is united at its inferior +margin to the coccyx. The _Coccyx_ is the terminal bone of the spinal +column. In infancy it is cartilaginous and composed of several pieces, +but in the adult these unite and form one bone. The _Innominata_, or +nameless bones, during youth, consist of three separate pieces on each +side; but as age advances they coalesce and form one bone. A deep +socket, called the _acetabulum_, is found near their junction, which +serves for the reception of the head of the thigh-bone. + +[Illustration: Fig. 16. +1. Portions of the backbone. 2. Cranial +bones. _4_. Breast-bone. _5_. Ribs. _7_. Collar-bone. +_8_. Arm-bone (humerus). _9_. Shoulder-joint. +_10, 11_. Bones of the fore-arm (ulna and +radius). _12_. Elbow-joint. _13_. Wrist-joint. _14_. +Bones of the hand. _15, 16_. Pelvic bones. _17_. +Hip-joint. _18_. Femur. _19, 20_. Bones of the +knee-joint. _21, 22_. Fibula and tibia. _23_. Ankle +bone. _24_. Bones of the foot.] + +THE BONES OF THE UPPER EXTREMITIES are sixty-four in number, and are +classified as follows: The Scapula, Clavicle, Humerus, Ulna, Radius, +Carpus, Metacarpus, and Phalanges. The _Scapula_, or shoulder-blade, is +an irregular, thin, triangular bone, situated at the posterior part of +the shoulder, and attached to the upper and back part of the chest. The +_Clavicle_, or collar-bone, is located at the upper part of the chest, +between the sternum and scapula, and connects with both. Its form +resembles that of the italic letter _f_, and it prevents the arms from +sliding forward. The _Humerus_, the first bone of the arm, is long, +cylindrical, and situated between the scapula and fore-arm. The _Ulna_ +is nearly parallel with the radius, and situated on the inner side of +the fore-arm. It is the longer and larger of the two bones, and in its +articulation with the humerus, forms a perfect hinge-joint. The +_Radius_, so called from its resemblance to a spoke, is on the outer +side of the fore-arm, and articulates with the bones of the wrist, +forming a joint. The ulna and radius also articulate with each other at +their extremities. The _Carpus_, or wrist, consists of eight bones, +arranged in two rows. The _Metacarpus_, or palm of the hand, is composed +of five bones situated between the carpus and fingers. The _Phalanges_, +fourteen in number, are the bones of the fingers and thumb, the fingers +each having three and the thumb two. + +THE BONES OF THE LOWER EXTREMITIES, sixty in number, are classed as +follows: The Femur, Patella, Tibia, Fibula, Tarsus, Metatarsus, and +Phalanges. The _Femur_, or thigh-bone, is the longest bone in the body. +It has a large round head, which is received into the acetabulum, thus +affording a good illustration of a ball and socket joint. The _Patella,_ +or knee-pan, is the most complicated articulation of the body. It is of +a round form, connects with the tibia by means of a strong ligament, and +serves to protect the front of the joint, and to increase the leverage +of the muscles attached to it, by causing them to act at a greater +angle. The _Tibia_, or shin bone, is enlarged at each extremity and +articulates with the femur above and the astragalus, the upper bone of +the tarsus, below. The _Fibula_, the small bone of the leg, is situated +on the outer side of the tibia, and is firmly bound to it at each +extremity. The _Tarsus_, or instep, is composed of seven bones, and +corresponds to the carpus of the upper extremities. The _Metatarsus_, +the middle of the foot, bears a dose resemblance to the metacarpus, and +consists of five bones situated between the tarsus and the phalanges. +The tarsal and the metatarsal bones are so united as to give an arched +appearance to the foot, thus imparting elasticity. The _Phalanges_, the +toes, consist of fourteen bones, arranged in a manner similar to that of +the fingers. + +We are not less interested in tracing the formation of bone through its +several stages, than in considering other parts of the human system. The +formation of the Haversian canals for the passage of blood-vessels to +nourish the bones, the earlier construction of bony tissue by a +metamorphosis of cartilaginous substance, and also the commencement of +ossification at distinct points, called _centers of ossification_, are +all important subjects, requiring the student's careful attention. The +bones are protected by an external membranous envelope, which, from its +situation is called the _periosteum_. The bones are divided into four +classes, _long, short, flat_ and _irregular_, being thus adapted to +subserve a variety of purposes. + +The Long Bones are found in the limbs, where they act as levers to +sustain the body and aid in locomotion. Each_long_ bone is composed of a +cylinder, known as the _shaft_, and two _extremities_. The shaft is +hollow, its wails being _thickest_ in THE middle and growing thinner +toward the extremities. The _extremities_ are usually considerably +enlarged, for convenience of connection with other bones, and to afford +a broad surface for the attachment of muscles. The clavical, humerus, +radius, ulna, femur, tibia, fibula, the bones of the metacarpus, +metatarsus and the phalanges, are classed as long bones. + +Where the principal object to be attained is strength, and the motion of +the skeleton is limited, the individual bones are short and compressed, +as the bones of the carpus and tarsus. The structure of these bones is +spongy, except at the surface, where there is a thin crust of compact +matter. + +[Illustration: Fig. 17. +Anatomy of a joint, _1, 1_. +Bones of a joint. _2, 2_. Cartilage. +_3, 3, 3, 3_. Synovial +membrane.] + +[Illustration: Fig. 18. +Anatomy of knee joint. +_1._ Lower end of thigh-bone. +_3._ Knee-pan. _2, 4_ Ligaments +of the knee-pan. _5_. Upper +end of the tibia, or shin-bone. +_6, 12_. Cartilages.] + +When protection is required for the organs of the body, or a broad flat +surface for the attachment of the muscles, the bones are expanded into +plates, as in the cranium and shoulder-blades. + +The _irregular_ or _mixed_ bones are those which, from their peculiar +shape, cannot be classed among any of the foregoing divisions. Their +structure is similar to the others, consisting of cancellar tissue, +surrounded by a crust of compact matter. + +The vertebræ, sacrum, coccyx, temporal, sphenoid, ethmoid, malar, two +maxillary, palate, inferior turbinated, and hyoid are known as irregular +bones. + +The formation of the joints requires not only bones, but also +cartilages, ligaments, and the synovial membrane, to complete the +articulation. _Cartilage_ is a smooth, elastic substance, softer than +bone, and invested with a thin membrane, called _perichondrium_. When +cartilage is placed upon convex surfaces, the reverse is true. The +_Ligaments_ are white, inelastic, tendinous substances, softer than +cartilage, but harder than membrane. Their function is to bind together +the bones. The _Synovial Membrane_ covers the cartilages, and is then +reflected upon the ligaments, thus forming a thin, closed sac, called +the _synovial capsule._ + +All the synovial membranes secrete a lubricating fluid, termed +_synovia_, which enables the surfaces of the bones and ligaments to move +freely upon one another. When this fluid is secreted in excessive +quantities, it produces a disease known as "dropsy of the joints." There +are numerous smaller sacs besides the synovial, called _bursæ mucosæ_, +which in structure are analogous to them, and secrete a similar fluid. +Some joints permit motion in every direction, as the shoulders, some in +two directions only, as the elbows, while others do not admit of any +movement. The bones, ligaments, cartilages, and synovial membrane, are +supplied with nerves, arteries, and veins. + +When an animal is provided with an internal bony structure, it indicates +a high rank in the scale of organization. An elaborate texture of bone +is found in no class below the vertebrates. Even in the lower order of +this sub-kingdom, which is the highest of animals, bone does not exist, +as is the case in some tribes of fishes, such as sharks, etc., and in +all classes below that of the cartilaginous fishes, the inflexible +substance which sustains the soft parts is either shell or some +modification of bone, and is usually found on the outside of the body. +True bone, on the contrary, is found in the interior, and, therefore, in +higher animals, the skeleton is always internal, while the soft parts +are placed external to the bony frame. While many animals of the lowest +species, being composed of soft gelatinous matter, are buoyant in water, +the highest type of animals requires not only a bony skeleton, but also +a flexible, muscular system, for locomotion in the water or upon the +land. Each species of the animal kingdom is thus organically adapted to +its condition and sphere of life. + + * * * * * + + + + +CHAPTER III. + +PHYSIOLOGICAL ANATOMY. + +THE MUSCLES. + + +[Illustration: Fig. 19. +Muscular fillers highly +magnified.] + +The _Muscles_ are those organs of the body by which motion is produced, +and are commonly known as _flesh_. A muscle is composed of _fascieuli_, +or bundles of fibers, parallel to one another. They are soft, varying in +size, of a reddish color, and inclosed in a cellular, membranous sheath. +Each _fasciculus_ contains a number of small fibers, which, when +subjected to a microscopic examination, are found to consist of +_fibrillae_, or little fibers; each of these fibrillae in turn being +invested with a delicate sheath. The fibers terminate in a glistening, +white _tendon_, or hard cord, which is attached to the bone. So firmly +are they united, that the bone will break before the tendon can be +released. When the tendon is spread out, so as to resemble a membrane, +it is called _fascia_. Being of various extent and thickness, it is +distributed over the body, as a covering and protection for the more +delicate parts, and aids also in motion, by firmly uniting the muscular +fibers. The spaces between the muscles are frequently filled with fat, +which gives roundness and beauty to the limbs. The muscles are of +various forms; some are longitudinal, each extremity terminating in a +tendon, which gives them a _fusiform_ or spindle-shaped appearance; +others are either fan-shaped, flat, or cylindrical. + +[Illustration: Fig. 20. +1. A spindle-shaped muscle, with tendinous +terminations. 2. Fan-shaped muscle. +3. Penniform muscle. 4. Bipenniform +muscle.] + +[Illustration: Fig. 21. +Striped muscular fibre showing cleavage in +opposite directions. 1. Longitudinal cleavage. +2. Transverse cleavage. 3. Transverse section of +disc. 4. Disc nearly detached. 5. Detached disc, +showing the sarcous elements. 6. Fibrillæ. 7,8. +Separated fibrillae highly magnified.] + +Every muscle has an _origin_ and an _insertion_. The term _origin_ is +applied to the more fixed or central attachment of a muscle, and the +term _insertion_ to the movable point to which the force of the muscle +is directed; but the origin is not absolutely fixed, except in a small +number of muscles, as those of the face, which are attached at one +extremity to the bone, and at the other to the movable integument, or +skin. In most instances, the muscles may act from either extremity. The +muscles are divided into the Voluntary, or muscles of animal life, and +the Involuntary, or muscles of organic life. There are, however, some +muscles which cannot properly be classified with either, termed +Intermediate. The _Voluntary Muscles_ are chiefly controlled by the +will, relaxing and contracting at its pleasure, as in the motion of the +eyes, mouth, and limbs. The fibers are of a dark red color, and possess +great strength. These fibers are parallel, seldom interlacing, but +presenting a striped or striated appearance; and a microscopic +examination of them shows that even the most minute consist of parallel +filaments marked by longitudinal and transverse _striae_, or minute +channels. The fibers are nearly the same length as the muscles to which +they belong. Each muscular fiber is capable of contraction; it may act +singly, though usually it acts in unison with others. By a close +inspection, it has been found that fibers may be drawn apart +longitudinally, in which case they are termed _fibrillae_, or they may +be separated transversely, forming a series of discs. The _Sarcolemma_, +or investing sheath of the muscles, appears to be formed even before +there are any visible traces of the muscle itself. It is a transparent +and delicate membrane, but very elastic. The _Involuntary Muscles_ are +influenced by the sympathetic nervous system, and their action pertains +to the nutritive functions of the body. They differ from the voluntary +muscles in not being striated, having no tendons, and in the net-work +arrangements of their fibers. The _Intermediate Muscles_ are composed of +striated and unstriated fibers; they are, therefore, both voluntary and +involuntary in their functions. The muscles employed in respiration are +of this class, for we can breathe rapidly or slowly, and, for a short +time, even suspend their action; but soon, however, the organic muscles +assert their instinctive control, and respiration is resumed. + +[Illustration: Fig. 22. +Unstriated muscular fiber; at _b_, in its natural +state; at _a_, showing the nuclei after the action of +acetic acid. ] + +[Illustration: Fig. 23. +A view of the under side of the diaphragm.] + +THE DIAPHRAGM, or midriff, is the muscular division between the thorax +and the abdomen. It has been compared to an inverted basin, the +concavity of which is directed toward the abdomen. The muscles receive +their nourishment from the numerous blood-vessels which penetrate their +tissues. The voluntary muscles are abundantly supplied with nerves, +while the involuntary are not so numerously furnished. The color of the +muscles is chiefly due to the blood which they contain. They vary in +size according to their respective functions. For example, the functions +of the heart require large and powerful muscles, and those of the eye, +small and delicate ones. There are between four hundred and sixty and +five hundred muscles in the human body. + +[Illustration: Fig. 24. +A representation of the superficial layer of muscles on the anterior +portion of the body.] + +[Illustration: Fig. 25. +A representation of the superficial layer of muscles on the posterior +portion of the body.] + +Very rarely is motion produced by the action of a single muscle, but by +the harmonious action of several. There is infinite variety in the +arrangement of the muscles, each being adapted to its purpose, in +strength, tenacity, or elasticity. While some involuntarily respond to +the wants of organic life, others obey, with mechanical precision, the +edicts of the will. The peculiar characteristic of the muscles is their +contractility; for example, when the tip of the finger is placed in the +ear, an incessant vibration, due to the contraction of the muscles of +the ear, can be heard. When the muscles contract, they become shorter; +but what is lost in length is gained in breadth and thickness, so that +their actual volume remains the same. Muscles alternately contract and +relax, and thus act upon the bones. The economy of muscular power thus +displayed is truly remarkable. In easy and graceful walking, the forward +motion of the limbs is not altogether due to the exercise of muscular +power, but partly to the force of gravity, and only a slight assistance +of the muscles is required to elevate the leg sufficiently to allow it +to oscillate. + +Motion is a characteristic of living bodies. This is true, not only in +animals, but also in plants. The oyster, although not possessing the +power of locomotion, opens and closes its shell at pleasure. The coral +insect appears at the door of its cell, and retreats at will. All the +varied motions of animals are due to a peculiar property of the muscles, +termed _contractility_. Although plants are influenced by external +agents, as light, heat, electricity, etc., yet it is supposed that they +may move in response to inward impulses. The sensitive stamens of the +barberry, when touched at their base on the inner side, resent the +intrusion, by making a sudden jerk forward. Venus's fly-trap, a plant +found in North Carolina, is remarkable for the sensitiveness of its +leaves; which close suddenly and capture insects which chance to alight +upon them. The muscles of the articulates are situated within the solid +framework, unlike the vertebrates, whose muscles are external to the +bony skeleton. All animals have the power of motion, from the lowest +radiate to the highest vertebrate, from the most repulsive polyp to that +type of organized life made in the very image of God. + +The muscles, then, subserve an endless variety of purposes. By their aid +the farmer employs his implements of husbandry, the mechanic deftly +wields his tools, the artist plies his brush, while the fervid orator +gives utterance to thoughts glowing with heavenly emotions. It is by +their agency that the sublimest spiritual conceptions can be brought to +the sphere of the senses, and the noblest, loftiest aims of to-day can +be made glorious realizations of the future. + + * * * * * + + + + +CHAPTER IV. + +PHYSIOLOGICAL ANATOMY. + +THE DIGESTIVE ORGANS. + + +_Digestion_ signifies the act of separating or distributing, hence its +application to the process by which food is made available for nutritive +purposes. The organs of digestion are the Mouth, Teeth, Tongue, Salivary +Glands, Pharynx, Esophagus, the Stomach and the Intestines, with their +glands, the Liver, Pancreas, Lacteals, and the Thoracic Duct. + +[Illustration: Fig. 26. +A view of the lower jaw. _1_. The body. +_2, 2_. Rami, or branches. _3, 3_. Processes of +the lower jaw. _m_. Molar teeth. _b_. Bicuspids, +_c_. Cuspids. _i_. Incisors.] + +The _Mouth_ is an irregular cavity, situated between the upper and the +lower jaw, and contains the organs of mastication. It is bounded by the +lips in front, by the cheeks at the sides, by the roof of the mouth and +teeth of the upper jaw above, and behind and beneath by the teeth of the +lower jaw, soft parts, and palate. The soft palate is a sort of pendulum +attached only at one of its extremities, while the other involuntarily +opens and closes the passage from the mouth to the pharynx. The interior +of the mouth, as well as other portions of the alimentary canal, is +lined with a delicate tissue, called _mucous membrane_. + +The _Teeth_ are firmly inserted in the alveoli or sockets, of the upper +and the lower jaw. The first set, twenty in number, are temporary, and +appear during infancy. They are replaced by permanent teeth, of which +there are sixteen in each jaw; four incisors, or front teeth, four +cuspids, or eye teeth, four bicuspids, or grinders, and four molars, or +large grinders. Each tooth is divided into the crown, body, and root. +The _crown_ is the grinding surface; the _body_, the part projecting +from the jaw, is the seat of sensation and nutrition; the _root_ is that +portion of the tooth which is inserted in the alveolus. The teeth are +composed of dentine, or ivory, and enamel. The ivory forms the greater +portion of the body and root, while the enamel covers the exposed +surface. The small white cords communicating with the teeth are the +nerves. + +The _Tongue_ is a flat oval organ, the base of which is attached to the +os hyoides, while the apex, the most sensitive part of the body, is +free. Its surface is covered with a membrane, which, at the sides and +lower part, is continuous with the lining of the mouth. On the lower +surface of the tongue, this membrane is thin and smooth, but on the +upper side it is covered with numerous papillae, which, in structure, +are similar to the sensitive papillae of the skin. + +[Illustration: Fig. 27. +The salivary glands. The largest one, near the ear, is the +parotid gland. The next below it is the submaxillary gland. +The one under the tongue is the sublingual gland.] + +The _Salivary Glands_ are six in number, three on each side of the +mouth. Their function is to secrete a fluid called _saliva_, which aids +in mastication. The largest of these glands, the _Parotid_, is situated +in front and below the ear; its structure, like that of all the salivary +glands, is cellular. The _Submaxillary_ gland is circular in form, and +situated midway between the angle of the lower jaw and the middle of the +chin. The _Sublingual_ is a long flattened gland, and, as its name +indicates, is located below the tongue, which when elevated, discloses +the saliva issuing from its porous openings. + +The _Pharynx_ is nearly four inches in length, formed of muscular and +membranous cells, and situated between the base of the cranium and the +esophagus, in front of the spinal column. It is narrow at the upper +part, distended in the middle, contracting again at its junction with +the esophagus. The pharynx communicates with the nose, mouth, larynx, +and esophagus. + +The _Esophagus_, a cylindrical organ, is a continuation of the pharynx, +and extends through the diaphragm to the stomach. It has three coats: +first, the muscular, consisting of an exterior layer of fibers running +longitudinally, and an interior layer of transverse fibers; second, the +cellular, which is interposed between the muscular and the mucous coat; +third, the mucous membrane, or internal coat, which is continuous with +the mucous lining of the pharynx. + +[Illustration: Fig. 28. +A representation of the interior of the stomach. +_1_. The esophagus. _2_. Cardiac orifice opening into +the stomach. _6_. The middle or muscular coat. +_7_. The interior or mucous coat. _10_. The beginning +of the duodenum. _11_. The pyloric orifice.] + +The _Stomach_ is a musculo-membranous, conoidal sac, communicating with +the esophagus by means of the cardiac orifice (see Fig. 28). It is +situated obliquely with reference to the body, its base lying at the +left side, while the apex is directed toward the right side. The stomach +is between the liver and spleen, subjacent to the diaphragm, and +communicates with the intestinal canal by the pyloric orifice. It has +three coats. The peritoneal, or external coat is composed of compact, +cellular tissue, woven into a thin, serous membrane, and assists in +keeping the stomach in place. The middle coat is formed of three layers +of muscular fibers: in the first, the fibres run longitudinally; in the +second, in a circular direction; and in the third, they are placed +obliquely to the others. The interior, or mucous coat, lines this organ. +The stomach has a soft, spongy appearance, and, when not distended, lies +in folds. During life, it is ordinarily of a pinkish color. It is +provided with numerous small glands, which secrete the gastric fluid +necessary for the digestion of food. The lining membrane, when divested +of mucus, has a wrinkled appearance. The arteries, veins, and +lymphatics, of the stomach are numerous. + +[Illustration: Fig. 29. +Small and large intestines. _1, 1, 2, 2_. +Small intestine. _3_. Its termination in the +large intestine. _4_. Appendix vermiformis. +_5_. Caecum. _6_. Ascending colon. +_7_. Transverse colon. _8_. Descending colon. +_9_. Sigmoid flexure of colon. _10_. Rectum.] + +The _Intestines_ are those convoluted portions of the alimentary canal +into which the food is received after being partially digested, and in +which the separation and absorption of the nutritive materials and the +removal of the residue take place. The coats of the intestines are +analogous to those of the stomach, and are, in fact, only extensions of +them. For convenience of description, the intestines may be divided into +the _small_ and the _large_. The small intestine is from twenty to +twenty-five feet in length, and consists of the Duodenum, Jejunum, and +Ileum. The _Duodenum_, so called because its length is equal to the +breadth of twelve fingers, is the first division of the small intestine. +If the mucous membrane of the duodenum be examined, it will be found +thrown into numerous folds, which are called _valvulæ conniventes_, the +chief function of which appears to be to retard the course of the +alimentary matter, and afford a larger surface for the accommodation of +the absorbent vessels. Numerous _villi_, minute thread-like projections, +will be found scattered over the surface of these folds, set side by +side, like the pile of velvet. Each _villus_ contains a net-work of +blood-vessels, and a lacteal tube, into which the ducts from the liver +and pancreas open, and pour their secretions to assist in the conversion +of the chyme into chyle. The _Jejunum_, so named because it is usually +found empty after death, is a continuation of the duodenum, and is that +portion of the alimentary canal in which the absorption of nutritive +matter is chiefly effected. The _Ileum_, which signifies something +rolled up, is the longest division of the small intestine. Although +somewhat thinner in texture than the jejunum, yet the difference is +scarcely perceptible. The large intestine is about five feet in length, +and is divided into the Caecum, Colon, and Rectum. The _Caecum_ is about +three inches in length. Between the large and the small intestine is a +valve, which prevents the return of excrementitious matter that has +passed into the large intestine. There is attached to the cæcum an +appendage about the size of a goose-quill, and three inches in length, +termed the _appendix vermiformis_. The _Colon_ is that part of the large +intestine which extends from the cæcum to the rectum, and which is +divided into three parts, distinguished as the ascending, the +transverse, and the descending. + +[Illustration: Fig. 30. +Villi of the small intestine greatly +magnified.] + +[Illustration: Fig. 31. +A section of the Ileum, turned inside out, +so as to show the appearance and arrangement +of the villi on an extended surface.] + +The _Rectum_ is the terminus of the large intestine. The intestines are +abundantly supplied with blood-vessels. The arteries of the small +intestine are from fifteen to twenty in number. The large intestine is +furnished with three arteries, called the _colic arteries_. The +_ileo-colic artery_ sends branches to the lower part of the ileum, the +head of the colon, and the appendix vermiformis. The _right colic +artery_ forms arches, from which branches are distributed to the +ascending colon. The _colica media_ separates into two branches, one of +which is sent to the right portion of the transverse colon, the other to +the left. In its course, the _superior hemorrhoidal artery_ divides into +two branches, which enter the intestine from behind, and embrace it on +all sides, almost to the anus. + +The _Thoracic Duct_ is the principal trunk of the absorbent system, and +the canal through which much of the chyle and lymph is conveyed to the +blood. It begins by a convergence and union of the lymphatics on the +lumbar vertebræ, in front of the spinal column, then passes upward +through the diaphragm to the lower part of the neck, thence curves +forward and downward, opening into the subclavian vein near its junction +with the left jugular vein, which leads to the heart. + +[Illustration: Fig. 32. +_c, c_. Right and left subclavian veins. _b_. +Inferior vena cava. _a_. Intestines. _d_. Entrance +of the thoracic duct into the left +subclavian vein. _4_. Mesenteric glands, +through which the lacteals pass to the +thoracic duct.] + +[Illustration: Fig. 33. +The inferior surface of the liver. 1. Right lobe. +2. Left lobe. 3. Gall-bladder.] + +The _Liver_, which is the largest gland in the body, weighs about four +pounds in the adult, and is located chiefly on the right side, +immediately below the diaphragm. It is a single organ, of a dark red +color, its upper surface being convex, while the lower is concave. It +has two large lobes, the right being nearly four times as large as the +left. The liver has two coats, the _serous_, which is a complete +investment, with the exception of the diaphragmatic border, and the +depression for the gall-bladder, and which helps to suspend and retain +the organ in position; and the _fibrous_, which is the inner coat of the +liver, and forms sheaths for the blood-vessels and excretory ducts. The +liver is abundantly supplied with arteries, veins, nerves, and +lymphatics. Unlike the other glands of the human body, it receives two +kinds of blood; the arterial for its nourishment, and the venous, from +which it secretes the bile. In the lower surface of the liver is lodged +the gall-bladder, a membranous sac, or reservoir, for the bile. This +fluid is not absolutely necessary to the digestion of food, since this +process is effected by other secretions, nor does bile exert any special +action upon, starchy or oleaginous substances, when mixed with them at a +temperature of 100° F. Experiments also show that in some animals there +is a constant flow of bile, even when no food has been taken, and there +is consequently no digestion to be performed. Since the bile is formed +from the venous blood, and taken from the waste and disintegration of +animal tissue, it would appear that it is chiefly an excrementitious +fluid. It does not seem to have accomplished its function when +discharged from the liver and poured into the intestine, for there it +undergoes various alterations previous to re-absorption, produced by its +contact with the intestinal juices. Thus the bile, after being +transformed in the intestines, re-enters the blood under a new form, and +is carried to some other part of the system to perform its mission. + +The _Spleen_ is oval, smooth, convex on its external, and irregularly +concave on its internal, surface. It is situated on the left side, in +contact with the diaphragm and stomach. It is of a dark red color, +slightly tinged with blue at its edges. Some physiologists affirm that +no organ receives a greater quantity of blood, according to its size, +than the spleen. The structure of the spleen and that of the mesenteric +glands are similar, although the former is provided with a scanty supply +of lymphatic vessels, and the chyle does not pass through it, as through +the mesenteric glands. The _Pancreas_ lies behind the stomach, and +extends transversely across the spinal column to the right of the +spleen. It is of a pale, pinkish color, and its secretion is analogous +to that of the salivary glands; hence it has been called the _Abdominal +Salivary Gland_. + +[Illustration: Fig. 34. +Digestive organs. _3_. The tongue. _7_. Parotid +gland. _8_. Sublingual gland. _5_. Esophagus. _9_. +Stomach. _10_. Liver. _11_. Gall-bladder, _14_. Pancreas. +_13, 13_. The duodenum. The small and large intestines +are represented below the stomach.] + +Digestion is effected in those cavities which we have described as parts +of the alimentary canal. The food is first received into the mouth, +where it is masticated by the teeth, and, after being mixed with mucus +and saliva, is reduced to a mere pulp; it is then collected by the +tongue, which, aided by the voluntary muscles of the throat, carries the +food backward into the pharynx, and, by the action of the involuntary +muscles of the pharynx and esophagus, is conveyed to the stomach. Here +the food is subjected to a peculiar, churning movement, by the alternate +relaxation and contraction of the fibers which compose the muscular wall +of the stomach. As soon as the food comes in contact with the stomach, +its pinkish color changes to a bright red; and from the numerous tubes +upon its inner surface is discharged a colorless fluid, called the +_gastric juice_, which mingles with the food and dissolves it. When the +food is reduced to a liquid condition, it accumulates in the pyloric +portion of the stomach. Some distinguished physiologists believe that +the food is kept in a gentle, unceasing, but peculiar motion, called +_peristaltic_, since the stomach contracts in successive circles. In the +stomach the food is arranged in a methodical manner. The undigested +portion is detained in the upper, or cardiac extremity, near the +entrance of the esophagus, by contraction of the circular fibers of the +muscular coat. Here it is gradually dissolved, and then carried into the +pyloric portion of the stomach. From this, then, it appears, that the +dissolved and undissolved portions of food occupy different parts of the +stomach. After the food has been dissolved by the gastric fluid, it is +converted into a homogeneous, semi-fluid mass, called _chyme_. This +substance passes from the stomach through the pyloric orifice into the +duodenum, in which, by mixing with the bile and pancreatic fluid, its +chemical properties are again modified, and it is then termed _chyle_, +which has been found to be composed of three distinct parts, a +reddish-brown sediment at the bottom, a whey-colored fluid in the +middle, and a creamy film at the top. Chyle is different from chyme in +two respects: First, the alkali of the digestive fluids, poured into the +duodenum, or upper part of the small intestine, neutralizes the acid of +the chyme; secondly, both the bile and the pancreatic fluid seem to +exert an influence over the fatty substances contained in the chyme, +which assists the subdivision of these fats into minute particles. While +the chyle is propelled along the small intestine by the peristaltic +action, the matter which it contains in solution is absorbed in the +usual manner into the vessels of the villi by the process called +_osmosis_. The fatty matters being subdivided into very minute +particles, but not dissolved, and consequently incapable of being thus +absorbed by osmosis, pass bodily through the epithelial lining of the +intestine into the commencement of the lacteal tubes in the villi. The +digested substances, as they are thrust along the small intestines, +gradually lose their albuminoid, fatty, and soluble starchy and +saccharine matters, and pass through the ileo-caecal valve into the +cæcum and large intestine. An acid reaction takes place here, and they +acquire the usual fæcal smell and color, which increases as they +approach the rectum. Some physiologists have supposed that a second +digestion takes place in the upper portion of the large intestine. The +lacteals, filled with chyle, pass into the mesenteric glands with which +they freely unite, and afterward enter the _receptaculum chyli_, which +is the commencement of the thoracic duct, a tube of the size of a +goose-quill, which lies in front of the backbone. The lymphatics, the +function of which is to secrete and elaborate lymph, also terminate in +the _receptaculum chyli_, or receptacle for the chyle. From this +reservoir the chyle and lymph flow into the thoracic duct, through which +they are conveyed to the left subclavian vein, there to be mingled with +venous blood. The blood, chyle, and lymph, are then transmitted directly +to the lungs. + +The process of nutrition aids in the development and growth of the body; +hence it has been aptly designated a "perpetual reproduction." It is the +process by which every part of the body assimilates portions of the +blood distributed to it. In return, the tissues yield a portion of the +material which was once a component part of their organization. The body +is constantly undergoing waste as well as repair. One of the most +interesting facts in regard to the process of nutrition in animals and +plants is, that all tissues originate in cells. In the higher types of +animals, the blood is the source from which the cells derive their +constituents. Although the alimentary canal is more or less complicated +in different classes of animals, yet there is no species, however low in +the scale of organization, which does not possess it in some form.[2] +The little polyp has only one digestive cavity, which is a pouch in the +interior of the body. In some animals circulation is not distinct from +digestion, in others respiration and digestion are performed by the same +organs; but as we rise in the scale of animal life, digestion and +circulation are accomplished in separate cavities, and the functions of +nutrition become more complex and distinct. + + + * * * * * + + + + +CHAPTER V. + +PHYSIOLOGICAL ANATOMY. + +ABSORPTION. + + +[Illustration: Fig. 35. +Villi of the small intestine greatly magnified.] + +_Absorption_ is the vital function by which nutritive materials are +selected and imbibed for the sustenance of the body. Absorption, like +all other functional processes, employs agents to effect its purposes, +and the _villi_ of the small intestine, with their numberless projecting +organs, are specially employed to imbibe fluid substances; this they do +with a celerity commensurate to the importance and extent of their +duties. They are little vascular prominences of the mucous membrane, +arising from the interior surface of the small intestine. Each villus +has two sets of vessels. (1.) The blood-vessels, which, by their +frequent blending, form a complete net-work beneath the external +epithelium; they unite at the base of the villus, forming a minute vein, +which is one of the sources of the portal vein. (2.) In the center of +the villus is another vessel, with thinner and more transparent walls, +which is the commencement of a lacteal. + +The _Lacteals_ originate in the walls of the alimentary canal, are very +numerous in the small intestine, and, passing between the laminae of the +mesentery, they terminate in the _receptaculum chyli_, or reservoir for +the chyle. The mesentery consists of a double layer of cellular and +adipose tissue. It incloses the blood-vessels, lacteals, and nerves of +the small intestine, together with its accessory glands. It is joined to +the posterior abdominal wall by a narrow _root_; anteriorly, it is +attached to the whole length of the small intestine. The lacteals are +known as the absorbents of the intestinal walls, and after digestion is +accomplished, are found to contain a white, milky fluid, called _chyle_. +The chyle does not represent the entire product of digestion, but only +the fatty substances suspended in a serous fluid. + +Formerly, it was supposed that the lacteals were the only agents +employed in absorption, but more recent investigations have shown that +the blood-vessels participate equally in the process, and are frequently +the more active and important of the two. Experiments upon living +animals have proved that absorption of poisonous substances occurs, even +when all communication by way of the lacteals and lymphatics is +obstructed, the passage by the blood-vessels alone remaining. The +absorbent power which the blood-vessels of the alimentary canal possess, +is not limited to alimentary substances, but through them, soluble +matters of almost every description are received into the circulation. + +The _Lymphatics_ are not less important organs in the process of +absorption. Nearly every part of the body is permeated by a second +series of capillaries, closely interlaced with the blood-vessels, +collectively termed the _Lymphatic System_. Their origin is not known, +but they appear to form a _plexus_ in the tissues, from which their +converging trunks arise. They are composed of minute tubes of delicate +membrane, and from their net-work arrangement they successively unite +and finally terminate in two main trunks, called the _great lymphatic +veins_. The lymphatics, instead of commencing on the intestinal walls, +as do the lacteals, are distributed through most of the vascular tissues +as well as the skin. The lymphatic circulation is not unlike that of the +blood; its circulatory apparatus is, however, more delicate, and its +functions are not so well understood. + +[Illustration: Fig. 36. +A general view of the Lymphatic System.] + +The _lymph_ which circulates through the lymphatic vessels is an +alkaline fluid composed of a plasma and corpuscles. It may be considered +as blood deprived of its red corpuscles and, diluted with water. Nothing +very definite is known respecting the functions of this fluid. A large +proportion of its constituents is derived from the blood, and the exact +connection of these substances to nutrition is not properly understood. +Some excrementitious matters are supposed to be taken from the tissues +by the lymph and discharged into the blood, to be ultimately removed +from the system. The lymph accordingly exerts an important function by +removing a portion of the decayed tissues from the body. + +[Illustration: Fig. 37. +1. A representation of a lymphatic +vessel highly magnified. 2. Lymphatic +valves. 3. A lymphatic gland and its vessels.] + +In all animals which possess a lacteal system there is also a lymphatic +system, the one being the complement of the other. The fact that lymph +and chyle are both conveyed into the general current of circulation, +leads to the inference that the lymph, as well as the chyle, aids in the +process of nutrition. The body is continually undergoing change, and +vital action implies waste of tissues, as well as their growth. Those +organs which are the instruments of motion, as the muscles, cannot be +employed without wear and waste of their component parts. Renovated +tissues must replace those which are worn out, and it is a part of the +function of the absorbents to convey nutritive material into the general +circulation. Researches in microscopical anatomy have shown that the +skin contains multitudes of lymphatic vessels and that it is a powerful +absorbent. + +Absorption is one of the earliest and most essential functions of animal +and vegetables tissues. The simpler plants consist of only a few cells, +all of which are employed in absorption; but in the flowering plants +this function is performed by the roots. It is accomplished on the same +general principles in animals, yet it presents more modifications and a +greater number of organs than in vegetables. While animals receive their +food into a sac, or bag called the _stomach_, and are provided with +absorbent vessels such as nowhere exist in vegetables, plants plunge +their absorbent organs into the earth, whence they derive nourishing +substances. In the lower order of animals, as in sponges, this function +is performed by contiguous cells, in a manner almost as elementary as in +plants. In none of the invertebrate animals is there any _special_ +absorbent system. Internal absorption is classified by some authors as +follows: _interstitial_, _recrementitial_, and _excrementitial_; by +others as _accidental_, _venous_, and _cutaneous_. The general cutaneous +and mucous surfaces exhale, as well as absorb; thus the skin, by means +of its sudoriferous glands, exhales moisture, and is at the same time as +before stated, a powerful absorbent. The mucous surface of the lungs is +continually throwing off carbonic acid and absorbing oxygen; and through +their surface poisons are sometimes taken into the blood. The continual +wear and waste to which living tissues are subject, makes necessary the +provision of such a system of vessels for conveying away the worn-out +materials and supplying the body with new. + + * * * * * + + + + +CHAPTER VI. + +PHYSICAL AND VITAL PROPERTIES OF THE BLOOD. + + +[Illustration: Fig. 38. +Red corpuscles of human blood, represented +at _a_, as they are seen when +rather _beyond_ the focus of the microscope; +and at _b_ as they appear when, +_within_ the focus. Magnified 400 diameters.] + +[Illustration: Fig. 39. +Development of human lymph and chyle-corpuscles +into red corpuscles of blood. _A_. A lymph, or white +blood-corpuscle. _B_. The same in process of conversion +into a red corpuscle. _C_. A lymph-corpuscle with the +cell-wall raised up around it by the action of water. _D_. +A lymph-corpuscle, from which the granules have +almost disappeared. _E_. A lymph-corpuscle, acquiring +color; a single granule, like a nucleus, remains. _F_. A +red corpuscle fully developed.] + +_Blood_ is the animal fluid by which the tissues of the body are +nourished. This pre-eminently vital fluid permeates every organ, +distributes nutritive material to every texture, is essentially modified +by respiration, and, finally, is the source of every secretion and +excretion. Blood has four constituents: Fibrin, Albumen, Salts (which +elements, in solution, form the _liquor sanguinis_), and the Corpuscles. +Microscopical examination shows that the corpuscles are of two kinds, +known as the _red_ and the _white_, the former being by far the more +abundant. They are circular in form and have a smooth exterior, and are +on an average 1/3200 part of an inch in diameter, and are about +one-fourth of that in thickness. Hence more than ten millions of them +may lie on a space an inch square. If spread out in thin layers and +subjected to transmitted light, they present a slightly yellowish color, +but when crowded together and viewed by refracted light, exhibit a deep +red color. These blood-corpuscles have been termed _discs_, and are not, +as some have supposed, solid material, but are very nearly fluid. The +red corpuscles although subjected to continual movement, have a tendency +to approach one another, and when their flattened surfaces come in +contact, so firmly do they adhere that they change their shape rather +than submit to a separation. If separated, however, they return to their +usual form. The colorless corpuscles are larger than the red and differ +from them in being extremely irregular in their shape, and in their +tendency to adhere to a smooth surface, while the red corpuscles float +about and tumble over one another. They are chiefly remarkable for their +continual variation in form. The shape of the red corpuscles is only +altered by external influences, but the white are constantly undergoing +alterations, the result of changes taking place within their own +substance. When diluted with water and placed under the microscope they +are found to consist of a spheroidal sac, containing a clear or granular +fluid and a spheroidal vesicle, which is termed the _nucleus_. They have +been regarded by some physiologists as identical with those of the lymph +and chyle. Dr. Carpenter believes that the function of these cells is to +convert albumen into fibrin, by the simple process of cell-growth. It is +generally believed that the red corpuscles are derived in some way from +the colorless. It is supposed that the red corpuscle is merely the +nucleus of a colorless corpuscle enlarged, flattened, colored and +liberated by the bursting of the wall of its cell. When blood is taken +from an artery and allowed to remain at rest, it separates into two +parts: a solid mass, called the clot, largely composed of fibrin; and a +fluid known as the _serum_, in which the clot is suspended. This process +is termed _coagulation_. The serum, mostly composed of _albumen_, is a +transparent, straw-colored fluid, having the odor and taste of blood. +The whole quantity of blood in the body is estimated on an average to be +about one-ninth of its entire weight. The distinctions between the +arterial and the venous blood are marked, since in the arterial system +the blood is uniformly bright red, and in the venous of a very dark red +color The blood-corpuscles contain both oxygen and carbonic acid in +solution. When carbonic acid predominates, the blood is dark red; when +oxygen, scarlet. In the lungs, the corpuscles give up carbonic acid, and +absorb a fresh supply of oxygen, while in the general circulation the +oxygen disappears in the process of tissue transformation, and is +replaced, in the venous blood, by carbonic acid. The nutritive portions +of food are converted into a homogeneous fluid, which pervades every +part of the body, is the basis of every tissue, and which is termed the +_blood_. This varies in color and composition in different animals. In +the polyp the nutritive fluid is known as _chyme_, in many mollusks, as +well as articulates, it is called _chyle_, but in vertebrates, it is +more highly organized and is called blood. In all the higher animal +types it is of a red color, although redness is not one of its essential +qualities. Some tribes of animals possess true blood, which is not red; +thus the blood of the insect is colorless and transparent; that of the +reptile yellowish; in the fish the principle part is without color, but +the blood of the bird is deep red. The blood of the mammalia is of a +bright scarlet hue. The temperature of the blood varies in different +species, as well as in animals of the same species under different +physiological conditions; for this reason, some animals are called +_cold-blooded._ Disease also modifies the temperature of the blood; thus +in fevers it is generally increased, but in cholera greatly diminished. +THE blood has been aptly termed the "vital fluid," since there is a +constant flow from the heart to the tissues and organs of the body, and +a continual return after it has circulated through these parts. Its +presence in every part of the body is one of the essential conditions of +animal life, and is effected by a special set of organs, called the +_circulatory organs_. + + * * * * * + + + + +CHAPTER VII. + +PHYSIOLOGICAL ANATOMY. + +CIRCULATORY ORGANS. + + +Having considered the formation of chyle, traced it through the +digestive process, seen its transmission into the _vena cava_, and, +finally, its conversion into blood, we shall now describe how it is +distributed to every part of the system. This is accomplished through +organs which, from the round of duties they perform, are called +_circulatory_. These are the Heart, Arteries, Veins, and Capillaries, +which constitute the _vascular system_. + +Within the thorax or chest of the human body, and enclosed within a +membranous sac, called the _pericardium_, is the great force-pump of the +system, the heart. This organ, to which all the arteries and veins of +the body may be either directly or indirectly traced, is roughly +estimated to be equal in size to the closed fist of the individual to +whom it belongs. + +It has a broad end turned upwards, and a little to the right side, +termed its _base_; and a pointed end called its _apex_, turned +downwards, forwards, and to the left side, and lying beneath a point +about an inch to the right of, and below, the left nipple, or just below +the fifth rib. Attached to the rest of the body only by the great +blood-vessels which issue from and enter it at its base, the heart is +the most mobile organ in the economy, being free to move in different +directions. + +The heart is divided into two great cavities by a fixed partition, which +extends from the base to the apex of the organ, and which prevents any +direct communication between them. Each of these great cavities is +further subdivided transversely by a movable partition, the cavity above +each transverse partition being called the _auricle_, and the cavity +below, the _ventricle_, right or left, as the case may be. + +[Illustration: Fig. 40. +General view of the heart and lungs, _t_. Trachea, or +windpipe, _a_. Aorta, _p_. Pulmonary artery, 1, 2. +Branches of the pulmonary artery, one going to the +right, the other to the left lung. _h._ The heart.] + +The walls of the auricles are much thinner than those of the ventricles, +and the wall of the right ventricle is much thinner than that of the +left, from the fact that the ventricles have more work to perform than +the auricles, and the left ventricle more than the right. + +In structure, the heart is composed almost entirely of muscular fibers, +which are arranged in a very complex and wonderful manner. The outer +surface of the heart is covered with the pericardium, which closely +adheres to the muscular substance. Inside, the cavities are lined with a +thin membrane, called the _endocardium_. At the junction between the +auricles and ventricles, the apertures of communication between their +cavities are strengthened by _fibrous rings_. Attached to these fibrous +rings are the movable partitions or valves, between the auricles and the +ventricles, the one on the right side of the heart being called the +_tricuspid valve_, and the one on the left side the _mitral valve._ A +number of fine, but strong, tendinous chords, called _chordæ +tendineæ_, connect the edges and apices of these valves with +column-like elevations of the fleshy substance of the walls of the +ventricles, called _columnæ carneæ_. + +[Illustration: Fig. 41. +1. The descending vena cava. 2. +The ascending vena cava. 3. The +right auricle. 4. The opening between +the right auricle and the right +ventricle. 5. The right ventricle. 6. +The tricuspid valves. 7. The pulmonary +artery. 8, 8. The branches +of the pulmonary artery which pass +to the right and the left lung. 9. The +semilunar valves of the pulmonary +artery. 10. The septum between the +two ventricles of the heart. 11, 11. +The pulmonary veins. 12. The left +auricle. 13. The opening between +the left auricle and ventricle. 14. +The left ventricle. 15. The mitral +valves. 16, 16. The aorta. 17. The +semilunar valves of the aorta.] + +The valves are so arranged that they present no obstacle to the free +flow of blood from the auricles into the ventricles, but if any is +forced the other way, it gets between the valve and the wall of the +heart, and drives the valve backwards and upwards, thus forming a +transverse partition between the auricle and ventricle, through which no +fluid can pass. + +At the base of the heart are given off two large arteries, one on the +right side, which conveys the blood to the lungs, called the _pulmonary +artery_, and one on the left side, which conveys the blood to the system +in general, called the _aorta_. At the junction of each of these great +vessels with its corresponding ventricle, is another valvular apparatus, +consisting of three pouch-like valves, called the _semilunar valves_, +from their resemblance, in shape, to a half-moon. Being placed on a +level and meeting in the middle line, they entirely prevent the passage +of any fluid which may be forced along the artery towards the heart, +but, flapping back, they offer no obstruction to the free flow of blood +from the ventricles into the arteries. + +[Illustration: Fig. 42. +A representation of the venous and arterial +circulation of the blood.] + +The _Arteries_, being always found empty after death, were supposed by +the ancients, who were ignorant of the circulation of the blood, to be +tubes containing air; hence their name, which is derived from a Greek +word and signifies an _air-tube._ Arteries are the cylindrical tubes +which carry blood to every part of the system. All the arteries, except +the coronary which supply the substance of the heart, arise from the two +main trunks, the pulmonary artery and the aorta. They are of a +yellowish-white color, and their inner surface is smooth. The arteries +have three coats. (1.) The external coat, which is destitute of fat, and +composed chiefly of cellular tissue, is very firm and elastic, and can +readily be dissected from the middle coat. (2.) The middle, or fibrous +coat, is thicker than the external, and composed of yellowish fibers, +its chief property is contractility. (3.) The internal coat consists of +a colorless, thin, transparent membrane, yet so strong that it can, it +is thought, better resist a powerful pressure than either of the others. +Arteries are very elastic as well as extensible, and their chief +extensibility is in length. If an artery of a dead body be divided, +although empty, its cylindrical form will be preserved. + +The _Veins_ are the vessels through which the venous blood returns to +the auricles of the heart. They are more numerous than the arteries, and +originate from numerous capillary tubes, while the arteries are given +off from main trunks. In some parts of the body, the veins correspond in +number to the arteries; while in others, there are two veins to every +artery. The veins commence by minute roots in the capillaries, which are +everywhere distributed through the body, and gradually increase in size, +until they unite and become large trunks, conveying the dark blood to +the heart. The veins, like the arteries, have three coats. The external, +or cellular coat, resembles that of the arteries; the middle is fibrous, +but thinner than the corresponding one of the arteries; and the internal +coat is serous, and analogous to that of those vessels. The veins belong +to the three following classes: (1.) The systemic veins, which bring the +blood from different parts of the body and discharge it into the vena +cava, by means of which it is conveyed to the heart; (2), the pulmonary +veins, which bring the arterial, or bright red blood from the lungs and +carry it to the left auricle; (3), the veins of the portal system, which +originate in the capillaries of the abdominal organs, then converge into +trunks and enter the liver, to branch off again into divisions and +subdivisions of the minutest character. + +The _Capillaries_ form an extremely fine net-work, and are distributed +to every part of the body. They vary in diameter from 1/3500 to 1/2000 +of an inch. They are so universally prevalent throughout the skin, that +the puncture of a needle would wound a large number of them. These +vessels receive the blood and bring it into intimate contact with the +tissues, which take from it the principal part of its oxygen and other +elements, and give up to it carbonic acid and the other waste products +resulting from the transformation of the tissues, which are transmitted +through the veins to the heart, and thence by the arteries to the lungs +and various excretory organs. + +The blood from the system in general, except the lungs, is poured into +the right auricle by two large veins, called the superior and the +inferior _vena cava_,' and that returning from the lungs is poured into +the left auricle by the _pulmonary veins._ + +During life the heart contracts rhythmically, the contractions +commencing at the base, in each auricle, and extending towards the apex. + +Now it follows, from the anatomical arrangement of this organ, that when +the auricles contract, the blood contained in them is forced through the +auriculo-ventricular openings into the ventricles; the contractions then +extending to the ventricles, in a wave-like manner, the great proportion +of the blood, being prevented from re-entering the auricles by the +tricuspid and mitral valves, is forced onward into the pulmonary artery +from the right ventricle, and into the aorta from the left ventricle. + +When the contents of the ventricles are suddenly forced into these great +blood-vessels, a shock is given to the entire mass of fluid which they +contain, and this shock is speedily propagated along their branches, +being known at the wrist as the _pulse_. + +On inspection, between the fifth and sixth ribs on the left side of the +chest, a movement is perceptible, and, if the hand be applied, the +impulse may be felt. This is known as the throbbing, or beating of the +heart. + +If the ear is placed over the region of the heart, certain sounds are +heard, which recur with great regularity. First is heard a comparatively +long, dull sound, then a short, sharp sound, then a pause, and then the +long, dull sound again. The first sound is caused mainly by the +tricuspid and mitral valves, and the second is the result of sudden +closure of the semilunar valves. + +No language can adequately describe the beauty of the circulatory +system. The constant vital flow through the larger vessels, and the +incessant activity of those so minute that they are almost +imperceptible, fully illustrate the perfectness of the mechanism of the +human body, and the wisdom and goodness of Him who is its author. + +Experiments have shown that the small arteries may be directly +influenced through the nervous system, which regulates their caliber by +controlling the state of contraction of their muscular walls. The effect +of this influence of the nervous system enables it to control the +circulation over certain areas; and, notwithstanding the force of the +heart and the state of the blood-vessels in general, to materially +modify the circulation in different spots. Blushing, which is simply a +local modification of the circulation, is effected in this way. Some +emotion takes possession of the mind, and the action of the nerves, +which ordinarily keep up a moderate contraction of the muscular coats of +the arteries, is lost, and the vessels relax and become distended with +arterial blood, which is a warm and bright red fluid; thereupon a +burning sensation is felt, and the skin grows red, the degree of the +blush depending upon the intensity of the emotion. + +The pallor produced by fright and by extreme anxiety, is purely the +result of a local modification of the circulation, brought about by an +over-stimulation of the nerves which supply the small arteries, causing +them to contract, and to thus cut off more or less completely the supply +of blood. + + * * * * * + + + + +CHAPTER VIII. + +PHYSIOLOGICAL ANATOMY. + +THE ORGANS OF RESPIRATION. + + +THE ORGANS OF RESPIRATION are the Trachea, or windpipe, the Bronchia, +formed by the subdivision of the trachea, and the Lungs, with their +air-cells. The _Trachea_ is a vertical tube situated between the lungs +below, and a short quadrangular cavity above, called the _larynx_, which +is part of the windpipe, and used for the purpose of modulating the +voice in speaking or singing. In the adult, the trachea, in its +unextended state, is from four and one-half to five inches in length, +about one inch in diameter, and, like the larynx, is more fully +developed in the male than in the female. It is a fibro-cartilaginous +structure, and is composed of flattened rings, or segments of circles. +It permits the free passage of air to and from the lungs. + +The _Bronchia_ are two tubes, or branches, one proceeding from the +windpipe to each lung. Upon entering the lungs, they divide and +subdivide until, finally, they terminate in small cells, called the +_bronchial or air-cells,_ which are of a membranous character. + +[Illustration: Fig. 43. +An ideal representation of the respiratory organs. _3._ The +larynx. _4._ The trachea. _5, 6._ The bronchia. _9, 9, 9, 9._ Air-cells. +_1, 1, 1, 2, 2, 2._ Outlines of the lungs.] + +The _Lungs_ are irregular conical organs rounded at the apex, situated +within the chest, and filling the greater part of it, since the heart is +the only other organ which occupies much space in the thoracic cavity. +The lungs are convex externally, and conform to the cavity of the chest, +while the internal surface is concave for the accommodation of the +heart. The size of the lungs depends upon the capacity of the chest. +Their color varies, being of a pinkish hue in childhood but of a gray, +mottled appearance in the adult. They are termed the _right_ and _left_ +lung. Each lung resembles a cone with its base resting upon the +diaphragm, and its apex behind the collar-bone. The right lung is larger +though shorter, than the left, not extending so low, and has three +_lobes_, formed by deep fissures, or longitudinal divisions, while the +left has but two lobes. Each lobe is also made up of numerous _lobules_, +or small lobes, connected by cellular tissue, and these contain great +numbers of cells. The lungs are abundantly supplied with blood-vessels, +lymphatics, and nerves. The density of a lung depends upon the amount of +air which it contains. Thus, experiment has shown that in a _foetus_ +which has never breathed, the lungs are compact and will sink in water; +but as soon as they become inflated with air, they spread over a larger +surface, and are therefore more buoyant. Each lung is invested, as far +as its root, with a membrane, called the _pleura_, which is then +continuously extended to the cavity of the chest, thus performing the +double office of lining it, and constituting a partition between the +lungs. The part of the membrane which forms this partition is termed the +_mediastinum_. Inflammation of this membrane is called _pleurisy_. The +lungs are held in position by the root, which is formed by the pulmonary +arteries, veins, nerves, and the bronchial tubes. Respiration is the +function by which the venous blood, conveyed to the lungs by the +pulmonary artery, is converted into arterial blood. This is effected by +the elimination of carbonic acid, which is expired or exhaled from the +lungs, and by the absorption of oxygen from the air which is taken into +the lungs, by the act of inspiration or inhalation. The act of +expiration is performed chiefly by the elevation of the diaphragm and +the descent of the ribs, and inspiration is principally effected by the +descent of the diaphragm and the elevation of the ribs. + +[Illustration: Fig. 44. +A representation of the heart and lungs. 4. The +heart. 5. The pulmonary artery. 8. Aorta. 9, 11. +Upper lobes of the lungs. 10, 13. Lower lobes. 12. +Middle lobe of the right lung. 2. Superior vena +cava. 3. Inferior vena cava.] + +When the muscles of some portions of the air-passages are relaxed, a +peculiar vibration follows, known as snoring. Coughing and sneezing are +sudden and spasmodic expiratory efforts, and generally involuntary. +Sighing is a prolonged deep inspiration, followed by a rapid, and +generally audible expiration. It is remarkable that laughing and +sobbing, although indicating opposite states of the mind, are produced +in very nearly the same manner. In hiccough, the contraction is more +sudden and spasmodic than in laughing or sobbing. The quantity of oxygen +consumed during sleep is estimated to be considerably less than that +consumed during wakefulness. + +[Illustration: Fig. 45. +View of the pulmonary circulation.] + +It is difficult to estimate the amount of air taken into the lungs at +each inspiration, as the quantity varies according to the condition, +size, and expansibility of the chest, but in ordinary breathing it is +supposed to be from twenty to thirty cubic inches. The consumption of +oxygen is greater when the temperature is low, and during digestion. All +the respiratory movements, so far as they are independent of the will of +the individual, are controlled by that part of the brain called the +_medulla oblongata_. The respiratory, or breathing process, is not +instituted for the benefit of man alone, for we find it both in the +lower order of animals and in plant life. Nature is very economical in +the arrangement of her plans, since the carbonic acid, which is useless +to man, is indispensable to the existence of plants, and the oxygen, +rejected by them, is appropriated to his use. In the lower order of +animals, the respiratory act is similar to that of the higher types, +though not so complex; for there are no organs of respiration, as the +lungs and gills are called. Thus, the higher the animal type, the more +complex its organism. The effect of air upon the color of the blood is +very noticeable. If a quantity be drawn from the body, thus being +brought into contact with the air, its color gradually changes to a +brighter hue. There is a marked difference between the properties of the +venous and the arterial blood. + +The venous blood is carried, as we have previously described, to the +right side of the heart and to the lungs, where it is converted into +arterial blood. It is now of uniform quality, ready to be distributed +throughout the body, and capable of sustaining life and nourishing the +tissues. Man breathes by means of lungs; but who can understand their +wonderful mechanism, so perfect in all its parts? Though every organ is +subservient to another, yet each has its own office to perform. The +minute air-cells are for the aeration of the blood; the larger bronchial +tubes ramify the lungs, and suffuse them with air; the trachea serves as +a passage for the air to and from the lungs, while at its upper +extremity is the larynx, which has been fitly called the organ of the +human voice. At its extremity we find a sort of shield, called the +_epiglottis_, the office of which is supposed to be to prevent the +intrusion of foreign bodies. + + * * * * * + + + + +CHAPTER IX. + +PHYSIOLOGICAL ANATOMY + +THE SKIN. + + +Through digestion and respiration, the blood is continually supplied +with material for its renewal; and, while the nutritive constituents of +the food are retained to promote the growth of the body, those which are +useless or injurious are in various ways expelled. There are, perhaps, +few parts of the body more actively concerned in this removal than the +skin. + +[Illustration: Fig. 46: An ideal +view of the papillae. 1, 1. Cutis vera. +2.2. Papillary layer. 3, 3. Arteries of the papillae. +4, 4. Nerves of the papillae. 5, 5. Veins of the papillae.] + +The skin is a membranous envelope covering the entire body. It consists +of two layers, termed the Cutis Vera, or true skin, and the Epidermis, +or cuticle. The _Cutis Vera_ is composed of fibers similar to those of +the cellular tissue. It consists of white and yellow fibers, which are +more densely woven near the surface than deeper in the structure; the +white give strength, the yellow strength and elasticity combined. The +true skin may be divided into two layers, differing in their +characteristics, and termed respectively the superficial or papillary +layer, and the deep or fibrous layer. Upon the external surface, are +little conical prominences, known as _papillae_. The papillae are +irregularly distributed over the body, in some parts being smaller and +more numerous than in others, as on the finger-ends, where their summits +are so intimately connected as to form a tolerably smooth surface. It is +owing to their perfect development, that the finger-tips are adapted to +receive the most delicate impressions of touch. Although every part of +the skin is sensitive, yet the papillae are extremely so, for they are +the principal means through which the impressions of objects are +communicated. Each papilla not only contains a minute vein and artery, +but it also incloses a loop of sensitive nerves. When the body is +exposed to cold, these papillae can be more distinctly seen in the form +of prominences, commonly known as "goose-pimples." + +[Illustration: Fig. 47. +A section of the skin, showing its arteries and +veins. A, A. Arterial branches. B, B. Capillaries +in which the branches terminate. C. The venous +trunk into which the blood from the capillaries +flows.] + +The internal, or fibrous layer of the skin, contains numerous +depressions, each of which furnishes a receptacle for fat. While the +skin is supplied with a complete net-work of arteries, veins, and +nerves, which make it sensitive to the slightest touch, it also contains +numerous lymphatic vessels, so minute that they are invisible to the +naked eye. + +Among the agents adapted for expelling the excretions from the system, +few surpass the _Sudoriferous Glands_. These are minute organs which +wind in and out over the whole extent of the true skin, and secrete the +perspiration. Though much of it passes off as insensible transpiration, +yet it often accumulates in drops of sweat, during long-continued +exercise or exposure to a high temperature. The office of the +perspiration is two-fold. It removes noxious matter from the system, and +diminishes animal heat, and thereby equalizes the temperature of the +body. It also renders the skin soft and pliable, thus better adapting it +to the movements of the muscles. The _Sebaceous Glands_, which are +placed in the true skin, are less abundant where the sudoriferous glands +are most numerous, and _vice versa_. Here, as elsewhere, nature acts +with systematic and intelligent design. The perspiratory glands are +distributed where they are most needed,--in the eyelids, serving as +lubricators; in the ear passages, to produce the _cerumen_, or wax, +which prevents the intrusion of small insects; and in the scalp, to +supply the hair with its natural pomatum. + +[Illustration: Fig. 48. +A perspiratory gland, highly +magnified. 1, 1. The gland. 2, 2. +Excretory ducts uniting to form +a tube which tortuously perforates +the cuticle at 3, and opens +obliquely on its surface at 4.] + +[Illustration: Fig. 49. +A representation of oil-tubes from the scalp +and nose.] + +[Illustration: Fig. 50. +Anatomy of the skin. 5, 5. Cutis vera (true skin). +4, 4. Nervous tissue. 3, 3. Sensitive layer in which are +seen the nerves. 2, 2. The layer containing pigment +cells. 1, 1. Epidermis (cuticle).] + +The _Epidermis_, or _Cuticle_, so called because it is _placed upon the +skin,_ is the outer layer of the skin. Since it is entirely destitute of +nerves and blood-vessels, it is not sensitive. Like the cutis vera, it +has two surfaces composed of layers. The internal, or _Rete Mucosum,_ +which is made up chiefly of pigment cells, is adapted to the +irregularities of the cutis vera, and sends prolongations into all its +glandular follicles. The external surface, or epidermis proper, is +elastic, destitute of coloring matter, and consists of mere horny +scales. As soon as dry, they are removed in the form of scurf, and +replaced by new ones from the cutis vera. These scales may be removed by +a wet-sheet pack, or by friction. The cuticle is constantly undergoing +renewal. This layer serves to cover and protect the nervous tissue of +the true skin beneath. We may here observe that the cuticle contains the +pigment for coloring the skin. In dark races, as the negro, the cuticle +is very thick and filled with black pigment. The radiation of animal +heat is dependent upon the thickness and color of this cuticle. Thus, in +the dark races, the pigment cells are most numerous, and in proportion +as the skin is dark or fair do we find these cells in greater or lesser +abundance. The skin of the Albino is of pearly whiteness, devoid even of +the pink or brown tint which that of the European always possesses. This +peculiarity must be attributed to the absence of pigment cells which, +when present, always present a more or less dark color. The theory that +_climate_ alone is capable of producing all these diversities is simply +absurd. The Esquimaux, who live in Greenland and the arctic regions of +America, are remarkable for the darkness of their complexion. Humboldt +remarks that the American tribes of the tropical regions have no darker +skin than the mountaineers of the temperate zone. Climate may _modify_ +the complexion, but it cannot _make_ it. + +[Illustration: Fig. 51. +Structure of the human hair. _A_. External surface of the shaft, showing the +transverse striae and jagged boundary, caused by the imbrications of the scaly +cortex. _B_. Longitudinal section of the shaft, showing the fibrous character of +the medullary substance, and the arrangement of the pigmentary matter. _C_. +Transverse sections, showing the distinction between the cortical and medullary +substances, and the central collection of pigmentary matter, sometimes found in +the latter. Magnified 310 diameters.] + +_Hairs_ are horny appendages of the skin, and, with the exception of the +hands, the soles of the feet, the backs of the fingers and toes, between +the last joint and the nail, and the upper eyelids, are distributed more +or less abundantly over every part of the surface of the body. Over the +greater part of the surface the hairs are very minute, and in some +places are not actually apparent above the level of the skin; but the +hair of the head, when permitted to reach its full growth, attains a +length of from twenty inches to a yard, and, in rare instances, even six +feet. A hair may be divided into a middle portion, or _shaft_, and two +extremities; a peripheral extremity, called the _point;_ and a central +extremity, inclosed within the hair sac, or follicle, termed the _root_. +The root is somewhat greater in diameter than the shaft, and cylindrical +in form, while its lower part expands into an oval mass, called the +_bulb_. The shaft of the hair is not often perfectly cylindrical, but is +more or less flattened, which circumstance gives rise to waving and +curling hair; and, when the flattening is spiral in direction, the +curling will be very great. A hair is composed of three different layers +of cell-tissues: a loose, cellulated substance, which occupies its +center, and constitutes the _medulla_, or pith; the fibrous tissue, +which incloses the medulla, and forms the chief bulk of the hair; and a +thin layer, which envelops this fibrous structure, and forms the smooth +surface of the hair. The medulla is absent in the downy hairs, but in +the coarser class it is always present, especially in white hair. The +color of hair is due partly to the granules and partly to an +inter-granular substance, which occupies the interstices of the granules +and the fibers. The quantity of hair varies according to the proximity +and condition of the follicles. The average number of hairs of the head +may be stated at 1,000 in a superficial square inch; and, as the surface +of the scalp has an area of about one hundred and twenty superficial +square inches, the average number of hairs on the entire head is +120,000. The hair possesses great durability, as is evinced by its +endurance of chemical processes, and by its discovery, in the tombs of +mummies more than two thousand years old. The hair is remarkable for its +elasticity and strength. Hair is found to differ materially from horn in +its chemical composition. According to Vauquelin, its constituents are +animal matter, a greenish-black oil, a white, concrete oil, phosphate of +lime, a trace of carbonate of lime, oxide of manganese, iron, sulphur, +and silex. Red hair contains a reddish oil, a large proportion of +sulphur, and a small quantity of iron. White hair contains a white oil, +and phosphate of magnesia. It has been supposed that hair grows after +death, but this theory was probably due to the lengthening of the hair +by the absorption of moisture from the body or atmosphere. + +The _nails_ constitute another class of appendages of the skin. They +consist of thin plates of horny tissue, having a root, a body, and a +free extremity. The root, as well as the lateral portion, is implanted +in the skin, and has a thin margin which is received into a groove of +the true skin. The under surface is furrowed, while the upper is +comparatively smooth. The nails grow in the same manner as the cuticle. + + * * * * * + + + + +CHAPTER X. + +PHYSIOLOGICAL ANATOMY. + +SECRETION. + + +The term _Secretion_, in its broadest sense, is applied to that process +by which substances are separated from the blood, either for the +reparation of the tissues or for excretion. In the animal kingdom this +process is less complicated than in vegetables. In the former it is +really a _separation_ of nutritive material from the blood. The process, +when effected for the removal of effete matter, is, in a measure, +chemical, and accordingly the change is greater. + +Three elementary constituents are observed in secretory organs: the +cells, a basement membrane, and the blood-vessels. Obviously, the most +_essential_ part is the _cell_. + +The physical condition necessary for the healthy action of the secretory +organs is a copious supply of blood, in which the nutritive materials +are abundant. The nervous system also influences the process of +secretion to a great extent. Intense emotion will produce tears, and the +sight of some favorite fruit will generally increase the flow of saliva. + +The process of secretion depends upon the anatomical and chemical +constitution of the cell-tissues. The principal secretions are (1), +Perspiration; (2), Tears; (3), Sebaceous matter; (4), Mucus; (5), +Saliva; (6), Gastric juice; (7), Intestinal juice; (8), Pancreatic +juice; (9), Bile; (10), Milk. + +PERSPIRATION is a watery fluid secreted in minute glands, which are +situated in every part of the skin, but are more numerous on the +anterior surfaces of the body. Long thread-like tubes, only 1/100th of +an inch in diameter, lined with epithelium, penetrate the skin, and +terminate in rounded coils, enveloped by a net-work of capillaries, +which supply the secretory glands with blood. It is estimated by Krause +that the entire number of perspiratory glands is two million three +hundred and eighty-one thousand two hundred and forty-eight, and the +length of each glandular coil being 1/16 of an inch, we may estimate the +length of tubing to be not less than two miles and a third. This +secretion has a specific gravity of 1003.5, and, according to Dr. +Dalton, is composed of + + Water, 995.50 + Chloride of Sodium, 2.23 + Chloride of Potassium, 0.24 + Sulphate of Soda and Potassa, 0.01 + Salts of organic acids, with Soda and Potassa, 2.02 + ------- + 1000.00 + +Traces of organic matter, mingled with a free volatile acid, are also +found in the perspiration. It is the acid which imparts to this +secretion its peculiar odor, and acid reaction. The process of its +secretion is continuous, but, like all bodily functions, it is subject +to influences which augment or retard its activity. If, as is usually +the case when the body is in a state of repose, evaporation prevents its +appearance in the _liquid_ form, it is called _invisible_ or _insensible +perspiration_. When there is unusual muscular activity, it collects upon +the skin, and is known as _sensible perspiration_. This secretion +performs an important office in the animal economy, by maintaining the +internal temperature at about 100° Fahr. Even in the Arctic regions, +where the explorer has to adapt himself to a temperature of 40° to 80° +below zero, the generation of heat in the body prevents the internal +temperature from falling below this standard. On the contrary, if the +circulation is quickened by muscular exertion, the warmer blood flowing +from the internal organs into the capillaries, raises the temperature of +the skin, secretion is augmented, the moisture exudes from the pores, +and perceptible evaporation begins. A large portion of the animal heat +is thrown off in this process, and the temperature of the skin is +reduced. A very warm, dry atmosphere can be borne with impunity but if +moisture is introduced, evaporation ceases, and the life of the animal +is endangered. Persons have been known to remain in a temperature of +about 300° Fahr. for some minutes without unpleasant effects. Three +conditions may be assigned as effective causes in retarding or +augmenting this cutaneous secretion, variations in the temperature of +the atmosphere, muscular activity, and influences which affect the +nerves. The emotions exert a remarkable influence upon the action of the +perspiratory glands. Intense fear causes great drops of perspiration to +accumulate on the skin, while the salivary glands remain inactive. + +TEARS. The lachrymal glands are small lobular organs, situated at the +outer and upper orbit of the eye, and have from six to eight ducts, +which open upon the conjunctiva, between the eyelid and its inner fold. +This secretion is an alkaline, watery fluid. According to Dr. Dalton, +its composition is as follows: + + Water, 882.0 + Albuminous matter, 5.0 + Chloride of Sodium, 13.0 + Mineral Salts, a trace, + ------ + 1000.0 + +The function of this secretion is to preserve the brilliancy of the eye. +The tears are spread over this organ by the reflex movement of the +eyelid, called winking, and then collected in the _puncta lachrymalia_ +and discharged into the nasal passage. This process is constant during +life. The effect of its repression is seen in the dim appearance of the +eye after death. Grief or excessive laughter usually excite these glands +until there is an overflow. + +SEBACEOUS MATTER. Three varieties of this secretion are found in the +body. A product of the sebaceous glands of the skin is found in those +parts of the body which are covered with hairs; also, on the face and +the external surface of the organs of generation. The _sebaceous glands_ +consist of a group of flask-shaped cavities, opening into a common +excretory duct. Their secretion serves to lubricate the hair and soften +the skin. The _ceruminous glands_ of the _external auditory meatus_, or +outer opening of the ear, are long tubes terminating in a glandular +coil, within which is secreted the glutinous matter of the ear. This +secretion serves the double purpose of moistening the outer surface of +the membrana tympani, or ear-drum, and, by its strong odor, of +preventing the intrusion of insects. The _Meibomian glands_ are arranged +in the form of clusters along the excretory duct, which opens just +behind the roots of the eyelashes. The oily nature of this secretion +prevents the tears, when not stimulated by emotion, from overflowing the +lachrymal canal. + +MUCUS. The mucous membranes are provided with minute glands which +secrete a viscid, gelatinous matter, called _mucus_. The peculiar animal +matter which it contains is termed _mucosin_. These glands are most +numerous in the Pharynx, Esophagus, Trachea, Bronchia, Vagina and +Urethra. They consist of a group of secreting sacs, terminating at one +extremity in a closed tube, while the other opens into a common duct. +The mucus varies in composition in different parts of the body; but in +all, it contains a small portion of insoluble animal matter. Its +functions are threefold. It lubricates the membranes, prevents their +injury, and facilitates the passage of food through the alimentary +canal. + +SALIVA. This term is given to the first of the digestive fluids, which +is secreted in the glands of the mouth. It is a viscid, alkaline liquid, +with a specific gravity of about 1005. If allowed to stand, a whitish +precipitate is formed. Examinations with the microscope show it to be +composed of minute, granular cells and oil globules, mingled with +numerous scales of epithelium. According to Bidder and Schmidt, the +composition of saliva is as follows: + + Water, 995.16 + Organic matter, 1.34 + Sulpho-cyanide of Potassium, 0.06 + Phosphates of Sodium, Calcium and Magnesium, .98 + Chlorides of Sodium and Potassium, .84 + Mixture of Epithelium, 1.62 + ------- + 1000.00 + +Two kinds of organic matter are present in the saliva; one, termed +_ptyalin_, imparts to the saliva its viscidity, and it obtained from the +secretions of the parotid, submaxillary and sublingual glands; another, +which is not glutinous, is distinguished by the property of coagulating +when subjected to heat. The saliva is composed of four elementary +secretions, derived respectively, from the mucous follicles of the +mouth, and the parotid, the submaxillary, and the sublingual glands. The +process of its secretion is constant, but is greatly augmented by the +contact of food with the lining membrane. The saliva serves to moisten +the triturated food, facilitate its passage, and has the property of +converting starch into sugar; but the latter quality is counteracted by +the action of the gastric juice of the stomach. + +GASTRIC JUICE. The minute tubes, or follicles, situated in the mucous +membrane of the stomach, secrete a colorless, acid liquid, termed the +gastric juice. This fluid appears to consist of little more than water, +containing a few saline matters in solution, and a small quantity of +free hydrochloric acid, which gives it an acid reaction. In addition to +these, however, it contains a small quantity of a peculiar organic +substance, termed _pepsin_, which in chemical composition, is very +similar to ptyalin, although it is very different in its effects. When +food is introduced into the stomach, the peristaltic contractions of +that organ roll it about, and mingle it with the gastric juice, which +disintegrates the connective tissue, and converts the albuminous +portions into the substance called chyme, which is about the consistency +of pea-soup, and which is readily absorbed through the animal membranes +into the blood of the delicate and numerous vessels of the stomach, +whence it is conveyed to the portal vein and to the liver. The secretion +of the gastric juice is influenced by nervous conditions. Excess of joy +or grief effectually retard or even arrest its flow. + +INTESTINAL JUICE. In the small intestine, a secretion is found which is +termed the _intestinal juice_. It is the product of two classes of +glands situated in the mucous membrane, and termed respectively, the +_follicles of Lieberkuhn_ and the _glands of Brunner_. The former +consist of numerous small tubes, lined with epithelium, which secrete by +far the greater portion of this fluid. The latter are clusters of round +follicles opening into a common excretory duct. These sacs are composed +of delicate, membranous tissue, having numerous nuclei on their walls. +The difficulty of obtaining this juice for experiment is obvious, and +therefore its chemical composition and physical properties are not +known. The intestinal juice resembles the secretion of the mucous +follicles of the mouth, being colorless, vitreous in appearance, and +having an alkaline reaction. + +PANCREATIC JUICE. This is a colorless fluid, secreted in a lobular gland +which is situated behind the stomach, and runs transversely from the +spleen across the vertebral column to the duodenum. The most important +constituent of the pancreatic juice is an organic substance, termed +_pancreatin_. + +THE BILE. The blood which is collected by the veins of the stomach, +pancreas, spleen, and intestines, is discharged into a large trunk +called the portal vein, which enters the liver. This organ also receives +arterial blood from a vessel called the _hepatic artery_, which is given +off from the aorta below the diaphragm. If the branches of the portal +vein and hepatic artery be traced into the substance of the liver, they +will be found to accompany one another, and to subdivide, becoming +smaller and smaller. Finally, the portal vein and hepatic artery will be +found to terminate in capillaries which permeate the smallest +perceptible subdivisions of the liver substance, which are polygonal +masses of not more than one-tenth of an inch in diameter, called the +_lobules_. Every lobule rests upon one of the ramifications of a great +vessel termed the _hepatic vein_, which empties into the inferior vena +cava. There is also a vessel termed the _hepatic duct_ leading from the +liver, the minute subdivisions of which penetrate every portion of the +substance of that organ. Connected with the hepatic duct, is the duct of +a large oval sac, called the _gall-bladder_. + +Each lobule of the liver is composed of minute cellular bodies known as +the _hepatic cells_. It is supposed that in these cells the blood is +deprived of certain materials which are converted into bile. This +secretion is a glutinous fluid, varying in color from a dark golden +brown to a bright yellow, has a specific gravity ranging from 1018 to +1036, and a slightly alkaline reaction. When agitated, it has a frothy +appearance. Physiologists have experienced much difficulty in studying +the character of this secretion from the instability of its constituents +when subjected to chemical examination. + +[Illustration: Fig. 52. +Section of the Liver, showing the +ramifications of the portal vein. 1. Twig +of portal vein. 2, 2', 2", 2"'. Interlobular +vein. 3, 3', 3", Lobules.] + +_Biliverdin_ is an organic substance peculiar to the bile, which imparts +to that secretion its color. When this constituent is re-absorbed by the +blood and circulates through the tissues, the skin assumes a bright +yellow hue, causing what is known as the jaundice. _Cholesterin_ is an +inflammable crystallizable substance soluble in alcohol or ether. It is +found in the spleen and all the nervous tissues. It is highly probable +that it exists in the blood, in some state or combination, and assumes a +crystalline form only when acted upon by other substances or elements. +Two other constituents, more important than either of the above, are +collectively termed _biliary salts_. These elements were discovered in +1848, by Strecker, who termed them _glycocholate_ and _taurocholate of +soda_. Both are crystalline, resinous substances, and, although +resembling each other in many respects, the chemist may distinguish them +by their reaction, for both yield a precipitate if treated with +subacetate of lead, but only the glycocholate will give a precipitate +with acetate of lead. In testing for biliary substances, the most +satisfactory method is the one proposed by Pettenkoffer. A solution of +cane-sugar, one part of sugar to four parts of water, is mixed with the +suspected substance. Dilute sulphuric acid is then added until a white +precipitate falls, which is re-dissolved in an excess of the acid. On +the addition of more sulphuric acid, it becomes opalescent, and passes +through the successive hues of scarlet, lake, and a rich purple. Careful +experiments have proved that it is a _constant_ secretion; but its flow +is mere abundant during digestion. During the passage through the +intestines it disappears. It is not eliminated, and Pettenkoffer's test +has failed to detect its existence in the portal vein. These facts lead +physiologists to the conclusion, that it undergoes some transformation +in the intestines and is re-absorbed. + +After digestion has been going on in the stomach for some time, the +semi-digested food, in the form of chyme, begins to pass through the +_pyloric orifice_ of the stomach into the duodenum, or upper portion of +the small intestine. Here it encounters the intestinal juice, pancreatic +juice, and the bile, the secretion of all of which is stimulated by the +presence of food in the alimentary tract. These fluids, mingling with +the chyme, give it an alkaline reaction, and convert it into chyle. The +transformation of starch into sugar, which is almost, if not entirely, +suspended while the food remains in the stomach, owing to the acidity of +the chyme, is resumed in the duodenum, the acid of the chyme, being +neutralized by the alkaline secretions there encountered. + +Late researches have demonstrated that the pancreatic juice exerts a +powerful effect on albuminous matters, not unlike that of the gastric +juice. + +Thus, it seems that while in the mouth only starchy, and while in the +stomach only albuminous substances are digested, in the small intestine +all kinds of food materials, starchy, albuminoid, fatty and mineral, are +either completely dissolved, or minutely subdivided, and so prepared +that they may be readily absorbed through the animal membranes into the +vessels. + +MILK. The milk is a white, opaque fluid, secreted in the lacteal glands +of the female, in the mammalia. These glands consist of numerous +follicles, grouped around an excretory duct, which unites with similar +ducts coming from other lobules. By successive unions, they form large +branches, termed the _lactiferous ducts_, which open by ten to fourteen +minute orifices on the extremity of the nipple. The most important +constituent of milk is _casein_; it also contains oily and saccharine +substances. This secretion, more than any other, as influenced by +nervous conditions. A mother's bosom will fill with milk at the thought +of her infant child. Milk is sometimes poisoned by a fit of ill-temper, +and the infant made sick and occasionally thrown into convulsions, which +in some instances prove fatal. Sir Astley Cooper mentions two cases in +which terror instantaneously and permanently arrested this secretion. It +is also affected by the food and drink. Malt liquors and other mild +alcoholic beverages temporarily increase the amount of the secretion, +and may, in rare instances, have a beneficial effect upon the mother. +They sometimes affect the child, however, and their use is not to be +recommended unless the mother is extremely debilitated, and there is a +deficiency of milk. + + * * * * * + + + + +CHAPTER XI. + +PHYSIOLOGICAL ANATOMY. + +EXCRETION. + + +The products resulting from the waste of the tissues are constantly +being poured into the blood, and, as we have seen, the blood being +everywhere full of corpuscles, which, like all living things, die and +decay, the products of their decomposition accumulate in every part of +the circulatory system. Hence, if the blood is to be kept pure, the +waste materials incessantly poured into this fluid, or generated in it, +must be as continually removed, or excreted. The principal sets of +organs concerned in effecting the separation of excrementitious +substances from the blood are the lungs, the skin, and the kidneys. + +The elimination of carbonic acid through the lungs has already been +described on page 66, and the excretory function of the skin on page 70. + +[Illustration: Fig. 53. +View of the kidneys, ureters, and bladder. ] + +The kidneys are two bean-shaped organs, placed at the back of the +abdominal cavity, in the region of the loins, one on each side of the +spine. The convex side of each kidney is directed outwards, and the +concave side is turned inwards towards the spine. From the middle of the +concave side, which is termed the _hilus_, a long tube of small caliber, +called the _ureter_, proceeds to the bladder. The latter organ is an +oval bag, situated in the pelvic cavity. It is composed principally of +elastic muscular fibers, and is lined internally with mucous membrane, +and coated externally with a layer of the _peritoneum_, the serous +membrane which lines the abdominal and pelvic cavities. The ureters +enter the bladder through its posterior and lower wall, at some little +distance from each other. The openings through which the ureters enter +the bladder are oblique, hence it is much easier for the secretion of +the kidneys to pass from the ureters into the bladder than for it to get +the other way. Leading from the bladder to the exterior of the body is a +tube, called the _urethra_, through which the urine is voided. + +The excretion of the kidneys, termed the _urine_, is an amber-colored or +straw-colored fluid, naturally having a slightly acid reaction, and a +specific gravity ranging from 1,015 to 1,025. Its principal constituents +are _urea_ and _uric acid_, together with various other animal matters +of less importance, and saline substances, held in solution in a +proportionately large amount of water. The composition of the urine and +the quantity excreted vary considerably, being influenced by the +moisture and temperature of the atmosphere, by the character of the food +consumed, and by the empty or replete condition of the alimentary tract. +On an average a healthy man secretes about fifty ounces of urine in the +twenty-four hours. This quantity usually holds in solution about one +ounce of urea, and ten or twelve grains of uric acid. In the amount of +other animal matters, and saline substances, there is great variation, +the quantity of these ranging from a quarter of an ounce to an ounce. +The principal saline substances are common salt, the sulphates and +phosphates of potassium, sodium, calcium, and magnesium. In addition to +the animal and the saline matters, the urine also contains a small +quantity of carbonic acid, oxygen and nitrogen. + + * * * * * + + + + +CHAPTER XII. + +PHYSIOLOGICAL ANATOMY. + +THE NERVOUS SYSTEM. + + +Hitherto, we have only considered the anatomy and functions of the +organs employed in Digestion, Absorption, Circulation, Respiration, +Secretion and Excretion. We have found the vital process of nutrition to +be, in all its essential features, a result of physical and chemical +forces; in each instance we have presupposed the existence and activity +of the nerves. There is not an inch of bodily tissue into which their +delicate filaments do not penetrate, and form a multitude of conductors, +over which are sent the impulses of motion and sensation. + +[Illustration: Fig. 54. +The Nervous System.] + +Two elements, _nerve-fibers_ and _ganglionic corpuscles_, enter into the +composition of nervous tissue. Ordinary nerve-fibers in the living +subject, or when fresh, are cylindrical-shaped filaments of a clear, but +somewhat oily appearance. But soon after death the matter contained in +the fiber coagulates, and then the fiber is seen to consist of an +extremely delicate, structureless, outer membrane, which forms a tube +through the center of which runs the _axis-cylinder_. Interposed between +the axis-cylinder and this tube, there is a fluid, containing a +considerable quantity of fatty matter, from which is deposited a highly +refracting substance which lines the tube. There are two sets of +nerve-fibers, those which transmit sensory impulses, called _afferent_ +or _sensory_ nerves, and those which transmit motor impulses, called +_efferent_ or _motor_ nerves. The fibers when collected in bundles are +termed nerve trunks. All the larger nerve-fibers lie side by side in the +nerve-trunks, and are bound together by delicate connective tissue, +enclosed in a sheath of the same material, termed the _neurilemma_. The +nerve-fibers in the trunks of the nerves remain perfectly distinct and +disconnected from one another, and seldom, or never, divide throughout +their entire length. However, where the nerves enter the nerve-centers, +and near their outer terminations, the nerve-fibres often divide into +branches, or at least gradually diminish in size, until, finally, the +axis-cylinder, and the sheath with its fluid contents, are no longer +distinguishable. The investing membrane is continuous from the origin to +the termination of the nerve-trunk. + +[Illustration: Fig. 55. +Division of a +nerve, showing a +portion of a nervous +trunk (_a_) +and separation of +its filaments (_b, c, d, e_.)] + +In the brain and spinal cord the nerve-fibers often terminate in minute +masses of a gray or ash-colored granular substance, termed _ganglia_, or +_ganglionic corpuscles_. + +The ganglia are cellular corpuscles of irregular form, and possess +fibrous appendages, which serve to connect them with one another. These +ganglia form the cortical covering of the brain, and are also found in +the interior of the spinal cord. According to Kölliker, the larger of +these nerve-cells measure only 1/200 of an inch in diameter. The brain +is chiefly composed of nervous ganglia. + +Nerves are classified with reference to their origin, as +_cerebral_--those originating in the brain, and _spinal_--those +originating in the spinal cord. + +There are two sets of nerves and nerve-centers, which are intimately +connected, but which can be more conveniently studied apart. These are +the _cerebro-spinal_ system, consisting of the cerebro-spinal axis, and +the cerebral and spinal nerves; and the _sympathetic_ system, consisting +of the chain of sympathetic ganglia, the nerves which they give off, and +the nervous trunks which connect them with one another and with the +cerebro-spinal nerves. + + +THE CEREBRO-SPINAL SYSTEM. + + +THE CEREBRO-SPINAL AXIS consists of the brain and spinal cord. It lies +in the cavities of the cranium and the spinal column. These cavities are +lined with a very tough fibrous membrane, termed the _dura mater_, which +serves as the periosteum of the bones which enter into the formation of +these parts. The surface of the brain and spinal cord is closely +invested with an extremely vascular, areolar tissue, called the _pia +mater_. The numerous blood-vessels which supply these organs traverse +the pia mater for some distance, and, where they pass into the substance +of the brain or spinal cord, the fibrous tissue of this membrane +accompanies them to a greater or less depth. The inner surface of the +dura mater and the outer surface of the pia mater are covered with an +extremely thin, serous membrane, which is termed the _arachnoid_ +membrane. Thus, one layer of the arachnoid envelopes the brain and +spinal cord, and the other lines the dura mater. As the layers become +continuous with each other at different points, the arachnoid, like the +pericardium, forms a shut sac, and, like other serous membranes, it +secretes a fluid, known as the _arachnoid fluid_. The space between the +internal and the external layers of the arachnoid membrane of the brain +is much smaller than that enclosed by the corresponding layers of the +arachnoid membrane of the spinal column. + +[Illustration: Fig. 56. +Cross-section of spinal cord.] + +THE SPINAL CORD is a column of soft, grayish-white substance, extending +from the top of the spinal canal, where it is continuous with the brain, +to about an inch below the small of the back, where it tapers off into a +filament. From this nerve are distributed fibers and filaments to the +muscles and integument of at least nine-tenths of the body. + +The spinal cord is divided in front through the middle nearly as far as +its center, by a deep fissure, called the _anterior fissure_, and +behind, in a similar manner, by the posterior _fissure_. Each of these +fissures is lined with the pia mater, which also supports the +blood-vessels which supply the spinal cord with blood. Consequently, the +substance of the two halves of the cord is only connected by a narrow +isthmus, or bridge, perforated by a minute tube, which is termed the +_central canal_ of the spinal cord. + +Each half of the spinal cord is divided lengthwise into three nearly +equal parts, which are termed the anterior, lateral, and posterior +columns, by the lines which join together two parallel series of bundles +of nervous filaments, which compose the roots of the spinal nerves. The +roots of those nerves, which are found along that line nearest the +posterior surface of the cord, are termed the posterior roots; those +which spring from the other line are known as the anterior roots. + +Several of these anterior and posterior roots, situated at about the +same height on opposite sides of the spinal cord, converge and combine +into what are called the _anterior_ and _posterior bundles_; then two +bundles, anterior and posterior, unite and form the trunk of a spinal +nerve. + +The nerve trunks make their way out of the spinal canal through +apertures between the vertebra, called the _inter-vertebral foramina_ +and then divide into numerous branches, their ramifications extending +principally to the muscles and the skin. There are thirty-one pairs of +spinal nerves, eight of which are termed cervical, twelve dorsal, five +lumbar, and six sacral, with reference to that part of the cord from +which they originate. + +When the cord is divided into transverse sections, it is found that each +half is composed of two kinds of matter, a white substance on the +outside, and a grayish substance in the interior. The _gray matter_, as +it is termed, lies in the form of an irregular crescent, with one end +considerably larger than the other, and having the concave side turned +outwards. The ends of the crescent are termed the _horns_, or _cornua_, +the one pointing forward being called the _anterior cornu_, the other +one the _posterior cornu_. The convex sides of these cornua approach +each other and are united by the bridge, which contains the central +canal. + +There is a marked difference in the structure of the gray and the white +matter. The white matter is composed entirely of nerve fibers, held +together by a framework of connective tissue. The gray matter contains a +great number of ganglionic corpuscles, or nerve-cells, in addition to +the nerve-fibers. + +When the nerve-trunks are irritated in any manner, whether by pinching, +burning, or the application of electricity, all the muscles which are +supplied with branches from this nerve-trunk immediately contract, and +pain is experienced, the severity of which depends upon the degree of +the irritation; and the pain is attributed to that portion of the body +to which the filaments of the nerve-trunk are distributed. Thus, persons +who have lost limbs often complain in cold weather of an uneasiness or +pain, which they locate in the fingers or toes of the limb which has +been amputated, and which is caused by the cold producing an irritation +of the nerve-trunk, the filaments, or fibers of which, supplied the +fingers or toes of the lost member. + +On the other hand, if the anterior bundle of nerve-fibers given off from +the spinal cord is irritated in precisely the same way, only half of +these effects is produced. All the muscles which are supplied with +fibers from that trunk contract, but no pain is experienced. Conversely, +if the posterior bundle of nerve-fibers is irritated, none of the +muscles to which the filaments of the nerve are distributed contract, +but pain is felt throughout the entire region to which these filaments +are extended. It is evident, from these facts, that the fibers composing +the posterior bundles of nerve-roots only transmit sensory impulses, and +the filaments composing the anterior nerve-roots only transmit motor +impulses; accordingly, they are termed respectively the _sensory_ and +the _motor_ nerve-roots. This is illustrated by the fact that when the +posterior root of a spinal nerve is divided, all sensation in the parts +to which the filaments of that nerve are distributed is lost, but the +power of voluntary movement of the muscles remains. On the other hand, +if the anterior roots are severed, the power of voluntary motion of the +muscles is lost, but sensation remains. + +It appears from these experiments, that, when a nerve is irritated, a +change in the arrangement of its molecules takes place, which is +transmitted along the nerve-fibers. But, if the nerve-trunks are +divided, or compressed tightly at any point between the portion +irritated, and the muscle or nerve-centre, the effect ceases +immediately, in a manner similar to that in which a message is stopped +by the cutting of a telegraph wire. When the nerves distributed to a +limb are subjected to a pressure sufficient to destroy the molecular +continuity of their filaments, it "goes to sleep," as we term it. The +power of transmitting sensory and motor impulses is lost, and only +returns gradually, as the molecular continuity is restored. + +From what has been said, it is plain that a sensory nerve is one which +conveys a sensory impulse from the peripheral or outer part of a nerve +to the spinal cord or brain, and which is, therefore, termed _afferent_; +and that a motor nerve is one which transmits an impulse from the nerve +centre, or is _efferent_. So difference in structure, or in chemical or +physical composition, can be discerned between the afferent and the +_efferent_ nerves. A certain period of time is required for the +transmission of all impulses. The speed with which an impulse travels +has been found to be comparatively slow, being even less than that of +sound, which is 1,120 feet per second. + +The experiments heretofore related have been confined solely to the +nerves. We may now proceed to the consideration of what takes place when +the spinal cord is operated upon in a similar way. If the cord be +divided with a knife or other instrument, all parts of the body supplied +with nerves given off below the division will become paralyzed and +insensible, while all parts of the body supplied with nerves from the +spinal cord _above_ the division will retain their sensibility and power +of motion. If, however, only the posterior half of the spinal cord is +divided, or destroyed, there is loss of sensation alone; and, if the +anterior portion is cut in two, and the continuity of the posterior part +is left undisturbed, there is loss of voluntary motion of the lower +limbs, but sensation remains. + +REFLEX ACTION OF THE SPINAL CORD. In relation to the brain, the spinal +cord is a great mixed motor and sensory nerve, but, in addition to this, +it is also a distinct nervous centre, in which originate and terminate +all those involuntary impulses which exert so potent an influence in the +preservation and economy of the body. That peculiar power of the cord by +which it is enabled to convert sensory into motor impulse is that which +distinguishes it, as a central organ, from a nerve, and is called +_reflex action_. + +The gray matter, and not the white, is the part of the cord which +possesses this power. This reflex action is a special function of the +spinal cord, and serves as a monitor to, and regulator of the organs of +nutrition and circulation, by placing them, ordinarily, beyond the +control of conscious volition. + +[Illustration: Fig. 57.] + +If the foot of a decapitated frog is irritated, there is an instant +contraction of the corresponding limb; if the irritation is intense the +other limb also contracts. These motions indicate the existence, in some +part of the spinal cord, of a distinct nerve-centre, capable of +converting and reflecting impulses. It has been found by experiment, +that the same movements will take place if the irritation be applied to +any portion of the body to which the spinal nerves are distributed, thus +giving undoubted evidence that the spinal cord in its entirety is +capable of causing these reflections. Fig. 57 represents the course of +the nervous impulses. The sensory impulse passes upward along the +posterior root, _a_, until it reaches the imbedded gray matter, _b_, of +the cord, by which it is reflected, as a motor impulse, downward along +the anterior root, _c_, to the muscles whence the sensation was +received. This is the reflex action of the spinal cord. There is no +consciousness or sensation connected with this action, and the removal +of the brain and the sympathetic system does not diminish its activity. +Even after death it continues for some time, longer in cold-blooded than +in warm-blooded animals, on account of the difference in temperature, +thus showing this property of the spinal cord. By disease, or the use of +certain poisons, this activity may be greatly augmented, as is +frequently observed in the human subject. A sudden contact with a +different atmosphere may induce these movements. The contraction of the +muscles, or cramp, often experienced by all persons, in stepping into a +cold bath, or emerging from the cozy sitting-room into a chilly December +temperature, are familiar illustrations of reflex movements. It has been +demonstrated that the irritability of the nerves may be impaired or +destroyed, while that of the muscles to which they are distributed +remains unchanged; and that the motor and sensory classes of filaments +may be paralyzed independently of each other. + +The reflex actions of the spinal cord have been admirably summed up by +Dr. Dalton, as exerting a general, protective influence over the body, +presiding over the involuntary action of the limbs and trunk, regulating +the action of the sphincters, rectum, and bladder, and, at the same +time, exercising an indirect influence upon the nutritive changes in all +parts of the body to which the spinal filaments are distributed. + +THE BRAIN. The brain is a complex organ, which is divided into the +_medulla oblongata_, the _cerebellum_, and the _cerebrum_. + +The _medulla oblongata_ is situated just above the spinal cord, and is +continuous with it below, and the brain above. It has distinct functions +which are employed in the preservation and continuance of life. It has +been termed the "vital knot," owing to the fact that the brain may be +removed and the cord injured and still the heart and lungs will continue +to perform their functions, until the medulla oblongata is destroyed. + +The arrangement of the white and gray matter of the medulla oblongata is +similar to that of the spinal cord; that is to say, the white matter is +external and the gray internal; whereas in the cerebellum and cerebrum +this order is reversed. The fibres of the spinal cord, before entering +this portion of the brain, decussate, those from the right side crossing +to the left, and those from the left crossing to the right side. By some +authors this crossing of the sensory and motor filaments has been +supposed to take place near the medulla oblongata. Dr. Brown-Sequard +shows, however, that it takes place at every part of the spinal cord. +The medulla oblongata is traversed by a longitudinal fissure, continuous +with that of the spinal cord. Each of the lateral columns thus formed +are subdivided into sections, termed respectively the _Corpora +Pyramidalia_, the _Corpora Olivaria_, the _Corpora Restiformia_ and the +_Posterior Pyramids_. + +The _Corpora Pyramidalia_ (see 1, 1, Fig. 58) are two small medullary +eminences or cords, situated at the posterior surface of the medulla +oblongata; approaching the Pons Varolii these become larger and rounded. + +The _Corpora Olivaria_ (3, 3, Fig. 58) are two elliptical prominences, +placed exterior to the corpora pyramidalia. By some physiologists these +bodies are considered as the nuclei, or vital points, of the medulla +oblongata. Being closely connected with the nerves of special sensation, +Dr. Solly supposed that they presided over the movements of the larynx. + +[Illustration: Fig. 58.] + +[Illustration: Fig. 59.] + +The _Corpora Restiformia_ (5, 5, Fig. 59) are lateral and posterior +rounded projections of whitish medulla, which pass upward to the +cerebellum and form the _crura cerebelli_, so called because they +resemble a leg. The filaments of the pneumogastric nerve originate in +the ganglia of these parts. + +The _Posterior Pyramids_ are much smaller than the other columns of the +medulla oblongata. They are situated (4, 4, Fig. 59) upon the margin of +the posterior fissures in contact with each other. + +The functions of the medulla oblongata, which begin with the earliest +manifestations of life, are of an instinctive character. If the +cerebellum and cerebrum of a dove be removed, the bird will make no +effort to procure food, but if a crumb of bread be placed in its bill, +it is swallowed naturally and without any special effort. So also in +respiration the lungs continue to act after the intercostal muscles are +paralyzed; if the diaphragm loses its power, suffocation is the result, +but there is still a convulsive movement of the lungs for sometime, +indicating the continued action of the medulla oblongata. + +The _Cerebellum_, or little brain, is situated in the posterior chamber +of the skull, beneath the _tentorium_, a tent-like process of the dura +mater which separates it from the cerebrum. It is convex, with a +transverse diameter of between three and one-half and four inches, and +is little more than two inches in thickness. It is divided on its upper +and lower surfaces into two lateral hemispheres, by the superior and +inferior vermiform processes, and behind by deep notches. The cerebellum +is composed of gray and white matter, the former being darker than that +of the cerebrum. From the beautiful arrangement of tissue, this organ +has been termed the _arbor vitae_. + +The _peduncles of the cerebellum_, the means by which it communicates +with the other portions of the brain, are divided into three pairs, +designated as the _superior_, _middle_ and _inferior_. The first pass +upward and forward until they are blended with the tubercles of the +_corpora quadrigemina_. The second are the _crura cerebelli_, which +unite in two large _fasciculi_, or pyramids, and are finally lost in the +_pons varolii_. The inferior peduncles are the corpora restiformia, +previously described, and consist of both sensory and motor filaments. +Some physiologists suppose that the cerebellum is the source of that +harmony or associative power which co-ordinates all voluntary movements, +and effects that delicate adjustment of cause to effect, displayed in +muscular action. This fact may be proved by removing the cerebellum of a +bird and observing the results, which are an uncertainty in all its +movements, and difficulty in standing, walking, or flying, the bird +being unable to direct its course. In the animal kingdom we find an +apparent correspondence between the size of the cerebellum and the +variety and extent of the movements of the animal. Instances are cited, +however, in which no such proportion exists, and so the matter is open +to controversy. The general function of the cerebellum, therefore, +cannot be explained, but the latest experiments in physiological and +anatomical science seem to favor the theory that it is in some way +connected with the harmony of the movements. This co-ordination, by +which the adjustment of voluntary motion is supposed to be effected, is +not in reality a _faculty_ having its seat in the brain substance, but +is the harmonious action of many forces through the cerebellum. + +The _Cerebrum_ occupies five times the space of all the other portions +of the brain together. It is of an ovoid form, and becomes larger as it +approaches the posterior region of the skull. A longitudinal fissure +covered by the dura mater separates the cerebrum into two hemispheres, +which are connected at the base of the fissure, by a broad medullary +band, termed the _corpus callosum_. Each hemisphere is subdivided into +three lobes. The anterior gives form to the forehead, the middle rests +in the cavity at the base of the skull, and the posterior lobe is +supported by the tentorium, by which it is separated from the cerebellum +beneath. One of the most prominent characteristics of the cerebrum is +its many and varied _convolutions_ These do not correspond in all +brains, nor even on the opposite sides of the same brain, yet there are +certain features of similarity in all; accordingly, anatomists enumerate +four _orders of convolutions_. The first order begins at the _substantia +perforata_ and passes upward and around the corpus callosum toward the +posterior margin of that body, thence descends to the base of the brain, +and terminates near its origin. The second order originates from the +first, and subdivides into two convolutions, one of which composes the +exterior margin and superior part of the corresponding hemisphere, while +the other forms the circumference of the _fissure of Sylvius_. The third +order, from six to eight in number, is found in the interior portion of +the brain, and inosculates between the first and second orders. The +fourth is found on the outer surface of the hemisphere, in the space +between the sub-orders of the second clasp. A peculiar fact relating to +these convolutions is observed by all anatomists: mental development is +always accompanied by an increasing dissimilarity between their +proportional size. + +The cerebral hemispheres may be injured or lacerated without any pain to +the patient. The effect seems to be one of stupefaction without +sensation or volition. A well-developed brain is a very good indication +of intelligence and mental activity. That the cerebrum is the seat of +the reasoning powers, and all the higher intellectual functions, is +proved by three facts. (1.) If this portion of the brain is removed, it +is followed by the loss of intelligence. (2.) If the human cerebrum is +injured, there is an impairment of the intellectual powers. (3.) In the +animal kingdom, as a rule, intelligence corresponds to the size of the +cerebrum. This general law of development is modified by differences in +the cerebral texture. Men possessing comparatively small brains may have +a vast range of thought and acute reasoning powers. Anatomists have +found these peculiarities to depend upon the quantity of gray matter +which enters into the composition of the brain. + +In the cerebro-spinal system there are three different kinds of reflex +actions. (1.) Those of the spinal cord and medulla oblongata are +performed without any consciousness or sensation on the part of the +subject. (2.) The second class embraces those of the tuber annulare, +where the perception gives rise to motion without the interference of +the intellectual faculties. These are denominated purely _instinctive_ +reflex actions, and include all those operations of animals which seem +to display intelligent forethought; thus, the beaver builds his +habitation over the water, but not a single apartment is different from +the beaver homestead of a thousand years ago; there is no improvement, +no retrogression. Trains of thought have been termed a third class of +reflex actions. It is evident that the power of reasoning is, in a +degree, possessed by some of the lower-animals: for instance, a tribe of +monkeys on a foraging expedition will station guards at different parts +of the field, to warn the plunderers of the approach of danger. A cry +from the sentinel, and general confusion is followed by retreat. Reason +only attains its highest development in man, in whom it passes the +bounds of ordinary existence, and, with the magic wand of love, reaches +outward into the vast unknown, lifting him above corporeal being, into +an atmosphere of spiritual and divine Truth. + +[Illustration: Fig. 60. +Section of the brain and an ideal +view of the pneumogastric nerve +on one side, with its branches, _a_. +Vertical section of the cerebrum. +_b_. Section of the cerebellum, _c_. +Corpus callosum. _d_. Lower section +of medulla oblongata. Above +_d_, origin of the pneumogastric +nerve. 1. Pharyngeal branch. 2. +Superior laryngeal. 5. Branches +to the lungs. 4. Branches to the +liver. 6. Branches to the stomach.] + +THE CRANIAL NERVES. From the brain, nerves are given off in pairs, which +succeed one another from in front backwards to the number of twelve. The +_first_ pair, the _olfactory_ nerves, are the nerves of the sense of +smell. The _second_ pair are the _optic_, or the nerves of the sense of +sight. The _third_ pair are called the _motores oculi_, the movers of +the eye, from the fact that they are distributed to all the muscles of +the eye with the exception of two. The _fourth_ pair and the _sixth_ +pair each supply one of the muscles of the eye, on each side, the fourth +extending to the superior oblique muscle, and the sixth to the external +rectus muscle. The nerves of the _fifth_ pair are very large; they are +each composed of two bundles of filaments, one motor and the other +sensory, and have, besides, an additional resemblance to a spinal nerve +by having a ganglion on each of their sensory roots, and, from the fact +that they have three chief divisions, are often called the _trigeminal_, +or _trifacial_, nerves. They are nerves of special sense, of sensation, +and of motion. They are the sensitive nerves which supply the cranium +and face, the motor nerves of the muscles of mastication, the +_buccinator_ and the _masseter_, and their third branches, often called +the _gustatory_, are distributed to the front portion of the tongue, and +are two of the nerves of the special sense of taste. The _seventh_ pair, +called also the _facial_ nerves, are the motor nerves of the muscles of +the face, and are also distributed to a few other muscles; the _eighth_ +pair, termed the auditory nerves, are the nerves of the special sense of +hearing. As the _seventh_ and _eighth_ pairs of nerves emerge from the +cavity of the skull together, they are frequently classed by anatomists +as one, divided into the _facial_, or _portio dura_, as it is sometimes +called, and the _auditory_, or _portio mollis_. The _ninth_ pair, called +the _glosso-pharyngeal,_ are mixed nerves, supplying motor filaments to +the _pharyngeal muscles_ and filaments of the special sense of taste to +the back portion of the tongue. The _tenth_ pair, called the +_pneumogastric_, or _par vagum_, are very important nerves, and are +distributed to the larynx, the lungs, the heart, the stomach, and the +liver, as shown in Fig. 60. This pair and the next are the only cerebral +nerves which are distributed to parts of the body distant from the head. +The _eleventh_ pair, also called _spinal accessory_, arise from the +sides of the spinal marrow, between the anterior and posterior roots of +the dorsal nerves, and run up to the medulla oblongata, and leave the +cranium by the same aperture as the pneumogastric and glosso-pharyngeal +nerves. They supply certain muscles of the neck, and are purely motor. +As the glosso-pharyngeal, pneumogastric, and spinal accessory nerves +leave the cranium together, they are by some anatomists counted as the +_eighth_ pair. The _twelfth_ pair, known as the _hypoglossal,_ are +distributed to the tongue, and are the motor nerves of that organ. + + +THE GREAT SYMPATHETIC. + + +A double chain of nervous ganglia extends from the superior to the +inferior parts of the body, at the sides and in front of the spinal +column, and is termed, collectively, the system of the _great +sympathetic_. These ganglia are intimately connected by nervous +filaments, and communicate with the cerebro-spinal system by means of +the motor and sensory filaments which penetrate the sympathetic. The +nerves of this system are distributed to those organs over which +conscious volition has no direct control. + +[Illustration: Fig. 61. +Course and distribution of the great Sympathetic Nerve] + +Four of the sympathetic centers, situated in the front and lower +portions of the head, are designated as the _ophthalmic, +spheno-palatine, submaxillary_ and _otic ganglia_. The first of these, +as its name indicates, is distributed to the eye, penetrates the +_sclerotic membrane_ (the white, opaque portion of the eyeball, with its +transparent covering), and influences the contraction and dilation of +the iris. The second division is situated in the angle formed by the +sphenoid and maxillary bone, or just below the ear. It sends motor and +sensory filaments to the palate, and _velum palati_. Its filaments +penetrate the carotid plexus, are joined by others from the motor roots +of the facial nerve and the sensory fibres of the superior maxillary. +The third division is located on the submaxillary gland. Its filaments +are distributed to the sides of the tongue, the sublingual, and +submaxillary glands. The otic ganglion is placed below the base of the +skull, and also connects with the _carotid plexus_. Its filaments of +distribution supply the internal muscles of the _malleus_, the largest +bones of the _tympanum_, the membranous linings of the tympanum and the +_eustachian tube._ Three ganglia, usually designated as the _superior, +middle_, and _inferior_, connect with the cervical and spinal nerves. +Their interlacing filaments are distributed to the muscular walls of the +larynx, pharynx, trachea, and esophagus, and also penetrate the _thyroid +gland_. The use of this gland is not accurately known. It is composed of +a soft, brown tissue, and consists of lobules contained in lobes of +larger size. It forms a spongy covering for the greater portion of the +larynx, and the first section of the trachea. That it is an important +organ, is evident from the fact that it receives four large arteries, +and filaments from two pairs of nerves. + +The sympathetic ganglia of the chest correspond in number with the +terminations of the ribs, over which they are situated. Each ganglion +receives two filaments from the intercostal nerve, situated above it, +thus forming a double connection. The thoracic ganglia supply with motor +fibres that portion of the aorta which is above the diaphragm, the +esophagus, and the lungs. + +In the abdomen the sympathetic centers are situated upon the _coeliac_ +artery, and are termed, collectively, the _semilunar coeliac ganglion_. +Numerous inosculating branches radiate from this center and are called, +from the method of their distribution, the _solar plexus_. From this, +also, originate other plexi which are distributed to the stomach, liver, +kidneys, intestines, spleen, pancreas, supra-renal glands, and to the +organs of generation. Four other pairs of abdominal ganglia connected +with, the lumbar branches are united by filaments to form the semilunar +ganglion. + +The sympathetic ganglia of the pelvis consist of five pairs, which are +situated upon the surface of the sacrum. At the extremity of the spinal +column this system terminates in a single knot, designated as the +_ganglion impar_. + +Owing to the position of the sympathetic ganglia, deeply imbedded in the +tissues of the chest and abdomen, it is exceedingly difficult to subject +them to any satisfactory experiments. A few isolated facts form the +basis of all our knowledge concerning their functions. They give off +both motor and sensory filaments. The contraction of the _iris_ is one +of the most familiar examples of the action of the sympathetic system. + +In the reflex actions of the nerves of special sense, the sensation is +transmitted through the cerebro-spinal system, and the motor impulse is +sent to the deep-seated muscles by the sympathetic system. Physiologists +enumerate three kinds of reflex actions, which are either purely +sympathetic, or partially influenced by the cerebro-spinal system. Dr. +Dalton describes them as follows: + +_First_.--"Reflex actions taking place from the internal organs, through +the sympathetic and cerebro-spinal systems, to the voluntary muscles and +sensitive surfaces.--The convulsions of young children are often owing +to the irritation of undigested food in the intestinal canal. Attacks of +indigestion are also known to produce temporary amaurosis [blindness], +double vision, strabismus, and even hemiplegia. Nausea, and a diminished +or capricious appetite, are often prominent symptoms of early pregnancy, +induced by the peculiar condition of the uterine mucous membrane." + +_Second_.--"Reflex actions taking place from the sensitive surfaces, +through the cerebro-spinal and sympathetic systems to the involuntary +muscles and secreting organs.--Imprudent exposure of the integument to +cold and wet, will often bring on a diarrhea. Mental and moral +impressions, conveyed through the special senses, will affect the +motions of the heart, and disturb the processes of digestion and +secretion. Terror, or an absorbing interest of any kind, will produce a +dilatation of the pupil, and communicate in this way a peculiarly wild +and unusual expression to the eye. Disagreeable sights or odors, or even +unpleasant occurrences, are capable of hastening or arresting the +menstrual discharge, or of inducing premature delivery." + +_Third_.--"Reflex actions taking place through the sympathetic system +from one part of the body to another.--The contact of food with the +mucous membrane of the small intestine excites a peristaltic movement in +the muscular coat. The mutual action of the digestive, urinary, and +internal generative organs upon each other takes place entirely through +the medium of the sympathetic ganglia and their nerves. The variation of +the capillary circulation in different abdominal viscera, corresponding +with the state of activity or repose of their associated organs, are to +be referred to a similar nervous influence. These phenomena are not +accompanied by any consciousness on the part of the individual, nor by +any apparent intervention of the cerebro-spinal system." + + * * * * * + + + + +CHAPTER XIII. + +THE SPECIAL SENSES. + +SIGHT. + + +The eye is the organ through which we perceive, by the agency of light, +all the varied dimensions relations, positions, and visible qualities of +external objects. + +The number, position, and perfection of the eyes, vary remarkably in +different orders, in many instances corresponding to the mode of life, +habitation, and food of the animal. A skillful anatomist may ascertain +by the peculiar formation of the eye, without reference to the general +physical structure, in what element the animal lives. Sight is one of +the most perfect of the senses, and reveals to man the beauties of +creation. The aesthetic sentiment is acknowledged to be the most +refining element of civilized life. Painting, sculpture, architecture, +and all the scenes of nature, from a tiny way-side flower to a Niagara, +are subjects in which the poet's eye sees rare beauties to mirror forth +in the rhythm of immortal verse. + +In the vertebrates, the organs of vision are supplied with filaments +from the second pair of cranial nerves. In mammalia, the eyes are +limited to two in number, which in man are placed in circular cavities +of the skull, beneath the anterior lobes of the cerebrum. Three +membranes form the lining of this inner sphere of the eye, called +respectively the Sclerotic, Choroid, and Retina. + +The _Sclerotic_, or outer covering, is the white, firm membrane, which +forms the larger visible portion of the eyeball. It is covered in front +by a colorless, transparent segment, termed the _cornea_, which gives +the eye its lustrous appearance. Within the sclerotic, and lining it +throughout, is a thin, dark membrane termed the _Choroid_. Behind the +cornea it forms a curtain, called the _iris_, which gives to the eye its +color. The muscles of the iris contract or relax according to the amount +of light received, thus enlarging or diminishing the size of the +circular opening called the _pupil_. The _Retina_ is formed by the optic +nerve, which penetrates the sclerotic and choroid and spreads out into a +delicate, grayish, semi-transparent membrane. The retina is one of the +most _essential_ organs of vision, and consists of two layers. A +spheroidal, transparent body, termed the _crystalline lens_, is situated +directly behind the pupil. It varies in density, increasing from without +inward, and forms a perfect refractor of the light received. The space +in front of the crystalline lens is separated by the iris into two +compartments called respectively the _anterior_ and _posterior +chambers_. The fluid contained within them, termed the _aqueous humor_, +is secreted by the cornea, iris, and ciliary processes. The space behind +the crystalline lens is occupied by a fluid, called the _vitreous +humor_. This humor is denser than the other fluids and has the +consistency of jelly, being perfectly transparent. "The function of the +crystalline lens is to produce distinct perception of form and +outline."[3] The transparent humors of the eye also contribute to the +same effect, but only act as auxiliaries to the lens. + +[Illustration: Fig. 62.] + +The figure on the next page represents the course of the rays of light +proceeding from an object _a b_, refracted by the lens, and forming the +inverted image _x y_ on the screen. All rays of light proceeding from +_b_ are concentrated at _y_, and those proceeding from _a_ converge at +_x_. Rays of light emanating from the center of the object _a b_ pursue +a parallel course, and form the center of the image. Rays of light +passing through a double convex lens converge at a point called the +_focus_. In the organ of vision, if perfect, the focus is on the retina, +which serves as a screen to receive the image or impression. We have a +distinct perception of the outline of a distant hill, and also of a book +lying before us. The rays of light we receive from these objects cannot +have the same focus. How, then, can we account for the evident +accommodation of the eye to the varying distances? Various theories have +been advanced to explain this adjustment; such as changes in the +curvature of the cornea and lens; a movement of the lens, or a general +change in the form of the eyeball, by which the axis may be lengthened +or shortened. + +[Illustration: Fig. 63.] + +Two facts comprise all the positive knowledge which we possess on this +subject. Every person is conscious of a muscular effort in directing the +eye to a near object" as a book, and of fatigue, if the attention is +prolonged. If, now, the eyes be directed to a distant object, there will +result a sense of rest, or passiveness. By various experiments it has +been proved that the accommodation or adjustment of the eye for near +objects requires a muscular effort, but for distant objects the muscles +are in an essentially passive condition. An increase in the convexity of +the crystalline lens is now admitted to be necessary for a distinct +perception of near objects. We may give two simple illustrations, cited +by Dr. Dalton in his recent edition of Human Physiology. If a candle be +held near the front of an eye which is directed to a distant object, +three reflected images of the flame will be seen in the eye, one on each +of the anterior surfaces of the cornea and lens, and a third on the +posterior surface of the latter. If the eye is directed to a near +object, the reflection on the cornea remains unchanged, while that on +the anterior surface of the lens gradually diminishes and approximates +in size the reflection on the cornea, thus giving conclusive evidence +that, in viewing a near object, the anterior surface of the crystalline +lens become _more convex_, and at the same time approaches the cornea. +Five or six inches is the minimum limit of the muscular adjustment of +the eye. From that point to all the boundless regions of space, to every +star and nebulae which send their rays to our planet, human vision can +reach. It is the sense by which we receive knowledge of the myriads of +worlds and suns which circle with unfailing precision through infinite +space. + + +HEARING. + + +[Illustration: Fig. 64. +Internal and external ear. 1. External ear. 2. Internal +auditory meatus. 3. Tympanum. 4. Labyrinth. +5. Eustachian tube.] + +Hearing depends upon the sonorous vibrations of the atmosphere. The +waves of sound strike the sensitive portions of the ear, and their +impressions upon the auditory nerves are termed the sensations of +hearing. The ear is divided into three parts, called respectively the +External, Middle, and Internal ear. + +The external organs of hearing are two in number, and placed on opposite +sides of the head. In most of the higher order of vertebrates, they are +so situated as to give expression and proportion to the facial organs, +and, at the same time, to suit the requirements of actual life. + +The _External ear_ is connected with the interior part by a prolongation +of its orifice, termed the _external auditory meatus_. In man, this +gristly portion of the auditory apparatus is about one inch in length, +lined by a continuation of the integument of the ear, and has numerous +hairs on its surface, to prevent the intrusion of foreign substances. +Between the external MEATUS and the cavity of the middle ear is the +_membrana tympani_, which is stretched across the opening like the head +of a drum. The _tympanum_, or ear-drum, communicates with the pharynx by +the _eustachian tube_, which is a narrow passage lined with delicate, +ciliated epithelium. On the posterior portion it is connected with the +_mastoid cells_. Three small bones are stretched across the cavity of +the tympanum, and called, from their form, the _malleus, incus_ and +_stapes_, or the hammer, anvil, and stirrup. Agassiz mentions a fourth, +which he terms the _os orbiculare_. Each wave of sound falling upon the +membrana tympani, throws its molecules into vibrations which are +communicated to the chain of bones, which, in turn, transmits them to +the membrane of the _foramen ovale_. The three muscles which regulate +the tension of these membranes are termed the _tensor tympani, laxator +tympani_, and _stapedium tympani._ + +The _Labyrinth_, or _Internal_ ear, is a complicated cavity, consisting +of three portions termed the _vestibule, cochlea_, and _semi-circular +canals_. The vestibule is the central portion and communicates with the +other divisions. The labyrinth is filled with a transparent fluid, +termed _perilymph_, in which are suspended, in the vestibules and +canals, small membranous sacs, containing a fluid substance, termed +_endolymph_ (sometimes called _vitrine auditive_ from its resemblance to +the vitreous humor of the eye). The filaments of the auditory nerve +penetrate the membranous tissues of these sacs, and also of those +suspended at the commencement of the semi-circular canals. These little +sacs are supposed to be the seat of hearing, and to determine, in some +mysterious way, the quality, intensity and pitch of sounds. + +The determination of the _direction_ of sound is a problem of acoustics. +Some have contended that the arrangement of the semi-circular canals is +in some way connected with this sensation. But this supposition, +together with the theory of the transmission of sound through the +various portions of the cranial bones, has been exploded. + +From the foregoing description, it will be seen that the labyrinth and +tympanum are the most essential parts of the organs of hearing. In +delicacy and refinement this sense ranks next to sight. The emotions of +beauty and sublimity, excited by the warbling of birds and the roll of +thunder, are scarcely distinguishable from the intense emotions arising +from sight. It is a remarkable fact, that the refinement or cultivation +of these senses is always found associated. Those nations which furnish +the best artists, or have the highest appreciation of painting and +sculpture, produce the most skillful musicians, those who reduce music +to a science. + + +SMELL. + + +[Illustration: Fig. 65. +1. Frontal sinus. 2. Nasal bone. 3. Olfactory +ganglion and nerves. 4. Nasal branch +of the fifth pair. 5. Spheno-palatine ganglion. +6. Soft palate. 7. Hard palate, _a_. +Cerebrum, _b_. Anterior lobes, _c_. Corpus +callosum. _d_. Septum lucidum. _f_. Fornix. +_g_. Thalami optici. _h_. Corpora striata.] + +Next in order of delicacy, and more closely allied with the physical +functions, is the sense of smell. Delicate perfumes, or the fragrance of +a flower, impart an exhilarating sensation of delight, while numerous +odors excite a feeling of disgust. The organ of smell is far less +complicated in its structure than the eye or the ear. It consists of two +cavities having cartilaginous walls, and lined with a thick mucous coat, +termed the _pituitary membrane_, over which are reflected the olfactory +nerves. Particles of matter, too minute to be visible even through the +microscope, are detached from the odorous body and come in contact with +the nerves of smell, which transmit the impressions or impulses thus +received to the brain. Fig. 65 shows the distribution of the olfactory +nerves in the nasal passages. The nose is supplied with two kinds of +filaments which are termed respectively nerves of _special_ and nerves +of _general sensation_. Compared with the lower animals, especially with +those belonging to the carnivorous species, the sense of smell in man is +feeble. The sensation of smell is especially connected with the +pleasures and necessities of animal life. + + +TASTE. + + +The sense of taste is directly connected with the preservation and +nutrition of the body. A delicious flavor produces a desire to eat a +savory substance. Some writers on hygiene have given this sense an +instinctive character, by assuming that all articles having an agreeable +taste are suitable for diet. The nerves of taste are distributed over +the surface of the tongue and palate, and their minute extremities +terminate in well developed _papillae_. These _papillae_ are divided +into three classes, termed, from their microscopic appearance, +_filiform_, _fungiform_ and _circumvallate_. The organ of taste is the +mucous membrane which covers the back part of the tongue and the palate. +The papillae of the tongue are large and distinct, and covered with +separate coats of epithelium. The filiform papillae are generally long +and pointed and are found over the entire surface of the tongue. The +fungiform are longer, small at the base and broad at the end. The +circumvallate are shaped like an inverted V and are found only near the +root of the tongue; the largest of this class of papillae have other +very small papillae upon their surfaces. It is now pretty satisfactorily +established that the circumvallate, or fungiform papillae are the only +ones concerned in the special sense of taste. + +The conditions necessary to taste are, that the substance be in solution +either by artificial means, or by the action of the saliva; and that it +be brought in contact with the sensitive filaments imbedded in the +mucous membrane. The nerves of taste are both _general_ and _special_ in +their functions. If the general sensibility of the nerves of taste is +unduly excited, the function of sensibility is lost for some time. If a +peppermint lozenge is taken into the mouth, it strongly excites the +general sensibilities of taste, and the power of distinguishing between +special flavors is lost for a few moments. A nauseous drug may then be +swallowed without experiencing any disagreeable taste. + +Paralysis of the facial nerve often produces a marked effect in the +sensibility of the tongue. Where this influence lies has not been fully +explained; probably it is indirect, being produced by some alteration in +the vascularity of the parts or a diminution of the salivary secretions. + + +TOUCH. + + +By the sense of touch, we mean the _general sensibility of the skin_. +Sensations of heat and cold are familiar illustrations of this faculty. +By the sense of touch, we obtain a knowledge of certain qualities of a +body, such as form consistency, roughness, or smoothness of surface, +etc. The tip of the tongue possesses the most acute sensibility of any +portion of the body, and next in order are the tips of the fingers. The +hands are the principal organs of tactile sensation. The nerves of +general sensibility are distributed to every part of the cutaneous +tissue. The contact of a foreign body with the back, will produce a +similar _tactile_ sensation, as with the tips of the fingers. The +sensation, however, will differ in _degree_ because the back is supplied +with a much smaller number of sensitive filaments; in _quality_ it is +the same. + + * * * * * + + + + +CHAPTER XIV. + +CEREBRAL PHYSIOLOGY. + + +By means of the nervous system, an intimate relation is maintained +between mind and body, for nervous energy superintends the functions of +both. The fibres of nervous matter are universally present in the +organization, uniting the physical and spiritual elements of man's +being. Even the minutest nerve-rootlets convey impressions to the dome +of thought and influence the intellectual faculties. We recognize +_muscular_ force, the strength of the body, _molecular_ force, molecules +in motion, as heat, light, chemical force, electricity, and _nervous_ +force, a certain influence which reacts between the animal functions and +the cerebrum, thus connecting the conditions of the body with those of +the mind. We cannot speak of the effects of mind or body separately, but +we must consider their action and reaction upon each other, for they are +always associated. There are many difficulties in understanding this +relationship, some of which may be obviated by a study of the +development of nervous matter, and its functions in the lower orders of +organization. + +Within the plant-cells is found a vital, vegetable substance termed +bioplasm, or protoplasm; which furnishes the same nutritive power as the +tissues of the polyp and jelly fish. Many families of animals have pulpy +bodies, and slight instinctive motion and sensibility, and in proportion +as the nervous system is developed, both of these powers are unfolded. +Plants have a low degree of sensibility, limited motion, respiratory and +circulatory organs. Animals possess quicker perceptions and +sensibilities, the power of voluntary motion, and, likewise a rudimental +nervous system. Some articulates have no bony skeleton, their muscles +being attached to the skin which constitutes a soft contracting +envelope. One of the simplest forms of animal life in which a nervous +system is found, is the five-rayed star-fish. In each ray there are +filaments which connect with similar nerve-filaments from other rays, +and form a circle around the digestive cavity. It probably has no +conscious perception, and its movements do not necessarily indicate +sensation or volition. In some worms a rudimentary nervous system is +sparingly distributed to the cavities of the thorax and abdomen, and, as +in the star-fish, the largest nerve-filament is found around the +esophagus, presiding over nutrition. + +[Illustration: Fig. 66.] + +A higher grade of organization requires a more complete arrangement of +nervous substance. Stimulus applied to one organ is readily communicated +to, and excites activity in another. + +[Illustration: Fig. 67. +A. Nervous system of a Crab, showing its +ganglia. B. The nervous system of a Caterpillar.] + +The nervous system of some insects consists of two long, white cords, +which run longitudinally through the abdomen, and are dilated at +intervals into knots, consisting of collections of nerve-cells, called +ganglia. They are really nerve-centers, which receive and transmit +impulses, originate and impart nervous influence according to the nature +of their organic surroundings. The ganglia situated over the esophagus +of insects correspond to the medulla oblongata in man, in which +originate the spinal accessory, glosso-pharyngeal, and pneumogastric +nerves. The latter possess double endowments, and not only participate +in the operations of deglutition, digestion, circulation, and +respiration, but are also nerves of sensation and instinctive motion. +The suspension of respiration produces suffocation. In insects, these +ganglia are scarcely any larger than those distributed within the +abdomen, with which they connect by means of minute, nervous filaments. +Insects are nimble in their movements, and manifest instinct, +corresponding to the perfection of their muscular and nervous systems. +When we ascend to vertebrates, those animals having a backbone, the +amount of the nervous substance is greater, the organic functions are +more complex, and the actions begin to display intelligence. + +Man possesses not only a complete sympathetic system, the rudiments of +which are found in worms and insects, and a complete spinal system, less +perfectly displayed in fishes, birds, and quadrupeds, but, superadded to +all these is a magnificent cerebrum, and, as we have seen, all parts of +the body are connected by the nervous system. The subtle play of sensory +and motor impulses, of sentient and spiritual forces, indicates a +perfection of nervous endowments nowhere paralleled, and barely +approached by inferior animals. This meager reference to brainless +animals, whoso knots of ganglia throughout their bodies act +automatically as little brains, shows that instinct arises +simultaneously with the development of the functions over which it +presides. Here begins rudimentary, unreasoning intelligence. It +originates within the body as an inward, vital impulse, is manifested in +an undeviating manner, and therefore displays no intention or +discretion. While Dr. Carpenter likens the human organism "to a keyed +instrument, from which any music it is capable of producing can be +called forth at the will of the performer," he compares "a bee or any +other insect to a barrel organ, which plays with the greatest exactness +a certain number of tunes that are set upon it, but can do nothing +else." Instinct cannot learn from experience, or improve by practice; +but it seems to be the prophetic germ of a higher intelligence. It is +nearly as difficult to draw the dividing line between instinct and a low +grade of intelligence, as it is to distinguish between the psychical and +psychological[4] functions of the brain. + +The intimate relation of instinct to intelligence is admirably +illustrated in the working honey-bee. With forethought it selects a +habitation, constructs comb, collects honey, provides a cell for the +ova, covers the chrysalis, for which it deposits special nourishment, +and is disposed to defend its possessions. It is a social insect, lives +in colonies, chastises trespassers, fights its enemies, and defends its +home. It manifests a degree of intelligence, but its sagacity is +instinctive. Reason, though not so acute as instinct, becomes, by +education, discerning and keenly penetrative, and reveals the very +secrets of profound thought. We recall the aptness of Prof. Agassiz's +remark: _"There is even a certain antagonism between instinct and +intelligence, so that instinct loses its force and peculiar +characteristics, whenever intelligence becomes developed."_ Animals +having larger reasoning powers manifest less instinct, and some, as the +leopard, exercise both in a limited degree. This double endowment with +instinct and low reasoning intelligence, is indicated by his lying in +ambush awaiting his prey, the hiding-place being selected near the haunt +of other animals, where nature offers some allurement to gratify the +appetite. + +Simple reflex action is an instinctive expression, manifesting an +intuitive perception, almost intelligent, as shown by the contraction of +the stomach upon the food, simply because it impinges upon the inner +coats, and thus excites them to action. A better illustration, because +it displays sympathy, is when the skin, disabled by cold, cannot act, +and its duties are largely performed by the kidneys. Though reflex +action is easily traced in the lower organic processes, some writers +have placed it on a level with rational deliberation. Undoubtedly, all +animals having perception have also what perception +implies--consciousness--and this indicates the possession, in some +degree, of reason. _Compound_ reflex action extends into the domain of +thought. _Simple_ reflex action, or instinct, answers to the animal +faculties, such as acquisitiveness, secretiveness, selfishness, +reproductiveness, etc., and accomplishes two important purposes; +self-preservation and the reproduction of the specie. With many persons, +these appear to be the chief ends of life! + +The psychical functions connect, not only with animal propensities, but +also with the highest psychological faculties. Instinct is the +representative of animal conditions, just as the highest spiritual +faculties are indicative of qualities and principles. The consistent +mean of conduct is an equilibrium between these ultimate tendencies of +our being. The psychological functions render the animal nature +subservient to the rule of purity and holiness, and deeply influence it +by the essential elements of spiritual existence. The psychical organs +sustain an intermediate relation, receiving the impressions of the +bodily propensities, and, likewise, of the highest emotions. Obviously, +these extreme influences, the one growing out of animal conditions, the +other, the result of spiritual relations, pass into the psychical medium +and are refracted by it, or made equivalent to one force. The body +requires the qualifying influences of mind. The tendencies of the animal +faculties are selfish and limiting, those of the emotive, general, +universal. The propensities, like gravity, expend their force upon +matter; the emotions pour forth torrents of feeling, and produce +rhapsodies of sentiment. The propensities naturally restrict their +expression to a specific object of sense; the emotions respond to +immaterial being. The tendencies of the former are acquisitive, selfish, +gratifying; of the latter, bestowing, expanding, diffusing. The one +class is restricted to the orbits of time and matter, the other flows on +through the limitless cycles of infinity and immortality. The former is +satiated in animal gratification, the latter in spiritual beatification. +The one culminates in animal enjoyment, the other expands to its +ultimate conceptions in the perfections of Divine Love. + +In the present life, mind and body are intimately connected by nervous +matter. In this dual constitution, the spiritual mental, and animal +functions are made inseparable, and modify one another. The ultimate +tendencies of each extreme exist, not absolutely for themselves, but for +qualifying purposes, to establish a basis for the deeper economy of +life. By the employment of reason, animal and spiritual experiences are +mutually benefited, and the consciousness rendered accountable. The +bodily and mental workings are in many senses one, and help to interpret +each other. + +Every fact of mind has many aspects. A brain force, which results in +thought, is simultaneously a physiological force, if it influences the +bodily functions. Likewise, spiritual conceptions take their rise in the +same blood that feeds the grosser tissues. This vital fluid is +momentarily imparting and receiving elements from all the bodily organs, +and these, in turn, must influence the process of thought, and, in a +degree, determine its quality. The delicate outline, yea, even the +substance of an idea, may depend upon the condition of the animal +organs. Thought is subject to the laws of biology, and, therefore, is a +symbol of health. Morbid conditions of the system hang out their signs +in words and utterances. Words which express fear are as true symptoms +of functional difficulty as is excessive palpitation. The organ +representing fear sustains a special relation to the functions of the +heart both in health and disease. Bright hopes characterize pulmonary +complaints as certainly as cough. Exquisite susceptibility of mind +indicates equally extreme sensibility of body, and those persons capable +of fully expressing the highest emotions are especially susceptible to +bodily sensations. Tears are physical emblems of grief, and +fellow-feeling calls forth sympathetic tears. Excessive anxiety of mind +produces general excitability of body, which soon results in chronic +disease. Pleasurable emotions stimulate the processes of nutrition, and +are restorative. This concomitance of mental and bodily states is very +remarkable. Joy and Love, as well as jealousy and anger, flash in the +eye and mould the features to their expression. Grief excites the +lachrymal, and rage the salivary glands. Shame reddens the ears, drops +the eyelids, and flushes the face; but profligacy destroys these +expressions. The blush which suffuses the forehead of the bashful maiden +betrays her love, and _maternal_ love, stirred by the appeals of an +idolized infant, excites the mammary gland to the secretion of milk. The +sigh of melancholia indicates hepatic torpor, thus showing a special +relation between the liver and respiratory organs. These conditions of +mind and body react upon one another. Even the thought of a luscious +peach may cause the mouth to water. The thought of tasting a lemon fills +the mouth with secretions, and a story with unsavory associations may +completely turn the stomach. + +The relationship of mental and physical functions may be illustrated by +entirely removing the spleen of an animal, as that of a dog. An +invariable result of its extirpation is an unusual increase of the +appetite, for at times the animal will eat voraciously any kind of food. +The dog will devour, with avidity, the warm entrails of recently killed +animals, and thrive in consequence of such an appetite. Another symptom, +which usually follows the removal of the spleen, is an unnatural +ferocity of disposition. Without any apparent provocation, the animal +will attack others of its own, or of a different species. In some +instances, these outbursts of irritability and violence are only +occasional, but the experiments show quite conclusively that the spleen +moderates combativeness, restrains the appetite, and co-operates with +the will and judgment in controlling them. + +We shall briefly consider the practical question whether the elements of +mind can be ideally arranged and presented, so as to more completely +reveal their relations to, and disclose their effects upon the bodily +functions. Modern philosophers conceive that mind consists of a triad of +essentials; _Intellect, Emotion,_ and _Volition_. Physiologists assign +to the cerebrum its functions, and neurological, as well as +phrenological writers, have located them as represented in Fig. 68. +True, there is no structural division between the parts of the cerebrum +to indicate this diversity of function, nor is there any perceptible +limit between the sensory and motor filaments of the game nerve. As no +one has any reason for denying that separate portions of the brain may +manifest distinct functions of the mind, we shall assume it as a +conceded proposition. The regions of the cerebrum, thus ideally +represented, occupy but little more than half of the arc of a circle, +whereas it is evident that the base of the nervous mass is not idle, and +is equally entitled to our consideration. In the posterior chamber of +the skull is the cerebellum, anterior to, and below which, is the +medulla oblongata, connecting with the spinal cord and sympathetic +system. These various parts are essential to the harmonious blending of +mind and body. To this end, two conditions are necessary. (1.) All the +nervous forces must be so related that action and reaction may be fully +established. (2.) A complete nervous circuit is requisite for the +reciprocal influence of mind and body. + +[Illustration: Fig. 68.] + +[Illustration: Fig. 69. ] + +Nature answers to mind in physical correspondences. The planetary system +is fashioned after a circle. Life itself springs from a spherule of +forces. The perfection of an idea, or the completeness of a conception +may be expressed by a circle. The elements of Science, Astronomy, +Geology, and Natural History, are pictorially represented in this +manner. How appropriately and logically can a fragment of natural +history, this epitome of all nature and science--_the mind_--be +illustrated by a simple circle! Every element must act and react, and be +equal and opposite. Thus may the existence of the opposing energies and +functions of each faculty be equally represented. The contrast aids us +in understanding their ultimate tendencies, and enables us to correctly +value and define their nature. Faculties of kindred qualities may be +grouped together, and their antagonisms represented in the opposite arc +of the circle. Let us employ a circle to represent mind. The conception +of the abstract quality of _good_, requires contrast with one of a +converse nature, _bad_, (see Fig. 69). Opposite faculties may be +portrayed in the same manner. The functions of the cerebrum and spinal +system may be symbolically represented as those of the highest and +lowest organs, thus giving rise to the positive and negative extremes of +feeling. The writer conceives of no other way in which the widely +contrasted facts of human experience can be so perfectly symbolized. +_Good_ (Fig. 69) may represent moral faculties, and _bad_, their +opposites. Undoubtedly, nature is not so arbitrary in her arrangements +as we are in shadowing forth our imperfect conceptions, yet is not this +a decided improvement in determining cerebral faculties and their +relations? We observe how scholars and philosophers confound the noblest +and most exalted emotions with the animal propensities instead of +distinguishing between them. "_The emotions are a department of the +feelings, formed by the intervention of intellectual processes. Several +of them are so characteristic that they can be known only by individual +experiences; as Wonder, Fear, Love, Anger_." See Logic: Deductive and +Inductive, by Alexander Bain, LL. D., page 508, (1874). + +This is not an exceptional, but a common example of classifying Love, +the highest and purest of the emotions, with Anger, an animal +propensity. Is it not more practical and philosophical to group the +emotional faculties together, and upon an opposite arc represent their +antagonistic energies, the ultimate tendencies of which are criminal? +Both groups are mutually modifying and restraining; the one relates +instinctively to the bodily wants, the other to the requirements of +mind, and each is essential to a consistent life. Accordingly, we deem +it philosophical to consider words as symbols of mental faculties, and +to classify together such spiritual unities as joy, hope, faith, and +love, the tendencies of which are to quicken and transform the ultimates +of carnal life into the rudiments of an immortal one, the beginning of +heaven on earth. These restrain those opposites, which lead to crime and +death. Love and Hate are as antagonistic as heat and cold, and the +usefulness of both depends upon their _proper_ temperament. Fig. 70 +represents the antagonism of the Intellectual faculties to the Animal, +the Emotional to the Criminal, the Volitive to the Enfeebling. It is not +essential to discover in the nerve-substance the precise power from +which an impulse originates. We may reasonably interpret the functions +of the brain, and yet be unable to disclose the duties of any ganglionic +corpuscle composing it. We may foretell what each season of the year +will bring forth, when we cannot forecast the history of a blade of +grass or a single grain of any kind. We may predict the amount of rain +for a month, and be unable to prognosticate correctly, the character of +any storm, or give the history of a special drop of water. Although we +cannot follow the movements of individuals in a battle, yet we may +predict the result of the combat; and thus, we judge of the functions of +the brain without the ability to reveal the actions of one of the +organic molecules of which it is composed. We aim to give a general, +reasonable, and popular description of cerebral functions and their +bearing upon health and disease. + +[Illustration: Fig. 70.] + + +REGIONAL DIVISIONS. + + +[Illustration: Fig. 71.] + +The anterior portion of the cerebrum is devoted to intellectual +processes, which freely expend the vital energies. The Intellectual +faculties are classified as represented in Fig. 71. The lower portion of +the brain, bounded exteriorly by the superciliary ridge, corresponds to +the Perceptive, the middle region to the Recollective, and the upper to +the Reflective faculties. (See also Fig. 65, _b_.) If we divide the +forehead by vertical lines, as shown in Fig. 71, the divisions thus +formed represent respectively, the Active, Deliberative, and +Contemplative departments of the intellect, all the processes of which +are sustained by vital changes, the transformation of organized +materials. No mental effort can be made without waste of nervous matter. +The gardener's hoe wears by use, and so does every part of the animal +organism. Otherwise, nutrition would be unnecessary for the adult. The +production of thought wears away the cerebral substance. In ordinary +use, the brain requires one-fifth of the blood to support its growth and +repair. Great mental efforts are attended by a corresponding expenditure +of vital treasures, which are abstracted from the total forces available +for the necessities of the system. To repair the losses thus occasioned, +materials are appropriated from the blood, which furnishes supplies in +proportion to the demands made by the mental activities. The production +of thought wears away the gray matter of the cerebrum as surely as the +digging of a canal wears away the iron particles of the spade. The brain +would soon wear out did not the nutritive functions constantly make good +the waste. The intellect, whether engaged in observation, +generalization, or profound study consumes the brain and blood, hence +intellectual activity implies VITAL EXPENDITURE. _Expenditure_ is an +emphatic word because all functions are essential to the production of +this nerve-energy, which returns to the system no equivalent. Physical +exercise, although attended by structural waste, is advantageous to the +circulation of the blood, nutrition, secretion, and, in fact, beneficial +to all the organic processes. This is not true of vigorous and prolonged +mental labor, which is not attended by any of these incidental +advantages. If a child attends a school in which mental development +supersedes physical culture, an inordinate ambition sways the youthful +mind, and its baneful effects upon the health soon become manifest. +Rigorous application of the intellectual faculties consumes the blood, +exhausts the vital forces, weakens the organic functions, while pallor +covers the face, and the eyes sparkle with a hectic radiance. The family +physician pronounces the condition _Anæmia_ (a deficiency of red +corpuscles in the blood), and this change in the quality of the blood is +owing to the undue appropriation by the brain. Conversely, if the blood +be destroyed, or its vitality reduced, in the same proportion will the +mental energies be weakened and all the functional powers of the +physical system enfeebled. In brief, if the intellect be unduly +exercised, the red corpuscles of the sanguine fluid will be gradually +destroyed, and the serum allowed to predominate. The blood becomes weak +and watery, the subject is nervous, dropsical, consumptive and +derangement of the important functions follows almost invariably. +Excessive intellectual activity often produces weak state of the system, +and the person thus affected becomes languid, spiritless, and an easy +prey to disease. This mental cause and its bodily results may be +classified in the following order. Mental Cause: EXCESSIVE MENTAL +EXERTION, which produces _waste of the brain substance and blood_. + + / VITAL EXPENDITURE, + Bodily results: { ANÆMIA, + \ A WEAK CONDITION. + +This kind of waste is best summed up in the words, VITAL EXPENDITURE. +Upon the forehead, as represented in Fig. 72, we will therefore inscribe +INTELLECT, ACTIVITY, and VITAL EXPENDITURE. Intellectual employment is +usually accompanied by sedentary habits, neglect of healthful exercise, +and a deprivation of pure air, to all of which ill health may be +attributed. Were the intellectual expenditure arrested, and the forces +turned into recuperative channels, many a person would become beautiful +with the ruddy glow of health. Without health there is no use for +thought; cultivation of the mind is just as natural and essential as the +culture of the body, and the trained development of both is needed for +mutual improvement. + + +EMOTIVE FACULTIES. + + +[Illustration: Fig. 72.] + +What results follow the _natural_ and the _excessive_ exercise of the +EMOTIVE FACULTIES? AS distinct organs of the body have diverse +functions, so, in like manner, different parts of the brain perform the +separate operations of the mind. It is easier to discriminate between +the products of these dissimilar endowments than to determine the +location of the faculties. The intellect deals with concrete subjects, +and the emotions with abstractions; the intellect is exercised with +material things, the emotions dwell upon attributes; the intellect +considers the forces of matter, the emotions, the powers of the soul; +the former deliberates upon the truths of science, the latter is +concerned with duties, obligations, or moral responsibilities; the first +is satisfied only with new truths, original ideas, and rational changes, +the last rest securely on fundamental principles, moral certainties, and +the absolute constancy of perfect love. The intellectual faculties are +wakeful, questioning, mistrustful; the emotions are blind, hopeful, +confiding; the one reasoning, exacting, demonstrating; the other, +believing, inspiring, devout. The intellect sees, the emotions feel; +and, though these functions may blend, the one can never supersede the +other. + +The quality of the emotional faculties is represented by Benevolence, +Sympathy, Joy, Hope, Confidence, Gratitude, Love, and Devotion, all of +which are the very antitheses of the attributes of animal feeling, +described as Melancholy, Fear, Anger, Hate, Malevolence, and Despair. To +the emotions we refer the highest qualities of character, while their +opposites represent the animal or baser impulses. True, the emotions +modify the propensities, as sympathy softens grief. They may subdue and +refine the animal feelings, and thus veil them with a delicacy +characteristic of their own purity; but the unrestrained influences of +grief find vent in loud lamentations, and the bitter disappointments of +the selfish faculties are passionate and violent. + +The _Emotive Faculties_--the organs of spiritual perceptions--are +impersonal, outflowing, bestowing. The function represented by +Benevolence, is willing, giving. Devotion expresses dedication, +consecration; Gratitude manifests a warm and friendly feeling toward a +benefactor. + + "The depth immense of endless gratitude."--MILTON. + +Love flames toward its object, is out-pouring, blessing; indeed, all the +emotions are gushing, effusive, impetuous, and profusely flowing; grand, +torrent-like, overwhelming; employing ideal, immaterial, spiritual +expressions, developing principles and perfections while aspiring to +happiness and immortality. Though beginning with humanity, they embody +the Divine. They expand to their ultimate conceptions in the sublime +attributes: the perfections of the God of Love; associating with +mortality a divine destiny commencing on earth, extending through time, +pausing not at the portals of death, the gateway to eternity, but +flowing onward into the realms of eternal day. + +We may consider their counteracting influences, for, without doubt, by +checking the selfish tendencies and restraining the animal propensities, +they assist in controlling the sensual passions, and thus balance the +mind and body. Such an equilibrium we call _happiness_. If the emotions +be acute and vehement, they will absorb all other impressions and revel +in their culminating and delightful experiences. They exhaust all the +bodily energies, and a functional suspension, termed _ecstasy_, follows. +It is a swooning, or fainting, a temporary loss of sensation and +volition, accompanied by involuntary movements of the arms, smiting of +the hands, sighing, and short ejaculatory expressions of rapture. This +condition, occasioned by excessive emotion, as in praying, singing, +exhortations, and sympathetic appeals, is contagious, often spreading +with mysterious rapidity. Its culmination, ecstasy, is popularly termed +"_the power_." When gradually induced, it is called _trance_, and each +state is regarded by many as supernatural, caused by the immediate +influence of the Holy Spirit. The explanation is this: when the emotive +faculties are suddenly and powerfully excited, they quickly expend the +organic forces, so that the individual swoons from sheer exhaustion. +Undue expenditure of this class of brain functions not only consumes the +bodily powers, but exhausts and prevents other mental operations. The +sudden collapse of all voluntary functions resembles the fainting +produced by blood-letting. We may sum up this rapid expenditure of +energy in one expressive word, EXHAUSTION, which results in _Ecstasy_, +or trance, and which, if carried a degree further, terminates in death. +Beginning with the natural exercise of the emotions, we may state the +order of sequences thus: + + Ordinary exercise leads to CALMNESS. + Proper exercise " " HAPPINESS. + Increased exercise " " ECSTASY. + Excessive exercise " " SYNCOPE. + Prolonged exercise " " TRANCE. + Fatal exercise " " MORTALITY. + Their tendencies are EXHAUSTIVE. + + +VOLITIVE FACULTIES. + + +What are the physiological and morbid results attending the ordinary and +the immoderate exercise of the VOLITIVE FACULTIES? + +The generic term _will_, comprehends those faculties, the action of +which is termed _volition_. The faculties of the will are Determination, +Firmness, Decision, Ambition, Authority, and Vigilance, all of which +indicate strength and continuity of purpose. Bordering upon the emotions +are Patience and Perseverance, while adjoining the animal faculties are +Power, Coarseness, and Love of Display. The former exhibit moral, the +latter animal heroism. A sense of power urges forward, whether it be +higher or lower, just as the sense of greatness makes a man _great_ by +inspiring him with confidence to put forth exertion. Nature is truthful +in her aspirations. We know that courage, assurance, and conscious power +are necessary for the fulfillment of purpose, because intention precedes +action. Will-power is an indication of HEALTH, and the constant exercise +of these mental faculties exerts a steady, regular, and strengthening +influence over the bodily functions. We translate mental energies into +physiological industry. These faculties impart tone to the system, +sustain the processes of nutrition, circulation, assimilation, secretion +and excretion, and their distinguishing characteristics are vigor, +tension, and elasticity. They temper each element of character, as well +as every vital act. They infuse the organism with a resisting power +which renders it proof against the influence of miasma and malaria, and +overcomes that passivity and impressionability so favorable to disease. +Firmness expresses a physiological cohesiveness which strongly binds +together the fibers of the tissues, and renders the organization compact +and powerful. He, who can skillfully employ these energies, is already +master of half of the diseases incident to mankind, and wields an +indispensable adjunct to medicine, in the practice of the healing art. +It is the key to success, for it unlocks difficulties and opens wide the +door which leads to favorable results. + +Surplus energy sustains the circulation, increases capillary action, as +if the excess of nerve-power were discharged from the distant extremity +of each nerve and pervaded every tissue. The voluntary muscles indicate +their participation in this energy, and, indeed, the whole organism is +exalted by the influence of the mental faculties. They oppose the +tendencies of Feebleness, Relaxation, and Derangement, and modify their +proclivities to Disease. The will is the servant of the intellect, +emotions, and propensities, and the executive agent of all the +faculties. When the volitive faculties are in excess, they may overdo +the other functions, prematurely break down the bodily organs, and, by +overtaxing the system, subject it to pain and disorder. + +_VOLITIVE FACULTIES._ + +The natural effect of FIRMNESS is physiological stability. The exercise +of the volitive faculties displays both mental and bodily ENERGY. + + / TEMPERANCE, + Their tendencies are to { SANITY, + \ HEALTH. + + +ANIMAL FACULTIES. + + +[Illustration: Fig. 73. is a representation of the cranial conformation +of Alexander VI., exhibiting a full development of the conservative +faculties. His character, according to history, brought reproach upon +the papal chair.] + +[Illustration: Fig. 74. represents Zeno, a profound thinker and moral +philosopher. The contrast in their cranial developments was no greater +than that of their lives.] + +Under this generic term we will group those cerebral powers which are +common to the inferior animals, and closely allied to bodily conditions +and necessities. As denoting a group of animal faculties they relate not +only to the organic functions and self-preservation, but combat the +action of the intellect, oppose the evolution of new ideas, resist +investigation, and discredit the value of truth. Adhesiveness, being +blindly conservative, clings to old ideas and traditionary opinions. The +animal faculties tend to stifle investigation, and put authority above +truth and science. Having a fixity of nature, a stationary attachment, +they treat all intellectual developments as absurd. When these faculties +predominate, thought is obscured, intolerance of disposition is +manifested, and mental progress is arrested. Thus they evince their +conservative nature, and, since they relate to individual interests, +they represent the elements of instinct. Such are the functions of +Acquisitiveness, Secretiveness, Selfishness, and Combativeness, as well +as the Generative powers. If these faculties predominate, all +intellectual advancements are treated as experiments or theoretical +novelties, and rejected as evanescent and worthless. If the promptings +of these be followed, there will be no innovation, and the orthodoxy of +the dark ages will remain the standard for all time. The animal +faculties coincide with Lethargy, Sleep, and Nutrition, thus favoring +organic restoration. The intellectual faculties are wakeful, active, +irrepressible, while the animal powers tend to repose, sleep, and +renovation, and thus suspend the activities of thought, sense, and +motion. The intellect expends the energy of the sensorial centers, +induces fatigue and suffering, whereas the animal faculties overcome the +vigils of thought, and produce refreshing slumber. Dr. Young styles +sleep "tired nature's sweet restorer." Swedenborg declared that, "in +sleep the brain folded itself up, and the soul journeyed through the +body, repairing the wastes of the previous day." When sleep is natural, +the insane are in a fair way to recovery, the sick become convalescent, +ulcers granulate, and lesions are made whole. + +The animal faculties are skeptical, stubborn, and dogmatic, readily +combining with those of the violent class, the ultimate tendencies of +which are criminal. They are likewise conceited, assuming, and clannish. +Any person distinguished by them, will cling to old associations, +perpetuate the status of existing parties, be a stickler for creed, +ceremonies, and stale opinions, and adhere to ancient orthodoxy in +medicine and religion. The animal faculties, since they are staid and +regular, are naturally antagonistic to genius, sensibility, and +originality. Their mental tendencies have been fairly described and +their physiological results may be represented as follows: + + / RESTRAINT, + / SLEEP, + The animal faculties produce { NUTRITION, + \ RESTORATION, + \ CONSERVATION. + + +BASILAR FACULTIES. + + +The ultimate tendencies of the faculties, represented by the posterior +base of the cerebrum, are violent and criminal. Being contiguous to the +junction of the cerebrum and spinal system, they are subject to the +influence of animal experiences. A large development of these faculties +is indicated by an unusual breadth and depth of the back part of the +base of the brain, and a full, thick neck, both of which denote good +alimentary and digestive powers. Active nutrition, plethora of the +circulation, vigorous secretion, a well developed muscular system, a +large heart and lungs, are accessory conditions. We do not associate +corpulence or surplus of vitality with a long, slender neck. The +character of cerebral manifestations is represented by the baser +faculties of mind, such as Combativeness, Destructiveness, Desperation, +Turbulence, Hatred, and Revenge. If unrestrained, these culminate in +violent and criminal acts; if _regulated_, they are employed in personal +defense. When _unduly excited_, they lead to dissipation, obscenity, +swearing, rowdyism, and licentiousness; when _perverted_, they are the +source of recklessness, quarrels, frauds, falsehoods, robberies, and +homicides. They are unlike instinct, inasmuch as they are not +self-limiting. The intimate relation which they sustain to the stomach +and nutritive functions is strikingly displayed in the habit of +alcoholic intoxication. Spirituous drinks deprave the appetite, derange +and destroy the stomach, poison the blood, and pervert all the functions +of mind and body; and their injurious influence upon the nerves and +basilar faculties is equally remarkable. They excite combativeness, +selfishness, irritability, and exaggerate the influence of the animal +organs. Intemperance results in disputes, fights, brawls, and +murders--the legitimate consequences of which are misunderstandings, +suits at law, criminal proceedings, imprisonment, and the gallows. It +is, therefore, evident that the ultimate tendencies of these faculties +are tyrannical, cruel, violent, and atrocious. They are opposed to the +noble, moral faculties--Faith, Love, and Devotion--and, whenever +temptation inordinately allures, the course of life is likely to be +characterized by dishonorable, deceptive, and treacherous conduct. + +The pangs of hunger cause soldiers to act more like ravenous beasts, +than rational beings. It is animal instinct which impels the soldier to +seek first for the gratification of his appetite. Some persons, +instigated by carnivorous desires, yearn for raw meat, and will not be +satisfied unless their food is flavored with the flesh of animals. Their +bodies increase and thrive, even to repletion. Contrast these +individuals with pale, lean, anæmic people, who crave innutritious +articles of diet, and eat soft stones, slate, chalk, blue clay, and soft +coal. Such perversions of the appetite are manifested only when there is +either a diminution in the volume of blood, deficient alimentation, +defective assimilation, or a general depravity of the nutritive +functions. Morbid conditions generate vitiating tendencies and destroy +the natural appetite. + +While alcoholic stimulants affect the medulla oblongata principally, +opium acts chiefly on the cerebrum, and excites reverie, dreamy +ideality, optical delusions, and the creative powers of the imagination; +some of these hallucinations are said to be grotesquely beautiful and +enjoyable. The effects of this agent differ from those of alcoholic +intoxication by not deadening the moral sensibilities, or arousing the +animal propensities. Opium smokers are dreamy and abstracted, not +quarrelsome or violent. Those who use ardent spirits lose their moral +delicacy, their intellect becomes dull, the reason cloudy, and the +judgment is overruled by appetite. It is conceded that the _trophic +center_ is principally in the medulla oblongata; the cerebellum and +lower cerebral ganglia, however, favorably influence the nutritive +functions, and, when these organs are large and active, a plethoric +condition is the natural consequence. Redundancy of blood in the body +indicates preponderance of the basilar organs. These faculties being +vehement in character, an excess of animal characteristics produces +those conditions which result in acute and inflammatory diseases. We may +express these conditions of the system as follows: + +The _Animal Faculties_ correspond to the lower instinctive +manifestations. + + / ACQUISITIVENESS, + The elements of character are { SELFISHNESS, + \ COMBATIVENESS + + They tend to / TURBULENCE, + \ CRIME. + + / ALIMENTATION, + They relate especially to the { SECRETION, + functions of \ NUTRITION, + \ REPRODUCTION. + + / VITALITY, + A large development of them { PLETHORA, + indicates \ HYPERAEMIA (congestion). + +These naturally give rise to the following diseases: Inflammation, +Rheumatism, Gout, Convulsions, etc., which, in these conditions, pursue +a violent course. + + +REGION OF FEEBLENESS. + + +Although the middle lobe of the cerebrum, at the base of the brain, does +not denote decided force of character, or energy of constitution, yet it +has a certain sphere of normal action which is essential to the harmony +of mind and body. If this region is largely developed, the constitution +is languid, inefficient, sensitive, and abnormally disposed. But if it +be deficient, the volitive energies preponderate, and there is a lack of +those susceptibilities of constitution, which prevent excessive waste. +The cerebral faculties are Fear, Anxiety, Sensibility, Servility, +Relaxation, and Melancholy, and their excessive predominance indicates a +weak, vacillating, irresolute character, and the existence of those +bodily conditions which produce _general excitability_ and chronic +derangement. A full development of this portion of the brain indicates +that the person is naturally dependent, inferior, and subservient to +stronger characters. Such a one is fearful, fretful, complaining, +irritable, dejected, morose, and, sooner or later, becomes a fit subject +for chronic disease.[5] The ultimate result of excessive fear, +excitability, and irritability, is functional or organic +derangement,--the morbid conditions represented by the word Disease. The +medulla oblongata and portions of the middle lobe of the brain, the +functions of which represent Excitability, Anxiety, Fear, and +Irritability (symbols of physical profligacy), are located just between +the ears (see Fig. 60). Inferior animals distinguished for breadth +between the ears are not only cunning and treacherous, but very +excitable and irritable. The head of the Fox is remarkable for its +extreme width at the region of Fear. He is proverbially crafty and +treacherous, always excitable, and so variable in temper that he can +never be trusted. He is a very timid thief, exceedingly suspicious, +irregular in habits, and frequently driven by hunger into mischievous +depredations. + +[Illustration: Fig. 75. +Sly Reynard] + +The organ of alimentiveness, located directly in front of the ear, +indicates the functional conditions of the stomach, which, when aroused +by excessive hunger, exerts a debasing influence upon this and all of +the adjacent organs, and is demoralizing to both body and mind. In +obedience to the instinct of hunger, children will slyly plunder gardens +and orchards, displaying profligate, if not reckless tendencies in the +gratification of the appetite. In this regional division we include the +medulla, the posterior and middle portions of which give rise to the +pneumogastric nerve. This nerve receives branches from the spinal +accessory, facial, hypoglossal, and the anterior trunks of the first and +second cervical, and its filaments are distributed to the lungs, +stomach, liver, spleen, pancreas, and gall bladder (see Fig. 60, with +explanation) Its agency is necessary to maintain the circulation, and +the respiration, since, as the medium of communication, it conveys from +the brain large supplies of nervous force to sustain these vital +functions. It likewise instantly reports the impressions of these +physiological processes to the brain, and especially to those parts +which, by analogy of functions. It likewise instantly reports the +impressions of these physiological processes of the brain, and +especially to those parts which, by analogy of functions, are intimately +related to the stomach. Hence, we observe that the conditions of the +stomach give rise to reflex impulses, which involuntarily excite the +animal faculties to the gratification of the appetite. That the stomach +has an intimate connection with the rest of the organism is evident from +the fact that when it is inflamed the body is completely prostrated. + +We have already alluded to the perverting tendencies of alcoholic +stimulants. Their peculiar influence upon the cerebellum causes the +subject to reel and stagger, as though a portion of that organ were +removed; the group of energetic faculties is stupefied, and mental as +well as corporeal lethargy is the result. The reaction, which inevitably +follows, is almost unbearable, and relief is sought by repeating and +increasing the poisonous draughts, the primary influence of which is +stimulating, the ulterior, depressing. Alcoholic stimulants unduly +excite the nervous centers, the heart, and the arteries, and, +consequently, the blood is carried to the surface of the body, where it +counteracts the influence of cold and exposure, the frequent attendants +upon drunkenness. The use of alcoholic beverages perverts the appetite, +interrupts habits of industry and destroys all force of character. +Pecuniary, physical, and mental ruin, therefore, are sure to follow as +the consequences of habitual, alcoholic intoxication. + +That ordinary alimentation, which includes the process of digestion, the +subsequent vital changes involved in the conversion of food into blood, +and its final transformation into tissue, causes mental languor and +dullness, as well as bodily exhaustion, is attested by universal +experience. A torpid condition of the liver, one of the most inveterate +of chronic derangements, is indicated by sullenness, melancholy, +despondency, loss of interest in the affairs of life, sluggishness, +etc., and the ultimate tendency of this morbid state is towards +_suicide_. A broad and deep development of the middle lobe of the brain, +shown by a fullness under the chin, and of the adjacent portion of the +neck, denotes tendencies to somnambulism, delirium, and insanity. If +such characteristics of the organization do not culminate in mental +derangement, they exhibit childishness, helplessness, and great +dependence. Age abates the vigor of the executive faculties, and old +people manifest not only bodily infirmities, but the relaxing and +enfeebling influences proceeding from the lower portions of the brain. +They totter about in their second childhood, mentally and physically +enervated. Those who become dissipated by the use of intoxicating +beverages are not only weak, trifling, and foolish, but walk with an +unsteadiness which betrays their condition. These illustrations show +that this part of the brain is destitute of energy. Diseases of the +digestive organs also indicate it. Cholera, whether induced by invisible +animalcules in the air, or in water, takes the route of the alimentary +canal, opens the vital gates, and myriads of victims are swept down to +death. It proves remarkably fatal to those having this cerebral +conformation. Perhaps enough has been said to indicate the relaxing and +enfeebling tendencies of this region of the brain. They may be +classified as follows: + + _REGION OF FEEBLENESS._ + + / SERVILITY, + / CAUTIOUSNESS, + / FEAR, + Cerebral Functions: { ANXIETY, + \ SENSIBILITY, + \ CUNNING, + \ PROFLIGACY. + + / ATONIC, + Physiological conditions / EXCITABILITY, + and tendencies: { RELAXATION, + \ FEEBLENESS, + \ DISEASE. + +This classification shows their tendencies to chronic disease, +functional derangement, insanity, and suicide. + + +GENERAL CONSIDERATIONS. + + +Before the structure of the brain was understood, Buffon spoke of it as +a "mucous substance of no great importance." Its functional significance +was so slightly appreciated that some people hardly suspected they had +any brains, until an _accident_ revealed their existence. Latterly, +however, it is generally understood that the perfection of an animal +depends upon the number and the development of the organs controlled by +the nervous system, the sovereign power of which is symbolized by a +grand cerebrum, the throne of Reason. That animal which is so low in the +scale of organization as to resemble a vegetable, belongs to an +ascending series ending in man. The lowest species have no conscious +perception, and their movements do not necessarily indicate sensation or +volition. Instinct culminates in the _Articulates_, especially in +Insects; while created intelligence reaches its acme in man, the highest +representative of the _Vertebrates_. + + "All things by regular degrees arise-- + From mere existence unto life, from life + To intellectual power; and each degree + Has its peculiar necessary stamp, + Cognizable in forms distinct and lines."--LAVATER. + +[Illustration: Fig. 76. +Outline of Skulls. 1. European. 2. Negro. 3. +Tiger. 4. Hedge Hog. 5. Sloth.] + +Man, in the faculties of mind, possesses more than a complement for +instinct; some of the lower animals, however, seem to share his rational +nature, and to a certain degree become responsible to him. Finally, the +manifestations of mind bear a relation to the development of cerebral +substance, and to the bodily organization which supplies the brain with +blood. Fig. 76 shows the relative amount of brain matter in the lower +animals, compared with that of man; the peculiarities of each agreeing +with its cerebral conformation. It is easier to measure the capacity of +skulls in different races than to procure and weigh their brains. The +following table has been published. + + CRANIAL CAPACITY OF HUMAN RACES. + + Race. CUBIC INCHES. + + Swedes,................. 100.00 + Anglo-Saxons,............ 96.60 + Finns,................... 95.00 + Anglo-Americans,......... 94.30 + Esquimaux,............... 86.32 + North America Indians,... 84.00 + Native Africans,......... 83.70 + Mexicans,................ 81.70 + American Negros,......... 80.80 + Peruvians and Hottentots, 75.30 + Australians,............. 75.00 + Gorilla, adult,.......... 34.50 + Idiot,................... 22.57 + +Mr. Davis, of England, having a collection of about eighteen hundred +cranial specimens obtained from different quarters of the globe, +ascertained the relative volume of brain in different races, by filling +the skulls with dry sand. He found that the European averaged 92 cubic +inches, the Oceanic 89, the Asiatic 88, the African 86, the Australian +81. Dr. Morton, of Philadelphia, had a collection of over one thousand +skulls, and his conclusions were that the Caucasian brain is the +largest, the Mongolian next in size, the Malay and American Indian +smaller, and the Ethiopian smallest of all. The average weight of brain, +in 278 Europeans, was 49.50 oz., in 24 White American soldiers, 52.06 +oz., indicating a greater _average_ for the American brain. + + OUNCES + The brain of Cuvier, the celebrated naturalist, weighed 64.33 + Ruloff, the murderer and linguist, 59.00 + Dr. Spurzheim--phrenologist, 55.06 + Celebrated philologist, 47.90 + Celebrated mineralogist, 43.24 + Upholsterer, 40.91 + +The weight of the human brain varies from 40 to 70 oz.; that of idiots +from 12 to 36 40 oz. The average of 273 male European brains was 49½ +oz., while that of 191 females was 44 oz. If we compare the weight of +the female brain with that of the body, the ratio is found to be as +1:36.46, while that of the male is as 1:36.50; showing that, relatively, +the female brain is the larger. It appears that neither the absolute nor +relative size of the cerebrum, but the amount of gray matter which it +contains, is the criterion of mental power. Although a large cerebrum is +generally indicative of more gray matter than a small one, yet it is +ascertained that the grey substance depends upon the number, and depth +of the convolutions of the brain, and the deeper its fissures, the more +abundant is this tissue. It is this substance which is the source of +thought, while the white portion only transmits impressions. + +We do not wish to underrate any attempt heretofore made to classify the +functions of mind and assign to them an appropriate nomenclature. It is +not unusual for scientists to give advice to phrenologists and point out +the fallacies of their system; but it is hardly worth while to indulge +in destructive criticism, unless something better is offered, as the day +has passed for ridiculing endeavors to understand and interpret the +physiology of the brain. The all important question is, not whether +phrenologists have properly located and rightly earned all the faculties +of mind, but have their expositions been useful in the development of +truth. While endeavoring to connect each mental power with a local +habitation in the brain, the system of phrenology may be chargeable with +some incongruous classification of the faculties, and yet it has +furnished an analysis of the mind which has been of incalculable service +to writers upon mental philosophy. Phrenology, in popularizing its +views, has interested thousands in their own organizations and powers, +who would otherwise have remained indifferent. It has called attention +to mental and bodily unities, has served as a guide to explain the +physical and psychical characteristics of individuals, and has been +instrumental in applying physiological and hygienic principles to the +habits of life, thus rendering a service for which the world is greatly +indebted. Samuel George Morton, M.D., whose eminent abilities and +scholarship are unquestionable, employs the following language: + +"The importance of the brain as the seat of the faculties of the mind, +is pre-eminent in the animal economy. Hence, the avidity with which its +structure and functions have been studied in our time; for, although +much remains to be explained, much has certainly been accomplished. We +have reason to believe, not only that the brain is the center of the +whole series of mental manifestations, but that its several parts are so +many organs, each one of which performs its peculiar and distinctive +office. But the number, locality, and functions of these several organs +are far from being determined; nor should this uncertainty surprise us, +when we reflect on the slow and devious process by which mankind has +arrived at some of the simplest physiological truths, and the +difficulties that environ all inquiries into the nature of the organic +functions." + +[Illustration: Fig. 77. +Side view of the brain of a Cat. A. Crucial sulcus +dividing anterior convolutions. B. Fissure of +Sylvius. C. Olfactory bulb.] + +We may here allude to the recent experimental researches with reference +to the functions of various portions of the brain, prosecuted by Dr. +Ferrier, of England. He applied the electric current to different parts +of the cortical substance of the cerebrum in lower animals which had +been rendered insensible by chloroform, and by it could call forth +muscular actions expressive of ideas and emotions. Thus, in a cat, the +application of the electrodes at point 2, Fig. 77, caused elevation of +the shoulder and adduction of the limb, exactly as when a cat strikes a +ball with its paw; at point 4, corrugation of the left eye-brow, and the +drawing inward and downward of the left ear; when applied at point 5, +the animal exhibited signs of pain, screamed, and kicked with both hind +legs, especially the left, at the same time turned its head around and +looked behind in an astonished manner; at point 6, clutching movement of +the left paw, with protrusion of the claws; at point 13, twitching +backward of the left ear, and rotation of the head to the left and +slightly upward, as if the animal were listening; at point 17, +restlessness, opening of the mouth, and long-continued cries as if of +rage or pain; at a point on the under side of the hemisphere, not shown +in this figure, the animal started up, threw back its head, opened its +eyes widely, lashed its tail, panted, screamed and spit as if in furious +rage; and at point 20, sudden contraction of the muscles of the front of +the chest and neck, and of the depressors (muscles) of the lower jaw, +with panting movements. The movements of the paws were drawn inward by +stimulating the region between points 1, 2, and 6; those of the eyelids +and face were excited between 7 and 8; the side movements of the head +and ear in the region between points 9 and 14; and the movements of the +mouth, tongue and jaws, with certain associated movements of the neck, +being localized in the convolutions bordering on the fissure of Sylvius +(B), which marks the division between the anterior and middle lobes of +the cerebrum. Dr. Ferrier made similar experiments on dogs, rabbits, and +monkeys. The series of experiments made on the brain of the monkey is +said to be the most remarkable and interesting, not only because of the +variety of movements and distinctly expressive character of this animal, +but on account of the close conformity which the simple arrangement of +the convolutions of its brain bears to their more complex disposition in +the human cerebrum. It is premature to say what import we shall attach +to these experiments, but they have established the correctness of the +doctrine, advanced on page 105, that thought, the product of cerebral +functions, is a class of _reflex actions_. The cerebrum is not only the +source of ideas but also of those co-ordinate movements which correspond +to and accompany these ideas. Certain cerebral changes call forth mental +states and muscular movements which are mutually responsive. They +indicate that various functions are automatic, or dependent upon the +will, and, as we have seen, experiments indicate that the electric +current, when applied to the cerebrum, excites involuntary reflex +action. We cannot say how far these experimental results justify the +phrenological classification of the faculties of mind, by establishing a +_causative_ relation between the physical and psychical states. This +short and unsatisfactory account furnishes one fact which seems to +support the claim of such a relation: the apparent similarity between +the motor center of the lips and tongue in lower animals, and that +portion of the human cerebrum in which disease is so often found to be +associated with _Aphasia_, or loss of voice. While these experiments are +by no means conclusive in establishing a theory, yet they favor it. + +It is wonderful that nervous matter can be so arranged as not only to +connect the various organs of the body, but at the same time to be the +agent of sensation, thought, and emotion. It is amazing, that a ray of +light, after traversing a distance of 91,000,000 miles, can, by falling +upon the retina, and acting as a stimulus, not only produce a +contraction of the pupil, but excite thoughts which analyze that ray, +instantly spanning the infinitude of trackless space! The same +penetrative faculties, with equal facility, can quickly and surely +discern the morbid symptoms of body and mind, become familiar with the +indications of disease, and classify them scientifically among the +phenomena of nature. The symptoms of disease which follow certain +conditions as regularly as do the signs of development, and mind itself +is no exception to this uniformity of nature. Thoughts result from +conditions, and manifest them as evidently as the falling of rain +illustrates the effect of gravity. The perceptive and highest emotive +faculties of man depend upon this simple, but marvelously endowed +nervous substance, which blends the higher spiritual with the lower +physical functions. The functions of the body are performed by separate +organs, distinguished by peculiar characteristics. To elucidate the +distinctions between dissimilar, mental faculties, we have assigned +their functions, with characteristic names, to different regions of the +head. As they unquestionably influence the bodily organs, we are +sustained by physical analogy, in our classification. Our knowledge of +the structure and functions of the nervous system is yet elementary, and +we are patiently waiting for scientists to develop its facts, and verify +them by experimental investigations and such researches as time alone +can bring to perfection. While real progress moves with slow and +measured foot-steps, the inspirations of consciousness and the +inferences of logic prepare the popular mind for cerebral analysis. No +true system can contradict the facts of our inner experience; it can +only furnish a more complete explanation of their relation to the bodily +organs. It should be expected that such careful and pains-taking +experiments, as are necessary to establish a science, will be preceded +by intuitive judgments and accredited observations, which may be, for a +time, the substitutes of those more abstruse in detail. + +We have, in accordance with popular usage, treated the organs of thought +as having anatomical relations. The views which we have presented in +this chapter may seem speculative, but the facts suggesting the theory +demand attention, and we have attempted to gather a few of the scattered +fragments and arrange them in some order, rather than leave them to +uncertainty and greater mystery. It is by method and classification that +we are enabled to apply our knowledge to practical purposes. Possibly, +to some, especially the non-professional, an allusion to the fact that +cerebral physiology contributes to successful results in the practice of +medicine, may seem to be an exaggerated pretension. None, however, who +are conversant with the facts connected with the author's experience, +will so regard this practical reference, for the statement might be +greatly amplified without exceeding the bounds of truth. Physicians +generally undervalue the nervous functions, and overlook the importance +of the brain as an indicator of the conditions of the physical system, +because they are not sufficiently familiar with its influence over the +bodily functions. Pathological conditions are faithfully represented by +the thoughts, and words, when used to describe symptoms, become the +symbols of feelings which arise from disease. How few physicians there +are who can interpret the thoughts, and glean, from the expressions and +sentences of a letter, a correct idea of the morbid conditions which the +writer wishes to portray! Each malady, as well as every temperament, has +its characteristics, _and both require careful and critical analysis_ +before subjecting the patient to the influence of remedial agents. + +In a treatise by Dr. J.R. Buchanan, entitled "Outlines of Lectures on +the Neurological System of Anthropology," are presented original ideas +pre-eminently useful to the physician. His researches, and those of +later writers, together with our own investigations, have greatly +increased our professional knowledge. It is by such studies and +investigations that we have been prepared to interpret, with greater +facility, the indications of disease, and diagnose accurately from +symptoms, which have acquired a deeper significance by the light of +cerebral physiology. We are enabled to adapt remedies to constitutions +and their varying conditions, with a fidelity and scientific precision +which has rendered our success in treatment widely known and generally +acknowledged. We annually treat thousands of invalids whom we have never +beheld, and relieve them of their ailments. This has been accomplished +chiefly through correspondence. When patients have failed to delineate +their symptoms currently, or have given an obscure account of their +ailments, we have been materially assisted in ascertaining the character +of the disease by photographs of the subjects. The cerebral conformation +indicates the predisposition of the patient, and enables us to estimate +the strength of his recuperative energies. Thus we have a valuable guide +in the selection of remedies particularly suited to different +constitutions. In the treatment of chronic diseases, the success +attending our efforts has been widely appreciated, not only in this, but +in other countries where civilization, refinement, luxurious habits, and +effeminating customs, prevail. This fact is mentioned, not only as an +illustration of the personal benefits actually derived from a thorough +knowledge of the nervous system, but to show how generally and +extensively these advantages have been shared by others. + +A careful study of cerebral physiology leads us deeper into the +mysteries of the human constitution, and to the philosophical +contemplation of the relations of mind and body. Self-culture implies +not only a knowledge of the powers of the mind, but also how to direct +and use them for its own improvement, and he who has the key to +self-knowledge, can unlock the mysteries of human nature and be +eminently serviceable to the worlds For centuries the mind has been +spreading out its treasury of revelations, to be turned to practical +account, in ascertaining the constitution, and determining better +methods of treating disease. Since comparative anatomists and +physiologists have revealed the structure of animals and the functions +of their organs, from the lowest protozoan to the highest vertebrate, +the physician may avail himself of this knowledge, and thus gain a +deeper insight into the structure and physiology of man. An intimate +acquaintance with the physical, is a necessary preparation for the study +of the psychical life, for it leads to the understanding of their mutual +relations and reactions, both in health and disease. + +Consciousness, or the knowledge of sensations and mental operations, has +been variously defined. It is employed as a collective term to express +all the psychical states, and is the power by which the soul knows its +own existence. It is the immediate knowledge of any object whatever, and +seems to comprise, in its broadest signification, both matter and mind, +for all objects are inseparable from the cognizance of them. Hence, the +significance of the terms, subjective-consciousness and +objective-consciousness. People are better satisfied with their +knowledge of matter than with their conceptions of the nature of mind. + + +THE NATURE OF MIND. + + +Since this subject is being discussed by our most distinguished +scientists, we will conclude this chapter with an extract from a lecture +delivered by Prof. Burt G. Wilder, at the American Institute: + +"There now remains to be disposed of, in some way, the question as to +the nature and reality of mind, which was rather evaded at the +commencement of the lecture. The reason was, that I am forced to differ +widely from the two great physiologists whom I have so often quoted this +evening. Most people, following in part early instruction, in part +revelation, in part spiritual manifestations, and in part trusting to +their own consciousness, hold that the human mind is a spiritual +substance which is associated with the body during the life of the +latter in this world, and which remains in existence after the death of +the body, and forms the spiritual clothing or embodiment of the immortal +soul; and that the individual, therefore, lives after death as a spirit +in the human form; that of this spiritual man, the soul is the essential +being, of which may be predicted a good or evil nature, while the mind, +which clothes it as a body, consists of the spiritual substances, +affections, and thoughts, which were cherished and formed during the +natural life. + +Together with the above convictions respecting themselves, most people, +when thinking independently of theological sublimations, feel willing to +admit that animals have, in common with man, fewer or more natural +affections and thoughts which make up their minds, but that the inner +and immortal soul, which would retain them as part of an individual +after death of the body, is not possessed by the beasts that perish. In +short, the vast majority of mankind, when thinking quietly, and +especially in seasons of bereavement, feel well assured of the real and +substantial existence of the human mind, independently of its temporary +association with the perishable body. + +But in antagonism to this simple and comforting faith, stand theological +incomprehensibilities on the one hand, and scientific skepticism on the +other. The former would have us believe that the soul is a mere vapor, a +cloud of something ethereal, of which can be expected nothing more +useful than 'loafing around the Throne,' while the latter asks us to +recognize the existence of nothing which the eyes cannot see and fingers +touch; to cease imagining that there is a soul, and to regard the mind +as merely the product of the brain; secreted thereby as the liver +secretes bile. Let us hear what the two leading nervous physiologists, +of this country, have to say upon this point: + +'The brain is not, strictly speaking, the organ of the mind, for this +statement would imply that the mind exists as a force, independent of +the brain; but the mind is produced by the brain substance; and +intellectual force, if we may term the intellect a force, can be +produced only by the transmutation of a certain amount of matter; there +can be no intelligence without brain substance.'--FLINT. + +'The mind may be regarded as a force, the result of nervous action, and +characterized by the ability to perceive sensations, to be conscious, to +understand, to experience emotions, and to will in accordance therewith. +Of these qualities, consciousness resides exclusively in the brain, but +the others, as is clearly shown by observation and experiment, cannot be +restricted to that organ, but are developed with more or less intensity, +in other parts of the nervous system.'--HAMMOND. + +Thus do the two extremes of theology and science meet upon a common +ground of dreamy emptiness, and we who confess our comparative ignorance +are comforted by the thought that some other things have been 'hid from +the wise and prudent and revealed unto babes.' Yet, while feeling thus, +it must be admitted that the existence of spirit and of a Creator do not +yet seem capable of logical demonstration. The denial of their existence +is not incompatible with a profound acquaintance with material forms and +their operations; and, on the other hand, the belief in their existence +and substantial nature, and in their powers as first causes, have never +interfered with the recognition of the so-called material forces, and of +the organisms through which they are manifested. At present, at least, +these are purely matters of faith; but although the Spiritualist (using +the term in its broadest sense as indicating a belief in spirits), may +feel that his faith discloses a beauty and perfection in the union, +otherwise imperceptible by him, there is no reason why this difference +in faith should make him despise or quarrel with his materialist +co-worker, for the latter may do as good service to science, may be as +true a man, and live as holy a life, although from other motives. + +The differences between religious sects are mainly of faith, not of +works, and the wise of all denominations are gradually coming to the +conviction that they will all do God more service by toleration and +co-operation than by animosity and disunion. And so I hold that, until +the spiritualist feels himself able to demonstrate to the unbeliever the +existence of spirit and of God, as convincingly as a mathematical +proposition, there should be no hard words or feelings upon these +points. For the present they are immaterial in every sense of the word; +and so long as he bows to the facts and the laws of Nature, and deals +with his fellow men as he would be done by, so long will I work with +him, side by side, knowing, even though I cannot tell him so, that +whether or not he joins me in this world, we shall meet in the other +world to come, where his eyes will be opened, and where his lips will at +least acquit me of bigotry and intolerance." + + * * * * * + + + + +CHAPTER XV. + +THE HUMAN TEMPERAMENTS. + + +Organization implies vital energy, since there can be no organization +without it. The sperm cell, as we have previously seen, exists before +the initiation of the life of every individual organism. The early +history of this fertilizing cell, which is composed of infinitesimal +molecules which contain the embryo powers of life, is only partially +written. It is a fact, authenticated by Faraday, that one drop of water +contains, and may be made to evolve, as much electricity as, under a +different mode of display, would suffice to produce a lightning-flash. +Chemical force is of a higher order than physical, and vital force is of +a still higher order. Within the microscopic compass of the sperm cell +are a great number of forces acting simultaneously, which require the +answering conditions of a germ cell, and are so blended as to occupy a +minimum of space. The union of these subtle elements through the agency +of their physical, chemical, and vital forces, constitutes the +initiation of life. Elementary matter is transformed into chemical and +organic compounds, by natural forces, upon the cessation of which, it is +liberated by nature's great destroyer, and re-appears in the world of +elements. Thus, man is formed out of the very dust by means of energies +which reconstruct the crude, inert matter, and to dust he returns when +those energies cease. + +When we enter upon the consideration of the temperaments, we should bear +in mind one peculiarity of life: that it combines, in a small space, +many complex powers. In the process of reproduction, there is a complex +combination of organic elements. Structures differ as greatly as their +functions. So likewise do animals vary in their nature and organization, +and individuals of the same species are, in some respects, dissimilar. +Yet the characteristics which have distinguished the races of mankind, +are fundamental and faithfully maintained. Time does not obliterate +them. Within race-limits are found enduring peculiarities, and, although +each individual is weaving out some definite pattern of organization, it +follows the type of the race, as well as the more immediate, antecedent +condition. + +What then is a _Temperament_ but a _mixing together_ of these +determining forces, a certain blending manifested in the constitution by +signs, or traits, which we denominate _character_. The different races +of mankind must have their several standards of temperament, for the +peculiarities of one are not fully descriptive of, and applicable to the +other. + +The term temperament is defined by Dunglison, as being "a name given to +the remarkable differences that exist between individuals, in +consequence of the variety of relations and proportions between the +constituent parts of the body. + +For its simplicity and scope, we prefer the following definition, +suggested by our friend, Orin Davis, M.D.: A TEMPERAMENT IS A +COMBINATION OF ORGANIC ELEMENTS SO ARRANGED AS TO CHARACTERIZE THE +CONSTITUTION. + +This leads us to consider some of the elements, conditions and forces +which give character to the organization. External circumstances supply +necessary conditions to inward activity, for without air, food, or +sunlight all living animals would perish. Everywhere, life is dependent +upon conditions and circumstances; it is _not_ self-generating. But the +conditions of reproduction are very complex. External forces are +transformed, and, in turn, become vital or formative powers. Development +is a transmutation of physical and chemical forces into vital energy. +Although unable to compute the ultimate factors of life, yet we may +illustrate their reproductive possibilities and results by comparing +them with those of a lower order. + +Animal structures are mainly composed of four elements: oxygen, +hydrogen, nitrogen and carbon. Other constituents, such as phosphorus, +sulphur, potassium, sodium, calcium, magnesium, and iron, enter into +their composition, but are found in much smaller quantities. From these +elements is fabricated an organism which manifests peculiar properties +and marvelous functions. If the proportion of these chemical elements be +varied, the organic compound will be changed, or, the proportions +remaining the same, if the _grouping_ of the elements be altered, +different compounds will be produced, showing that the properties of +organized substances depend upon the _molecular_ constitution of matter. + +Rising in the scale of organization, we observe that every variation of +the physical and chemical processes implies a corresponding modification +of the vital. This is verified by the peculiarities of the several races +of mankind. Individual differences are likewise modifications of these +processes. Dynamical or vital differentiation depends upon these +modifications for the display of vital energy, and is always associated +with molecular changes. But it should be borne in mind that an effect +may not resemble its cause in _properties_, and the _qualities_ of a +chemical compound may be quite different from those of its individual +constituents. Organic matter, although more complex, may exhibit +properties, both like and unlike its constituent elements. Within +certain boundaries, the elements seek to satisfy their affinities. We +discover that there are limits between the genera of animals, as well as +the races of mankind. Not less really, though perhaps not as absolutely, +are there individual precincts within the sphere of the human +temperaments, which cannot be passed. + +If we cannot satisfactorily explain, we can at least discover a reason +for temperamental limitation. It is not designed to circumscribe +healthful reproduction, but to serve as an effectual hindrance to +abnormal deviations. We may state our belief in more positive terms: +that the temperamental variations are essential to _genesis_ and +_fertility_, and indispensable to _health_ and _normal development_. + +Every individual is susceptible to impressions which dispose to action. +Impressions which excite or increase this disposition, are called +_stimuli_. Vital change implies the existence of _stimuli_ and +_susceptibility_ to stimulation. The stimulus may not be furnished +because the conditions on which it depends are wanting; again, +susceptibility may exist at one time and not at another. Stimuli and +susceptibility may be present in different degrees, but for the purpose +of healthful reproduction they must not be impaired. No single class of +foods, albuminous, starchy, saccharine, or mineral, is sufficient for +the nutrition of the body, but the food must contain substances +belonging to each of the different classes. If an animal be fed +exclusively upon albumen, though this substance constitutes the largest +part of the bodily mass, exhaustion will rapidly follow, since the food +does not contain all the essential, nutritive elements. Again, when the +solids of the body have been wasted, they lose their susceptibility to +stimuli, and the food does no good. Thus patients become emaciated +during acute attacks of disease, upon the cessation of which they are +too feeble to recover, simply because they have lost the power to digest +and assimilate their food. + +In inanimate bodies, as in crystals, forces come to rest, but the very +idea of life implies action and continual change. Hence diversity of +constitutions and different temperaments are essential in order that +marriage may result in the reproduction of vigorous beings. + + +VITAL AND NON-VITAL TEMPERAMENTS. + + +[Illustration: Fig. 78.] + +In the preceding chapter, we attempted to illustrate the unique blending +of mind and body by means of the nervous system, and we now propose to +exemplify the physical conditions of the organism by certain +correspondences, observed in the development and conditions of that +system. If nature answer to mind in physical correspondences, she will +observe the same regularity in physical development. The simplest +classification of the temperaments is represented in Fig. 78. Not only +is mental activity dependent upon a vital activity in the brain, but the +development of the cerebrum is dependent upon the supply of blood. The +growth of the intellect requires the same conditions that aided in the +development of Vulcan's right arm: waste and supply; disintegration and +reparation of tissue. Our modern iron forges produce many an artisan +whose great right arm proclaims him to be a son of power as well as of +fire. Thus the fervid intellect, while forging out its thoughts, +increases in size and strength. The difference between the development +of the two is this; that the exercise of the blacksmith's right arm +quickens the activities of all the bodily functions, whereas the +employment of the intellect does not offer any healthy equivalent. +Physical exercise is a hygienic demand, but intellectual employment +exerts no salutary influence on the body, while it is constantly +expending the nutritive energies of the blood. The emotions, likewise, +make exhaustive draughts upon nutrition to supply the waste of brain +substance, just as certainly as physical labor causes muscular change, +and demands reparation. One expends cerebral, the other, muscular +substance. The one is healthful in its general tendencies, the other, +comparatively wasteful and destructive. + + / DISINTEGRATING, + The intellectual faculties are { EXPENDING, + \ DERIVING. + + / ENGROSSING, + The emotive faculties are { EXHAUSTING, + \ DEVITALIZING. + +These nervous forces are transformed into spiritual products. + +The base of the anterior lobes of the brain belong to the atonic +region--the source of those languid, deranging influences which coincide +with morbidity and disease. A disturbance of the corporeal organs, which +especially influence this portion of the brain, naturally tends to the +development of insanity or imbecility. Morel has traced, through four +generations, the family history of a youth who was admitted to the +asylum at Rouen while in a state of stupidity and semi-idiocy. The +following summary of his investigations illustrates the natural course +of degeneracy as it extends through successive generations: immorality, +depravity, alcoholic excess, and moral degradation, in the +great-grandfather, who was killed in a tavern brawl; hereditary +drunkenness, maniacal attacks, ending in general paralysis, in the +grandfather; sobriety, but hypochondriacal tendencies, delusions of +persecutions, and homicidal tendencies in the father; defective +intelligence in the son. His first attack of mania occurred at sixteen, +and was followed by stupidity, and finally ended in complete idiocy. +Furthermore, there was probably an extinction of the family, for the +son's reproductive organs were as little developed as those of a child +of twelve years of age. He had two sisters who were both defective +physically and morally, and were classed as imbeciles. To complete the +proof of heredity in this case, Morel adds that the mother had a child +while the father was confined in the asylum, and that this child +exhibited no signs of degeneracy. Statistics show that multitudes of +human beings are born with a destiny against which they have neither the +will nor the power to contend; they groan under the worst of all +tyrannies, the tyranny of a bad organization, which is theirs by +inheritance. We may represent the tendencies of the anterior portion of +the brain by Fig. 79. The functional exercise of the anterior and +superior portions of the cerebrum is _disintegrating_ and +_devitalizing_, while the anterior and inferior portions coincide with +mental and physical derangement, unless counteracted by opposing forces. +It is therefore evident that in any organization, upon which is entailed +a perverted or excessive action of this portion of the cerebrum, the +tendencies are NON-VITAL, _i.e._, unfavorable to fertility and physical +health. + +If the antagonizing regions are well developed, the tendencies are +favorable to life. + + / SANITY, + The volitive organs promote { TEMPERANCE, + \ HARDIHOOD. + + / NUTRITION, + The animal organs tend to { RESTORATION, + \ CONSERVATION. + + / SECRETION, + The basilar faculties instigate { CIRCULATION, + \ VITALITY. + + / ENERGY, + The combined action of these { HEALTH, + faculties express \ REPRODUCTION. + +[Illustration: Fig. 79] + +If this portion of the brain indicates a full development, we say of +such a temperament that it is VITAL, because the functions of its +nerve-centers are favorable to evolution. As degeneration observes +conditions, so endurance and development conform to certain laws, and it +is the duty of all truthful inquirers, who believe not only in the +progress of human intelligence, but in physical improvement from +generation to generation, to ascertain and comply with these essential +conditions. When the anterior and middle lobes of the brain are fully +developed at their inferior surfaces, it is regarded as an insane +temperament, _i.e._ containing the germs of mental and bodily +derangement. + +How shall we distinguish the combination of organic elements, if not by +the manner in which they characterize the constitution? Every human +being is distinguished by natural peculiarities, both mental and +physical. These are indicated not only by the color of the eyes, hair, +and skin, and the mental expressions, but in the conformation and +capabilities of the corporeal system. The color, form, size, and texture +of a leaf indicate to the expert pomologist the nature of the fruit +which the tree will bear, but how much more important is it to +understand the harmonies of human development. If Prof. Agassiz could +determine the form and size of a fish by seeing its scales, and Prof. +Owen outline the skeleton of an unknown animal by viewing a portion of +its fossil, why should not the physician understand the language of +temperaments, since it opens to him the revelations of human +development? The sculptor blends character with form, the artist endows +the face with natural expression, the anatomist accurately traces the +nerves and arteries, the physiognomist reads character, which the +novelist delineates and the actor personates, because there are facts +behind all these, the materials wherewith to construct a science. In +organization there are permanent forces which operate uniformly, thus +revealing the order of nature. + + +THE TEMPERAMENTS CLASSIFIED. + + +[Illustration: Fig. 80] + +We propose to speak of four constitutional variations entitled to +separate consideration; the lymphatic, the sanguine, the volitive, and +the encephalic. The brain controls all the voluntary, and modifies the +involuntary functions of the body. A particular cerebral development +modifies the functions of all the bodily organs, and thus tempers the +constitution. We shall, therefore, base our classification of +temperaments upon the mental and physiological characteristics, which +are portrayed by cerebral development. Such an arrangement is +illustrated by Fig. 80. + + +THE LYMPHATIC TEMPERAMENT. + + +The lymphatic temperament predominates when the anterior base of the +brain and the middle lobe are developed so as to exert a preponderating +influence over the bodily functions. The character of this influence we +have described in cerebral physiology. It is difficult to state +precisely the normal influences and nerve-forces which arise from these +faculties, but it is evident that they are specially related to +nutritive attraction, in opposition to volitive repulsion. It is only +their excessive influence which produces worthless, miserable, morbid +characters. A constitution marked by this development is indolent, +relaxative, and an easy prey to epidemics. This treatment is also +characterized by a low grade of vitality or resistance. When life is +sustained by the volitive powers, it is distinguished by a softness of +the bodily tissues, and the prevalence of lymph. The fact that all the +organic functions are performed indolently, indicates lack of vital +power. An excellent illustration of this temperament is found in Fig. +81, which represents a Chinese gentleman of distinction. In the lower +order of animals, as in sponges, absorption is performed by contiguous +cells, which are quite as effortless as in plants. Because of their +organic indolence, sponges are often classed as vegetables. A body +having an atonic or a lymphatic temperament is abundantly supplied with +absorbent organs, which are very sluggish in their operations. In the +lymphatic temperament, there seems to be less constructive energy, +slower elaboration, and greater frugality. Lymph is a colorless or +yellow fluid containing a large proportion of water. It is not so highly +organized as the blood, but resembles it, when that fluid is deprived of +its red corpuscles. In the sanguine temperament, circulation in the +blood-vessels is the most active, in the lacteals next, and in the +lymphatics the least so, but in the lymphatic temperament, this order is +reversed. + +[Illustration: Fig. 81.] + +Dr. W.B. Powell has observed that a lymphatic man has a large head, +while a fat man has a small one, and also that fat and lymph, are +convertible, one following the other, _i.e.,_ "a repletion consisting of +fat may be removed, and one of lymph may replace it, and _vice versa_." +He could not account for these alternations. The bear goes into his +winter quarters sleek and fat, and comes forth in the spring just as +plump with lymph, but he loses this fat appearance soon after obtaining +food. This simply indicates that, during lymphatic activity, the +digestive organs are comparatively quiescent. But when these are +functionally employed again, lymphatic economy is not required. It is +the duty of the lymphatics to slowly convert the fat by such +transformation, that when it reaches the general circulation, it may +there unite with other organic compounds, the process being aided by +atmospheric nitrogen, introduced during the act of respiration. In this +way it may become changed into those chemically indefinite, artificial +products, called proteid compounds. This view is supported by the +disappearance of fat as an organized product in the lymph of the +lymphatic vessels, indicating that such transformation has occurred. In +this way, by uniting with other organic compounds, it appears that lymph +may serve as a weak basis for blood; that atmospheric nitrogen is also +employed in forming these artificial compounds, is indicated by the fact +that there is sometimes less detected in arterial than in venous blood. + +[Illustration: Fig. 82. +Judge Green, of the United States Court. ] + +This temperament is indicated by lymphatic repletion, soft flesh, pale +complexion, watery blood, slow and soft pulse, oval head, and broad +skull, showing breadth at its base. Fig. 82 illustrates this temperament +combined with sanguine elements. In all good illustrations of this +temperament, there is a breadth of the anterior base of the skull +extending forward to the cheek bones. There is likewise a corresponding +fullness of the face under the chin, and in the neck, denoting a large +development of the anterior base of the cerebrum. The cerebral +conformation of the Hon. Judge Green indicates mental activity, and we +have no reason to suppose that lymph was particularly abundant in his +brain. + +[Illustration: Fig. 83.] + +While this description of the lymphatic temperament is correct, when +illustrated by the civilized races of men who are accustomed to luxury, +ease, and an abundance of food, it does not apply with equal accuracy to +the cerebral organization of the American Indian. His skull, though +broad at its anterior base, and high and wide at the cheek bones, +differs from the European in being broader and longer behind the ears. +Fig. 83 is an excellent representation of a noted North American Indian. +While a great breadth of the base of the brain indicates morbid +susceptibilities, yet these, in the Indian, are opposed by a superior +height of the posterior part of the skull. Consequently, he is restless, +impulsive, excitable, passionate, a wanderer upon the earth. The basilar +faculties, however, are large, and he is noted for instinctive +intelligence. His habits alternate from laziness to heroic effort, from +idleness and quiet to the fierce excitement of the chase, from +vagabondism to war, sometimes indolent and at other times turbulent, but +under all circumstances, irregular and unreliable. In this case, lacteal +activity is greater than lymphatic, as his nomadic life indicates. +Nevertheless, he manifests a morbid sensibility to epidemic diseases, +especially those which engender nutritive disorders and corrupt the +blood. Figs. 84 and 85 represent the brain of an American Indian, and +that of a European, and show the remarkable difference in their +anatomical configuration. Evidently it is a race-distinction. Observe +the greater breadth of the brain of the Indian, which according to +cerebral physiology indicates great alimentiveness, indolence, morbid +sensibility, irritability, profligacy, but also note that it _differs +materially in the proportion of all its parts_, from the European brain. +Judging the character of the Indian from the aforesaid representation, +we should say that he was cunning, excitable, treacherous, fitful, +taciturn, or violently demonstrative. His constitution is very +susceptible to diseases of the bowels and blood. His appetite is +ungovernable, and his love of stimulants is strong. Syphilitic poison, +small-pox, and strong drink will annihilate all these tribes sooner than +gunpowder. Their physical traits of constitution are no less +contradictory than their extremes of habit and character, for while +there is evidence of _lymphatic elements_, yet it is contradicted by the +color of the hair, eyes, and skin. This peculiar organization will not +blend in healthful harmony with that of the European, and this +demonstrates that the race-temperaments require separate and careful +analytical consideration. + +[Illustration: Fig. 84. + American Indian. + Fig 85. + European. + +(FROM MORTON'S CRANIA AMERICANA.) + +In the American Indian, the anterior lobe, lying between _AA_, and +_BB_, is small, and in the European it is large, in proportion to the +middle, lying between _BB_ and _CC_. In the American Indian, the +posterior lobe, lying between _C_ and _D_ Is much smaller than in the +European. In the Indian, the cerebral convolutions on the anterior +lobe and upper surface of the brain, are smaller than the European. If +the anterior lobe manifests the intellectual faculties--the middle +lobe the propensities common to man with the lower animals--and the +posterior lobe, the conservative energies, the result seems to be, +that the intellect of the American Indian is comparatively feeble--the +European, strong; the animal propensities of the Indian will be +great--in the European, more moderate; while reproduction, vital +energy, and conservation of the species in the Indian is not as great +as with the European. The relative proportions of the different parts +of the brain differ very materially.] + +By physical culture and regulation of the habits, the excessive +tendencies of this temperament may be restrained. Solid food should be +substituted for a watery diet. If it be limited in quantity, this change +will not only diminish the size, but increase the strength of the body. +The body should be disciplined by daily percussion until the imperfectly +constructed cells, which are too feeble to resist this treatment, are +broken and replaced by those more hardy and enduring. Add to this +treatment brisk, dry rubbing, calisthenic exercises, and daily walks, +which should be gradually extended. Continue this treatment for three +months, and its favorable effects upon the temperament will surprise the +most skeptical; if continued for a year, a radical alteration will be +effected, and the hardihood, health, and vigor of the constitution will +be greatly increased. + +This temperament may be improved physiologically, by being blended with +the sanguine and volitive. The offspring will be stronger, the +structures firmer, the organization more dense. Nutrition, assimilation, +and all the constructive functions will be more energetic in weaving +together the cellular fabric of the body. The sanguine temperament will +add a stimulus to the organic activities, while the volitive will +communicate manly, brave, and enduring qualities. When this temperament +is united with the encephalic, if such a union does not result in +barrenness, it adds _expending_ and _exhaustive_ tendencies to the +_enfeebling_'ones already existing, and, consequently, the offspring +lacks both physical power and intellectual activity. + +The peculiarities of this temperament are observed in the diseases which +characterize it. It is specially liable to derangements of digestion, +nutrition, and blood-making. The blood is easily poisoned by morbid +products formed within the body, as well as by those derived from the +body of another. This is seen in pyæmia, produced by the introduction of +decomposing pus, or "matter," into the blood. This condition is most +likely to occur when the vital powers are low and the energies weak, for +then the fibrin decreases, the red corpuscles diminish in number, the +circulation becomes languid, the pulse grows fluttering and weak, and +this increases until death ensues. An individual of this temperament is +more easily destroyed than any other "by the poison of syphilis, +small-pox, and other contagious diseases. If the blood has received any +hereditary taint, the lymphatic glands not only reproduce it but often +increase the virulency of the original disease. This temperament +indicates a necessity for the employment of stimulating, alterative, and +antiseptic medicines. The torpid functions need arousing, the blood +needs depuration, i.e., the elimination of corrupting matter, and the +system requires alteratives to produce these salutary changes. The +secretions need the correcting influence of cleansing remedies for the +purification of the blood. + +Persons of this temperament are more liable to absorption of morbid +products within the body, which are in a state of decomposition, +producing an infection of the blood, technically termed _septicæmia_. +The fatal results which so suddenly follow child-bed fever are thus +produced. This kind of poisoning sometimes takes place from the +absorption of decomposed exudation in diphtheria, and, though rarely, +from decomposing organic products collected in the lungs. Whenever the +absorption of poison does take place, fatal consequences usually follow. + +This passive temperament is more likely to sink under acute attacks of +disease, especially alimentary disorders, such as diarrhea, dysentery, +and cholera. It quickly succumbs to their prostrating effects, such as +depression, congestion, and fatal collapse which rapidly succeed one +another. Venesection and harsh purgatives are contra-indicated, and the +physician who persists in their employment kills his patient. How +grateful are warmth and stimulating medicines! The most powerful, +diffusible, and nervous stimulants are required in cholera, when the +system is devastated by the disease, as the plain is laid waste by the +fierce tornado. + + +THE SANGUINE TEMPERAMENT. + + +Lymph is the characteristic of the lymphatic temperament, and its +specific gravity, temperature, and standard of vitality are all lower +than that of red blood. In the sanguine temperament all the vital +functions are more active, the blood itself has a deeper hue, its +corpuscles carry more oxygen, the complexion is quite florid, and the +arterial currents impart to every faculty a more hopeful vigor. The +blood-vessels are the most active absorbents, eagerly appropriating +nutritive materials for the general circulation, while the respiration +adds to it oxygen, that agent which makes vital manifestation possible. +This temperament exhibits greater sensibility, the conceptions are +quicker, the imagination more vivid, the appetite stronger, the passions +more violent, and there is found every display of animal life and +enjoyment. + +A full development of the basilar faculties, indicated by an unusual +breadth and depth of the base of the brain, accompanies this +temperament. Its cerebral area includes the posterior and inferior +portions of the cerebrum, the entire cerebellum, and that part of the +medulla which connects with the spinal cord, all of which sustain +intimate relations to vital conditions. Accordingly, such a development +indicates good digestion, active nutrition, vigorous secretion, large +heart and lungs, powerful muscles, and surplus vitality. The violent +faculties, such as Combativeness, Destructiveness, and Hatred, are +natural adjuncts, and their excess tends to sensuality and crime. They +are not only secretive, appropriative, selfish, and self-defensive, but +when redundant are aggressive and tend to destructiveness, the +gratification of animal indulgence, intemperance, and debauchery. The +correspondence between the cerebral conformation and the physical +development is very obvious. Lower orders of animals possess these +faculties, and their spontaneous exhibition is called instinct. They +possess the acquisitive, destructive, and propagative propensities, +which lead them to provide for their wants and secure to themselves a +posterity. The exercise of their bodies causes a continual waste which +demands incessant reparation, and they are governed measurably by these +animal impulses. + +All of these lower psychical faculties have a physiological +significance. Acquisitiveness functionally expresses assimilation, +accretion, animal growth, and tends to bodily repletion. Secretiveness +expresses concealing, separating, withdrawing, and functionally +signifies secretive action. Secretion is the separating and withdrawing +from the blood some of its constituents, as mucus, bile, saliva, etc. +This latter process indicates complex conditions of organization, so +that the higher and more complex the tissue, the greater the number of +secretory organs. Unrestrained selfishness, while it naturally conserves +the individual interests, in its ultimate tendencies, is the very +essence of human depravity. Without qualification, clearly, it is crime, +for blind devotion to the individual must be in utter disregard for the +good of others. The ultimate tendencies of these faculties are, +therefore, criminal. + +Exaggerate the faculty of acquisitiveness, and it becomes +avariciousness. Develop secretiveness and selfishness, and they become +cunning and profligacy, desperation and crime. Their functional +development tends to produce physical disorder and violent disease. All +of these faculties are vehement, contentious, thriving by opposition. +Life itself has been called a forced state, because it wars with the +elements it appropriates, and transmutes their powers into vitality. + +[Illustration: Fig. 86.] + +We find men and women of this temperament, who are models of character +and organization. George Washington is an excellent illustration. The +impression that his presence made upon the Marquis de Chastellux, is +given in the following words: "I wish only to express the impression +General Washington has left on my mind; the idea of a perfect whole, +brave without temerity, laborious without ambition, generous without +prodigality, noble without pride, virtuous without severity." Gen. +Scott, Lord Cornwallis, Dr. Wistar, Bishop Soule John Bright, Jenny Lind +Goldsmidt, and Dr. Gall are good representatives of this temperament. +Fig. 86 is an excellent illustration of it, finely blended and well +balanced, in the person of Madame de Stael. This temperament requires +fewer tonics and stimulants than the lymphatic. This constitution is +best able to restore vital losses. It is a vital temperament, in other +words, it combines favorably with all the others, and better adapts +itself to their various conditions. Some regard it as the best adjusted +one in all its organs and tissues, and as the most satisfactory and +serviceable. + +[Illustration: Fig. 87.] + +Excess of nutrition tends to plethora, to animal indulgence, and gross +sensuality. Not only do the propensities rouse desire, but they excite +the basilar faculties, and portray their wants in the outlines of the +face, mould the features to their expression, and flash their +significance from the eye. Who can mistake the picture of sensuality +represented by Fig. 87? It is enough to shock the sensibility of a dumb +animal, and to say that such a face has a beastly look, is an unkind +reflection upon the brute creation. A large neck and corresponding +development of the occipital half of the brain indicate nervous energy, +yet nutrition is not absolutely dependent upon it, for the nutritive +processes are active before a nervous system is formed. The lower +faculties of the mind exert a remarkable influence over nutrition, +secretion, and the molecular changes incident to life. Anger or fear may +transmute the mother's nourishing milk into a virulent poison. The +following incident, taken from Dr. Carpenter's Physiology, illustrates +this statement: "A carpenter fell into a quarrel with a soldier billeted +in his house, and was set-upon by the latter with his drawn sword. The +wife of the carpenter at first trembled from fear and terror, and then +suddenly threw herself between the combatants, wrested the sword from +the soldier's hand, broke it in pieces, and threw it away. During the +tumult, some neighbors came-in and separated the men. While in this +state of strong excitement, the mother took up her child from the +cradle, where it lay playing, and in the most perfect health, never +having had a moment's illness; she gave it the breast, and in so doing +sealed its fate. In a few minutes the infant left-off sucking, became +restless, panted, and sank dead upon the mother's bosom. The physician +who was instantly called-in, found the child lying in the cradle, as if +asleep, and with its features undisturbed; but all resources were +fruitless. It was irrecoverably gone. In this interesting case, the milk +must have undergone a change, which gave it a powerful sedative action +upon the susceptible nervous system of the infant." + +Anxiety, irritation, hatred, all tend to the vitiation of the +disposition and bodily functions, perverting the character and +constitution at the same time. Depravity of thought and secretion go +together. Degradation of mind and corruption of the body are +concomitants. There is a very close affinity between mental and moral +perversion and physical prostitution, of which fact too many are +unconscious. Nervous influence preserves the fluidity of the blood and +facilitates its circulation, for it appears that simple _arrestment_ of +this influence favors the coagulation of the blood in the vessels; clots +being found in their trunks within a few minutes after the brain and +spinal marrow are broken down. Habitual constipation is the source of +many ills. Perversion of the functions of the stomach, and of the +circulation of the blood, produce general disaster. + +Diseases which characterize this temperament are acute, violent, or +inflammatory, indicating repletion and active congestion; intense +inflammation, burning fevers, severe rheumatism, a quick, full pulse, +great bodily heat, and functional excitement are its morbid +accompaniments. These diseases will bear thorough depletion of the +alimentary canal, active, hydragogue cathartics being indicated. +Sedatives and anodynes are also essential to modify the circulatory +forces, and to relieve pain. Violent disturbance must be quelled, and +among the remedial agents required for this duty we may include +Veratrum, Ipecac, Digitalis, Opium, Conium, and Asclepias. While +equalizing the circulatory fluids, restoring the secretions, and +thoroughly evacuating the system, and thus endeavoring to remove +disturbing causes, we find that the conditions of this temperament are +exceedingly favorable for restoration to health. True, many chronic +diseases are obstinate, yet a course of restorative medication +persistently followed, promises a fortunate issue in this tractile +temperament. + +Hygienic management of the lymphatic and sanguine temperaments consists +in the vigorous toning of the former, while restraint of the latter will +greatly exempt it from the anxieties, contentions, and vexations which +excite the mind, disturb the bodily functions, and end in chronic +disease. People of the latter organization love mental and physical +stimulants, are easily inflamed by passion, and their excitability +degenerates into irritability, succeeded by serious functional +derangements, which prematurely break down the individual with +inveterate, deep-seated disorder. Serenity, hope, faith, as well as +firmness, are natural hygienic elements. It is a duty we owe ourselves +to promptly relinquish a business which corrodes with its cares, and +depresses with its increasing troubles. Constant solicitude, and the +apprehension of financial disaster, frustrate the bodily functions, +disconcert the organic processes, and lead to mental aberration as well +as physical degeneracy. Melancholy is chronic, while despair is acute +mania, whose impulses drive the victim desperately toward +self-destruction. The chronic derangement of these organs exerts with +less force the same morbid tendency. Hence the necessity for exercising +those hygienic and countervailing influences born of resolution, +assurance, and confident trust, and the belief which strengthens all of +the vital operations. + +Doubtless, this temperament is the source of the reproductive powers. It +is the corner-stone essential to the foundation of all other +temperaments. It has been supposed by some that the cerebellum is the +seat of sexual instinct. The fact appears that an ample development of +the posterior base of the cerebrum and the cerebellum indicates +nutritive activity, which is certainly a condition most favorable to the +display of amativeness. In a double sense, then, this temperament is a +vital one; both by nutritive repletion, and by reproduction. It is the +blood-manufacturing, tissue-generating, and body-constructing +temperament, causing growth to exceed waste, and promptly repairing the +wear which follows continual labor. + +While the sleazy structures of the lymphatic temperament are favorable +to the functions of transudation, exhalation, and mutual diffusion of +liquids, the sanguine, as its name indicates, is adapted to promote the +circulation of the blood, to favor nutrition and reproduction. The +former temperament does not move the world by its energies, or impress +it vividly with its wisdom, and the latter is more enthusiastic, +enjoyable, and quickening. Each temperament, however, possesses salient +qualities and advantages. + + +THE LIFE LINE. + + +Dr. W.B. Powell, in his work on "The Human Temperaments," announces the +discovery of a measurement which indicates the tenacity of life, and the +vital possessions of the individual. He has observed that some persons +of very feeble appearance possess remarkable powers of resistance to +disease, and continue to live until the machinery of life literally +wears out. Others, apparently stronger and more robust, die before the +usual term of life is half completed. He also noticed that some families +were remarkable for their longevity, while others reached only a certain +age, less than the average term of life, and then died. He remarked also +that some patients sank under attacks of disease, when, to all +appearances, they should recover, and that others recovered, when, +according to all reasonable calculations, they ought to die. He, +therefore, not only believed that the duration of human life was more +definitely fixed by the organization than is supposed, but he set +himself to work to discover the line of life, and the measure of its +duration. He made a distinction between vital vigor, and vital tenacity. +_Vital vigor_ he believed to be equivalent to the condition of vitality, +which is indicated by the breadth of the brain found in the sanguine +temperament; and _vital tenacity_ to be measured by the _depth_ of the +base of the brain. Dr. Powell was an indefatigable student of nature, +and followed his theory through years of observation, and measured +hundreds of heads of living persons, in order to verify the correctness +of the hypothesis. His method of measuring the head may be stated as +follows: He drew a line from the occipital protuberance on the back of +the head to the junction of the frontal and malar bones, extending it to +a point above the center of the external orbit of the eye, near the +termination of the brow. Then he measured the distance between this line +and the orifice of the ear and thus obtained the measure indicating the +vital tenacity or duration of, life. Fig. 88 is a representation of the +skull of Loper, who was executed for murder in Mississippi. He might +have attained a great age, had not his violent and selfish faculties led +him into the commission of crime. In this illustration, B represents the +occipital protuberance, and A the junction of the frontal and malar +bones at the external angle of the eye. The distance between this line +(A B) and the external orifice of the ear, is the measure of the +life-force of Loper at the time of his: execution. + +[Illustration: Fig. 88.] + +[Illustration: Fig. 89.] + +The tenacity of an individual's life, Dr. Powell determined by the +following scale of measurements: three-fourths of an inch from the +orifice of the ear to the life-line, is the average length in the adult, +and indicates _ordinary_ tenacity of life. As the distance decreases to +five-eighths, one-half, or three-eighths of an inch, vital tenacity +diminishes. If the distance is more than three-quarters of an inch, it +denotes great vital endurance, excellent recuperative powers, and is +indicative of longevity. If it measures less than half an inch, it shows +that the constitution has a feeble, uncertain hold upon life, and an +acute disease is very likely to sunder the vital relations. Dr. Powell +contended that "life force and vital force are not equivalent terms, +because much more vital force is expended upon our relations, than upon +our organization in the preservation of life. Every muscular +contraction, every thought, and every emotion requires an expenditure of +vital force." He asserted that we _inherit_ our life force or +constitutional power, and that we can determine by this _life-line,_ the +amount which we so receive. And he believed that it could be increased +by _intellectual_ effort, just as we can increase vital force by +_physical_ exercise. Fig. 89 represents the skull of a man who died, at +nearly the same age as Loper, of consumption, in the Charity Hospital, +at New Orleans. The measurement of the skull in this case gives a space +between the life-line and the orifice of the ear of one-sixteenth of an +inch, showing that the consumptive had lived the full term of his life. +Dr. Powell contended that the depth of a man's brain may be increased +after maturity; muscular effort, mental activity, and a sense of +responsibility being favorable to longevity, while idleness and +dissipation are adverse to it. In justice to the Doctor, we have stated +fully his theory and his method of determining the hardihood and +endurance of the constitution, and we bespeak for it a candid +examination. Without doubt it embodies a great deal of truth. Hereafter +we shall endeavor to indicate by cerebral configuration, a better system +of judging of the vital tenacity, hardihood, and constitutional +energies, both inherited and acquired. + + +THE VOLITIVE TEMPERAMENT. + + +By reference to Figs. 72 and 80, the reader will be able to locate the +region of the volitive faculties, previously described under the generic +term _will_. This temperament is characterized by ambition, energy, +industry, perseverance, decision, vigilance, self-control, arrogance, +love of power, firmness, and hardihood. These faculties express +concentration of purpose and their functional equivalents are power of +elaboration, constructiveness, condensation, firmness of fiber, +compactness of frame, and endurance of organization. The pulse is full, +firm, and regular, the muscles are strong and well marked, the hair and +skin dark, the temporal region is not broadly developed, the face is +angular, its lines denoting both power of purpose and strength of +constitution, with resolution and hardihood blended in the expression. +The volitive temperament is distinguished by height of the posterior, +superior occipital region, called the crown of the back head, and by +corresponding breadth from side to side. The rule given by Dr. J.R. +Buchanan applies not only to the convolutions, but to the general +development of the brain; _length gives power, or range of action_, and +_breadth gives copiousness, or activity of manifestation_. Thus a high, +_narrow_ back head indicates firmness and decision, but it is not as +constant and copious in its manifestation as when it is associated with +breadth. An individual having a narrow, high head, may determine readily +enough upon a course of action, but he requires a longer period for its +completion than one whose head is both high and broad. Such a cerebral +conformation cannot accomplish its objects without enjoying regular +rest, and maintaining the best of habits. Breadth of this region of the +brain indicates ample resources of energy, both psychical and physical. +It denotes greater vigor of constitution, one that continually generates +volitive forces, and its persistency of purpose may be interpreted as +functional tenacity. Inflexibility of will and purpose impart their +tenacious qualities to every bodily function. The _will_ to recover is +often far more potent than medicine. We have often witnessed its power +in restraining the ravages of disease. The energetic faculties, located +at the upper and posterior part of the head, are the invigorating, or +_tonic_ elements of the constitution, imparting hardy, firm, steady, and +efficient influences, checking excess of secretion, repressing +dissipation, and tending to maintain self-possession, as well as healthy +conditions of life. Fig. 90 is a portrait of U.S. Grant, which shows a +well-balanced organization, with sufficient volitive elements to +characterize the constitution. + +[Illustration: Fig. 90.] + +The old term _bilious temperament_ might possibly be retained in +deference to long usage, did it not inculcate a radical error. _Bilious_ +is strictly a medical term, relating to bile, or to derangements +produced by it, and it was used originally to distinguish a temperament +supposed to be characterized by a predominance of the biliary secretion. +In the volitive temperament, the firm, tenacious, toning, and +restraining faculties _repress_, rather than _encourage_ biliary +secretion, and hence the necessity for administering large doses of +cholagogues, remedies which stimulate the secretion of bile. When the +system is surcharged with bile, from a congested condition of the liver, +we use these agents in order to obtain necessary relief. In this +temperament there is moderate hepatic development, lack of biliary +activity, deficiency in the secretion of bile, and a sluggish portal +circulation. Therefore, to apply the term bilious to this temperament is +not only unreasonable, but it is calculated to mislead. The condition of +the bowels is generally constipated, the skin dark and sometimes sallow. +For these and other obvious reasons, we dismiss the word _bilious_, and +substitute one which is more characteristic. + +We will not dwell upon the volitive as _psychical_ organs, except to +show that, when their influence is transmitted to the body, they act as +_physiological_ organs, and thus demonstrate that all parts of the brain +have their physiological, as well as mental functions. When Andrew +Jackson uttered with great emphasis the memorable words, "BY THE +ETERNAL," the effect was like a shock from a galvanic battery, thrilling +the cells in his own body, and paralyzing with fear every one in +Calhoun's organization. This is an illustration of the power or range of +action of these faculties. Breadth or copiousness is illustrated in Gen. +Grant's reply, "I PROPOSE TO FIGHT IT OUT ON THIS LINE, IF IT TAKES ALL +SUMMER." Such a temperament has a profusion of constitutional power, +great durability of the life-force, and, in our opinion, the combined +height and breadth of this region correctly indicate the natural +hardihood of the body and its _retentiveness of life_. No one need doubt +its influence upon the sympathetic system, and, through that system, its +power over absorption, circulation, assimilation, and secretion, as well +as the voluntary processes. Mental hardihood seems wrought into concrete +organization. It checks excess of glandular absorption, restrains the +impulses of tumultuous passion, tones and regulates the action of the +heart, and helps to weave the strands of organization into a more +compact fabric. The toning energies of the volitive faculties are better +than quinine to fortify the system against _miasma_ or _malaria_, and +they co-operate with all tonic remedies in sustaining organic action. +Fig. 91 is a portrait of Prof. Tyndall, the eminent chemist, whose +likeness indicates volitive innervation, showing great strength of +character and of constitution; he is an earnest, thorough, and intense +mental toiler; ambitious, but modest; brilliant, because persevering; +diligent in scientific inquiry, and who follows the star of truth, +whithersoever it may lead him. The expression of his countenance +indicates his honest intentions, and displays strength of conscientious +purpose; his physical constitution may be correctly interpreted in all +of its general characteristics by the analysis of his energetic +temperament, the great secret of his strength and success. + +[Illustration: Fig. 91.] + +[Illustration: Fig. 92.] + +We desire to offer one more illustration of a marvelous blending of this +temperament with large mental and emotional faculties. Fig. 92 is a +representation of the martyred President Abraham Lincoln. During an +eventful career, his temperament and constitution experienced marked +changes, and while always distinguished for strength of purpose and +corresponding physical endurance, he was governed by noble, moral +faculties, manifesting the deepest sympathy for the down-trodden and +oppressed, blending tenderness and stateliness without weakness, +exhibiting a human kindness, and displaying a genuine compassion, which +endeared him to all hearts. He was hopeful, patriotic, _magnanimous_ +even, while upholding the majesty of the law and administering the +complicated affairs of government. The balances of his temperament +operated with wonderful delicacy, through all the perturbating +influences of the rebellion, showing by their persistence that he was +never for a moment turned aside from the great end he had in view; the +protection and perpetuation of republican liberty. His life exhibited a +sublime, moral heroism, elements of character which hallow his name, and +keep it in everlasting remembrance. + +We have treated the brain, not as a mass of organs radiating from the +medulla oblongata as their real center, but as two cerebral masses, each +of which is developed around the great ventricle. We have freely applied +an easy psychical and physiological nomenclature to the functions of its +organs, knowing that there is no arbitrary division of them by specific +number, for the cerebrum, in an anatomical sense, is a single organ. The +doctrine of cerebral unity is true, and the doctrine of its plurality of +function is true also. Whatever effect an organ produces when acting in +entire predominance, is regarded as the function of that organ and is +expressed by that name. Although our names and divisions are arbitrary +and designed for convenience, yet they facilitate our consideration of +the psychical, and their corresponding physiological functions. Every +cerebral manifestation denotes a _psychical_ organ, and in proportion as +these acts are transmitted to the body it becomes a _physiological_ +organ. We have ventured to repeat this proposition for the sake of the +non-professional reader, that he may be able to distinguish between' the +two results of the manifestation of one organ. The transmission of the +influence of the brain into the body enables the former to act +physiologically, whereas, if its action were confined within the +cranium, it would only be psychical. In the language of Prof. J.R. +Buchanan, "every organ, therefore, has its mental and corporeal, its +psychological and physiological functions--both usually manifested +together--_either capable of assuming the predominance_." We have +already seen to what degree the _Will_ operates upon the organism, or +how "the soul imparts special energy to single organs, so that they +perform their functions with more than usual efficiency," and thus +resist the solicitations of morbific agents. Doubtless our best thoughts +are deeply tinged by the healthful or diseased conditions of such organs +as the stomach, the lungs, the heart, or even the muscular or +circulatory systems, and these impressions, when carried to the +sensorium, are reflected by the thoughts, for reflex action is the third +class of functions, assigned to the cerebrum. These reflex actions are +either hygienic and remedial, or morbid and pernicious. Hence, it is +philosophical not only to interpret the thoughts as physiological and +pathological indications, but to consider the cerebrum as exerting real +hygienic and remedial forces, capable of producing salutary reparative, +and restorative effects. When a boiler carries more steam than can be +advantageously employed, it is subjected to unnecessary and injurious +strain, and is weakened thereby; so, when the body is overtasked by +excessive pressure of the volitive faculties, it is prematurely +enfeebled and broken down. There are many individuals who need to make +use of some sort of safety valve to let off the surplus of their +inordinate ambition; they need some kind of patent brake to slacken +their speed of living; they should relieve the friction of their +functional powers by a more frequent lubrication of the vital movements, +and by stopping, for needed refreshment and rest, at some of the many +way-stations of life. + + +THE ENCEPHALIC TEMPERAMENT. + + +The encephalic temperament is distinguished by prominence and breadth of +the forehead, or by a full forehead associated with height and breadth +at its coronal junction with the parietal bones, and extending toward +the volitive region. (See Fig. 10, the space between 1 and 2 represents +the coronal region, 1 indicating the frontal bone, and 2 the parietal). +Prominence and great breadth of the forehead display _analytical, i.e._, +scientific powers applicable to concretes, whereas a fair intellect, +associated with a preponderating development of the coronal region, +indicates _analogical_ powers, _i.e._, faculties to perceive the +relation and the agreement of principles. The former classifies and +arranges facts, the latter invests them with moral and spiritual import. +The one treats of matter, its physical properties, and chemical +composition, the other of thoughts and intentions which involve right +and wrong, relating to spiritual accountability. The intellect is +employed upon an observable order of things, while the emotive faculties +arrange the general laws of being into abstract science. + +Fig. 93, a portrait of Prof. Tholuck, is a remarkable example of an +encephalic organization. Figs. 72 and 79 fairly indicate the effects of +undue mental activity, the intellect causing vital expenditure resulting +in the devitalization of the blood. While the intellect displays keen +penetration, subtle discrimination, and profound discernment, the +emotions exhibit intense sensitiveness, acute susceptibility, and +inspirational impressibility. The encephalic temperament is +characterized by mental activity, great delicacy of organization, a high +and broad forehead, expressive eyes, fine but not very abundant hair, +great sensitiveness, refined feelings, vividness of conception, and +intensity of emotion. If the brain is developed on the sides, there is +manifested Ideality, Modesty, Hope, Sublimity, Imagination, and +Spirituality. If the brain and forehead project, the Perceptive, +Intuitive, and Reasoning faculties predominate. If it rises high, and +nearly perpendicularly, Liberality, Sympathy, Truthfulness, and +Sociability are manifested. When the emotive faculties are large, Faith, +Hope, Love, Philanthropy, Religion, and Devotion characterize the +individual. It is an artistic, creative, and aesthetic temperament, +beautiful in conception and grand in expression, yet its sensitiveness +is enfeebling, and its crowning excellence, when betrayed by the +propensities, trails in defilement. Its purity is God-like, its +debauchment, Perdition! + +[Illustration: Fig. 93.] + +Fig. 94 is the likeness of Prof. George Bush. His forehead is amply +developed in the region of Foresight, Liberality, Sympathy, +Truthfulness, and Benevolence; his mouth expresses Amiability and +Cheerfulness, and the whole face beams with Kindness and Generosity. +This philanthropist, who is both a preacher and an author, has published +several works upon theology, which distinguish him for great research +and originality. + +[Illustration: Fig. 94.] + +Fig. 95 represents the sanguine-encephalic temperament, the two elements +being most happily blended. The portrait is that of Emmanuel Swedenborg, +the great scholar and spiritual divine. The reader will observe how high +and symmetrical is the forehead, and how well balanced appears the +entire organization. He was remarkable for vivid imagination, great +scientific acquirements, and all his writings characterize him as a +subtle reasoner. + +When the encephalic predominates, and the sanguine is deficient in its +elements, we find conditions favorable to _waste_ and _expenditure_, and +adverse to a generous _supply_ and _reformation_ of the tissues. A child +inheriting this cerebral development is already top-heavy, and supports, +at an immense disadvantage, this disproportionate organization. The +nutritive functions are overbalanced; consequently there is a +predisposition to scrofulous diseases and disorders of the blood, +various degenerating changes taking place in its composition; loss of +red corpuscles, signified by shortness of breath; morbid changes, +manifested by cutaneous eruptions; exhaustion from lack of nourishment, +etc., until, finally, consumption finishes the subject. + +[Illustration: Fig. 95.] + +Harmony is the support of all institutions, and applies with special +cogency to the maintenance of health. When the mind dwells on one +subject to the exclusion of all others, we call such a condition +monomania. If we have an excessive development of mind, and deficient +support of body, the result is corporeal derangement. It is unfortunate +for any child to inherit unusually large brain endowments, unless he is +possessed of a vigorous, robust constitution. Such training should be +directed to that body as will encourage it to grow strong, hearty, and +thrifty, and enable it to support the cerebral functions. The mental +proclivities should be checked and the physical organization cultivated, +to insure to such a child good health. Cut off all unnecessary +brain-wastes, attend to muscular training and such invigorating games +and exercises as encourage the circulation of the blood; keep the skin +clean and its functions active, the body warm and well protected, the +lungs supplied with pure air, the stomach furnished, with wholesome +food, besides have the child take plenty of sleep to invigorate the +system, and thus, by regular habits, maintain that equilibrium which +tends to wholesome efficiency and healthful endurance. + + +TRANSMISSION OF LIFE. + + +As has been already stated in the chapter on Biology, reproduction of +the species depends upon the union of a sperm-cell with a germ-cell, the +male furnishing the former and the female the latter. It is a well-known +fact that the marriage of persons having dissimilar temperaments is more +likely to be fertile than the union of persons of the same temperaments; +consanguineous marriages, or the union of persons nearly related by +blood, diminish fertility and the vigor of the offspring. Upon this +subject Francis Galton has given some very interesting historical +illustrations in his well-known work, entitled "Hereditary Genius." The +half-brother of Alexander the Great, Ptolemy I, King of Egypt, had +twelve descendants, who successively became kings of that country, and +who were also called Ptolemy. They were matched in and in, but in nearly +every case these near marriages were unprolific and the inheritance +generally passed through other wives. Ptolemy II married his niece, and +afterwards his sister; Ptolemy IV married his sister. Ptolemy VI and VII +were brothers, and they both consecutively married the same sister; +Ptolemy VII also subsequently married his niece; Ptolemy VIII married +two of his sisters in succession. Ptolemy XII and XIII were brothers, +and both consecutively married their sister, Cleopatra. Mr. Galton and +Sir Jas. Y. Simpson have shown that many peerages have become extinct +through the evil results of inter-marriage. Heiresses are usually only +children, the feeble product of a run-out stock, and statistics have +shown that one-fifth of them bear no children, and fully one-third never +bear more than one child. Sir J.Y. Simpson ascertained that out of 495 +marriages in the British Peerage, 81 were unfruitful, or nearly one in +every six; while out of 675 marriages among an agricultural and +seafaring population, only 65 were sterile or barren, or a little less +than one in ten. + +While the marriages of persons closely related, or of similar +temperaments are frequently unfruitful, we would not have the reader +understand that sterility, or barrenness, is usually the result of such +unions. It is most frequently due to some deformity or diseased +condition of the generative organs of the female. In the latter part of +this work may be found a minute description of the conditions which +cause barrenness, together with the methods of treatment, which have +proved most effectual in the extensive practice at the Invalids' Hotel +and Surgical Institute. + +The temperaments may be compared to a magnet, _the like poles of which +repel, and the unlike poles of which attract each other._ Thus +similarity of temperament results in barrenness while dissimilarity +makes the vital magnetism all the more powerful. Marriageable persons +moved by some unknown influence, have been drawn instinctively toward +each other, have taken upon themselves the vows and obligations of +wedlock, and have been fruitful and happy in this relation. Alliances +founded upon position, money, or purely arbitrary considerations, mere +contracts of convenience, are very apt to prove unhappy and +unproductive. + +Men may unconsciously obey strong instinctive impulses without being +conscious of their existence, and by doing so, avoid those ills, which +otherwise might destroy their connubial happiness. The _philosophy_ of +marriage receives no consideration, because the mind is pre-occupied +with newly awakened thoughts and feelings. Lovers are charmed by certain +harmonies, feel interior persuasions, respond to a new magnetic +influence and are lost in an excess of rapture. + +If the parties to a marriage are evenly balanced in organic elements, +although both of them are vigorous, yet it is physiologically more +suitable for them to form a nuptial alliance with an unlike combination. +The cause of the wretchedness attending many marriages may be traced to +a too great similarity of organization, ideas, taste, education, +pursuits, and association, which similarity almost invariably terminates +in domestic unhappiness. The husband and wife should be as different as +the positive and negative poles of a magnet. When life is begotten under +these circumstances we may expect a development bright with +intelligence. + + * * * * * + + + + +CHAPTER XVI + +MARRIAGE. + +LOVE. + + "Love is the root of creation; God's essence; worlds without number + Lie in his bosom like children; he made them for this purpose only. + Only to love and to be loved again, he breathed forth his spirit + Into the slumbering dust, and upright standing, it laid its + Hand on its heart, and felt it was warm with a flame out of heaven." + + --LONGFELLOW. + + +Love, that tender, inexplicable feeling which is the germinal essence of +the human spirit, is the rudimental element of the human soul. It is, +therefore, a Divine gift, a blessing which the Creator did not withdraw +from his erring children, when they were driven from a paradise of +innocence and loveliness into a world of desolation and strife. He left +it as an invisible cord by which to draw the human heart ever upward, to +a brighter home--the heavenly Eden. Love is the very essence of Divine +law, the source of inspiration, even the fountain of life itself. It is +spontaneous, generous, infinite. To its presence we are indebted for all +that is good, true, and beautiful in Art and Nature. It endows humanity +with countless virtues, and throws a mystic veil over our many faults. +It is this feeling, this immutable law, which controls the destiny of +the race. From its influence empires have fallen, scepters have been +lost. Literature owes to Love its choicest gems. The poet's lay is +sweeter when Cupid tunes the lyre. The artist's brush is truer when +guided by Love. Greece was the cradle of letters and art. Her daughters +were queens of beauty, fitted to inspire the Love of her noblest sons. + +[Illustration: Fig. 96.] + +The materialism of the nineteenth century has sought to degrade Love; to +define it as purely physical. The result has been a corresponding +degradation of art, and even literature has lost much of its lofty +idealism. Nudity has become a synonym of vulgarity; Love, of lust. "Evil +be to him who evil thinks." True Love never seeks to degrade its object; +on the contrary, it magnifies every virtue, endows it with divinest +attributes, and guards its chastity, or honor, at the sacrifice of its +own life. It increases benevolence by opening the lover's heart to the +wants of suffering humanity. Ideality is the canvas, and imagination the +brush with which Love delineates the beauties of the adored. Love +heightens spirituality, awakens hope, strengthens faith, and enhances +devotion. It quickens the perceptions, intensifies the sensibilities, +and redoubles the memory. It augments muscular activity, and imparts +grace to every movement. The desire to love and to be loved is innate, +and forms as much a part of our being as bone or reason. In fact, Love +may be considered as the very foundation of our spiritual existence, as +bone and reason are the essential bases of our physical and intellectual +being. Every man or woman feels the influence of this emotion, sooner or +later. It is the Kadesh-barnea of human existence; obedience to its +intuitions insures the richest blessings of life, while neglect or +perversion enkindles God's wrath, even as did the disobedience of the +wandering Israelites. + +The one great fact which pervades the universe is _action_. The very +existence of Love demands its activity, and, hence, the highest +happiness is attained by a normal and legitimate development of this +element of our being. The heart demands an object upon which to lavish +the largess of its affection. In the absence of all others, a star, a +flower, or even a bird, will receive this homage. The bird warbles a gay +answer to the well-known voice, the flower repays the careful cultivator +by displaying its richest tints, the star twinkles a bright "good +evening" to the lonely watcher, and yet withal there is an unsatisfied +longing in the lover's heart, to which neither can respond; the desire +to be loved! Hence, the perfect peace of reciprocated love. If its laws +are violated, nature seeks revenge in the utter depression or +prostration of the vital energies. Thus has the Divine Law-giver +engraven His command on our very being. To love is, therefore, a duty, +the fulfillment of which should engage our noblest powers. + +This emotion manifests itself in several phases, prominent among which +is filial affection, the natural harmonizer of society. Paternal love +includes a new element--protection. Greater than either, and second only +in fortitude to maternal affection, is + + +CONJUGAL LOVE. + + "He is blest in Love alone + Who loves for years and loves but one."--HUNT. + + +With Swedenborg, we may assert, "_that there is given love truly +conjugal, which at this day is so rare, that it is not known what it is, +and scarce that it is_." The same author has defined this relation to be +a union of Love and Wisdom. The fundamental law of conjugal love is +_fidelity to one love_. God created but one Eve, and the essential +elements of paternal and maternal love pre-suppose and necessitate, for +their normal development, the Love of _one_ only. Again, Love is the sun +of woman's existence. Only under its influence does she unfold the +noblest powers of her being. Woman's intuitions should therefore be +taken as the true love-gauge. If she desire a plurality of loves, it +must be a law of her nature; but is communism the desire of our wives +and daughters? No! Every act which renders woman dear to us, denounces +such an idea and reveals the exclusive sacredness of her Love. As +condemning promiscuity in this relation, we may cite the lovers' pledges +and oaths of fidelity, the self-perpetuity of Love itself, the common +instincts of mankind, as embodied in public sentiment, and the inherent +consciousness that first love should he kept inviolable forever. Again, +Love is conservative. It clings tenaciously to all the memories +connected with its first object. The scenes consecrated to "Love's young +dream" are sacred to every heart. The woodland with its winding paths +and arbors, the streamlet bordered with drooping violets and dreamy +pimpernel, the clouds, and even "the very tones in which we spoke," are +indelibly imprinted on the memory. There is also the "mine and thine" +intuition of love. This sentiment is displayed in every thought and act +of the lover. Every pleasure is insipid unless shared by the beloved; +selfish and exacting to all others, yet always generous and forgiving to +the adored. "Mine and thine, dearest," is the language of Conjugal Love. + +The consummation desired by all who experience this affection, is the +union of souls in a true marriage. Whatever of beauty or romance there +may be in the lover's dream, is enhanced and spiritualized in the +intimate communion of married life. The crown of wifehood and maternity +is purer, more divine, than that of the maiden. Passion is lost; the +emotions predominate. + +The connubial relation is not an institution; it was born of the +necessities and desires of our nature. "It is not good for man to be +alone," was the Divine judgment, and so God created for him "an +helpmate." Again, "Male and female created He them;" therefore, sex is +as divine as the soul. It is often perverted, but so is reason, aye, so +is devotion. + +The consummation of marriage involves the mightiest issues of life. It +may be the source of infinite happiness or the seal of a living death. +"Love is blind" is an old saying, verified by thousands of ill-assorted +unions. Many unhappy marriages are traceable to one or both of two +sources, Physical Weaknesses and Masquerading. Many are the candidates +for marriage who are rendered unfit therefor from weaknesses of their +sexual systems, induced by the violation of well-established physical +laws. + +We cannot too strongly urge upon parents and guardians the imperative +duty of teaching those youths who look to them for instruction, in all +matters which pertain to their future well-being such lessons as are +embraced in the chapter of this book entitled, "Hygiene of the +Reproductive Organs." By attending to such lessons as will give the +child a knowledge of the physiology and hygiene of his whole system, the +errors into which so many of the young fall, and much of the misery +which is so often the dregs of the hymeneal cup, will be avoided. + +Masquerading is a modern accomplishment. Girls wear tight shoes, +burdensome skirts, and corsets, all of which prove very injurious to +their health. At the age of seventeen or eighteen, our young ladies are +sorry specimens of womankind, and "palpitators," cosmetics, and all the +modern paraphernalia of fashion are required to make them appear fresh +and blooming. Man is equally to blame. A devotee to all the absurd +devices of fashion, he practically asserts that "dress makes the man." +But physical deformities are of far less importance than moral +imperfections. Frankness is indispensable in love. Each should know the +other's faults and virtues. Marriage will certainly disclose them; the +idol falls and the deceived lover is transformed into a cold, unloving +husband or wife. By far the greater number of unhappy marriages are +attributable to this cause. In love especially, honesty is policy and +truth will triumph. + + +HISTORY OF MARRIAGE. + + +POLYGAMY AND MONOGAMY. We propose to give only a brief dissertation on +the principles and arguments of these systems, with special reference to +their representatives in the nineteenth century. Polygamy has existed in +all ages. It is, and always has been, the result of moral degradation or +wantonness. The Garden of Eden was no harem. Primeval nature knew no +community of love. There was only the union of two "and the twain were +made one flesh." Time passed; "the sons of God saw the daughters of men +that they were fair; and they took them wives of all which they chose." +The propensities of men were in the ascendant, and "God repented Him +that He had created man." He directed Noah to take into the ark, two of +every sort, male and female. But "the imagination of man's heart is evil +from his youth," and tradition points to Polygamy as the generally +recognized form of marriage among the ancients. The father of the Hebrew +nation was unquestionably a polygamist, and the general history of +patriarchal life shows that a plurality of wives and concubines were +national customs. In the earlier part of Egyptian history, Menes is said +to have founded a system of marriage, ostensibly monogamous, but in +reality it was polygamous, because it allowed concubinage. As +civilization advanced, the latter became unpopular, and "although +lawful, was uncommon," while polygamy was expressly forbidden. Solomon, +according to polygamous principles, with his thousand women, should have +enjoyed a most felicitous condition. Strange that he exclaimed "A woman +among all these have I not found." According to the distinguished Rabbi, +Maimonides, polygamy was a Jewish custom as late as the thirteenth +century. When Cecrops the Egyptian King, came to Athens (1550, B.C.) he +introduced a new system, which proved to be another step toward the +recognition of Monogamy. Under this code a man was permitted to have one +wife and a concubine. Here dawned the era of Grecian civilization, the +glory of which was reflected in the social and political principles of +Western Europe. During the fourth and fifth centuries B.C., concubinage +disappeared, but, under the new regime, the condition of the wife was +degraded. She was regarded as simply an instrument of procreation and a +mistress of the household, while a class of foreign women, who devoted +themselves to learning and the fine arts, were the admired, and often +the beloved companions of the husbands. These were the courtesans who +played the same role in Athenian history, as did the chaste matron, in +the annals of Rome. When Greece became subject to Rome and the national +characteristics of these nations were blended, marriage became a loose +form of monogamy. In Persia, during the reign of Cyrus, about 560 B.C., +polygamy was sustained by custom, law, and religion. The Chinese +marriage system was, and is, practically polygamous, for, from their +earliest traditions, we learn that although a man could have but one +wife, he was permitted to have as many concubines as he desired. + +In the Christian era the first religious system which incorporated +polygamy as a principle was Mohammedanism. This system, which is so +admirably adapted to the voluptuous character of the Orientals, has +penetrated Western Europe, Asia, and Africa. Hayward estimated the +number of its adherents to be one hundred and forty millions. The heaven +of the Mohammedan is replete with all the luxuries which appeal to the +animal propensities. Ravishing Houris attend the faithful, who recline +on downy couches, in pavilions of pearl. On the Western Continent a +system of promiscuity was practiced by the Mexicans, Peruvians, +Brazilians, and the barbarous tribes of North America. + +The Mormon Church was founded by Joseph Smith, and professes to be in +harmony with the Bible and a special revelation to its leading Saint. +According to the Mormon code, "Love is a yearning for a higher state of +existence, and the passions, properly understood, are feeders of the +spiritual life;" and again, "nature is dual; to complete his +organization a man must marry." The leading error of Mormonism is that +it mistakes a legal permission for a Divine command. The Mormon logic +may be premised as follows: the Mosaic law allowed polygamy; the Bible +records it; therefore, the Bible _teaches_ polygamy. + +A Mormon Saint can have not less than three wives but as many more as he +can conveniently support. The eight fundamental doctrines of the Mormon +Church are stated as follows: 1. God is a person with the flesh and form +of a man. 2. Man is a part of the substance of God and will himself +become a god. 3. Man is not created by God but existed from all +eternity. 4. Man is not born in sin, and is not accountable for offenses +other than his own. 5. The earth is a colony of embodied spirits, one of +many such settlements in space. 6. God is president of the immortals, +having under Him four orders of beings: (1.) Gods--_i.e._, immortal +beings, possessed of a perfect organization of soul and body, being the +final state of men who have lived on earth in perfect obedience to the +law. (2.) Angels, immortal beings who have lived on earth in imperfect +obedience to the law. (3.) Men, immortal beings in whom a living soul is +united with a human body. (4.) Spirits, immortal beings, still waiting +to receive their tabernacle of flesh. 7. Man, being one of the race of +gods, became eligible, by means of marriage, for a celestial throne, and +his household of wives and children are his kingdom, not only on earth +but in heaven. 8. The kingdom of God has been again founded on earth, +and the time has now come for the saints to take possession of their +own; but by virtue, not by violence; by industry, not by force. This +sect has met with stern and bitter opposition. It was successively +located in New York, Ohio, Missouri, and Illinois, from the last of +which it was expelled by force of arms, and in 1848 established in Utah. +Its adherents number, at the present time, more than two hundred +thousand. + +Another organization, differing from the Mormons, in many of its radical +principles, is that of the "Communists," popularly termed "Free Lovers." +It is located at Lennox, Madison Co., N.Y. Its members advocate a system +of "complex marriage" which they claim is instituted with a +conscientious regard for the welfare of posterity. They disclaim +"promiscuity," and assert that the tie which binds them together is as +permanent and as sacred as that of marriage. Community of property is +commensurate with freedom of Love. They define love to be "social +appreciation," and this element in their code of civilization, which +they deem superior to all others, is secondary to "bodily support." The +principles upon which their social status is founded may be briefly +summarized as follows: "Man offers woman support and love +(unconditional). Woman enjoying freedom, self-respect, health, personal +and mental competency, gives herself to man in the boundless sincerity +of an unselfish union. State--, Communism." In this, as in all forms of +polygamous marriages, love is made synonymous with sexuality, and its +purely spiritual element is lost. In every instance this spiritual +element should constitute the basis of marriage, which, without it, is +nothing more than legal prostitution. Without it, the selfish, +degrading, animal propensities run rampant, while the emotions with all +their boundless sweetness lie dormant. Woman is regarded as only a +plaything to gratify the animal caprice. + +That Monogamy is a law of nature is evident from the fact that it +fulfills the three essential conditions which form the basis of true +marriage: (1.) The development of the individual (2.) The welfare of +society. (3.) The reproduction of the species. + + +THE DEVELOPMENT OF THE INDIVIDUAL. + + +PHYSICALLY. Reciprocated love produces a general exhilaration of the +system. The elasticity of the muscles is increased, the circulation is +quickened, and every bodily function is stimulated. The duties of life +are performed with a zest and alacrity never before experienced. "It is +not possible for human beings to attain their full stature of humanity, +except by loving long and perfectly. Behold that venerable man! He is +mature in judgment, perfect in every action and expression, and saintly +in goodness. You almost worship as you behold. What rendered him thus +perfect? What rounded off his natural asperities, and moulded up his +virtues? Love mainly. It permeated every pore, so to speak, and seasoned +every fiber of his being, as could nothing else. Mark that matronly +woman. In the bosom of her family, she is more than a queen and goddess +combined. All her looks and actions express the outflowing of some or +all of the human virtues. To know her is to love her. She became thus +perfect, not in a day or a year, but by a long series of appropriate +efforts. Then by what? Chiefly in and by love, which is specifically +adapted thus to develope this maturity." But all this occurs only when +there is a normal exercise of the sexual propensities. Excessive +indulgence in marital pleasures deadens all the higher faculties, love +included, and results in an utter prostration of the bodily powers. The +Creator has endowed man and woman with passions, the suppression of +which leads to pain, their gratification to pleasure, their satiety to +disgust. Excessive marital indulgence produces abnormal conditions of +the generative organs and not unfrequently leads to incurable disease. +Many cases of uterine disease are traceable to this cause. + +MORALLY AND INTELLECTUALLY. In no country where the polygamous system +prevails do we find a code of political and social ethics which +recognizes the rights and claims of the individual. The condition of +woman is that of the basest slave, a slave to the caprice and tyranny of +her master. Communism raises her from the slough of slavery, but +subjects her to the level of prostitution. An inevitable sequence of +polygamy is a decline of literature and science. The natural tendency of +each system is to _sensualism._, The blood is diverted from its normal +channels and the result is a condition which may be appropriately termed +_mental starvation_. Sensualism is in its very nature directly opposed +to literary attainments or advancement. Happily there is a golden mean, +an equalization of those elements which constitutes the acme of +individual enjoyment. + + +THE WELFARE OF SOCIETY. + + +The general law of ethics, that "whatever is beneficial to the +individual, contributed to the highest good of society and _vice +versa_," applies with equal force to the hygienic conditions of +marriage. Each family, like the ancient Roman household, is the +prototype of the natural government under which it lives. Wherever the +marriage relation is regarded as sacred, there you will find men of pure +hearts and noble lives. Of all foreign nations the Germans are +celebrated for their sacred regard of woman, and the duties of marriage, +and all scholars from the age of Tacitus to the present day, have +concurred in attributing the elevation of woman to the pure-minded +Teutons. In America, the law recognizes only Monogamy; but domestic +unhappiness is a prominent feature of our national life; therefore, +argues the would-be free-lover, monogamy does not accord with the best +interests of mankind. The fallacy lies in the first premise. Legally, +our marriage system is monogamous but _socially_ and _practically_ it is +_not!_ Prostitution is the source of this domestic infelicity. The +"mistress" sips the sweet nectar that is denied to the deceived wife. +Legislators have battled with intemperance, but have done comparatively +little to banish from our midst this necessary (?) evil. They recoil +with disgust from this abyss of iniquity and disease. Within it is +coiled a hydra-headed monster, which invades our hearthstones, +contaminates our social atmosphere, and whose very breath is laden with +poisonous vapors, the inexhaustible source of all evil. + +The perverted appetites of mankind are mistaken for the natural desires +and necessities of our being; and, accordingly, various arguments have +been advanced to prove that monogamy is not conducive to social +developement. It is curious that no one of these arguments refers to the +health and well-being of the _individual_, thus overlooking, perhaps +willfully, the great law of social economy. Even a few medical writers +sometimes advocate the principles of this so-called liberalism. In a +recently published work, there are enumerated only _two_ demerits of +polygamy and _six_ of monogamy. These six demerits which the author is +pleased to term a "bombshell," he introduces on account of his moral +convictions no less than humanitarian considerations. The same author +terms monogamy a "worm-eaten and rotten-rooted tree." The worm that is +devastating the fairest tree of Eden and draining its richest juices is +what our contemporary thinks, may be "_plausibly termed, a necessary +evil_." It is claimed that monogamy begets narrow sympathies and leads +to selfish idolatry. The fallacy of this argument lies in the +misapprehension of the term _selfishness_. Self-preservation is +literally selfishness, yet who will deny that it is a paramount duty of +man. If perverted, it may be vicious, even criminal; but selfishness, in +so far as it is generated by monogamy, is one of the chief elements of +social economy; furthermore, it favors the observance of the laws of +sexual hygiene. As we have said elsewhere, true love _increases +benevolence_, and correspondingly expands and develops the sympathies. +Selfish idolatry is preferable to social neglect. This argument will not +bear a critical examination; for it is asserted that in a happy union, +"love is so exclusive that there is hardly a liking for good neighbors, +and scarcely any love at all for God." If the "good neighbors" were +equally blessed, they would not suffer from this exclusiveness, and it +is practically true that there is no higher incentive to love and obey +our Maker than the blessing of a happy marriage. + + +THE PERPETUATION OF THE SPECIES. + + +The third essential object of marriage is the perpetuation of the +species. The desire for offspring is innate in the heart of every true +man or woman. It is thus a law of our nature, and, as such, must have +its legitimate sphere. The essential features of reproduction proclaim +monogamy to be the true method of procreation. Promiscuity would render +the mother unable to designate the father of her children. Among lower +animals, pairing is an instinctive law whenever the female is incapable +of protecting and nourishing her offspring alone. During at least +fifteen years, the child is dependent for food and clothing upon its +parents, to say nothing of the requisite moral training and loving +sympathy, which, in a great measure, mould its character. Fidelity to +one promotes multiplication. It has been argued by the advocates of +polygamy that such a system interferes with woman's natural right to +maternity. Of the many marriages celebrated yearly, comparatively few +are sterile. The statement that many single women are desirous of having +children, would apply only to a very limited number, as it is seldom +that they would be able to support children without the aid and +assistance of a father. Promiscuity diminishes the number and +_vitiates_, the quality of the human products. "Women of pleasure never +give to the world sons of genius, or daughters of moral purity." + + * * * * * + + + + +CHAPTER XVII. + +REPRODUCTION. + + +Every individual derives existence from a _parent_, which word literally +means one who brings forth. We restrict the meaning of the term +_reproduction_, ordinarily, to that function by which living bodies +produce other living bodies similar to themselves. _Production_ means to +bring forth; _reproduction_, the producing again, or renewing. To +protract individual existence, nutrition is necessary, because all vital +changes are attended by _wear_ and _waste_. Nutrition is always engaged +in the work of reparation. Every organism that starts out upon its +career of development depends upon nourishing materials for its growth, +and upon this renewing process for its development. Nutrition is all the +while necessary to prolong the life of the individual, but at length its +vigor wanes, its functions languish, and, finally, the light of earthly +life goes out. Although the single organization decays and passes away, +nevertheless the species is uninterruptedly continued; the tidal wave of +life surges higher on the shores of time, for reproduction is as +constant and stable as the attractive forces of the planetary system. + +It is a fact, that many species of the lower order of animals which once +existed are now extinct. It has been asserted and denied, that fossil +remains of man have been found, indicating that races which once existed +have disappeared from the face of the earth. The pyramids are unfolding +a wonderful history, embracing a period of forty-five hundred years, +which the world of science receives as literally authentic, and admits, +also, that fifty-four hundred years are _probably_ as correctly +accounted for. The extinction of races is not at all improbable. At the +present time, the aboriginal inhabitants of this continent seem to be +surely undergoing gradual extinguishment! It, therefore, seems to be +possible for a weaker race to deteriorate, and finally become extinct, +unless the causes of their decadence can be discovered and remedied. All +people are admonished to earnestly investigate the essential conditions +necessary for their continuance, for the rise and fall of nations is in +obedience to natural principles and operations. Viewed from this +standpoint, it is possible that a careful study of the human +temperaments and their relations to reproduction may be of greater +moment than has hitherto been supposed, and a proper understanding of +them may tend to avert that individual deterioration, which, if suffered +to become general, would end in national disaster and the extinction of +the race. + +Until recently, even naturalists believed that descendants were strictly +like their parents in form and structure. Now it is known that the +progeny may differ in both form and structure from the parent, and that +these may produce others still more unlike their ancestry. But all these +peculiar and incidental deviations finally return to the original form, +showing that these changes have definite limits, and that the +alterations observe a specific variableness, which is finally completed +by its assuming again the original form. (See page 16, Figs. 2 and 3). + +_Reproduction_ may be _sexual_ or _non-sexual._ In some plants and +animals it is non-sexual. The propagation of species is accomplished by +buds. Thus the gardener grafts a new variety of fruit upon an old stock. +The florist understands how to produce new varieties of flowers, and +make them radiantly beautiful in their bright and glowing colors. The +bud personates the species and produces after its kind. Some of the +_annelides_, a division of articulate animals, characterized by an +elongated body, formed of numerous rings or annular segments, multiply +by spontaneous division. A new head is formed at intervals in certain +segments of the body. (See Fig. 97). + +Something similar to this process of budding, we find taking place in a +low order of animal organization. Divide the fresh water polyp into +several pieces, and each one will grow into an entire animal. Each piece +represents a polyp, and so each parent polyp is really a compound +animal, an organized community of beings. Just as the buds of a tree, +when separated and engrafted upon another tree, grow again, each +preserving its original identity, so do the several parts of this +animal, when divided, become individual polyps, capable of similar +reproduction. + +[Illustration: Fig. 97. +An annelid dividing spontaneously, a new head having been formed toward the +hinder part of the body of the parent.] + +The revolving volvox likewise increases by growth until it becomes a +society of animals, a multiple system of individuals. There are +apertures from the parent, by which water gains a free access to the +interior of the whole miniature series. This monad was once supposed to +be a single animal, but the microscope shows it to be a group of animals +connected by means of six processes, and each little growing volvox +exhibits his red-eye speck and two long spines, or horns. These animals +also multiply by dividing, and thus liberate another series, which, in +their turn, reproduce other groups. + +Generation requires the concurrence of _stimuli_ and _susceptibility_, +and, to perfect the process, two conditions are also necessary. The +first is the sperm, which communicates the principle of action; the +other is the germ, which receives the latent life and provides the +conditions necessary to organic evolution. The vivifying function +belongs to the male, that of nourishing and cherishing is possessed by +the female; and these conditions are sexual distinctions. The former +represents _will_ and _understanding_; the latter, _vitality_ and +_emotion_. The father directs and controls, the mother fosters and +encourages; the former counsels and admonishes, the latter persuades and +caresses; and their union in holy matrimony represents one; that is, the +blending of vitality and energy, of love and wisdom,--the elements +indispensable to the initiation of life under the dual conditions of +male and female,--_one in the functions of reproduction_. + +Let us consider the modes of Sexual Reproduction, which are +_hermaphroditic_ and _dioecious_. + + +HERMAPHRODITIC REPRODUCTION. + + +We have said that two kinds of cells represent reproduction, namely, +sperm and germ-cells. These may be furnished by different individuals, +or both may be found in one. When both are found in the same individual, +the parent is said to be a _natural hermaphrodite_. A perfect +hermaphrodite possesses the attributes of both male and female--uniting +both sexes in one individual. Natural hermaphroditic reproduction occurs +only among inferior classes of animals, and naturalists inform us that +there are a greater number of these than of the more perfect varieties. +These are found low in the scale of animal organization, and one +individual is able to propagate the species. In the oyster and ascidians +no organs can be detected in the male, but in the female they are +developed. Polyps, sponges, and cystic entozoa, may also be included +among hermaphrodites. + +It is only very low organisms indeed in which it is a matter of +indifference whether the united sperm-cells and germ-cells are those of +the same individual, or those of different individuals. In more +elaborate structures and highly organized beings, the essential thing in +fertilization is the union of these cells specially endowed by +_different_ bodies, the unlikeness of derivation in these united +reproductive centers being the desideratum for perpetuating life and +power. + +In other classes, as _entozoa_, there appear to be special provisions +whereby the sperm-cells and germ-cells may be united; _i.e._, the male +organs are developed and so disposed as to fecundate the ova of the same +individual. Sexual and non-sexual modes of reproduction are illustrated +by that well-defined group of marine invertebrate animals, called +_cirripedia_ Fig. 98 represents one of this genus. + +[Illustration: Fig. 98. +Pollicipes Mitella.] + +Some of these are not only capable of self-impregnation, but likewise +have what are called _complemental males_ attache to some of the +hermaphrodites. In the whole animal kingdom, it may be doubted if there +exists another such class of rudimentary creatures as the parasitic +males, who possess neither mouth, stomach, thorax, nor abdomen. After +exerting a peculiar sexual influence, they soon die and drop off; so +that in this class of animals may be found the sexual distinctions of +male, female, and perfect hermaphrodites. + +[Illustration: Fig. 99. +Rotiferia; Brachionus Urceolaris; +largely magnified. ] + +There is a class of wheel-animalcules termed _rotifera_, of which the +revolving volvox is one example. They have acquired this name on account +of the apparent rotation of the disc-like organs which surround their +mouths and are covered with _cilia_, or little hairs. They are minute +creatures, and can best be viewed with a microscope, although the larger +forms may be seen without such assistance. They are widely diffused on +the surface of the earth, inhabit lakes as well as the ocean, and are +found in cold, temperate, and tropical climates. The rotifera were once +supposed to be hermaphrodites, but the existence of sexes in one species +has been clearly established. The male, however, is much smaller, and +far less developed than the female. In some of these species, +germ-cells, or eggs, are found, which do not require fecundation for +reproduction or development, so that they belong to the non-sexual +class. + +The third variety of hermaphrodites embraces those animals in which the +male organs are so disposed as not to fecundate the ova of the same +body, but require the co-operation of two individuals, notwithstanding +the co-existence in each of the organs of both sexes. Each in turn +impregnates the other. The common leech, earth-worm, and snail, +propagate in this manner. + +_Unnatural hermaphrodism_ is characteristic of insects and crustaceans, +in which the whole body indicates a neutral character, tending to +exhibit the peculiarities of male or female, in proportion to the kind +of sexual organs which predominates. Half of the body may be occupied by +male, the other half by female organs, and each half reflects its +peculiar sexual characteristics. Some butterflies are dimidiate +hermaphrodites; _i.e._ one side of the body has the form and color of +the male, the other the form and color of the female. The wings show by +their color and appearance these sexual distinctions. The stag-beetle is +also an example. We have accounts of dimidiate hermaphrodite lobster, +male in one half and female in the other half of the body. + +Among the numerous classes of higher animals, which have red blood, we +have heard of no well-authenticated instance of hermaphrodism, or the +complete union of _all_ the reproductive organs in one individual. True, +the term _hermaphrodite_ is often applied to certain persons in whom +there is some malformation, deficiency, or excess, of the genital +organs. These congenital deformities consisting of combined increase or +deficiency, supernumerary organs, or transposition of them, which +usually render generation physically impossible, have been called +_bisexual hermaphrodism_ and classed as monstrosities. We have many +published accounts of them, hence, further reference to them here is +unnecessary. We would especially refer those readers who may desire to +make themselves further acquainted with this interesting subject, to the +standard physiological works of Flint, Foster, Carpenter, Bennett, +Dalton, and others equally eminent in this particular branch of science. + +Certain theories have been advanced concerning conditions which may +influence the sex of the offspring. One is that the right ovary +furnishes the germs for males, the left for females that the right +testicle furnishes sperm capable of fecundating the germs of males, and +the left testicle, the germs of the left ovary, for females. That +fecundation sometimes takes place from right to left and thus produces +these abnormal variations. We merely state the hypothesis, but do not +regard it as accounting for the distinction of sex, or as causing +monstrosities, though it is somewhat plausible as a theory, and is not +easily disproved. In the lower order of animals, as sheep and swine, one +of the testicles has been removed, and there resulted afterward both +male and female progeny, so that the theory seems to lack facts for a +foundation. + +We sometimes witness in the child excessive development, as five +fingers, a large cranium, which results in dropsical effusion, or +deficient brain, as in idiots; sometimes a hand or arm is lacking, or +possibly there is a dual connection, as in the case of the Siamese +twins; or, two heads united on one body. It is difficult to give any +satisfactory explanation of these abnormal developments. From age to +age, the type is _constant_, and preserves a race-unity. The crossings +of the races are only transient deviations, not capable of perpetuation, +and quickly return again to the original stock. This force is +persistent, for inasmuch as the individual represents the race, so does +his offspring represent the parental characteristics, in tastes, +proclivities, and morals, as well as in organic resemblances. This +constancy is unaccountable, and more mysterious than the occasional +malformation of germs in the early period of foetal life. If to every +deviation from that original form and structure, which gives character +to the productions of nature, we apply the term _monster_, we shall find +but very few, and from this whole class there will be a very small +number indeed of _sexual_ malformations. If the sexes be deprived of the +generative organs, they approach each other in disposition and +appearance. All those who are partly male and partly female in their +organization, unite, to a certain extent, the characteristics of both +sexes. When the female loses her prolific powers, many of her sexual +peculiarities and attractions wane. + + +DIOECIOUS REPRODUCTION. + + +_Dioecious_ is a word derived from the Greek, and signifies _two +households;_ hence, _dioecious reproduction_ is sexual generation by +male and female individuals. Each is distinguished by sexual +characteristics. The male sexual organs are complete in one individual, +and all the female organs belong to a separate feminine organization. In +some of the vertebrates, impregnation does not require sexual congress; +in other words, fecundation may take place _externally_. The female fish +of some species first deposits her ova, and afterwards the male swims to +that locality and fertilizes them with sperm. + +In higher orders of animals, fecundation occurs _internally_, the +conjunction of the sperm and germ cells requiring the conjugation of the +male and female sexual organs. The sperm-cells of the male furnish the +quickening principle, which sets in play all the generative energies, +while the germ-cell, susceptible to its vivifying presence, responds +with all the conditions necessary to evolution. The special laboratory +which furnishes spermatic material is the _testes_, while the stroma of +the _ovaries_ contributes the germ-cell. Several different modes of +reproducing are observed when fecundation occurs within the body, which +vary according to the peculiarities and organization of the female. + +MODES OF DIOECIOUS REPRODUCTION.--A very familiar illustration of one +mode is found in the common domestic fowl, the egg of which vivified +within the ovarium, is afterward expelled and hatched by the simple +agency of warmth. This mode of reproduction is called _oviparous +generation_. + +The ovaries, as well as all their latent germs, are _remarkably_ +influenced by the first fecundation. It seems to indicate monogamy as +the rule of higher sexual reproduction. The farmer understands that if +he wishes to materially improve his cows, the first offspring must be +begotten by a better, purer breed, and all that follow will be +essentially benefited, even if not so well sired. Neither will the best +blood exhibit its most desirable qualities in the calves whose mothers +have previously carried inferior stock. So that there are sexual +ante-natal influences which may deteriorate the quality of the progeny. +The Jews understood this principle, in the raising up of sons and +daughters unto a deceased brother. The fact that the sexual influence of +a previous conception is not lost, is illustrated when, in a second +marriage, the wife bears a son or daughter resembling bodily or +mentally, or in both of these respects the former husband. This +indicates a union for life by natural influences which never die out. + +With some species of fish and reptiles, the egg is impregnated +internally, and the process of _laying_ commences immediately, but it +proceeds so slowly through the excretory passages, that it is hatched +and born alive. This is called _ovo-viviparous generation_. + +As we rise in the scale of organization, animals are more completely +developed, and greater economy is displayed in their preservation. The +germ passes from the ovary into an organ prepared for its reception and +growth, to which, after fecundation, it becomes attached, and where it +remains until sufficiently developed to maintain respiratory life. This +organ is called the _womb_, or _uterus_, and is peculiar to most +mammalia. This mode of reproduction is termed _viviparous generation_. + +The kangaroo and oppossum are provided with a pouch attached to the +abdomen, which receives the young born at an early stage of development. +They remain in contact with the mammæ, from which they obtain their +nourishment, until their growth is sufficiently completed to maintain an +independent existence. This is called _marsupial generation_. The +variety of reproduction which is most interesting, is that of the human +species, and is called _viviparous generation_. It includes the +functions of copulation, fecundation, gestation, parturition, and +lactation. + +For the full and perfect development of mankind, both mental and +physical chastity is necessary. The health demands abstinence from +unlawful intercourse. Therefore children should not be allowed to read +impure works of fiction, which tend to inflame the mind and excite the +passions. Only in total abstinence from illicit pleasures is there moral +safety and health, while integrity, peace, and happiness, are the +conscious rewards of virtue. Impurity travels downward with +intemperance, obscenity, and corrupting diseases, to degradation and +death. A dissolute, licentious, free-and-easy life is filled with the +dregs of human suffering, iniquity, and despair. The penalties which +follow a violation of the law of chastity are found to be severe and +swiftly retributive. + +[Illustration: Fig. 100. +Male] + +[Illustration: Fig. 101. +Female] + +[Illustration: Fig. 102. +Outline of the Female Urinary and +Generative Organs.] + +The union of the sexes in holy matrimony is a law of nature finding +sanction in both morals and legislation. Even some of the lower animals +unite in this union for life, and instinctively observe the law of +conjugal fidelity with a consistency which might put to blush other +animals more highly endowed. It is important to discuss this subject and +understand our social evils, as well as the unnatural desires of the +sexes, which must be controlled or they lead to ruin. Sexual +propensities are possessed by all, and they must be held in abeyance, +until they are exercised for legitimate purposes. Hence parents ought to +understand the value of mental and physical labor to elevate and +strengthen the intellectual and moral faculties of their children, to +develop the muscular system and direct the energies of the blood into +healthful channels. Vigorous employment of mind and body engrosses the +vital energies and diverts them from undue excitement of the sexual +desires. + +[Illustration: Fig. 103. +Outline of the Male Reproductive Organs.] + +Sexual generation by pairing individuals is the most economical mode of +propagating the species. The lower orders of animals possess wonderful +multiplicative powers and their faculty for reproduction is offset by +various destructive forces. The increased ability for self-maintenance +implies diminished reproductive energy; hence the necessity for greater +economy and safety in rearing the young. As certain larvae and insects +increase, the birds which feed upon them become more numerous. When this +means of support becomes inadequate, these same birds diminish in number +in proportion to the scarcity of their food. Many have remarked that +very prolific seasons are followed by unusual mortality, just as periods +of uncommon prosperity precede those of severe disaster. + +The increased mental and moral cultivation of mankind imposes upon them +the necessity for greater physical culture. "Wiser and weaker," is a +trite saying, and means that the exercise of the higher nature discloses +the equivalent necessity of culturing the body, in order to support the +increasing expenditures of the former. Mental and moral discipline are +essential for a proper understanding how to provide for the body, for +physical training increases the capacity of the individual for +self-preservation. Constant vigilance is the price of health as well as +of liberty. + +It is an interesting physiological fact that, while the growth and +development of the individual are rapidly progressing, the reproductive +powers remain almost inactive, and that the commencement of reproduction +not only indicates an arrest of growth, but, in a great measure, +contributes toward it. From infancy to puberty, the body and its +individual organs, structurally as well as functionally, are in a state +of gradual and progressive evolution. Men and women generally increase +in stature until the twenty-fifth year, and it is safe to assume that +perfection of function is not established until maturity of bodily +development is completed. Solidity and strength are represented in the +organization of the male, grace, and beauty in that of the female. His +broad shoulders represent physical power and the right of dominion, +while her bosom is the symbol of love and nutrition. The father +encounters hardships, struggles against difficulties, and braves dangers +to provide for his household; the mother tenderly supplies the infant's +wants, finding relief and pleasure in imparting nourishment, and +surrounds helpless infancy with an affection which is unwearied in its +countless ministering attentions. Her maternal functions are indicated +by greater breadth of the hips. Physical differences so influence their +mental natures, that, "before experience has opened their eyes, the +dreams of the young man and maiden differ." The development of either is +in close sympathy with their organs of reproduction. Any defect of the +latter impairs our fair ideal, and detracts from those qualities which +impart excellence, and crown the character with perfections. Plainly has +Nature marked out, in the organization, very different offices to be +performed by the sexes, and has made these distinctions fundamental. + +Likewise, Nature expresses the intention of reproduction by giving to +plants and animals distinctive organs for this purpose. These are +endowed with exquisite sensibility, so that their proper exercise +produces enjoyment beneficial to both. Excessive sexual indulgence not +only prostrates the nervous system, enfeebles the body, and drains the +blood of its vivifying elements, but is inconsistent with intellectual +activity, morality, and spiritual development. The most entrancing +delights and consummate enjoyments are of the emotive order, ideal, +abstract, and pure, so inspiring that they overpower the grosser sensual +pleasures and diffuse their own sweet chastity and refining influence +over all the processes of life. + +Hence, the gratification of the sexual instincts should always be +moderate. It should be regulated by the judgment and will, and kept +within the bounds of health. No person has a moral right to carry this +indulgence so far as to produce injurious consequences to either party, +and he who cannot refrain from it is in no proper condition to propagate +his species. In all culture there must be self-control, and the practice +of self-denial at the command of love and justice is always a virtue. +Self-government is the polity of our people, and we point with pride and +laudable exultation to our political maxims, laws, and free +institutions. The family is the prototype of society. If self-restraint +be practiced in the marital relation, then the principle of self-control +will carry health, strength, and morality into all parts of the +commonwealth. The leading characteristics of any nation are but the +reflection of the traits of its individual members, and thus the family +truly typifies the practical morality and enduring character of a +people. + + +OVULATION. + + +The _Ovaries_ are those essential parts of the generative system of the +human female in which the ova are matured. There are two ovaries, one on +each side of the uterus, and connected with it by the Fallopian tubes; +they are ovoidal bodies about an inch in diameter, and furnish the +_germs_ or ovules. These latter are very minute, seldom measuring 1/120 +of an inch in diameter, and frequently are not more than half that size. +The ovaries develop with the growth of the female, so that, finally, at +the pubescent period, they ripen and liberate an ovum, or germ vesicle, +which is carried into the uterine cavity through the Fallopian tubes. +With the aid of the microscope, we find that these ova are composed of +granular substance, in which is found a miniature yolk surrounded by a +transparent membrane, called the _zona pellucida_. This yolk contains a +germinal vesicle in which can be discovered a nucleus, called the +_germinal spot_. The process of the growth of the ovaries is very +gradual, and their function of ripening and discharging an ovum every +month into the Fallopian tubes and uterus is not developed until between +the twelfth and fifteenth years. + +This period, which indicates, by the feelings and ideas, the desires and +will, that the subjects are capable of procreation, is called _puberty_. +The mind acquires new and more delicate perceptions, the person becomes +plumper, the mammæ enlarge, and there is grace and perfection in every +movement, a conscious completeness for those relations of life for which +this function prepares them. The period of puberty is also indicated by + + +MENSTRUATION. + + +The catamenial discharge naturally follows the ripening and liberation +of an ovum, and as the ovaries furnish one of these each month, this +monthly flow is termed the _menses_ (the plural of the Latin word +_mensis_, which signifies a month). The menstrual flow continues from +three to five days, and is merely the exudation of ordinary venous blood +through the mucous lining of the cavity of the uterus. At this time, the +nervous system of females is much more sensitive, and from the fact that +there is greater aptitude to conception immediately before and after +this period, it is supposed that the sexual feeling is then the +strongest. When impregnation occurs immediately before the appearance of +the menses, their duration is generally shortened, but not sufficiently +to establish the suspicion that conception has taken place. The germ is +the contribution of the female, which provides the conditions which only +require the vivifying principle of the sperm for the development of +another being. The period of aptitude for conception terminates at the +time both ovulation and menstruation cease, which, unless brought about +earlier by disease, usually occurs about the forty-fifth year of her +age. + + +FECUNDATION. + + +Since in the beginning God created male and female, and said unto them, +"Be fruitful, and multiply, and replenish the earth," it is evident that +what was originated by creation must be continued by procreation. The +process of generation the reader will find described on pages 12 and 13. +Then commences a wonderful series of transforming operations, +rudimentary changes preliminary to the formation of tissues, structures +and functions, which finally qualify the organism for independent +existence. The ovum, when expelled from the ovary, enters the +fimbriated, or fringe-like extremity of the Fallopian tube, to commence +at once its descent to the uterus. The process of passing through this +minute tube varies in different animals. In birds and reptiles, the bulk +of the expelled ova is so great as to completely fill up the tube, and +it is assisted in its downward course, partly by its own weight and +partly by the peristaltic action of the muscular coat of the canal. In +the human subject, however, the ova are so minute that nature has +supplied a special agent for their direct transmission; otherwise they +might be retained, and not reach their destination. Accordingly, the +fimbriated, trumpet-shaped extremity of the Fallopian tubes, which is +nearest to the ovaries, and, consequently from the ovary first receives +the ovum when expelled; is provided with a series of small hairs, termed +_cilia_, forming the lining or basement membrane of the tubes, and, the +movements of these cilia being towards the uterus, transmit, by their +vibrating motion, the ovum from the ovary, through the Fallopian tubes, +to the uterus. + +The mature ovum, however, is not by itself capable of being converted +into the embryo. It requires fecundation by the spermatic fluid of the +male, and this may take place immediately on the expulsion of the ovum +from the ovary, or during its passage through the Fallopian tube, or, +according to Bischoff, Coste, and others, in the cavity of the uterus, +or even upon the surface of the ovary. Should impregnation, however, +fail, the ovum gradually loses its vitality, and is eventually expelled +by the uterine secretions. It occasionally happens that the descent of +the impregnated ovum is arrested, and the formation of the embryo +commences in the ovary. This is termed _ovarian pregnancy_. Or again, +the ovum may be arrested in its passage through the Fallopian tube, +causing what is termed _tubal pregnancy_; or, after it has been expelled +from the ovary, it may fail to be received by the fimbriated extremity, +and escape into the cavity of the abdomen, forming what has been termed +_ventral pregnancy_. If the microscopic germ lodges in some slight +interstice of fiber, during its passage through the walls of the uterus, +it may be detained long enough to fix itself there, and when this +occurs, it is termed _interstitial pregnancy_. All these instances of +extra-uterine pregnancy may necessitate the employment of surgical +skill, in order that they may terminate with safety to the mother. Their +occurrence, however, is very rare. + +The intense nervous excitement produced by the act of coition is +immediately followed by a corresponding degree of depression, and a too +frequent repetition of it is necessarily injurious to health. The +secretions of the seminal fluid being, like other secretions, chiefly +under the influence of the nervous system, an expenditure of them +requires a corresponding renewal. This renewal greatly taxes the +corporeal powers, inducing lassitude, nervousness, and debility. It is a +well known fact that the highest degree of mental and bodily vigor is +inconsistent with more than a moderate indulgence in sexual intercourse. + +To ensure strength, symmetry, and high intellectual culture in the human +race, requires considerable care. Consideration should be exercised in +the choice of a companion for life. Constitutional as well as hereditary +ailments demand our closest attention. Age has also its judicious +barriers. As before stated, when reproduction commences, growth, as a +rule, ceases, therefore, it is inexpedient that matrimony should be +consummated before the parties have arrived at mature stature. + + +PREVENTION OF CONCEPTION. + + +Much has been written upon the question whether married people have a +right to decline the responsibilities of wedlock. The practice of +inducing abortion is not only immoral but criminal, because it is +destructive to both the health of the mother and the life of the embryo +being. If both the parties to a marriage be feeble, or if they be not +temperamentally adapted to each other, so that their children would be +deformed, insane, or idiotic, then to beget offspring would be a +flagrant wrong. If the mother is already delicate, possessing feeble +constitutional powers, she is inadequate to the duties of maternity, +_and it is not right to lay such burdens upon her_. Self-preservation is +the first law of nature, which all ought to respect. The woman may be +able to discharge the duties of a loving wife and companion, when she +cannot fulfill those of child-bearing. If the husband love his wife as +he ought, he will resign all the pleasure necessary to secure her +exemption from the condition of maternity. It seems to us, that it is a +great wickedness, unpardonable even, to be so reckless of consequences, +and so devoid of all feeling, as to expose a frail, feeble, affectionate +woman to those perils which almost insure her death. To enforce +pregnancy under such circumstances is a crime. Every true man, +therefore, should rather practice self-control and forbearance, than +entail on his wife such certain misery, if not danger to life. + +Undoubtedly, the trial is great, but if a sacrifice be required, let the +husband forbear the gratification of passions which will assuredly be +the means of developing in his delicate wife symptoms that may speedily +hurry her into a premature grave. Before she has recovered from the +effects of bearing, nursing, and rearing one child, ere she has regained +proper tone and vigor of body and mind, she is unexpectedly overtaken, +_surprised_ by the manifestation of symptoms which again indicate +pregnancy. Children thus begotten are not apt to be hardy and +long-lived. From the love that parents feel for their posterity, from +their wishes for their success, from their hopes that they may be useful +from every consideration for their future well-being, let them exercise +precaution and forbearance, until the wife becomes sufficiently healthy +and enduring to bequeath her own vital stamina to the child she bears. + +From what has been said on this subject, it behooves the prudent husband +to weigh well the injurious, nay criminal results which may follow his +lust. Let him not endanger the health, and it may be the life, of his +loving and confiding wife through a lack of self-denial. Let him +altogether refrain, rather than be the means of untold misery and, +perhaps, the destruction of the person demanding his most cherished love +and protection. On so important a subject, we feel we should commit an +unpardonable wrong were we not to speak thus plainly and openly. An +opportunity has been afforded us, which it would be reprehensible to +neglect. We shall indeed feel we have been amply rewarded, if these +suggestive remarks of ours tend in any way to remove or alleviate the +sufferings of an uncomplaining and loving wife. Our sympathies, always +susceptible to the conditions of sorrow and suffering, have been +enlisted to give faithfully, explicitly, and plainly, warnings of danger +and exhortations to prudence and nothing remains for us but to maintain +the principles of morality, and leave to the disposal of a wise and +overruling Providence the mystery of all seemingly untoward events. In +every condition of life, evils arise, and most of those which are +encountered are avoidable. Humanity should be held accountable for those +evils which it might, but does not shun. + +By a statute of the national government, prevention of pregnancy is +considered a punishable offense; whereas every physician is instructed +by our standard writers and lecturers on this subject, that not only +prevention is necessary in many instances, but even abortion must +sometimes be produced in order to save the mother's life. As we view the +matter, the law of the national government asserts the ruling principle, +and the exceptions to it must be well established by evidence, in order +to fully justify such procedure. The family physician may, with the +concurrence of other medical counselors, be justified, in rare cases, in +advising means for the prevention of conception, but he should exercise +this professional duty _only_ when the responsibility is shared by other +members of the profession, and the circumstances fully and clearly +warrant such a practice. + +After fecundation, the length of time before conception takes place is +variously estimated. Should impregnation occur at the ovary or within +the Fallopian tubes, usually about a week elapses before the fertilized +germ enters the uterus, so that ordinarily the interval between the act +of insemination and that of conception varies from eight to fourteen +days. + + +DOUBLE CONCEPTION. + + +If two germs be evolved simultaneously, each may be impregnated by +spermatozoa, and a twin pregnancy be the result. This is by no means a +rare occurrence. It is very unusual, however, to have one birth followed +by another after an interval of three or four months, and each babe +present the evidences of full maturity. Perhaps such occurrences may be +accounted for on the supposition that the same interval of time elapses +between the impregnation of the two germs as there is difference +observed in their birth; that after the act of insemination, sperm was +carried to each ovary; that one had matured a germ ready for +fecundation, then impregnation and conception immediately followed, and +the decidua of the uterus hermetically sealed both Fallopian tubes, and +thus securely retained the sperm within the other Fallopian canal. The +stimulus of the sperm so pent up causes that ovary to mature a germ, +although it may do so slowly, and after two or three months it is +perfected, fertilized, and a second conception occurs within the uterus. +If each embryo observe a regular period of growth and each be born at +maturity, there must be an interval of two or three months between their +births. But it is far more common for the parturition of the first, +displaying signs of full maturity, to coincide with the birth of a +second which is immature and which cannot sustain respiratory life. The +birth of the latter is brought about prematurely, by the action of the +uterus in expelling the matured child. + + +UTERINE PREGNANCY. + + +There are many who manifest a laudable desire to understand the +physiology of conception, the changes which take place, and the order of +their natural occurrence. When impregnation takes place at the ovaries +or within the Fallopian tubes, there is exuded upon the inner surface of +the womb a peculiar nutritious substance. It flows out of the minute +porous openings surrounding the termination of the Fallopian tube within +the uterine cavity, and, thus, is in readiness to receive the germ, and +retain it there until it becomes attached. Undoubtedly, the germ imbibes +materials from this matter for its nurture and growth. This membranous +substance is termed the _decidua_, and disappears after conception is +insured. Two membranes form around the embryo; the inner one is called +the _amnion_, the outer one the _chorion_. Both serve for the protection +of the embryo, and the inner one contains the _liquor amnii,_ in which +it floats during intra-uterine life. Immediately after conception, the +small glands in the neck of the uterus usually throw out a sticky +secretion, filling the canal, or uniting its sides, so that nothing can +enter or leave the uterine cavity. + +The fertilized ovum rapidly develops. After its conception it imbibes +nourishment, and there is a disposition in fluids to pass into it, +through its delicately-organized membranes. If this process is not +involuntary, it is, at all events, at the convenience and use of the +developing germ. After three months the embryo is termed the _foetus_. +Its fluids are then so much more highly organized, that some of them are +tinged with sanguine hues, and thenceforward acquire the characteristics +of red blood. Out of red blood, blood-vessels are formed, and from the +incipient development of the heart follow faint lines of arteries, and +the engineers of nutrition survey a circulatory system, perfecting the +vascular connections by supplementing the arteries with a complete +net-work of veins and capillaries. + + +THE PLACENTA OR AFTERBIRTH. + + +Whenever conception occurs, a soft, spongy substance is formed between +the uterus and the growing ovum, called the _placenta_. It is composed +of membrane, cellular tissue, blood-vessels, and connecting filaments. +The principal use of this organ seems to be to decarbonate the blood of +the foetus, and to supply it with oxygen. It performs the same function +for the foetus that the lungs do for the organism after birth. It allows +the blood of the foetus to come into very close contact with that of the +mother, from which it receives a supply of oxygen, and to which it gives +up carbonic acid. This interchange of gases takes place in the placenta, +or between it and the uterus, through the intervening membranes. This +decarbonating function requires the agency of the maternal lungs, for +the purpose of oxygenating the mother's blood. + +The placenta is attached to the uterus by simple adhesion. True, in some +instances, morbid adhesion takes place, or a growing together in +consequence of inflammation, but the natural junction is one merely of +contact, the membranes of the placenta spreading out upon the cavity of +the uterus, so that, finally, the former may be entirely removed without +a particle of disturbance or injury to the latter. Formerly, it was +supposed that the placental vessels penetrated into the substance of the +uterus. We know now there is no such continuation of the vessels of the +one into the other. The decarbonation of the blood requires the +placental and uterine membranes to be in contact with each other. + +If the union were vascular, the mother's blood would circulate in the +foetal body, and the impulses of the maternal heart might prove too +strong for the delicate organism of the embryo. Besides, the separation +of the placenta from the uterus might prove fatal to both parent and +offspring. The placenta is only a temporary organ, and when its +functions are no longer required, it is easily and safely removed. + + +THE UMBILICAL CORD. + + +The foetal blood is transmitted to and fro between the body of the child +and the placenta, by a cord which contains two arteries and one vein. +This is called the _umbilical cord_, because it enters the body at the +middle of the abdominal region, or _umbilicus_. It is composed, also, of +its own proper membranous sheath, or skin, and cellular tissues, besides +the blood-vessels. Two months after pregnancy, this cord can be seen, +when it commences to grow rapidly. + + +QUICKENING. + + +Not until the mother feels motion is she said to be quick with child. +That is, the child must be old and strong enough to communicate a +physical impulse, which the mother can distinctly perceive, before it is +regarded as having received life. This is a fallacy, for the germ has to +be endowed with life before organization can begin. The act of +impregnation communicates the vital principle, and from that moment it +starts upon its career of development. A long period elapses after this +occurs before it can make the mother feel its motions. Before +quickening, the attempt to destroy the foetus is not considered so grave +a crime by our laws, but after this quickening takes place, it is deemed +a felony. + + +THE RIGHT TO TERMINATE PREGNANCY. + + +The expediency and the moral right to prematurely terminate pregnancy +must be admitted when weighty and sufficient reasons for it exist. Such +a course should never be undertaken, however, without the advice and +approval of the family physician, and, whenever it is possible, the +counsel of another medical practitioner should be obtained. There may be +so great a malformation of the pelvic bones as to preclude delivery at +full term, or, as in some instances, the pregnant condition may endanger +the life of the mother, because she is not able to retain nourishment +upon the stomach. In such cases only, is interference warranted, and +even then the advice of some well-informed physician should be first +obtained, to make sure that the life of the mother is endangered before +so extreme a measure is resorted to. + +Those who are qualified for maternal duties should not undertake to +defeat the intentions of nature, simply because they love ease and +dislike responsibility. Such persons may be considered genteel ladies, +but, practically, they are indifferent to the claims of society and +posterity. How such selfishness contrasts with the glorious, heroic, +Spartan spirit of the young woman who consulted us in reference to the +acceptance of a tempting offer of marriage! She was below medium size +and delicately organized. She hesitated in her answer, because she was +uncertain as to her duty to herself, and to her proposed husband, and on +account of the prospective contingencies of matrimony. After she was +told that it was doubtful whether she could discharge the obligations of +maternity with safety to herself, and yet that she might prove to her +intended husband a true and valuable wife, she quickly answered, her +black eyes radiant with the high purpose of her soul: "If I assent to +this offer, I shall accept the condition and its consequences also, even +if pregnancy be my lot and I know it will cost me my life!" She acceded +to the proposal, and years found them one in happiness; then a daughter +was born, but the bearing and nursing were too much for her delicate +constitution, and she continued to sink until she found rest in the +grave. Of all her beautiful and noble sayings, none reflect more moral +grandeur of spirit than the one in which she expressed her purpose to +prove true to posterity. + + +THE SIGNS OF PREGNANCY. + + +The symptoms which indicate pregnancy are cessation of the menses, +enlargement of the mammæ, nausea, especially in the morning, distention +of the abdomen, and movement of the foetus. A married woman has reason +to suspect that she may have conceived, when, at the proper time, she +fails to menstruate, especially when she knows that she is liable to +become pregnant. A second menstrual failure strengthens this suspicion, +although there are many other causes which might prevent the appearance +of the menses, such as disease of the uterus, general debility, or +taking cold, and all of these should be taken into account. In the +absence of all apparent influences calculated to obstruct the menses, +the presumption ordinarily is that pregnancy is the cause of their +non-appearance. The evidence is still more conclusive when the mammæ and +abdomen enlarge after experiencing morning sickness. Notwithstanding all +these symptoms, the audible sound of the heart, or the movements of the +foetus, are the only _infallible_ signs of a pregnant condition. + + +THE DURATION OF PREGNANCY. + + +The ordinary duration of pregnancy is about forty weeks, or 280 days. It +is difficult to foretell exactly when a pregnancy will be completed, for +it cannot be known precisely when it began. Some gestations are more +protracted than others, but the average duration is the time we have +given. A very reasonable way to compute the term, is to reckon three +months back from the day when the menses ceased and then add five days +to that time, which will be the date of the expected time of +confinement. It is customary, also, for women to count from the middle +of the month after the last appearance of the menses, and then allow ten +_lunar_ months for the term. This computation generally proves correct, +except in those instances in which conception takes place immediately +before the fast appearance of the catamenia. A few women can forecast +the time of labor from the occurrence of quickening, by allowing +eighteen weeks for the time which has elapsed since conception, and +twenty-two more for the time yet to elapse before the confinement. With +those in whom quickening occurs regularly in a certain week of +pregnancy, this calculation may prove nearly correct. + +The English law fixes no precise limit for the legitimacy of the child. +In France a child is regarded as lawfully begotten if born within three +hundred days after the death or departure of the husband. There are a +sufficient number of cases on record to show that gestation may be +prolonged two, and even three, weeks beyond the ordinary, or average +term. The variation of time may be thus accounted for: after +insemination, a considerable interval elapses before fecundation takes +place, and the passage of the fertilized germ from the ovary to the +uterus is also liable to be retarded. There are many circumstances and +conditions which might serve to diminish its ordinary rate of progress, +and postpone the date of conception. This would materially lengthen the +_apparent_ time of gestation. + +It is likewise difficult to determine the shortest period at which +gestation may terminate, and the child be able to survive. A child may +be born and continue to live for some months, after twenty-four or +twenty-five weeks of gestation; it was so decided, at least, in an +ecclesiastical trial. + +We have not the space to describe minutely, or at length, the formation +and growth of the foetal structures, and trace them separately from +their origin to their completion at the birth of the child. The student +of medicine must gain information by consulting large works and +exhaustive treatises on this interesting subject. + +What trifling contingencies defeat vitality! Conception may be prevented +by acrid secretions, the result of disease of the reproductive organs. +Leucorrheal matter may destroy the vitalizing power of the sperm-cells. +There are many ways, even after impregnation, of compromising the +existence of the frail embryo. Accidents, injuries, falls, blows, acute +diseases, insufficient nutrition and development, in fact, a great +variety of occurrences may destroy the life of the embryo, or foetus. +After birth, numerous diseases menace the child. By what constant care +must it ever be surrounded, and how often is it snatched from the very +jaws of death! + +What, then, is man but simply a germ, evolving higher powers, and +destined for a purer and nobler existence! His latent life secretly +emerges from mysterious obscurity, is incarnated, and borne upon the +flowing stream of time to a spiritual destination--to realms of +immortality! As he nears those ever-blooming shores, the eye of faith, +illuminated by the inspired word, dimly discerns the perennial glories. +Quickened by Faith, Hope, and Love, his spirit is transplanted into the +garden of paradise, the Eden of happiness, redeemed, perfected, and made +glorious in the divine image of Him who hath said, "I am the Way, the +_Truth_, and the LIFE." + + * * * * * + + + + +PART II. + +HYGIENE. + + + + +CHAPTER I. + +HYGIENE DEFINED.--PURE AIR. + + +The object of hygiene is the _preservation of health_. Hitherto, we have +considered, at some length, the science of functions, or _Physiology_, +and now, under the head of _Hygiene_, we will give an outline of the +means of maintaining the functional integrity of the system. It is +difficult to avoid including under this head Preventive Medicine, the +special province of which is to abate, remove, or destroy the many +causes of disease. + +The Greeks bestowed divine honors upon Aesculapius, because he remedied +the evils of mankind and healed the sick. The word hygiene is derived +from Hygeia, the name of the Greek goddess of health. As male and female +are made one in wedlock, so Medicine and Hygiene, restoration and +preservation, are inseparably united. + +Hygiene inculcates sanitary discipline, medicine, remedial discipline; +hygiene prescribes healthful agencies, medical theory and practice, +medicinal agencies; hygiene ministers with salubrious and salutary +agents, medicine assuages with rectifying properties and qualities; +hygiene upholds and sustains, medical practice corrects and heals; the +one is preservative and conservative, the other curative and +restorative. These discriminations are as radical as health and +sickness, as distinct as physiology and pathology, and to confound them +is as unnatural as to look for the beauties of health in the chamber of +sickness. + +The true physician brings to his aid Physiology, Hygiene, and Medicine, +and combines the science of the former with the art of the latter, that +restoration may be made permanent, and the health preserved by the aid +of hygiene. But when any one makes Hygiene exclusively the physician, or +deals wholly in hygienic regulations with little respect for physiology, +or lavishly advertises with hygienic prefixes, we may at once consider +it a display, not of genuine scientific knowledge, but only of the +ignorance of a quack. Some of the modern twaddle about health is a +conglomeration of the poorest kind of trash, expressing and inculcating +more errors and whims than it does common sense. Many persons dilate +upon these subjects with amazing flippancy, their mission seeming to be +to traduce the profession rather than to act as help-mates and +assistants. We do not believe that there is any real argument going on +between the educated members of the medical profession but rather that +the senseless clamor we occasionally hear comes only from the stampede +of some routed, demoralized company of quacks. + +In the following pages we shall introduce to the reader's attention +several important hygienic subjects, although there are many more that +ought to receive special notice. Such as we do mention, demand universal +attention, because a disregard of the conditions which we shall +enumerate, is fraught with great danger. Our lives are lengthened or +shortened by the observance or neglect of the rules of common sense, and +these do not require any great personal sacrifice, or the practice of +absurd precautions. + + +PURE AIR FOR RESPIRATION. + + +Ordinary atmospheric air contains nearly 2,100 parts of oxygen and 7,900 +of nitrogen, and about three parts of carbonic acid, in 10,000 parts; +expired air contains about 470 parts of carbonic acid, and only between +1500 and 1600 parts of oxygen, while the quantity of nitrogen undergoes +little or no alteration. Thus air which has been breathed has lost about +five per cent. of oxygen and has gained nearly five per cent. of +carbonic acid. In addition the expired air contains a greater or less +quantity of highly decomposable animal matter, and, however dry the +atmospheric air may be, the expired air is always saturated with watery +vapor, and, no matter what the temperature of the external air may be, +that of the exhaled air is always nearly as warm as the blood. An adult +man on a average breathes about sixteen times in a minute and at every +inspiration takes in about thirty cubic inches of air, and at every +expiration exhales about the same amount. Hence, it follows that about +16-2/3 cubic feet of air are passed through the lungs of an adult man +every hour, and deprived of oxygen and charged with carbonic acid to the +amount of nearly five per cent. The more nearly the composition of the +external air approaches that of the expired air, the slower will be the +diffusion of carbonic acid outwards and of oxygen inwards, and the more +charged with carbonic acid and deficient in oxygen will the blood in the +lungs become. Asphyxia takes place whenever the proportion of carbonic +acid in the external air reaches ten per cent., providing the oxygen is +diminished in like proportion, and it does not matter whether this +condition of the external air is produced by shutting out fresh air from +a room or by increasing the number of persons who are consuming the same +air; or by permitting the air to be deprived of oxygen by combustion by +a fire. A deficiency of oxygen and an accumulation of carbonic acid in +the atmosphere, produce injurious effects, however, long before the +asphyxiating point is attained. Headache, drowsiness, and uneasiness +occur when less than one per cent. of the oxygen of the atmosphere is +replaced by other matters, and the constant breathing of such an +atmosphere lowers vitality and predisposes to disease. + +Therefore, every human being should be supplied, by proper ventilation, +with a sufficient supply of fresh air. Every adult individual ought to +have at least 800 cubic feet of air-space to himself, and this space +ought to communicate freely with the external atmosphere by means of +direct or indirect channels. Hence, a sleeping-room for one adult person +should not be less than nine by ten feet in breadth and length and nine +feet in height. What occurred in the Black Hole at Calcutta is an +excellent illustration of the effect of vitiated air. One hundred and +forty-six Englishmen were confined in a room eighteen feet square, with +two small windows on one side to admit air. Ten hours after their +imprisonment, only twenty-three were alive. + +VENTILATION OF SCHOOL ROOMS. The depression and faintness from which +many students suffer, after being confined in a poorly ventilated school +room, is clearly traceable to vitiated air, while the evil is often +ascribed to excessive mental exertion. The effect of ventilation upon +the health of students is a subject of universal interest to parents and +educators, and at present is receiving the marked attention of school +authorities. Dr. F. Windsor, of Winchester, Mass., made a few pertinent +remarks upon this subject in the annual report of the State Board of +Health, of Massachusetts, 1874. One of the institutions, which was +spoken of in the report of 1873, as a _model_, in the warming and +ventilation of which much care had been bestowed, was visited in +December, 1873. He reports as follows: "I visited several of the rooms, +and found the air in all, offensive to the smell, the odor being such as +one would imagine old boots, dirty clothes, and perspiration would make +if boiled down together;" again, in the new _model_ school-house the hot +air enters at two registers in the floor on one side, and makes (or is +supposed to make) its exit by a ventilator at the floor, on the other +side of the room." The master said "_the air was supposed to have some +degree of intelligence, and to know that the ventilator was its proper +exit_." Thorough ventilation has been neglected by many school officials +on account of the increased expense it causes. In our climate, during +seven months at least, pure atmospheric air must be paid for. The +construction of vertical ducts, the extra amount of fuel, and the +attendant expenditures are the objections which, in the opinion of many +persons, outweigh the health and happiness of the future generation. It +is necessary for the proper ventilation of our school rooms that an +adequate supply of fresh air should be admitted, which should be warmed +before being admitted to the room, and which should be discharged as +contaminated, after its expiration. The proper ventilation of the school +room consists in the warming and introduction of fresh air from without, +and the discharge of the expired and unwholesome air from within. This +may be accomplished by means of doors, windows, chimneys, and finally by +ventilators placed, one near the level of the floor, and the other near +the ceiling of the room. The ventilators ought to be arranged on the +opposite sides of the room, in order to insure a current, and an +abundant supply of air. When trustees and patrons realize that pure air +is absolutely essential to health, and that their children are being +slowly poisoned by the foul air of school rooms, then they will +construct our halls of learning with a due regard for the laws of +hygiene, and students will not droop under their tasks on account of the +absence of Nature's most bountiful gift, _pure air_. + +VENTILATION OF FACTORIES AND WORKSHOPS. This is a subject which demands +the immediate attention of manufacturers and employers. The odors of +oil, coal gas, and animal products, render the air foul and stagnant, +and often give rise to violent diseases among the operatives. From two +to four hundred persons are often confined in workshops six hundred feet +long, with no means of ventilation except windows _on one side only_. +The air is breathed and re-breathed, until the operatives complain of +languor and headache, which they attribute to overwork. The _real_ cause +of the headache is the inhalation of foul air at every expansion of the +lungs. If the proprietors would provide efficient means for ventilating +their workshops, the cost of construction would be repaid with compound +interest, in the better health of their operatives and the consequent +increase of labor. Our manufacturers must learn and practice the great +principle of political economy, namely, that the interests of the +laborer and employer are mutual. + +VENTILATION OF OUR DWELLINGS. Not less important is the ventilation of +our dwellings; each apartment should be provided with some channel for +the escape of the noxious vapors constantly accumulating. Most of the +tenements occupied by the poor of our cities are literally dens of +poison. Their children inhale disease with their earliest breath. What +wonder that our streets are filled with squalid, wan-visaged children! +Charity, indeed, visits these miserable homes, bringing garments and +food to their half-famished inmates; but she has been slow to learn that +fresh air is just as essential to life as food or clothing. Care should +be taken by the public authorities of every city, that its tenement +houses do not degenerate into foul hovels, like those of the poor +English laborer, so graphically portrayed by Dickens. But ill-ventilated +rooms are not found exclusively in the abodes of the poor. True, in the +homes of luxury, the effect of vitiated air is modified by food, etc. +Men of wealth give far more attention to the architecture and adornment +of their houses, to costly decorations and expensive furniture, than to +proper ventilation. Farmers, too, are careless in the construction of +their cottages. Their dwellings are often built, for convenience, in too +close proximity to the barn. Because they do not construct a suitable +sewer or drain, the filth and refuse food is thrown out of the back +door, where it accumulates and undergoes putrefaction; the vitiated air +penetrates the interior of the house, and, there being no means of +ventilation, it remains to be breathed by the occupants. The result is, +that for the sake of saving a few dollars, which ought to be expended in +the construction of necessary flues and sewers, the farmer often sees +the child he prizes far more than his broad acres gradually decline, or +suddenly fall a victim to fevers or malignant disease. Parents, make +your homes healthy, let in the pure, fresh air and bright sunlight, so +that your conscience may never upbraid you with being neglectful of the +health and lives of your little ones. + + +SITE FOR HOMES. + + +MALARIA. When about to construct our residences, besides securing proper +ventilation and adequate drainage, we ought to select the location for a +home on dry soil. Low levels, damp surroundings, and marshy localities +not only breed malaria and fevers, but are a prolific cause of colds, +coughs, and consumption. Care should be taken not to locate a dwelling +where the natural currents of air, or high winds, will be likely to +bring the poison of decayed vegetable matter from low lands. Certain +brooks, boggy land, ponds, foggy localities, too much shade, all these +are favorable to the development of disease. Then the walls of a +building should be so constructed as to admit air between the exterior +and interior surfaces, otherwise the interior of the house will be damp +and unwholesome. In the dead of winter in northern latitudes the house +ought to be kept slightly tempered with warmth, both night and day, a +condition very favorable to the introduction and change of atmospheric +currents. The invigorating tendencies of a dry, pure atmosphere are +remarkably beneficial, while air charged with moisture and decay is +exceedingly baneful, introducing diseases under various forms. + +Neither should the dwelling be shaded by dense foliage. The dampness of +the leaves tends to attract malaria. Trees growing a little distance +from the house, however, obstruct the transmission of unhealthy vapors +arising beyond them. Malaria generally lurks near the surface of the +earth, and seems to be more abundant in the night time. Persons sleeping +in the upper story of a house may escape its morbid influence, while +those occupying apartments on the lower floor, become affected. + + +DAMP CELLARS. + + +Damp cellars, under residences, are a fruitful cause of disease. Dr. +Sanford B. Hunt, in an article in the _Newark Daily Advertiser_, +speaking of the recent epidemic of diphtheria in New York City, says: + +"Pestilences that come bodily, like cholera, are faced and beaten by +sanitary measures. Those which come more subtly need for their defeat +only a higher detective ability and a closer study of causes, many of +which are known, but hidden under the cellars of our houses, and which +at last are only preventable by public authority and at public expense +in letting out the imprisoned dampness which saturates the earth on +which our dwellings are built. Where wood rots, men decay. This is +clearly shown in the sanitary map printed in the _Times_. In the great +district surrounding Central Park, and which participates in its +drainage system, there are no cases. On the whole line of Fifth Avenue +there are none. The exempt districts are clearly defined by the +character of the soil, drainage, and sewerage, and by the topography, +which either has natural or artificial drainage, but most of which is so +dry that only surface-water and house-filth--which does not exist in +those palaces--can affect the health of the residents. But in the +tenement houses and on the made lands where running streams have been +filled in and natural springs choked up by earth fillings, diphtheria +finds a nidus in which to develop itself. The sanitary map coincides +precisely with the topographic map made by Gen. Viele. Where he locates +buried springs and water-courses, there we find the plague spots of +diphtheria and in the same places, on previous maps prepared by the +Board of Health, we find other low types and stealthy diseases, such as +typhoid and irruptive fevers, and there we shall find them again when +the summer and autumnal pestilences have yielded place to those which +belong to the indoor poisoned air in the winter. The experience of other +cities, notably London and Dublin, once plague spots and now as healthy +as any spot on earth, proves that most of the causations of disease are +within the control of the competent sanitary engineer, even in +localities crowded beyond American knowledge, and houses built upon soil +saturated for centuries with the offal of successive and uncleanly +generations. Wet earth, kept wet by the boiling up of imprisoned +springs, is a focus of disease. Dry earth is one of the most perfect +deodorizers, the best of oxydizers and absorbents, destroying the germs +of disease with wonderful certainty. On those two facts rests the theory +of public hygiene." + + +DUST AND DISEASE. + + +The air we breathe is heavily loaded with minute particles of floating +dust, their presence being revealed only by intense local illumination. +Professor Tyndall says: "solar light, in passing through a dark room, +reveals its track by illuminating the dust floating in the air. 'The +sun,' says Daniel Culverwell, 'discovers atoms, though they be invisible +by candle-light, and makes them dance naked in his beams.'" + +After giving the details and results of a series of experiments in which +he attempted to extract the dust from the air of the Royal Institute by +passing it through a tube containing fragments of glass wetted with +concentrated sulphuric acid, and thence through a second tube containing +fragments of marble wetted with a strong solution of caustic potash, +which experiments were attended with perfect failure, the Professor +continues, "I tried to intercept this floating matter in various ways; +and on the day just mentioned, prior to sending the air through the +drying apparatus, I carefully permitted it to pass over the tip of a +spirit-lamp flame. The floating matter no longer appeared, having been +burnt up by the flame. It was, therefore, of _organic origin_. I was by +no means prepared for this result; for I had thought that the dust of +our air was, in great part, inorganic and non-combustile." In a foot +note he says, "according to an analysis kindly furnished me by Dr. +Percy, the dust collected _from the walls_ of the British Museum +contains fully fifty per cent of inorganic matter. I have every +confidence in the results of this distinguished chemist; they show that +the _floating_ dust of our rooms is, as it were, winnowed from the +heavier matter." Again he says: "the air of our London rooms is loaded +with this organic dust, nor is the country air free from its presence. +However ordinary daylight may permit it to disguise itself, a +sufficiently powerful beam causes dust suspended in air to appear almost +as a semi-solid. Nobody could, in the first instance, without +repugnance, place the mouth at the illuminated focus of the electric +beam and inhale the thickly-massed dust revealed there. Nor is the +repugnance abolished by the reflection that, although we do not see the +floating particles, we are taking them into our lungs every hour and +minute of our lives." "The notion was expressed by Kircher and favored +by Linnaeus, that epidemic diseases are due to germs which float in the +atmosphere, enter the body, and produce disturbance by the development +within the body of parasitic life. While it was struggling against great +odds, this theory found an expounder and a defender in the President of +this institution. At a time when most of his medical brethren considered +it a wild dream, Sir Henry Holland contended that some form of the +germ-theory was probably true." Professor Tyndall proposes means by the +application of which air loaded with noxious particles may be freed from +them before entering the air passages. The following embodies his +suggestions on this point: + + +COTTON-WOOL RESPIRATOR. + + +"I now empty my lungs as perfectly as possible, and placing a handful of +cotton-wool against my mouth and nostrils, inhale through it. There is +no difficulty in thus filling the lungs with air. On expiring this air +through a glass tube, its freedom from floating matter is at once +manifest. From the very beginning of the act of expiration the beam is +pierced by a black aperture. The first puff from the lungs abolishes the +illuminated dust, and puts a patch of darkness in its place; and the +darkness continues throughout the entire course of the expiration. When +the tube is placed below the beam and moved to and fro, the same +smoke-like appearance as that obtained with a flame is observed. _In +short, the cotton-wool, when used in sufficient quantity, and with due +care, completely intercepts the floating matter on its way to the +lungs_. + +The application of these experiments is obvious. If a physician wishes +to hold back from the lungs of his patient, or from his own, the germs +or virus by which contagious disease is propagated, he will employ a +cotton-wool respirator. If perfectly filtered, attendants may breathe +the air unharmed. In all probability the protection of the lungs and +mouth will be the protection of the entire system. For it is exceedingly +probable that the germs which lodge in the air-passages, or find their +way with the saliva into the stomach with its absorbent system, are +those which sow in the body epidemic disease. If this be so, then +disease can be warded off by carefully prepared filters of cotton-wool. +I should be most willing to test their efficacy in my own person. But +apart from all doubtful applications, it is perfectly certain that +various noxious trades in England may be rendered harmless by the use of +such filters. I have had conclusive evidence of this from people engaged +in such trades. A form of respirator devised by Mr. Garrick, a hotel +proprietor in Glasgow, in which inhalation and exhalation occur through +two different valves, the one permitting the air to enter through the +cotton-wool, and the other permitting the exit of the air direct into +the atmosphere, is well adapted for this purpose. But other forms might +readily be devised." + + +LIGHT AND HEALTH. + + +Our dwellings ought freely to admit the sunlight. Diseases which have +baffled the skill of physicians have been known to yield when the +patients were removed from dark rooms to light and cheerful apartments. +Lavoisier placed light, as an agent of health, even before pure air. +Plants which grow in the shade are slender and weak, and children +brought up in dark rooms are pale, sallow, and rickety. It is a bad +practice to avoid the sunlight through fear of spoiling the complexion, +since the sun's rays are necessary to give to it the delicate tints of +beauty and health. Air is necessary for the first inspiration and the +last expiration of our lives, but the purity and healthfulness of the +atmosphere depend upon the warming rays of the sun, while our bodies +require light in order that their functions may be properly performed. +We know that without solar light, there can be no proper vegetable +growth, and it is equally necessary for the beauty and perfection of +animal development. Our dwellings should therefore be well lighted and +made as bright and cheerful as possible. Women who curtain the windows, +soften the light, and tint the room with some mellow shade, may do so in +order to hide their own faulty complexions. The skin of persons confined +in dungeons or in deep mines becomes pale or sickly yellow, the blood +grows watery, the skin blotches, and dropsy often intervenes. On the +other hand, invalids carried out from darkened chambers into the bright +sunlight are stimulated, the skin browns, nutrition becomes more active, +the blood improves, and they become convalescent. Light is especially +necessary for the healthy growth of children. There is nothing more +beautiful and exhilarating than the glorious sunlight. Let its luminous, +warming, and physiological forces come freely into our dwellings, enter +into the chemistry of life, animate the spirits, and pervade our homes +and our hearts with its joy-inspiring and health-imparting influences. + + * * * * * + + + + +CHAPTER II. + +FOOD. BEVERAGES. ALCOHOLIC LIQUORS. CLOTHING. + + +The human body is continually undergoing changes, which commence with +the earliest dawn of existence and end only with death. The old and +worn-out materials are constantly being removed to make room for the +new. Growth and development, as well as the elimination of worn-out and +useless matter, continually require new supplies, which are to be +derived from our food. To fulfill these demands it is necessary that the +nutriment should be of the proper quality, and of sufficient variety to +furnish all the constituents of the healthy body. In order that food may +be of utility, like other building materials, it must undergo +preparation; the crude substance must be worked up into proper condition +and shape for use, in other words, it must be _digested_. But this does +not end the process of supply, each different substance must be taken by +the different bands of workmen, after due preparation in the workshop, +to its appropriate locality in the structure, and there fitted into its +proper place; this is _assimilation_. In reality it becomes a portion of +the body, and is advantageous in maintaining the symmetry and usefulness +of the part to which it is assigned; this constitutes the ultimate +object of food, _nutrition_. + +EATING is the process of receiving the food into the mouth, _i.e., +prehension; mastication and insalivation_--minutely dividing and mixing +it with the saliva; _deglutition_--conveying it to the stomach. Plenty +of time should be taken at meals to thoroughly masticate the food and +mix it with the saliva, which, being one of the natural solvents, favors +its farther solution by the juices of the stomach; the healthy action of +the digestive powers is favored by tranquility of mind, agreeable +associations, and pleasant conversation while eating. It is proverbial +of the American people that they bolt their food whole, washing it down +with various fluids, thus forcing the stomach to perform not only its +own duties, but also those of the teeth and salivary glands. This manner +of dispatching food, which should go through the natural process above +described, is not without its baleful consequences, for the Americans +are called a nation of _dyspeptics_. + +Eating slowly, masticating the food thoroughly, and drinking but +moderately during meals, will allow the juices of the stomach to fulfill +their proper function, and healthy digestion and nutrition will result. +If the food is swallowed nearly whole, not only will a longer time be +required for its solution, but frequently it will ferment and begin to +decay before nutritive transformation can be effected, even when the +gastric juice is undiluted with the fluids which the hurried eater +imbibes during his meal. + +REGULARITY OF MEALS cannot be too strongly insisted upon. The stomach, +as well as other parts of the body, must have intervals of rest or its +energies are soon exhausted, its functions impaired, and _dyspepsia_ is +the result. Nothing of the character of food should ever be taken except +at regular meal times. Some persons are munching cakes, apples, nuts, +candies, etc., at all hours, and then wonder why they have weak +stomachs. They take their meals regularly, and neither eat rapidly nor +too much, and yet they are troubled with indigestion. The truth is they +keep their stomachs almost constantly at work, and hence tired out, +which is the occasion of the annoyance and distress they experience. + +EATING TOO MUCH. It should always be remembered that the nutrition of +our bodies does not depend upon the amount eaten, but upon the amount +that is digested. Eating too much is nearly as bad as swallowing the +food whole. The stomach is unable to digest all of it, and it ferments +and gives rise to unpleasant results. The unnatural distention of the +stomach with food causes it to press upon the neighboring organs, +interfering with the proper performance of their functions, and, if +frequently repeated, gives rise to serious disease. People more +frequently eat too much than too little, and to omit a meal when the +stomach is slightly deranged is frequently the best medicine. It is an +excellent plan to rise from the table before the desire for food is +quite satisfied. + +LATE SUPPERS. It is generally conceded that late suppers are injurious, +and should never be indulged in. Persons who dine late have little need +of food after their dinner, unless they are kept up until a late hour. +In such cases a moderate meal may be allowed, but it should be eaten two +or three hours before retiring. Those who dine in the middle of the day +should have supper, but sufficiently early so that a proper length of +time may elapse before going to bed, in order that active digestion may +not be required during sleep. On the other hand, it is not advisable to +go wholly without this meal, but the food eaten should be light, easily +digestible, and moderate in quantity. Persons who indulge in hearty +suppers at late hours, usually experience a poor night's rest, and wake +the next morning unrefreshed, with a headache and a deranged stomach. +Occasionally more serious consequences follow; gastric disorders result, +apoplexy is induced; or, perhaps, the individual never wakes. + +FEEDING INFANTS. For at least six or seven months after birth, the most +appropriate food for an infant is its mother's milk, which, when the +parent is healthy, is rich in all the elements necessary for its growth +and support. Next to the mother's milk, that of a healthy nurse should +be preferred; in the absence of both, milk from a cow that has recently +calved is the most natural substitute, in the proportion of one part +water to two parts milk, slightly sweetened. The milk used should be +from but one cow. All sorts of paps, gruels, panadas, cordials, +laxatives, etc., should be strictly prohibited, for their employment as +food cannot be too severely censured. Vomiting, diarrhea, colic, green +stools, griping, etc., are the inevitable results of their continued +use. The child should be fed at regular intervals, of about two hours, +and be limited to a proper amount each time, which, during the first +month, is about two ounces. From 11 P.M. to 5 A.M. the child should be +nursed but once. As the child grows older the intervals should be +lengthened, and the amount taken at a time gradually increased. The plan +of gorging the infant's stomach with food every time it cries, cannot be +too emphatically condemned. + +After the sixth or seventh month, in addition to milk, bits of bread may +be allowed, the quantity being slowly increased, thus permitting the +diet to change gradually from fluid to solid food, so that, when the +teeth are sufficiently developed for mastication, the child has become +accustomed to various kinds of nourishment. Over-feeding, and +continually dosing the child with cordial, soothing syrups, etc., are +the most fruitful sources of infant mortality, and should receive the +condemnation of every mother in the land. + +PREPARATION OF FOOD. The production of pure blood requires that all the +food selected should be rich in nutritious elements, and well cooked. To +announce a standard by which all persons shall be guided in the +selection and preparation of their food is impossible. Especially is +this the case in a country the inhabitants of which represent almost +every nation on the face of the globe. Travelers are aware that there is +as much diversity in the articles of food and methods of cookery, among +the various nationalities, as in the erection of their dwellings, and in +their mental characteristics. In America we have a conglomeration of all +these peoples; and for a native American to lay down rules of cookery +for his German, French, English, Welsh, and Irish neighbors, or _vice +versa_, is useless, for they will seldom read them, and, therefore, +cannot profit by them. There are, however, certain conditions recognized +by the hygienic writers of every nation. The adequate nutrition of the +organic tissues demands a plentiful supply of pure blood, or the +digestive apparatus will become impaired, the mental processes deranged, +and the entire bony and muscular systems will lose their strength and +elasticity, and be incapacitated for labor. + +DIFFERENT KINDS OF FOOD REQUIRED. The different periods and +circumstances of life require their appropriate food, and the welfare of +mankind demands that it should supply both the inorganic and organic +substances employed in the development of every tissue. The inorganic +elements employed in our construction, of which _Phosphorus, Sulphur, +Soda, Iron, Lime,_ and _Potash_ are the most important, are not +considered as aliments, but are found in the organic kingdom, variously +arranged and combined with organic materials in sufficient quantities +for ordinary purposes. When, however, from any cause, a lack of any of +these occurs, so that their relative normal proportions are deranged, +the system suffers, and restoration to a healthy condition can only be +accomplished by supplying the deficiency; this may be done by selecting +the article of food richest in the element which is wanting, or by +introducing it as a medicine. It must be remembered that those +substances which enter into the construction of the human fabric, are +not promiscuously employed by nature, but that each and every one is +destined to fulfill a definite indication. + +_Lime_ enters largely into the formation of bone, either as a +_phosphate_ or a _carbonate_, and is required in much greater quantities +in early life, while the bone is undergoing development, than +afterwards. In childhood the bones are composed largely of animal +matter, being pliable and easily moulded. For this reason the limbs of +young children bend under the weight of their bodies, and unless care is +taken they become bow-legged and distorted. Whenever there is a +continued deficiency of the earthy constituents, disease of the bones +ensues. Therefore, during childhood, and particularly during the period +of dentition, or teething, the food should be nutritious and at the same +time contain a due proportion of lime, which is preferable in the form +of a phosphate. When it cannot be furnished by the food, it should be +supplied artificially. Delayed, prolonged, and tedious dentition +generally arises from a deficiency of lime. + +With the advance of age it accumulates, and the bone becomes hard, +inelastic, and capable of supporting heavy weights. Farther on, as in +old age, the animal matter of bone becomes diminished, and lime takes +its place, so that the bones become brittle and are easily broken. Lime +exists largely in hard water, and to a greater or less extent in milk, +and in nearly all foods except those of an acid character. + +_Phosphorus_ exists in various combinations in different parts of the +body, particularly in the brain and nervous system. Persons who perform +a large amount of mental labor require more phosphorus than those +engaged in other pursuits. It exists largely in the hulls of wheat, in +fish, and in eggs. It should enter to a considerable extent into the +diet of brain workers, and the bread consumed by them should be made of +unbolted flour. + +_Sulphur, Iron, Soda_, and _Potash_ are all necessary in the various +tissues of the body, and deficiency of any one of them, for any +considerable length of time, results in disease. They are all supplied, +variously arranged and combined, in both animal and vegetable food; in +some articles they exist to a considerable extent, in others in much +smaller quantities. _Sulphur_ exists in eggs and in the flesh of +animals, and often in water. _Iron_ exists in the yolk of eggs, in +flesh, and in several vegetables. _Soda_ is supplied in nearly all food, +and largely in common salt, which is a composition of sodium and +hydrochloric acid, the latter entering into the gastric juice. _Potash_ +exists, in some form or other, in sufficient quantities for health, in +both vegetable and animal food. + +CLASSES OF FOOD. All kinds of food substances may be divided into four +classes. _Proteids, Fats, Amyloids_, and _Minerals_. Proteids are +composed of the four elements, carbon, hydrogen, oxygen, and nitrogen, +sometimes combined with sulphur and phosphorus. In this class are +included the _gluten_ of flour; the _albumen_, or white of eggs; and the +_serum_ of the blood; the _fibrin_ of the blood; _syntonin_, the chief +constituent of muscle and flesh, and _casein_, one of the chief +constituents of cheese, and many other similar, but less frequent +substances. + +Fats are composed of carbon, hydrogen, and oxygen only, and contain more +hydrogen than would be required to form water if united with the oxygen +which they contain. All vegetable and animal oils and fatty matters are +included in this class. + +Amyloids consist of substances which are also composed of carbon, +oxygen, and hydrogen only; but they contain just enough hydrogen to +produce water when combined with their oxygen, or two parts of hydrogen +to one of oxygen. This division includes _sugar, starch, dextrine_, and +_gum_. The above three classes of food-stuffs are only obtained through +the activity of living organisms, vegetable or animal, and have been, +therefore, appropriately termed by Prof. Huxley, _vital food-stuffs._ + +The mineral food-stuffs may, as we have seen, be procured from either +the living or the non-living world. They include water and various +earthy, metallic, and alkaline salts. + +VARIETY OF FOOD NECESSARY. No substance can serve permanently for food +except it contains a certain quantity of proteid matter in the shape of +albumen, fibrin, casein, etc., and, on the other hand, any substance +containing proteid matter in a shape in which it can be readily +assimilated, may serve as a permanent vital food-stuff. Every substance, +which is to serve as a permanent food, must contain a sufficient +quantity, ready-made, of this most important and complex constituent of +the body. In addition, it must also contain a sufficient quantity of the +mineral ingredients which enter into the composition of the body. Its +power of supporting life and maintaining the weight and composition of +the body remains unaltered, whether it contains fats or amyloids or not. +The secretion of urea, and, consequently, the loss of nitrogen, goes on +continually, and the body, therefore, must necessarily waste unless the +supply of proteid matter is constantly renewed, since this is the only +class of foods that contains nitrogen in any considerable quantity. +There can be no absolute necessity for any other food-stuffs but those +containing the proteid and mineral elements of the body. From what has +been said, it will readily be seen that whether an animal be carnivorous +or herbivorous, it begins to starve as soon as its vital food-stuffs +consist only of amyloids, or fats, or both. It suffers from what has +been termed _nitrogen starvation,_ and if proteid matters are withheld +entirely, it soon dies. In such a case, and still more in the case of an +animal which is entirely deprived of vital food, the organism, as long +as it continues to live, feeds upon itself, the waste products +necessarily being formed at the expense of its own body. + +Although proteid matter is the essential element of food, and under +certain circumstances may be sufficient of itself to support the body, +it is a very uneconomical food. The white of an egg, which may be taken +as a type of the proteids, contains about fifteen per cent. of nitrogen, +and fifty-three per cent. of carbon; therefore, a man feeding upon this, +would take in about three and a half times as much carbon as nitrogen. +It has been proved that a healthy, adult man, taking a fair amount of +exercise and maintaining his weight and body temperature, eliminates +about thirteen times as much carbon as nitrogen. However, if he is to +get his necessary quantity, about 4000 grains of carbon, out of albumen, +he must eat 7,547 grains of that substance; but this quantity of albumen +contains nearly four times as much nitrogen as he requires. In other +words, it takes about four pounds of lean meat, free from fat, to +furnish 4,000 grains of carbon, the quantity required, whereas one pound +yields the requisite quantity of nitrogen. Thus a man restricted +exclusively to a proteid diet, must take an enormous quantity of it. +This would involve a large amount of unnecessary physiological labor, to +comminute, dissolve, and absorb the food, and to excrete the superfluous +nitrogenous matter. Unproductive labor should be avoided as much in +physiological as in political economy. The universal practice of +subsisting on a mixed diet, in which proteids are mixed with fats or +amyloids, is therefore justifiable. + +Fats contain about 80 per cent. of carbon, and amyloids about 40 per +cent. We have seen that there is sufficient nitrogen in a pound of meat +free from fat, to supply a healthy adult man for twenty-four hours, but +that it contains only one-fourth of the quantity of carbon required. +About half a pound of fat, or one pound of sugar, will supply the +quantity of carbon necessary. The fat, if properly subdivided, and the +sugar, by reason of its solubility, pass with great ease into the +circulation, the physiological labor, consequently, being reduced to a +minimum. + +Several common articles of diet contain in themselves all the necessary +elements. Thus, butchers' meat ordinarily contains from 30 to 50 per +cent. of fat; and bread contains the proteid, gluten, and the amyloids, +starch and sugar, together with minute quantities of fat. However, on +account of the proportion in which these proteid and other components of +the body exist in these substances, neither of them, by itself is such a +physiologically economical food, as it is when combined with the other +in the proportion of three to eight, or three quarters of a pound of +meat to two pounds of bread a day. + +It is evident that a variety of food is necessary for health. Animals +fed exclusively upon one class, or upon a single article of diet, droop +and die; and in the human family we know that the constant use of one +kind of diet causes disgust, even when not very long continued. +Consequently, we infer that the welfare of man demands that his food be +of sufficient variety to supply his body with all of its component +parts. If this is not done the appetite is deranged, and often craves +the very article which is necessary to supply the deficiency. After the +component parts of the organism have assimilated the nutritious elements +of particular kinds of food for a certain length of time, they lose the +power of effecting the necessary changes for proper nutrition, and a +supply of other material is imperatively demanded. When the diet has +been long restricted to proteids, consisting largely of salt meats, +fresh vegetables and fruits containing the organic acids, become +indispensable; otherwise, the scorbutic condition, or scurvy, is almost +sure to be developed. Fresh vegetables and fruits should be eaten in +considerable quantities at the proper seasons. + +VALUE OF ANIMAL FOOD. The principal animal food used in this country +consists of _Pork, Mutton, Beef_, and _Fish_. Beef and mutton are rich +in muscle-producing material. Although pork is extensively produced in +some portions of this country, and enters largely into the diet of some +classes, yet its use, except in winter, is not to be encouraged. The +same amount of beef would give far greater returns in muscular power. + +In addition to the meats mentioned, _Wild Game_ furnishes palatable, +nutritious, and easily-digested food. _Domestic Fowls_, when young, are +excellent, and with the exception of geese and ducks, are easily +digested. _Wild Birds_ are considered much healthier food than those +which are domesticated. All of these contain more or less of the +elements which enter into the composition of the four classes of foods. + +VEGETABLE FOODS. _Wheat_ is rich in all the elements which compose the +four classes, and, when the flour is unbolted, it is one of the best +articles for supplying all the elements. + +_Barley_ stands next to wheat in nourishing qualities, but is not so +palatable. + +_Oats_ are rich in all the elements necessary for nutrition. Oatmeal is +a favorite article of diet among the Scotch, and, judging from their +hardy constitutions, their choice is well founded. In consequence of the +large proportion of phosphorus which they contain, they are capable of +furnishing a large amount of nourishment for the brain. + +_Rye_ is nutritious, but it is not so rich in tissue-forming material. + +_Indian Corn_ is an article well known and extensively used throughout +the United States, and is a truly valuable one, capable of being +prepared in a great variety of ways for food. It contains more carbon +than wheat, and less nitrogen and phosphorus, though enough of both to +be extremely valuable. + +_Rice_ is rather meagre in nutriment; it contains but little phosphorous +matter, with less carbon than other cereals, and is best and most +generally employed as a diet in tropical countries. + +_Beans and Peas_ are rich in nutritious matter, and furnish the manual +laborer with a cheap and wholesome diet. + +The _Potato_ is the most valuable of all fresh vegetables grown in +temperate climates. Its flavor is very agreeable, and it contains very +important nutritive and medicinal qualities, and is eaten almost daily +by nearly every family in North America. Until very recently it, with +the addition of a little butter-milk or skim-milk, constituted almost +the sole diet of the Irish people. The average composition of the potato +is stated by Dr. Smith to be as follows: Water 75 per cent., nitrogen +2.1, starch 18.8, sugar 3.2, fat 0.2, salts 0.7. The relative values of +different potatoes may be ascertained very correctly by weighing them in +the hand, for the heavier the tuber the more starch it contains. + +_Turnip and Cabbage_ are 92.5 per cent. water, and, consequently, poor +in nutrition, though they are very palatable. The solid portions of +cabbage, however, are rich in albumen. + +It is evident that the quantity necessary to maintain the system in +proper condition must be greatly modified by the habits of life, the +condition of the organism, the age, the sex, and the climate. The daily +loss of substance which must be replaced by material from without, as we +have seen, is very great. In addition to the loss of carbon and +nitrogen, about four and a half pounds of water are removed from the +system in twenty-four hours, and it is necessary that about this +quantity should be introduced into the system in some form or other, +however much it may be adulterated. Professor Dalton states: "From +experiments performed while living on an exclusive diet of bread, fresh +meat, and butter, with coffee and water for drink, we have found that +the entire quantity of food required during twenty-four hours by a man +in full health and taking free exercise in the open air is as follows: + + Meat, . . . . . . 16 oz., or 1.03 lb. avoir. + Bread, . . . . . . 19 " 1.19 " " + Butter or fat, . . . 3½ " 0.22 " " + Water, . . . . . 52 fluid oz., 3.38 " " + +That is to say, rather less than two and a half pounds of solid food, +and rather over three pounds of liquid food." + +CLIMATE exerts an important influence on the quantity and quality of +food required by the system. In northern latitudes the inhabitants are +exposed to extreme cold and require an abundant supply of food, and +especially that which contains a large amount of fat. On this account +fat meat is taken in large quantities and with a relish. The quantity of +food consumed by the natives of the Arctic zone is almost incredible. +The Russian Admiral, Saritcheff, relates that one of the Esquimaux in +his presence devoured a mass of boiled rice and butter which weighed +twenty-eight pounds, at a single meal, and Dr. Hayes states that usually +the daily ration of an Esquimau is from twelve to fifteen pounds of +meat, one-third of which is fat, and on one occasion he saw a man eat +ten pounds of walrus flesh at a single meal. The intense cold creates a +constant craving for fatty articles of food, and some members of his own +party were in the habit of drinking the contents of the oil-kettle with +great apparent relish. + +DIGESTIBILITY OF FOOD. Unless an article of diet can be digested it is +of no value, no matter how rich it may be in nutriment. The quantity of +food taken, will influence to a considerable extent, the time consumed +in its digestion. The stomachs of all are not alike in this respect, and +the subject of time has been a difficult one to determine. The +experiments of Dr. Beaumont with the Canadian, St. Martin, who +accidentally discharged the contents of a loaded gun into his stomach, +creating an external opening through which the process of digestion +could be observed, have furnished us with the following table, which is +correct enough to show relatively, if not absolutely, the time required +for the digestion of various articles: + + ====================================================== + ARTICLES OF DIET. | Mode of | Hours. Min. + |Preparation.| + ----------------------------|------------|------------ + Milk........................|Boiled......| 2 00 + " ........................|Raw.........| 2 15 + Eggs, fresh.................| " .........| 2 00 + " " .................|Whipped.....| 1 30 + " " .................|Roasted.....| 2 15 + " " .................|Soft boiled.| 3 00 + " " .................|Hard boiled.| 3 30 + " " .................|Fried.......| 3 30 + Custard.....................|Baked.......| 2 45 + Codfish, cured, dry.........|Boiled......| 2 00 + Trout, salmon, fresh........| " .........| 1 30 + Trout, salmon, fresh........|Fried.......| 1 30 + Bass, striped, " ........|Broiled.....| 3 00 + Flounder, " ........|Fried.......| 3 30 + Catfish, " ........| " .........| 3 30 + Salmon, salted..............|Boiled......| 4 00 + Oysters, fresh..............|Raw.........| 2 55 + " " ..............|Roasted.....| 3 15 + " " ..............|Stewed......| 3 30 + Venison steak...............|Broiled.....| 1 35 + Pig, sucking................|Roasted.....| 2 30 + Lamb, fresh.................|Broiled.....| 2 30 + Beef, fresh, lean, dry......|Roasted.....| 3 30 + " with mustard, etc........|Boiled......| 3 10 + " " salt only...........| " ......| 3 36 + " " " " ...........|Fried.......| 4 00 + " fresh, lean, rare........|Roasted.....| 3 00 + Beefsteak...................|Broiled.....| 3 00 + Mutton, fresh...............| " .....| 3 00 + " " ...............|Boiled......| 3 00 + " " ...............|Roasted.....| 3 15 + Veal, fresh.................|Broiled.....| 4 00 + " " .................|Fried.......| 4 30 + Porksteak...................|Broiled.....| 3 15 + Pork, fat and lean..........|Roasted.....| 5 15 + " recently salted.......|Raw.........| 3 00 + " " " .......|Stewed......| 3 00 + " " " .......|Broiled.....| 3 15 + ------------------------------------------------------ + + + ARTICLES OF DIET. |Mode of Preparation. |Hours/Min. + ---------------------------|---------------------|---------- + Pork, recently salted----- |Fried------------ |4 15 + " " " ----- |Boiled----------- |4 30 + Turkey, wild ------------- |Roasted---------- |2 18 + " tame ------------- | " ---------- |2 30 + " " ------------- |Boiled ---------- |2 25 + Goose, wild -------------- |Roasted --------- |2 30 + Chickens, full-grown ----- |Fricasseed ------ |2 45 + Fowls, domestic ---------- |Boiled ---------- |4 00 + " " ---------- |Roasted --------- |4 00 + Ducks, tame -------------- | " --------- |4 00 + " wild -------------- | " --------- |4 30 + Soup, barley ------------- |Boiled ---------- |1 30 + " bean --------------- | " ---------- |3 00 + " chicken ------------ | " ---------- |3 00 + " mutton ------------- | " ---------- |3 30 + " oyster ------------- | " ---------- |3 30 + " beef, vegetables, | | + and bread ---------- | " ---------- |4 00 + " marrow-bones ------- | " ---------- |4 15 + Pig's feet, soused ------- | " ---------- |1 00 + Tripe, soused ------------ | " ---------- |1 00 + Brains, animal ----------- | " ---------- |1 45 + Spinal marrow, animal ---- | " ---------- |2 40 + Liver, beef, fresh ------- |Broiled --------- |2 00 + Heart, animal ------------ |Fried ----------- |4 00 + Cartilage ---------------- |Boiled ---------- |4 15 + Tendon ------------------- | " ---------- |5 30 + Hash, meat, and vegetables |Warmed ---------- |2 30 + Sausage, fresh ----------- |Broiled --------- |3 20 + Gelatine ----------------- |Boiled ---------- |2 30 + Cheese, old, strong ------ |Raw ------------- |3 30 + Green corn and beans ----- |Boiled ---------- |3 45 + Beans, pod --------------- | " ---------- |2 30 + Parsnips ----------------- | " ---------- |2 30 + Potatoes ----------------- |Roasted --------- |2 30 + " ----------------- |Baked ----------- |2 30 + " ----------------- |Boiled ---------- |2 30 + Cabbage, head ------------ |Raw ------------- |2 30 + " " with vinegar | " ------------- |2 00 + " " ------------ |Boiled ---------- |4 30 + Carrot, orange ----------- | " ---------- |3 13 + Turnips, flat ------------ | " ---------- |3 30 + Beets -------------------- | " ---------- |3 45 + Bread, corn -------------- |Baked ----------- |3 15 + " wheat, fresh ------ | " ----------- |3 30 + Apples, sweet, mellow ---- |Raw ------------- |1 30 + " sour ------------- | " ------------- |2 00 + " " hard --------- | " ------------- |2 50 + +Milk is more easily digested than almost any other article of food. It +is very nutritious, and, on account of the variety of the elements which +it contains, it is extremely valuable an article of diet, especially +when the digestive powers are weakened, as in fevers, or during +convalescence from any acute disease. Eggs are also very nutritious and +easily digested. Whipped eggs are digested and assimilated with great +ease. Fish, as a rule, are more speedily digested than is the flesh of +warm-blooded animals. Oysters, especially when taken raw, are very +easily digested. We have known dyspeptics who were unable to digest any +other kind of animal food, to subsist for a considerable period upon raw +oysters. The flesh of mammalia seems to be more easily digested than +that of birds. Beef, mutton, lamb, and venison are easily digested, +while fat roast pork and veal are digested with difficulty. According to +the foregoing table vegetables were digested in about the same time as +ordinary animal food, but it should be remembered that a great part of +the digestion of these is effected in the small intestine. Soups are, as +a rule, very quickly digested. The time required for the digestion of +bread is about the same as that required for the digestion of ordinary +meats. Boiled cabbage is one of the most difficult substances to digest. + +COOKERY. "Cookery," says Mrs. Owen, "Is the art of turning every morsel +to the best use; it is the exercise of skill, thought, and ingenuity to +make every particle of food yield the utmost nourishment and pleasure, +of which it is capable." We are indebted to this practical woman for +many valuable suggestions in this art; and some of our recommendations +are drawn from her experience. + +SOUPS. The nutritious properties, tone, and sweetness of soup depend in +the first place upon the freshness and quality of the meat; secondly on +the manner in which it is boiled. Soups should be nicely and delicately +seasoned, according to the taste of the consumer, by using parsley, +sage, savory, thyme, sweet marjoram, sweet basil, or any of the +vegetable condiments. These may be raised in the garden, or obtained at +the drug stores, sifted and prepared for use. In extracting the juices +of meats, in order that soups may be most nutritious, it is important +that the meat be put into _cold_ water, or that which is not so hot as +to coagulate the albumen (which would prevent it from being extracted), +and then, by slow heat and a simmering process, the most nutritious +properties will be brought out. + +BEEF SOUP may be made of any bone of the beef, by putting it into cold +water, adding a little salt, and skimming it well just before it boils. +If a vegetable flavor be desired, celery, carrots, onions, turnips, +cabbage, or potatoes, may be added, in sufficient quantities to suit the +taste. + +MUTTON SOUP may be made from the fore-quarter, in the same manner as +described above, thickened with pearl-barley or rice, and flavored to +suit the taste. + +BOILED FISH. Clean the fish nicely, then sprinkle flour on a cloth and +wrap it around them; salt the water, and, when it boils, put in the +fish; let them boil half an hour, then carefully remove them to a +platter, adding egg sauce and parsley. To _bake fish_, prepare by +cleaning, scaling, etc., and let them remain in salt water for a short +time. Make a stuffing of the crumbs of light bread, and add to it a +little salt, pepper, butter, and sweet herbs, and stir with a spoon. +Then fill the fish with the stuffing and sew it up. Put on butter, salt, +pepper, and flour, having enough water in the dish to keep it from +burning, and baste often. A four pound fish will bake in fifty or sixty +minutes. + +BROILED STEAK. Sirloin and porter-house steaks should be broiled +quickly. Preserve them on ice for a day or two and their tenderness is +much increased. Never broil them until the meal is ready to be served. + +BOILED HEAT. When meat is to be boiled for _eating,_ put it into boiling +water, by which its juices are coagulated and its richness preserved. +The slower it boils, the more tender, plump, and white it will be. Meat +should be removed as soon as done, or it will lose its flavor and become +soggy. + +PORK STEAKS. The best steaks are cut off the shoulder--ham steaks being +rather too dry. They should be well fried, in order to destroy the +little living parasites, called Trichinae which sometimes infest this +kind of meat. They are introduced into the stomach by eating ham, pork, +or sausages made from the flesh of hogs infested by them. Thorough +cooking destroys them, and those who will persist in the use of swine's +flesh can afford to have it "_done brown._" + +BAKED MUTTON. To bake mutton well, a person should have a brisk, sharp +fire, and keep the meat well basted. It requires two hours to bake a leg +of mutton, weighing eight pounds. + +BREAD. The health and happiness of a family depend, to a certain extent, +on good, well-baked bread. At all events, our enjoyment would be greater +if it were only better prepared. We make the following extract from an +article printed by the State Board of Health, concerning the food of the +people of Massachusetts: "As an example of good bread we would mention +that which is always to be had at the restaurant of Parker's Hotel, in +Boston. It is not better than is found on the continent of Europe on all +the great lines of travel, and in common use by millions of people in +Germany and France; but with us, it is a rare example of what bread may +be. It is made from a mixture of flour, such as is generally sold in our +markets, water, salt, and yeast--nothing else. The yeast is made from +malt, potatoes, and hops. _The dough is kneaded from one and a half to +two hours, and is then thoroughly baked."_ The truth seems to be that +the kneading, which in this country takes the housewife's time and +muscle, in Europe is done by the help of machinery. So here, in large +villages and cities, people might furnish themselves with good bread, by +means of co-operative associations, even at a less cost than at present. + + +BEVERAGES. + + +WATER. The importance of water in the economy of nature is obvious to +all. It is the most abundant substance of which we have knowledge. It +composes four-fifths of the weight of vegetables, and three-fourths of +that of animals. It is essential to the continuance of organic life. +Water is universally present in all of the tissues and fluids of the +body. It is not only abundant in the blood and secretions, but it is +also an ingredient of the solids of the body. According to the most +accurate computations, water is found to constitute from two-thirds to +three-fourths of the entire weight of the human body. The following +table, compiled by Robin and Verdeil, shows the proportion of water per +thousand parts in different solids and fluids: + + QUANTITY OF WATER IN 1,000 PARTS. + + Teeth, 100 + Bones, 130 + Cartilage, 550 + Muscles, 750 + Ligaments, 768 + Brain, 789 + Blood, 795 + Synovial fluid, 805 + Bile, 880 + Milk, 887 + Pancreatic juice, 900 + Urine, 936 + Lymph, 960 + Gastric juice, 975 + Perspiration, 986 + Saliva, 995 + +THE NATURAL DRINK OF MAN. Water constitutes the natural drink of man. No +other liquid can supply its place. Its presence, however, in the body is +not permanent. It is discharged from the body in different ways; by the +urine, the feces, the breath, and the perspiration. In the first two, it +is in a liquid form, in the others in a vaporous form. It is estimated +that about forty-eight per cent. is discharged in the liquid, and +fifty-two per cent. in the vaporous form; but the absolute as well as +the relative amount discharged depends upon a variety of circumstances. + +Water is never found perfectly pure, since it holds in solution more or +less of almost every substance with, which it comes in contact. Rain +falling in the country remote from habitations is the purest water that +nature furnishes, for it is then only charged with the natural gases of +the atmosphere. In cities it absorbs organic and gaseous impurities, as +it falls through the air, and flowing over roofs of houses carries with +it soot and dust. Water from melted snow is purer than rain-water, since +it descends in a solid form, and is therefore incapable of absorbing +gases. Rain-water is not adapted to drinking purposes, unless well +filtered. All water, except that which has been distilled, contains air, +and it is due to this fact, that aquatic animals can live in it; for +example, put a fish in distilled water and it will soon die. + +MINERAL IMPURITIES. Rain-water, which has filtered through the soil and +strata of the earth, dissolves the soluble materials, and carries them +down to lower levels, until they finally collect in the sea. Common +well, spring, and mineral waters contain from 5 to 60 grains to the +gallon; sea-water contains 2,000 grains while in some parts of the Dead +Sea there are 20,000 grams to the gallon. The principal mineral +impurities of well and spring water are lime, magnesia, soda, and oxide +of iron, combined with carbonic and sulphuric acids, forming carbonates, +sulphates, and chloride of sodium, or common salt. The most general, +however, are carbonate and sulphate of lime. + +Mineral waters are usually obtained from springs which contain a +considerable amount of saline matter. Those waters which abound in salts +of iron are called _chalybeate_ or _ferruginous_. Those containing salt +are termed _saline_. Those in which contain sulphur are termed +_sulphurous_. Water derives the quality of hardness from the salts of +lime--chiefly the sulphates--which it contains. Hard water, being an +imperfect solvent, is unsuitable for washing purposes. There are two +varieties of hardness, one of which is temporary, being due to the +presence of carbonic acid gas in the water which holds the salts in +solution and may be removed by merely boiling the water and thus +expelling the gas when the salts are deposited, while the other is +permanent and can only be removed by the distillation of the water. It +has been ascertained that twelve pounds of the best hard soap must be +added to 10,000 gallons of water of one degree of hardness before a +lather will remain and, consequently, 0.12 lb. to 100 gallons of water +is a measure of one degree of hardness. Since hard water is not so +useful in cooking and other domestic purposes, as soft water, causing a +great waste of labor and material, it is often highly desirable to +soften it, which is effected by the addition of lime in what is known as +_Clark's process_. One ounce of quicklime should be added to 1000 +gallons of water for each degree of hardness. It should be first slacked +and stirred up in a few gallons and then thoroughly mixed with the +entire quantity. Then it should be allowed to remain, and will become +clear in about three hours, but should not be drunk for twelve hours. + +The purity of drinking water is a matter of much importance. That which +contains a minute quantity of lead will give rise to all the symptoms of +lead poisoning, if the use of it be sufficiently prolonged. An account +is given of the poisoning of the royal family of France, many of whom +suffered from this cause when in exile at Claremont. The amount of lead +was only one grain in the gallon. Care should therefore be taken to +avoid drinking the water which has been contained in leaden pipes. It +should always be allowed to run a few minutes before being used. + +An excess of saline ingredients, which in small quantities are harmless, +frequently produces marked disorders of the digestive organs. A small +amount of putrescent matter habitually introduced into the system, as in +the use of food, is productive of the most serious results, which can be +traced to the direct action of the poison introduced. A case is recorded +of a certain locality favorably situated with regard to the access of +pure air, where an epidemic of fever broke out much to the astonishment +of the inhabitants. Upon observation it was found that the attacks of +fever were limited to those families who used water from a neighboring +well. The disagreeable taste of the water which had been observed, was +subsequently traced to the bursting of a sewer, which had discharged a +part of its contents into the well. When the cause was removed, there +was no recurrence of the evil effects. + +ORGANIC IMPURITIES. "Water is liable to organic contamination from a +multitude of causes, such as drainage from dwellings, dust, insects, the +decaying of vegetable and animal matter. These impurities may be +mechanically suspended or held in solution in the water. Although +organic impurities, which are mechanically suspended in water, are +poisonous, yet they are generally associated with animalculea, and these +feed upon, and finally consume them. Good water never contains +animalculæ. They are never found in freshly fallen rain-water, remote +from dwellings, but abound, to a greater or less extent in cisterns, +marshes, ponds, and rivers. These little workers serve a useful purpose +since they consume the dead organic matter from the water, and, having +fulfilled their mission, sink to the bottom and die. Water which +contains organic matter is exceedingly dangerous to health, and its use +should be carefully avoided. + +In low lands where the current of streams is sluggish, and shallow pools +abound, the water is apt to be more or less infected with decaying +vegetable substances. Many people living in such localities, and wishing +to obtain water with as little trouble as possible, dig a hole in the +ground, a few feet in depth, and allow the stagnant surface water to +accumulate. This water is used for drinking and cooking. The result is +that ague prevails in such localities. + +Care should be taken that wells, from which the water is used for +household purposes, are located at a distance from barn-yards, privies, +sinks, vaults, and stagnant pools. + +PURIFICATION OF WATER. There are various methods of purifying water. It +may be accomplished by distillation, which is the most perfect method; +by filtration through sand, crushed charcoal, and other porous +substances, which deprives it of suspended impurities and living +organisms; by boiling, which destroys the vitality of all animal and +vegetable matters, drives out the gases and precipitates carbonate of +lime, which composes the crust frequently seen upon the inside of +tea-kettles or boilers; by the use of chemical agents, which may be +employed to destroy or precipitate the deleterious substances. Alum is +often used to cleanse roily water, two or three grains in solution, +being sufficient for a quart. It causes the impurities to settle to the +bottom, so that the clear water can be poured or dipped out for use. One +or two grains of the permanganate of potassium will render wholesome a +gallon of water containing animal impurities. + +HOW TO USE WATER. Very little if any water should be taken at meal time, +since the salivary glands furnish an abundance of watery fluid to assist +in mastication. When these glands are aided with water to "wash down" +the food, their functions become feeble and impaired. The gastric juice +is diluted and digestion is weakened. Large draughts of cold water ought +never to be indulged in, since they cause derangement of the stomach. +When the body is overheated, the use of much water is injurious. It +should only be taken in small quantities. Thirst may be partially +allayed, without injury, by holding cold water in the mouth for a short +time and then spitting it out, taking care to swallow but very little. +Travelers frequently experience inconvenience from change of water. If +the means are at hand, let them purify their drinking water, if not, +they should drink as little as possible. Persons who visit the banks of +the Ohio, Missouri, or Mississippi rivers and similar localities, almost +invariably suffer from some form of gastric or intestinal disease. Water +standing in close rooms soon becomes unfit to drink and should not be +used. A drink of cold water taken on going to bed, and another on rising +are conducive to health, especially in the case of persons troubled with +constipation. "_Drink water_" said the celebrated Dubois to the young +persons who consulted him, "_drink water, I tell you!_" Du Moulin, the +great medical authority of his time, wrote, just previous to his death, +"_I leave two great physicians behind me--diet and water_." + +TEA AND COFFEE. These substances are almost universally used as +beverages, and when properly employed, serve a four-fold purpose: they +quench thirst, excite an agreeable exhilaration, repress the waste of +the system, and supply nourishment. In consequence of being generally +used at meal times, their stimulant properties are employed to promote +digestion, and consequently they are not so objectionable as they might +otherwise be. The liquids introduced into the stomach at meal times +should not be cold. Tea and coffee are drunk warm, while water, except +in a few instances, is always drunk cold, the effects of which have +already been shown. That their inordinate use may be injurious no body +can deny, but this is equally true of other beverages, even pure, cold +water. Scientific investigators inform us that the use of these agents +as beverages, when judiciously employed, is not injurious. It has been +urged that they are poisonous, but if they are, they are very slow in +their operation. + +When properly prepared, they are very agreeable beverages, and as man +will drink more or less at meals, they are allowable; for if their use +were excluded, some other beverage would be sought after, and quite +likely one of an alcoholic character employed, so of two evils, if this +be an evil, let us choose the least. Unlike alcoholic stimulants, they +exhilarate without a depressing reaction after their influence has +passed off. But one cup should be drunk at a meal, and it should be of +moderate strength. The use of large quantities of drink at meals retards +digestion by diluting the digestive fluids. The excessive use of large +quantities of strong tea or coffee stimulates the brain and causes +wakefulness, and produces irritability of the nervous system. When they +are productive of such effects, their use is injurious, and should be +considerably moderated or wholly discontinued. No criterion can be given +by which the amount the system will tolerate can be regulated. What one +person may take with impunity, may be deleterious to an other. +Individuals differ greatly in this respect. There are some who cannot +tolerate them at all, either because of some peculiarity of +constitution, or on account of disease. And sometimes when tea is +agreeable and beneficial, coffee disagrees with the individual and _vice +versa._ Persons of nervous habits whether natural or acquired, are apt +to find their wakefulness and irritability increased by the use of tea, +particularly if strong, while coffee will have a tranquilizing effect. +Persons of a lymphatic or bilious temperament often find that coffee +disagrees with them, aggravating their troubles and causing biliousness, +constipation, and headache, while tea proves agreeable and beneficial. +Whenever they disagree with the system, the best rule is to abandon +their use. We find many persons who do not use either, and yet enjoy +health, a fact which proves that they are not by any means +indispensable, and, no doubt, were it customary to go without them, +their absence would be but slightly missed. + +Tea and coffee are adulterated to a very great extent, and persons using +them will be greatly imposed upon. This is an evil we cannot remedy. If +people make use of them, their experience in selecting them must be +their guide; however, it is believed that the Black and Japan varieties +of tea are the least apt to be adulterated, and coffee, to insure +purity, should be purchased in the berry, and ground by the purchaser. + +In preparing tea an infusion should be made by adding boiling water to +the leaves, and permitting them to steep for a few minutes only, for a +concentrated decoction, made by boiling for a long time, liberates the +astringent and bitter principles and drives off the agreeable aroma +which resides in a volatile oil. + +Coffee should be prepared by adding cold water to the ground berry, and +raising it slowly to the boiling point. Long-continued boiling liberates +the astringent and bitter principles upon which its stimulant effects to +a great extent depend, and drives off with the steam the aromatic oil +from which the agreeable taste is derived. + + +ALCOHOLIC LIQUORS. + + +These are divided into three classes: malted, fermented, and distilled. +They all contain more or less alcohol, and their effects are, therefore, +in some respects similar, and, in the words of Dr. B.W. Richardson, the +great English authority on hygiene: "To say this man only drinks ale, +that man only drinks wine, while a third drinks spirits, is merely to +say, when the apology is unclothed, that all drink the same danger. * * +Alcohol is a universal intoxicant, and in the higher orders of animals +is capable of inducing the most systematic phenomena of disease. But it +is reserved for man himself to exhibit these phenomena in their purest +form, and to present, through them, in the morbid conditions belonging +to his age, a distinct pathology. Bad as this is, it might be worse; for +if the evils of alcohol were made to extend equally to animals lower +than man, we should soon have, none that were tameable, none that were +workable, and none that were eatable." Researches have shown that the +proportion of half a drachm of alcohol to the pound weight of the body, +is the quantity which usually produces intoxication, and that an +increase of this amount to one drachm immediately endangers the life of +the individual. The first symptom which attracts attention, when alcohol +commences to take effect upon the body, is an increase in the number of +the pulsations of the heart. Dr. Parkes and Count Wolowicz conducted a +series of interesting experiments on young adult men. They counted the +pulsations of the heart, at regular intervals, during periods when the +subject drank only water; and then they counted the beats of the heart +in the same individual during successive periods in which alcohol was +drunk in increasing quantities. + +The following details are taken from their report: + +"The highest of the daily means of the pulse observed during the first +or water period was 77.5; but on this day two observations were +deficient. The next highest daily mean was 77 beats. + +If instead of the mean of the eight days, or 73.57, we compare the mean +of this one day, viz., 77 beats per minute, with the alcoholic days, so +as to be sure not to over-estimate the action of the alcohol, we find: + + On the ninth day, with one fluid ounce of alcohol, + the heart beat 430 times more. + On the tenth day, with two fluid ounces, 1,872 times more. + On the eleventh day, with four fluid ounces, 12,960 times more. + On the twelfth day, with six fluid ounces, 30,672 times more. + On the thirteenth day, with eight fluid ounces, 23,904 times more. + On the fourteenth day, with eight fluid ounces, 25,488 times more. + +But as there was ephemeral fever on the twelfth day, it is right to make +a deduction, and to estimate the number of beats in that day as midway +between the twelfth and twenty-third days, or 18,432. Adopting this, the +mean daily excess of beats during the alcoholic days was 14,492, or an +increase of rather more than thirteen per cent. + +The first day of alcohol gave an excess of one per cent., and the last +of twenty-three per cent.; and the mean of these two gives almost the +same percentage of excess as the mean of the six days. + +Admitting that each beat of the heart was as strong during the alcoholic +as in the water period (and it was really more powerful), the heart on +the last two days of alcohol was doing one-fifth more work. + +Adopting the lowest estimate which has been given of the daily work done +by the heart, viz., as equal to 122 tons lifted one foot, the heart, +during the alcoholic period, did daily work in excess equal to lifting +15.8 tons one foot, and in the last two days did extra work to the +amount of twenty-four tons lifted as far. + +The period of rest for the heart was shortened, though, perhaps, not to +such an extent as would be inferred from the number of beats; for each +contraction was sooner over. The beat on the fifth and sixth days after +alcohol was left off, and apparently at the time when the last traces of +alcohol were eliminated, showed, in the sphygmographic tracing, signs of +unusual feebleness; and, perhaps, in consequence of this, when the +brandy quickened the heart again, the tracing showed a more rapid +contraction of the ventricles, but less power than in the alcoholic +period. The brandy acted, in fact, on a heart whose nutrition had not +been perfectly restored." + +The flush often seen on the cheeks of those who are under the influence +of alcoholic liquors, and which is produced by a relaxed and distended +condition of the superficial blood vessels, is erroneously supposed by +many to merely extend to the parts exposed to view. On this subject, Dr. +Richardson says: "If the lungs could be seen, they, too, would be found +with their vessels injected; if the brain and spinal cord could be laid +open to view, they would be discovered in the same condition; if the +stomach, the liver, the spleen, the kidneys, or any other vascular +organs or parts could be laid open to the eye, the vascular engorgement +would be equally manifest. In the lower animals I have been able to +witness this extreme vascular condition in the lungs, and once I had the +unusual, though unhappy opportunity of observing the same phenomenon in +the brain of a man who, in a paroxysm of alcoholic delirium, cast +himself under the wheels of a railway carriage. The brain, +instantaneously thrown out from the skull by the crash, was before me +within three minutes after the accident. It exhaled the odor of spirit +most distinctly, and its membranes and minute structures were vascular +in the extreme. It looked as if it had been recently injected with +vermilion injection. The white matter of the cerebrum, studded with red +points, could scarcely be distinguished when it was incised, it was so +preternaturally red; and the pia mater, or internal vascular membrane +covering the brain, resembled a delicate web of coagulated red blood, so +tensely were its fine vessels engorged. This condition extended through +both the larger and the smaller brain, cerebrum, and cerebellum, but was +not so marked in the medulla, or commencing portion of the spinal cord, +as in the other portions. + +In course of time, in persons accustomed to alcohol, the vascular +changes, temporary only in the novitiate, become confirmed and +permanent. The bloom on the nose which characterizes the genial toper is +the established sign of alcoholic action on the vascular structure. + +Recently, physiological research has served to explain the reason why, +under alcohol the heart at first beats so quickly, why the pulse rises, +and why the minute blood-vessels become so strongly injected. + +At one time it was imagined that alcohol acts immediately upon the heart +by stimulating it to increased motion; and from this idea,--false idea, +I should say,--of the primary action of alcohol, many erroneous +conclusions have been drawn. We have now learned that there exist many +chemical bodies which act in the same manner as alcohol, and that their +effect is not to stimulate the heart, but to weaken the contractile +force of the extreme and minute vessels which the heart fills with blood +at each of its strokes. These bodies produce, in fact, a paralysis of +the organic nervous supply of the vessels which constitute the minute +vascular structures. The minute vessels when paralysed offer inefficient +resistance to the force of the heart, and the pulsating organ thus +liberated, like the main-spring of a clock from which the resistance has +been removed, quickens in action, dilating the feebly resistant vessels, +and giving evidence really not of increased, but of wasted power." + +The continued use of alcoholic liquors in any considerable quantity +produces irritation and inflammation of the stomach, and structural +disease of the liver. Dr. Hammond has shown that alcohol has a special +affinity for nervous matter, and is, therefore, found in greater +quantity in the brain and spinal cord than elsewhere in the body. The +gray matter of the brain undergoes, to a certain extent, a fatty +degeneration, and there is a shrinking of the whole cerebrum, with +impairment of the intellectual faculties, muscular tremor, and a +shambling gait. + +Large doses of alcohol cause a diminution of the temperature of the +body, which in fevers is more marked than in the normal state. + +In addition to the organic diseases enumerated above, and delirium +tremens, the following diseases are frequently the result of the +excessive use of alcoholic liquors: epilepsy, paralysis, insanity, +diabetes, gravel, and diseases of the heart and blood-vessels. + +The physiological deductions of Dr. Richardson are so much in accord +with our own that we quote them in full: + +"In the first place we gather from the physiological reading of the +action of alcohol that the agent is narcotic. I have compared it +throughout to chloroform, and the comparison is good in all respects +save one, viz.: that alcohol is less fatal than chloroform as an instant +destroyer. It kills certainly in its own way, but its method of killing +is slow, indirect, and by disease. + +The well-proven fact that alcohol, when it is taken into the body, +reduces the animal temperature, is full of the most important +suggestions. The fact shows that alcohol does not in any sense act as a +supplier of vital heat as is commonly supposed, and that it does not +prevent the loss of heat as those imagine 'who take just a drop to keep +out the cold,' It shows, on the contrary, that cold and alcohol, in +their effects on the body, run closely together, an opinion confirmed by +the experience of those who live or travel in cold regions of the earth. +The experiences of the Arctic voyagers, of the leaders of the great +Napoleonic campaigns in Russia, of the good monks of St. Bernard, all +testify that death from cold is accelerated by its ally alcohol. +Experiments with alcohol in extreme cold tell the like story, while the +chilliness of the body which succeeds upon even a moderate excess of +alcoholic indulgence leads directly to the same indication of truth. + +The conclusive evidence now in our possession that alcohol taken into +the animal body sets free the heart, so as to cause the excess of motion +of which the record has been given above, is proof that the heart, under +the frequent influence of alcohol, must undergo deleterious change of +structure. It may, indeed, be admitted in proper fairness, that when the +heart is passing through these rapid movements it is working under less +pressure than when its movements are slow and natural; and this +allowance must needs be made, or the inference would be that the organ +ought to stop at once, in function, by the excess of strain put upon it. +At the same time the excess of motion is injurious to the heart and to +the body at large; it subjects the heart to irregularity of supply of +blood, it subjects the body in all its parts to the same injurious +influence; it weakens, and, as a necessary sequence, degrades both the +heart and the body. + +Speaking honestly, I cannot, by any argument yet presented to me, admit +the alcohols by any sign that should distinguish them from other +chemical substances of the paralysing narcotic class. When it is +physiologically understood that what is called stimulation or excitement +is, in absolute fact, a relaxation, a partial paralysis, of one of the +most important mechanisms in the animal body, the minute, resisting, +compensating circulation, we grasp quickly the error in respect to the +action of stimulants in which we have been educated, and obtain a clear +solution of the well-known experience that all excitement, all passion, +leaves, after its departure, lowness of heart, depression of mind, +sadness of spirit. We learn, then, in respect to alcohol, that the +temporary excitement it produces is at the expense of the animal force, +and that the ideas of its being necessary to resort to it, that it may +lift up the forces of the animal body into true and firm and even +activity, or that it may add something useful to the living tissues, are +errors as solemn as they are widely disseminated. In the scientific +education of the people no fact is more deserving of special comment +than this fact, that excitement is wasted force, the running down of the +animal mechanism before it has served out its time of motion. + +It will be said that alcohol cheers the weary, and that to take a little +wine for the stomach's sake is one of the lessons that comes from the +deep recesses of human nature. I am not so obstinate as to deny this +argument, There are times in the life of man when the heart is +oppressed, when the resistance to its motion is excessive, and when +blood flows languidly to the centres of life, nervous and muscular. In +these moments alcohol cheers. It lets loose the heart from its +oppression; it lets flow a brisker current of blood into the failing +organs; it aids nutritive changes, and altogether is of temporary +service to man. So far, alcohol may be good, and if its use could be +limited to this one action, this one purpose, it would be amongst the +most excellent of the gifts of science to mankind. Unhappily, the border +line between this use and the abuse of it, the temptation to extend +beyond the use, the habit to apply the use when it is not wanted as +readily as when it is wanted, overbalance, in the multitude of men, the +temporary value that attaches truly to alcohol as a physiological agent. +Hence alcohol becomes a dangerous instrument even in the hands of the +strong and wise, a murderous instrument in the hands of the foolish and +weak. Used too frequently, used too excessively, this agent, which in +moderation cheers the failing body, relaxes its vessels too extremely; +spoils vital organs; makes the force of the circulation slow, imperfect, +irregular; suggests the call for more stimulation; tempts to renewal of +the evil, and ruins the mechanism of the healthy animal before its hour +for ruin, by natural decay, should be at all near. + +It is assumed by most persons that alcohol gives strength, and we hear +feeble persons saying daily that they are being 'kept up by stimulants.' +This means actually that they are being kept down; but the sensation +they derive from the immediate action of the stimulant deceives them and +leads them to attribute passing good to what, in the large majority of +cases, is persistent evil. The evidence is all-perfect that alcohol +gives no potential power to brain or muscle. During the first stage of +action it may enable a wearied or a feeble organism to do brisk work for +a short time; it may make the mind briefly brilliant; it may excite +muscle to quick action, but it does nothing substantially, and fills up +nothing it has destroyed, as it leads to destruction. A fire makes a +brilliant sight, but leaves a desolation. It is the same with alcohol. + +On the muscular force the very slightest excess of alcoholic influence +is injurious. I find by measuring the power of muscle for contraction in +the natural state and under alcohol, that so soon as there is a distinct +indication of muscular disturbance, there is also indication of muscular +failure, and if I wished by scientific experiment to spoil for work the +most perfect specimen of a working animal, say a horse, without +inflicting mechanical injury, I could choose no better agent for the +purpose of the experiment than alcohol. But alas! the readiness with +which strong, well-built men slip into general paralysis under the +continued influence of this false support, attests how unnecessary it +would be to subject a lower animal to the experiment. The experiment is +a custom, and man is the subject. + +The true place of alcohol is clear; it is an agreeable temporary shroud. +The savage, with the mansions of his soul unfurnished, buries his +restless energy under its shadow. The civilized man overburdened with +mental labor, or with engrossing care, seeks the same shade; but it is +shade, after all, in which, in exact proportion as he seeks it, the +seeker retires from perfect natural life. To search for force in alcohol +is, to my mind, equivalent to the act of seeking for the sun in +subterranean gloom until all is night. + +It may be urged that men take alcohol, nevertheless, take it freely, and +yet live; that the adult Swede drinks his average cup of twenty-five +gallons of alcohol per year and remains on the face of the earth. I +admit force even in this argument, for I know under the persistent use +of alcohol there is a limited provision for the continuance of life. In +the confirmed alcoholic the alcohol is, in a certain sense, so disposed +of that it fits, as it were, the body for a long season, nay, becomes +part of it; and yet it is silently doing its fatal work. The organs of +the body may be slowly brought into a state of adaptation to receive it +and to dispose of it. But in that very preparation they are themselves +made to undergo physical changes tending to the destruction of their +function, to perversion of their structure, and to all those varied +modifications of organic parts which the dissector of the human subject +learns to recognize,--almost without concern, and certainly without +anything more than commonplace curiosity,--as the devastations incident +to alcoholic indulgence." + +The statistics collected from the census of the United States for 1860, +and given by Dr. De Marmon, in the _New York Medical Journal_ for +December, 1870, must carry conviction to all minds of the correctness of +the foregoing deductions: + +"For the last ten years the use of spirits has, 1. Imposed on the nation +a direct expense of 600,000,000 dollars. 2. Has caused an indirect +expense of 600,000,000 dollars. 3. Has destroyed 300,000 lives. 4. Has +sent 100,000 children to the poorhouses. 5. Has committed at least +150,000 people into prisons and workhouses. 6. Has made at least 1,000 +insane. 7. Has determined at least 2,000 suicides. 8. Has caused the +loss by fire or violence, of at least 10,000,000 dollars' worth of +property. 9. Has made 200,000 widows and 1,000 orphans." + +If these were the statistics twenty-four years ago, with our greatly +increased population, what must they be to-day? We will let the reader +draw his own conclusions. + +MALTED LIQUORS. Under this head are included all those liquors into the +composition of which malt enters, such as beer, ale, and porter. The +proportion of alcohol in these liquors varies greatly. In beer, it is +from two to five per cent.; in Edinburgh ale, it amounts to six per +cent.; in porter, it is usually from four to six per cent. In addition +to alcohol and water, the malted liquors contain from five to fourteen +per cent. of the extract of malt, and from 0.16 to 0.60 per cent. of +carbonic acid. They possess, according to Pereira, three properties: +they quench thirst; they stimulate, cheer, and, if taken in sufficient +quantity, intoxicate; and they nourish or strengthen. The first of these +qualities is due to the water entering into their composition; the +second, to the alcohol; the third is attributed the nutritive principles +of the malt. + +OBJECTIONS TO THEIR USE AS BEVERAGES. These articles are either pure or +adulterated. In their pure state the objection to their use for this +purpose lies in the fact that they contain alcohol. This, as we have +seen, is a poisonous substance, which the human system in a state of +health does not need. Its use, when the body is in a normal condition, +is uncalled for, and can only be deleterious. Beverages containing this +poison are more or less deleterious to healthy persons, according to the +amount of it which they contain. + +These liquors are frequently adulterated, and this increases their +injurious effects. The ingenuity of man has been taxed to increase their +intoxicating properties; to heighten the color and flavor, to create +pungency and thirst; and to revive old beer. To increase the +intoxicating power, tobacco or the seeds of the Cocculus indicus are +added; to heighten the color and flavor, burnt sugar, liquorice, or +treacle, quassia, or strychnine, coriander, and caraway seeds are +employed; to increase the pungency, cayenne pepper or common salt is +added; to revive old beer, or ale, it is shaken up with green vitriol or +sulphate of iron, or with alum and common salt. + +FERMENTED LIQUORS. These are cider and wine. Cider contains alcohol to +the amount of from five to ten per cent., saccharine matter, lactic +acid, and other substances. New cider may be drunk in large quantities +without inducing intoxication, but old cider is quite as intoxicating as +ale or porter. + +The composition of wine is very complex, the peculiar qualities which +characterize the different varieties cannot be ascertained by chemical +analysis. Wine is a solution of alcohol in water, combined with various +constituents of the grape. The amount of alcohol in wines ranges from +six to forty per cent. As beverages, these are open to the same +objections as those manufactured from malt. As a medicine, wine is a +useful remedy. Concerning its use in this capacity, Prof. Liebig says: +"Wine is a restorative. As a means of refreshment when the powers of +life are exhausted--as a means of compensation where a misappropriation +occurs in nutrition, and as a means of protection against transient +organic disturbances, it is surpassed by no product of nature or art." +That an article is useful in medicine, however, is no reason why it +should be used as a beverage by those in health. It is rather an +argument against such a practice. For it is generally true that the +drugs used to restore the diseased system to health, are pernicious or +poisonous to it when in a normal condition. + +DISTILLED LIQUORS. These are whiskey, brandy, and the kindred +productions of the still. Whiskey is a solution of alcohol in water, +mixed with various other principles which impart to it peculiar physical +properties. The amount of alcohol which it contains varies from +forty-eight to fifty-six per cent. Old whiskey is more highly prized +than the more recent product of the still, from the fact that when kept +for some years certain volatile oils are generated which, impart to it a +mellowness of flavor. + +Brandy is a solution of alcohol in water, together with various other +substances. It contains from fifty to fifty-six per cent. of alcohol. +Pure brandy is distilled from wine, 1,000 gallons of wine yielding from +100 to 150 gallons of brandy, but a very large proportion of the brandy +is made with little or no wine. It is made artificially from high wines +by the addition of oil of Cognac, to give it flavor, burnt sugar to give +it color, and logwood or catechu, to impart astringency and roughness of +taste. The best brandy is obtained by distillation from the best quality +of white wines, from the districts of Cognac and Armagnac in France. + + +THE CLOTHING. + + +There is no physical agent which exerts a more constant or more powerful +influence upon health and life, than the atmosphere. The climate in +these latitudes is exceedingly variable, ranging all the way from 110° +Fahr. in summer to 40° below zero in the winter season. The body of +every individual should be so protected from cold, that it can maintain +a mean temperature of 98° Fahr. + +When the body is warm there is a free and equal circulation of the blood +throughout all the structures. When the surface is subjected to cold, +the numerous capillaries and minute vessels carrying the blood, contract +and diminish in size, increasing the amount of this fluid in the +internal organs, thus causing congestion. The blood must go somewhere, +and if driven from the surface, it retreats to the cavities within. +Hence this repletion of the vital organs causes pain from pressure and +fullness of the distended blood-vessels, and the organic functions are +embarrassed. Besides, cold upon the surface shuts up the pores of the +skin, which are among the most active and important excretory ducts of +the system. It is evident, then, that we require suitable clothing, not +only for comfort, but to maintain the temperature and functions +essential to health and life. + +The chief object to be attained by dress is the maintenance of a uniform +temperature of the body. To attain this end, it is necessary that the +exhalations of the system, which are continually escaping through the +pores of the skin, should be absorbed or conducted away from the person. +These exudations occur in the form of sensible or insensible +perspiration, and the clothing, to be healthy, should be so porous as to +allow them freely to escape into the air. + +A substance should also be chosen which is known to be a poor conductor +of heat. That generated by the system will thus be retained where it is +needed, instead of being dispersed into the atmosphere. + +We might add that the better the material for accomplishing these +purposes, the less will be needed to be worn; for we do not wish to wear +or carry about with us any more material than is necessary. It so +happens that all of these qualities are found combined in _flannel_. The +value of this article worn next to the skin cannot be over-rated, for +while it affords protection from cold during the winter months, it is +equally beneficial during the heat of summer, because it imbibes the +perspiration, and being very porous, allows it to escape. The skin +always feels soft, smooth, and pliable, when it is worn; but, when +cotton takes its place, it soon becomes dry and harsh. Its natural +adaptability to these purposes, shows that it is equally a comfort and a +source of health. Where the skin is very delicate, flannel sometimes +causes irritation. In such cases a thin fabric of linen, cotton, or +silk, should be worn next the skin, with flannel immediately over it. +Where there is a uniform and extreme degree of heat, cotton and linen +are very conducive to comfort. But they are unsuitable in a climate or +season liable to sudden fluctuations in temperature. + +The value of furs, where people are exposed to extreme cold, cannot be +overestimated. They are much warmer than wool, and are chiefly used as +wraps on going outdoors. They are too cumbrous and expensive for +ordinary wear in this latitude, but in places near the poles they +constitute the chief clothing of the inhabitants. + +The quantity of clothing worn is another important item. The least that +is necessary to keep the body well protected and evenly tempered when +employed is the rule of health. Some people, instead of wearing flannels +next to the body, put on other material in greater abundance, thus +confining the perspiration to the skin and making the body chilly. The +amount of clothing is then increased, until they are so heavily clad +that they cannot exercise. It is far better to wear one thickness of +flannel next to the skin, and then cotton, or woolen, for outside +garments, and be able to exercise, thus allowing the blood to circulate +and to assist in the warming process. + +One great fault in dress consists in neglecting to properly clothe the +upper extremities. Some people do not reflect upon the necessity, while +others are too proud to be directed by plain common sense. In the winter +season, the feet should be covered with woolen stockings. The next +matter of importance, is to get a thick, broad-soled shoe, so large that +it will not prevent the free circulation of the blood. Then for walking, +and especially for riding, when the earth is wet and cold, or when there +is snow on the ground, wear a flannel-lined rubber or "Arctic" +over-shoe. _Be sure and keep the feet comfortable and warm at all +times._ + +Our next advice is to keep the legs warm. We were called not long ago, +to see a young lady who had contracted a severe cold. She had been to an +entertainment where the apartments were nicely warmed, and from thence +had walked home late in the evening. We inquired into the circumstances +of the case, and ascertained that she wore flannel about her chest, and +that she also wore rubbers over her shoes, but the other portions of the +lower extremities were protected by cotton coverings. In short, her legs +were not kept warm, and she took cold by going out from warm rooms into +a chilly atmosphere. A good pair of woolen leggings might have saved her +much suffering. The results of insufficient protection of the lower +extremities are colds, coughs, consumption, headaches, pain in the side, +menstrual derangements, uterine congestion and disorders, besides +disablement for the ordinary and necessary duties of life. All these may +be prevented by clothing the legs suitably, and wearing comfortable +flannels. + +Young people can bear a low temperature of the body better than old +people, because they possess greater power of endurance. But that is no +reason for unnecessary exposure. + +The amount of clothing should be regulated according to the +heat-generating power of the individual, and also according to the +susceptibility to cold. No two persons are exactly alike in these +respects. But it is never proper for young people to reject the counsels +of experience, or treat lightly the advice to protect themselves +thoroughly against the cold. Many a parent's heart has ached as he has +followed the mortal remains of a darling child to the grave, knowing +that if good advice had been heeded, in all human probability, the life +would have been prolonged. + +The most deleterious mechanical errors in clothing are those which +affect the chest and body. Tight lacing still plays too important a part +in dress. It interferes with the free and healthy movements of the body, +and effects a pressure which is alike injurious to the organs of +respiration, circulation, and digestion. The great muscle of +respiration, the diaphragm, is impeded in its motion, and is, therefore, +unable to act freely. The large blood-vessels are compressed, and when +the pressure is excessive the heart and lungs are also subjected to +restraint and thrown out of their proper positions. From the compression +of the liver and stomach, the functions of digestion are impeded, a +distaste for solid food, flatulency and pain after eating are the +unmistakable proofs of the injury which is being inflicted. + +The evil effects of such pressure are not confined to actual periods of +time during which this pressure is applied. They continue after it has +been removed and when the chest and trunk of the body have thus been +subjected to long-continued pressure they become permanently deformed. +These deformities necessarily entail great suffering in child-bearing. + +The evil effects of mechanical pressure on other parts of the body are +not uncommon. The leg is sometimes so indented by a tight garter that +the returning flow of blood through the veins is prevented, and a +varicose condition of these vessels is produced. + +Irregular and excessive pressure on the foot by imperfectly fitting +shoes or boots produce deformities of the feet and cause much suffering. +The high heels which are so common on the shoes of women and children +inflict more than a local injury. Every time the body comes down upon +the raised heel with its full weight a slight shock or vibration is +communicated throughout the entire extent of the spinal column, and the +nervous mechanism is thereby injured. Furthermore, displacements of the +pelvic organs frequently result from these unnatural and absurd articles +of dress. Women of fashion are subjected to much annoyance from wearing +long, flowing skirts suspended from their waists to trail uselessly on +the floor and gather dust. It is impossible for the wearers of these +ridiculous garments to exercise their limbs properly or to breathe +naturally. Indigestion, palpitation, shortness of breath, and physical +degeneracy are the inevitable consequences of their folly. The skirts +should always be suspended from the shoulders and not from the hips. It +is especially important that the clothing of children should not fit too +tightly. + +It is very important that the clothing should be kept clean. That which +is worn for a long time becomes saturated with the excretions and +exhalations of the body, which prevent free transpiration from the pores +of the skin, and thereby induce mental inactivity and depression of the +physical powers. Unclear clothing may be the means of conveying disease. +Scarlet fever has been conveyed frequently by the clothing of a nurse +into a healthy family. All of the contagious diseases have been +communicated by clothing contaminated in laundries. + +Certain dyes which are largely used in the coloring of wearing apparel +are poisonous, and give rise to local disease of the skin, accompanied +in some instances, with constitutional symptoms. The principal poisonous +dyes are the red and yellow aniline. A case of poisoning from wearing +stockings colored with aniline dyes, in which there were severe +constitutional symptoms, came under our observation at the Invalids' +Hotel recently. + + * * * * * + + + + +CHAPTER III. + +PHYSICAL EXERCISE. MENTAL CULTURE. SLEEP. CLEANLINESS. + + +A well-developed physical organization is essential to perfect health. +Among the Greeks, beauty ranked next to virtue, and an eminent author +has said that "the nearer we approach Divinity, the more we reflect His +eternal beauty." The perfect expression of thought requires the physical +accompaniments of language, gesture, etc. The human form is pliable, +and, with proper culture, can be made replete with expression, grace and +beauty. The cultivation of the intellectual powers has been allowed to +supplant physical training to a great extent. The results are abnormally +developed brains, delicate forms, sensitive nerves and shortened lives. +That the physical and mental systems should be collaterally developed, +is a fact generally overlooked by educators. The fullness of a great +intellect is generally impaired when united with a weak and frail body. +We have sought perfection in animals and plants. To the former we have +given all the degree of strength and grace requisite to their peculiar +duties; to the latter we have imparted all the delicate tints and +shadings that fancy could picture. We have studied the laws of their +existence, until we are familiar with every phase of their production; +yet it remains for man to learn those laws of his own being, by a +knowledge of which he may promote and preserve the beauty of the human +form, and thus render it, indeed, an image of its Maker. When the body +is tenanted by a cultivated intellect, the result is a unity which is +unique, commanding the respect of humanity, and insuring a successful +life to the possessor. Students are as a rule pale and emaciated. Mental +application is generally the cause assigned when, in reality, it is the +result of insufficient exercise, impure air, and dietetic errors. An +intelligent journalist has remarked that "many of our ministers weigh +too little in the pulpit, because they weigh too little on the scales." +The Greek Gymnasium and Olympian Games were the sure foundations of that +education from which arose that subtle philosophy, poetry, and military +skill which have won the admiration of nineteen centuries. The laurel +crown of the Olympian victor was far more precious to the Grecian youth +than the gilded prize is to our modern genius. A popular lecturer has +truly remarked, that "we make brilliant mathematicians and miserable +dyspeptics; fine linguists with bronchial throats; good writers with +narrow chests and pale complexions; smart scholars, but not that union, +which the ancients prized, of a sound mind in a sound body. The brain +becomes the chief working muscle of the system. We refine and re-refine +the intellectual powers down to a diamond point and brilliancy, as if +they were the sole or reigning faculties, and we had not a physical +nature binding us to earth, and a spiritual nature binding us to the +great heavens and the greater God who inhabits them. Thus the university +becomes a sort of splendid hospital with this difference, that the +hospital _cures_, while the university _creates_ disease. Most of them +are indicted at the bar of public opinion for taking the finest young +brain and blood of the country, and, after working upon them for four +years, returning them to their homes skilled indeed to perform certain +linguistic and mathematical dexterities, but very much below par in +health and endurance, and, in short, seriously damaged and physically +demoralized." We read with reverence the sublime teachings of Aristotle +and Plato; we mark the grandeur of Homer and the delicate beauties of +Virgil; but we do not seek to reproduce in our modern institutions the +gymnasium, which was the real foundation of their genius. Colleges which +are now entering upon their career, should make ample provision for +those exercises which develop the _physical man._ This lack of bodily +training is common with all classes, and its effects are written in +indelible characters on the faces and forms of old and young. +Constrained positions in sitting restrict the movements of the diaphragm +and ribs and often cause diseases of the spine, or unnatural curvatures, +which prove disastrous to health and happiness. The head should be held +erect and the shoulders thrown backward, so that at each inspiration the +lungs may be fully expanded. + +Physical exercise should never be too violent or too prolonged. Severe +physical labor, and athletic sports, if indulged in to an extreme +degree, produce undue excitability of the heart, and sometimes cause it +to become enlarged. There is a form of heart disease induced by undue +exertion which may be called a wearing out or wasting away of that +organ. It is common in those persons whose occupations expose them to +excessive physical labor for too many hours together. This feebleness of +heart is felt but little by vigorous persons under forty years of age, +but in those who have passed this age it becomes manifest. However, when +any person so affected is attacked by any acute disease, the heart is +more liable to fail, and thus cause a fatal termination. + +Aneurism of the aorta or the large arteries branching off from it, which +is a dilatation of the walls of these vessels, caused by the rupture of +one or two of their coats, is generally induced by excessive physical +strain, such as lifting heavy weights, or carrying weights up long +flights of stairs, violent horseback exercise, or hurrying to catch a +train or street car. + +[Illustration: Fig. 104.] + +AN ERECT CARRIAGE is not only essential to health, but adds grace and +beauty to every movement. Although man was made to stand erect, thus +indicating his superiority over all other animals, yet custom has done +much to curve that magnificent central column, upon the summit of which +rests the "grand dome of thought." Many young persons unconsciously +acquire the habit of throwing the shoulders forward. The spinal column +is weakened by this unnatural posture, its vertebræ become so sensitive +and distorted that they cannot easily support the weight of the body or +sustain its equilibrium. It is generally believed that persons of +sedentary habits are more liable to become round-shouldered than any +other class of individuals. Observation shows, on the contrary, that the +manual laborer, or even the idler, often acquires this stooping posture. +It can be remedied, not by artificial braces, but by habitually throwing +the shoulders backwards. Deformed trunks and crooked spines, although +sometimes the effects of disease are more frequently the results of +carelessness. Jacques has remarked that "one's standing among his +fellow-men is quite as important a matter in a _physiological_, as in a +_social_ sense." _Walking_ is one of the most efficient means of +physical culture, as it calls all the muscles into action and produces +the amount of tension requisite for their tonicity. Long walks or +protracted physical exercise of any kind should never be undertaken +immediately after meals. The first essential to a healthful walk is a +pleasurable object. Beautiful scenery, rambles in meadows rich with +fragrant grasses, or along the flowery banks of water-courses, affords +an agreeable stimulus, which sends the blood through the vital channels +with unwonted force, and imparts to the cheeks the ruddy glow of health. +Our poets acknowledge the silent influence of nature. Wordsworth has +expressed this thought in his own sublime way: + + "The floating clouds their state shall lend + To her: for her the willow bend; + Nor shall she fail to see, + E'en in the motions of the storm + Grace that shall mould the maiden's form + By silent sympathy. + The stars of midnight shall be dear + To her: and she shall lean her ear + In many a secret place, + Where rivulets dance their wayward round, + And beauty, born of murmuring sound, + Shall pass into her face." + +BASE BALL, CRICKET, BOXING, AND FENCING, are all manly exercises when +practiced solely with a view to their hygienic advantages and as such +have our approval. + +[Illustration: Fig. 105.] + +[Illustration: Fig. 109.] + +THE ART OF SWIMMING was regarded by the Greeks as an important +accomplishment. As a hygienic agency, it occupies a high place in +physical culture. The varied movements impart strength and elasticity to +the muscles. It is as charming a recreation for women and girls as for +men and boys. Furthermore, it is not only a means of physical culture, +but is often essential for self-preservation. + +[Illustration: Fig. 110.] + +THE EXERCISES OF THE GYMNASIUM are especially productive of health and +longevity. The most important of these are balancing, leaping, climbing, +wrestling, and throwing, all of which are especially adapted to the +development of the muscles. In conclusion, we offer the following +suggestions, viz: all gymnastic exercises should be practiced in the +morning, and in the open air; extremes should be avoided; and it should +be always borne in mind, that their chief object is to combine, in a +proper proportion, mental and physical development. In every relation of +life we should cultivate all those faculties which pertain to our +physical, moral, and mental natures, subdue our passions, and nature +will bestow upon us her richest rewards of health, beauty, and +happiness. + + +CYCLING. + + +[Illustration] + +If one were asked what athletic exercise deserves to be the most popular +in America to-day, the answer would of necessity be cycling. The bicycle +is being used by people of all ages and conditions of health in daily +life; its hygienic value as a means to healthy exercise cannot be +overestimated. In this, as in everything else, immoderation is to be +condemned, particularly where persons have not had sufficient training +to take long "spins," or attempt racing. Beginners should ride only 10 +or 12 minutes at a time--resting then to permit the circulation to +become equalized. In all cyclists, at all ages, in veteran riders as +well as those not practiced in the art, there is, in the beginning of +each attempt, a quickened circulation; the pulse is full and bounding, +and rarely falls under a hundred pulsations per minute. So long as the +exercise is continued, an increase of cardiac motion is observable, and +a vigorous circulation is kept up. This accounts for the astounding +journeys a fully trained cyclist can accomplish, and also for his +endurance without sleep. In spite of the quickened motion of the heart, +rarely have riders been known to grow giddy or show symptoms of cardiac +embarrassment. A good rider may climb a hill without trouble, yet be +unable to climb a flight of stairs without breathlessness and +palpitation. Bicycle riding as a means for acquiring strength and vigor, +improving the circulation and developing the respiratory organs, is +unexcelled. Fast riding, or "scorching," among those not used to +physical exertion, and leaning over the handle-bars so as to ride in a +stooping position, are to be heartily condemned. The latter prevents the +lungs from getting their full expansion, and cultivates a tendency to +round shoulders. Men or women suffering from diseases of the sexual +organs should, before riding, consult the physician having their case in +charge. + +[Illustration: Fig. 112.] + +RIDING ON HORSEBACK is a fine exercise for both sexes. It promotes +digestion, improves the circulation, and expands and develops the +respiratory organs. The pure, fresh air, pleasant scenery, and +pleasurable excitement, impart renewed vigor to the equestrian. In the +Southern States it is a universal accomplishment, and children are +taught to ride as well as to walk. + +DANCING. Notwithstanding the fact that dancing has been perverted to the +basest purposes, has been made the fruitful source of dissipation, and +has often laid the foundation for disease, it is yet capable of being +made to minister to health and happiness. As a means of physical +culture, it favors the development of the muscular system, and promotes +health and cheerfulness. When practiced for this purpose, Jacques terms +it "the best of all indoor exercises," as it brings to bear upon the +physical system a great number of energizing and harmonious influences. + + +MENTAL CULTURE. + + +The brain, like all other organs of the body, requires alternate +exercise and repose; and, in physical endurance, it is subject to +general physiological laws. When exercised with moderation it acquires +strength, vigor, and an accelerated activity. Excessive mental exertion +is liable to result in softening of the brain, and various nervous +diseases, sometimes culminating in insanity, and in many instances +proving fatal to life. The mere votaries of pleasure who avoid all +effort of the mind, fall into the opposite error. In all cases of +intellectual activity, the exertions should be directed to some subject +interesting to the student. In this manner duty will become a pleasure, +which in turn will re-invigorate the mental functions. + +When the mind in confined to one subject for any considerable length of +time together, it becomes fatigued, and requires relaxation, recreation, +rest. This may be obtained by directing the attention to some other +subject, either study or amusement, the latter of which is preferable. +The amusement, however, may be of an intellectual or physical character +or both combined, and will, if properly conducted, restore vigor to both +mind and body. + +Prominent among physical phenomena is the mutual relation between the +brain and the organs of nutrition. Mental exertion should be avoided for +at least one hour after a hearty meal, and all mental labor which +requires concentration of thought ought to be accomplished in the +earlier portion of the day, when the brain is refreshed and repaired by +the night's repose. Mental, like physical endurance, is modified by age, +health and development. A person accustomed to concentration of thought, +can endure a longer mental strain than one inured to manual labor only. +One of the most injurious customs, is the cultivation of the intellect +at the expense of the physical powers. + +MENTAL CULTURE DURING CHILDHOOD. One of the greatest mistakes which +people make in the management of their children, is to overtask their +mental faculties. Although it is exceedingly gratifying to see children +acquire knowledge, and manifest an understanding far beyond their years, +this gratification is often purchased too dearly, for precocious +children are apt to die young. The tissue of the brain and nerves of +children is very delicate; they have not yet acquired the powers of +endurance which older persons possess. The greater portion of the +nutriment assimilated, is required for growth and organic development, +and they can ill afford its expenditure for mental manifestations. They +receive impressions easier and learn much more readily than in after +life, but it is at the expense of the physical organization. Their +mental faculties continue to be developed by the expenditure of brain +nutriment, while physical growth and the powers of endurance are +arrested. It is much better to give physical development the precedence +in order that the mental organism may be well supported and its +operations carried into effect; for it must be apparent to all that an +ordinary intellect in a healthy body, is capable of accomplishing +infinitely more than a strong mind in a _weak_ body. Regularity should +be observed in exercising the mental functions. For this reason a fixed +order in the pursuit of any literary occupation is very essential. The +pursuit of the most abstruse studies will thus become habitual and +comparatively easy, a consequence of systematic application. Mental +labor should always cease when the train of thought becomes confused, +and there is the slightest sensation of depression. All distracting +influences should be absent from the mind, in order to facilitate +intense study, for the intellect cannot attend perfectly to two subjects +at the same time. Painful sensations always have a tendency to paralyze +mental exertion. Great care should be taken that the head is not +subjected to injury of any kind, as it is almost invariably accompanied +by some nervous derangement. Exposure to extreme heat should be +carefully avoided. An attack of sun-stroke although it may not be +immediately fatal, may occasion tumors in the brain, or some organic +disease. + + +SLEEP. + + +For all animated beings sleep is an imperious necessity, as +indispensable as food. The welfare of man requires alternate periods of +activity and repose. It is a well-established physiological fact, that +during the wakeful hours the vital energies are being expended, the +powers of life diminished, and, if wakefulness is continued beyond a +certain limit, the system becomes enfeebled and death is the result. +During sleep there is a temporary cessation of vital expenditures, and a +recuperation of all the forces. Under the influence of sleep "the blood +is refreshed, the brain recruited, physical sufferings are extinguished, +mental troubles are removed, the organism is relieved, and hope returns +to the heart." + +The severest punishment which can be inflicted upon a person, is to +entirely deprive him of sleep. In China, a few years since, three +criminals were sentenced to be kept awake until they should die. To do +this it was necessary to keep a guard over them. The sentinels were +armed with sharp, pointed instruments, with which to goad the victims +and thus prevent them from sleeping. Life soon became a burden, and, +although they were well fed during the time, death occurred sooner than +it would have done had starvation been the punishment. + +SLEEPING ROOMS. The sleeping room should be large and well ventilated, +and the air kept moderately cool. The necessity for a fire may be +determined by the health of the occupant. Besides maintaining a proper +temperature in the room, a little fire is useful, especially if in a +grate, for the purpose of securing good ventilation. The windows should +not be so arranged as to allow a draught upon the body during the night, +but yet so adjusted that the inmate may obtain plenty of fresh air. + +THE BED should not be too soft, but rather hard. Feathers give off +animal emanations of an injurious character, and impart a feeling of +lassitude and debility to those sleeping on them. No more coverings +should be used than are actually necessary for the comfort of the +individual. Cotton sheets are warmer than linen, and answer equally as +well. + +SLEEPING ALONE. Certain effluvia are thrown off from our persons, and +when two individuals sleep together each inhales from the other more or +less of these emanations. There is little doubt that _consumption_, and +many other diseases, not usually considered contagious, are sometimes +communicated in this manner. When it is not practicable for individuals +to occupy separate beds, the persons sleeping together should be of +about the same age, and in good health. Numerous cases have occurred in +which healthy, robust children have gradually declined and died within a +few months, from the evil effects of sleeping with old people. Again, +those in feeble health have been greatly benefited, and even restored, +by sleeping with others who were young and healthy. + +TIME FOR SLEEP. _Night_ is the proper time for sleep. When day is +substituted for night, the sleep obtained does not fully restore the +exhausted energies of the system. Nature does not allow her laws to be +broken with impunity. + +Children require more sleep than old persons. They are sometimes +stupefied with "soothing syrups," and preparations of opium, in order to +get them temporarily out of the way. Such narcotics are very injurious +and dangerous. We have known a young child to be killed by a _single +drop_ of laudanum. This practice, therefore, cannot be too emphatically +condemned. + +HOW TO PUT CHILDREN TO BED. The following characteristic lines are from +the pen of Fanny Fern, and contain such good advice that we cannot +refrain from quoting them: "Not with a reproof for any of the day's sins +of omission or commission. Take any other time than bed-time for that. +If you ever heard a little creature sighing or sobbing in its sleep, you +could never do this. Seal their closing eyelids with a kiss and a +blessing. The time will come, all too soon, when they will lay their +heads upon their pillows lacking both. Let them at least have this sweet +memory of happy childhood, of which no future sorrow or trouble can rob +them. Give them their rosy youth. Nor need this involve wild license. +The judicious parent will not so mistake my meaning. If you ever met the +man or the woman, whose eyes have suddenly filled when a little child +has crept trustingly to its mother's breast, you may have seen one in +whose childhood's home 'dignity' and 'severity' stood where love and +pity should have been. Too much indulgence has ruined thousands of +children; too much love not one." + +POSITION IN SLEEP. The proper position in sleep is upon the right side. +The orifice leading from the stomach to the bowels being on this side, +this position favors the passage of the contents into the duodenum. +Lying on the back is injurious, since by so doing the spine becomes +heated, especially if the person sleeps on feathers, the circulation is +obstructed and local congestions are encouraged. The face should never +be covered during sleep, since it necessitates the breathing of the same +air over again, together with the emanations from the body. + +THE AMOUNT OF SLEEP. The amount of sleep required varies with the age, +habits, condition, and peculiarities of the individual. No definite rule +can be given for the guidance of all. The average amount required, +however, is eight or nine hours out of the twenty-four. Some persons +need more than this, while others can do with less. Since both body and +mind are recuperated by sleep, the more they are exhausted the more +sleep is required. A person employed at mental labor should have more +than one who is merely expending muscular strength. Six hours of +unbroken sleep do more to refresh and revive than ten when frequently +interrupted. If it is too prolonged it weakens and stupefies both body +and mind. If an insufficient amount is taken the flagging energies are +not restored. Persons who eat much, or use stimulants generally require +more than others. To sleep regularity is desirable. If a person goes to +bed at a certain hour for several nights in succession, it will soon +become a habit. The same holds true with regard to rising. If children +are put to sleep at a stated hour for several days in succession, it +will soon become a habit with them. + + +CLEANLINESS. + + +"Cleanliness is next to godliness," and is essential to the health and +vigor of the system. Its importance cannot be overestimated, and it +should be inculcated early on the minds of the young. "Even from the +body's purity, the mind receives a secret sympathetic aid." + +When we consider the functions of the skin, with its myriads of minute +glands, innumerable little tubes, employed in removing the worn-out, +useless matter from the system, we cannot fail to appreciate the utility +of frequent bathing with soap and water. Unless these excretions are +removed, the glands become obstructed, their functions are arrested, and +unpleasant odors arise. Many persons think because they daily bathe the +face, neck, and hands, dress the hair becomingly and remove the dirt +from their clothing that the height of cleanliness has been reached. +From a hygienic point of view, bathing the _entire_ body is of much +greater importance. + +Notwithstanding the necessity for cleanliness of the body, we +occasionally meet with persons who, although particular about their +personal appearance, permit their bodies to be for weeks and even months +without a bath. Such neglect should never exceed one week. Plenty of +sunlight and at least one or two general baths every week are essential +to perfect health. Cleanliness is necessary to health, beauty, +attractiveness, and a cheerful disposition. + + * * * * * + + + + +CHAPTER IV. + +HYGIENE OF THE REPRODUCTIVE ORGANS. + + +The structure and functions of organized bodies are subject to continual +alteration. The changes of nutrition and growth, which are constantly +taking place in the tissues render them at the same time the seat of +repair and waste, of renovation and decomposition, of life and death. +The plant germinates and blossoms, then withers and decays; animal life, +in like manner, comes into being, grows to maturity, fades, and dies. It +is, therefore, essential to the perpetuation of life, that new organisms +be provided to take the place of those which are passing out of +existence. There is no physiological process which presents more +interesting phenomena than that of reproduction, which includes the +formation, as well as the development of new beings. + +Since self-preservation is Nature's first law, the desire for food is a +most powerful instinct in all living animals. Not inferior to this law +is that for the perpetuation of the race; and for this purpose, +throughout the animal and vegetable kingdoms, we find the Biblical +statement literally illustrated: "Male and female created He them." + +Health is the gauge by which the prosperity of a people may be measured. +Were we to trace the history of nations,--their rise and fall,--we would +find that much of the barbarism and crime, degradation and vice, as well +as their decline and final extinction, was due to licentiousness and +sexual excesses. Since there is an intimate relation between mind and +body, when the body is enfeebled the mind becomes enervated. Morbid +conditions of the body prevent the highest mental development, and, on +the other hand, when the mind is debilitated, general depravity, +physical as well as mental, is the result. The highest development of +the body results from the equal and harmonious cultivation of all the +mental powers. The perfect development and health of the physical organs +is therefore essential to the happiness of mankind. But, before health +can be insured the nature and general functions of the physical system +must be understood. This being done, the question naturally arises: _How +can health be best maintained and longevity secured?_ + +INFLUENCE OF FOOD. We have previously noticed the effects which food, +exercise, and other hygienic agencies, have upon digestion, circulation, +and respiration; and we find that they exert a not less potent influence +upon the health of the generative organs. Excessive stimulation excites +the sexual passions. For this reason, children should not be +immoderately indulged in highly seasoned foods. Those persons who have +great muscular vigor are endowed with violent passions, and unless +restrained by moral considerations, are very likely to be overcome by +their animal propensities. + +_Alcoholic stimulants_ have a debasing influence upon the whole system, +and especially upon the sexual organs; they excite the animal and debase +the moral nature; they exhaust the vitality, and, after the excitement, +which they temporarily induce, has passed away, the body is left in a +prostrated condition. + +PHYSICAL LABOR MODIFIES THE PASSIONS. Labor consumes the surplus +vitality which a person may possess, and no better protective can be +found against the gratification of the passions, unless it be high moral +training, than daily toil extended to such a degree as to produce +fatigue. Labor determines the blood to the surface and to other parts of +the body, and prevents excitement and congestion of the sexual centers. +If, by education or association, the passions of children be excited, +they will be increased. If, on the contrary, they be taught to avoid +these social or solitary evils, they will be abated. Let them be +educated to work and the intellectual faculties will assert their sway, +the moral powers will be strengthened, and the body better developed, +for purity of mind is the result of the perfect development of man. + +INFLUENCES OF CLIMATE. Individuals possess distinguishing peculiarities +characteristic of the nation to which they belong. Climate exerts a +powerful influence upon mankind. In tropical regions the inhabitants are +enervated, effeminate, and sensual. The rich live in luxury and ease, +vice is unrestrained and license unbridled. When the animal propensities +are allowed to predominate, the mental faculties are kept in subjection. +Hence races that inhabit those latitudes rarely produce scholars or +philosophers. A warm climate hastens the development of the reproductive +organs. Men and women become mature at a much earlier age in those +regions, than in countries where the temperature is lower. In like +manner there is a tendency to premature enfeeblement, for the earlier +the system matures, the sooner it deteriorates. + +MAN IS A SOCIAL BEING. History demonstrates that when man is deprived of +the society of women, he becomes reckless, vicious, depraved, and even +barbarous in his habits, thus illustrating the maxim: "It is not good +for man to be alone." Social intercourse promotes mental and physical +development. The development of the individual implies the unfolding of +every power, both physical and mental. Nothing so regulates and +restrains passion as a healthy condition of the organs through which it +finds expression. And every organ of the body is powerful in proportion +to its soundness. The propensities play a prominent part in the +education of the child. When properly disciplined and held in +subordination to the higher faculties, they constitute an important +factor in the economy of man. Boys are more liable to be morbidly +excited when secluded from the society of girls, and vice versa. Again, +when the sexes are accustomed to associate, the passions are not apt to +be aroused, because of the natural antagonistic constitutional elements. +The influence of the one refines, and ennobles the other. Let children +be taught to understand their natures, and knowing them, they will learn +self-government. "As man rises in education and moral feeling he +proportionately rises in the power of self-restraint; and consequently +as he becomes deprived of this wholesome law of discipline he sinks into +self-indulgence and the brutality of savage life. + +The passions may be aroused by the language, appearance or dress of the +opposite sex. A word spoken without any impure intent is often construed +in a very different sense by one whose passions color the thought, and +is made to convey an impression entirely unlike that which was intended +by the speaker. Also, the dress may be of such a character as to excite +the sexual passion. The manner in which the apparel is worn is often so +conspicuous as to become bawdy, thereby appealing to the libidinous +desires, rather than awakening an admiration for the mental qualities. + +OBSCENE LITERATURE. Literature is a powerful agent either for good or +evil. If we would improve the morals, _choice_ literature must be +selected, whether it be that which realizes the ideal, or idealizes the +real. Obscene literature, or books written for the express purpose of +exciting or intensifying sexual desires in the young, goads to an +illicit gratification of the passions, and ruins the moral and physical +nature. + +It not unfrequently happens that a child is born with a vigorous, mental +organism which promises a brilliant future, but manhood finds him +incompetent, debilitated, and totally incapacitated for mental or manual +labor. This may be the result of youthful indiscretion, ignorantly +committed, but not unfrequently it is the effect of a pernicious +literature which inflames the imagination, tramples upon reason, and +describes to the youth a realm where the passions are the ruling +deities. + +Many persons are born into the world with disordered organizations for +which they are not themselves responsible. Such individuals are entitled +to the sympathy of humanity. Dyspepsia, scrofula, consumption, and a +thousand ills to which mankind is heir, are inherited from parents, the +results of ill-assorted marriages. Intoxicated parents often produce +offspring utterly demented. Children of healthy parents, with good +constitutions, are usually healthy and intelligent. There are marked +varieties of character in children of the same parents. One manifests +great precocity, another is below the average in mental attainments; one +is amiable, another irritable in disposition; indeed, there are often as +great differences between children of the same, as of different +families. This is due to the physical and mental conditions of the +parents, more especially the mother, not only at the time of the +impregnation but also during the period intervening between conception +and the birth of the offspring. The ancients regarded courage as the +principal virtue. By us, purity is so estimated. Moral purity is an +essential requisite to the growth and perfection of the character. + +SELF-ABUSE. Untold miseries arise from the pollution of the body. +Self-pollution, or onanism, is one of the most prolific sources of evil, +since it leads both to the degradation of body and mind. It is practiced +more or less by members of both sexes, and the habit once established, +is overcome with the greatest difficulty. It is the source of numerous +diseases which derange the functional activity of the organs involved, +and eventually impair the constitution. This vicious habit is often +practiced by those who are ignorant of its dangerous results. Statistics +show that insanity is frequently caused by masturbation. + +Immoderate indulgence in any practice is deleterious to the individual. +Emphatically true is this with regard to sexual excesses. Not +unfrequently does the marriage rite "cover a multitude of sins." The +abuse of the conjugal relation produces the most serious results to both +parties, and is a prolific source of some of the gravest forms of +disease. Prostatorrhea, spermatorrhea, impotency, hypochondria, and +general debility of the generative organs, arise from sexual excesses. + +The health of the reproductive organs can only be maintained by leading +a _temperate_ life. The food should be nourishing but not stimulating. +Lascivious thoughts should be banished from the mind, and a taste +cultivated for that literature which is elevating in its nature, and the +associations should be refining and ennobling. Let these conditions and +the rules of hygiene, be observed, and virtue will reward her subjects +with a fine physique and a noble character. + +Woman, from the nature of her organization, has less strength and +endurance than man. Much, however, of the suffering and misery which she +experiences arises from insufficient attention to the sexual organs. The +menstrual function is generally established between the ages of twelve +and fourteen. For want of proper instruction, many a girl through +ignorance HAS caused derangements which have enfeebled her womanhood or +terminated her life. At this critical period the mother cannot be too +considerate of her daughter's health. Preceding the first appearance of +the menses, girls usually feel an aching in the back, pains in the +limbs, chilliness, and general languor. The establishment of this +function relieves these symptoms. Every precaution should be taken +during the period to keep the feet dry and warm, to freely maintain a +general circulation of the blood, to avoid exertion, and to refrain from +standing or walking too much. Menstrual derangements should never be +neglected, for they predispose to affections of the brain, liver, heart, +and stomach, induce consumption and frequently end in death. Young women +should, therefore, properly protect themselves, and avoid extremes of +heat and cold. + + * * * * * + + + + +CHAPTER V. + +PRACTICAL SUMMARY OF HYGIENE. + + +1. The first step which should be taken for the prevention of disease, +is to make provision for the health of the unborn child. Greater care +should be exercised with women who are in a way to become mothers. Those +who are surrounded by all the luxuries which health can bestow, indulge +too much in rich food, and take too little exercise; while the poor get +too little nourishment, and work too hard and too long. A woman in this +condition should avoid over-exertion, and all scenes which excite the +passions or powerful emotions. She should take moderate exercise in the +open air; eat moderately of wholesome food, and of meat not oftener than +twice a day; take tea or coffee in limited quantities, and avoid the use +of all alcoholic liquors; she should go to bed early and take not less +than nine hours sleep; her clothing should be loose, light in weight, +and warm. She should take every precaution against exposure to +contagious or infectious diseases. + +2. There is no better method for preventing the spread of contagious +diseases than perfect isolation of the infected, and thorough +disinfection of all articles of clothing or bedding which have been in +contact with the infected. Many persons erroneously believe that every +child must necessarily have the measles, and other contagious diseases, +and they, therefore, take no precautions against the exposure of their +children. The liability to infection diminishes as age advances, and +those individuals are, as a rule, the strongest and best developed who +have never suffered from any of the contagious diseases. Although, +vaccination is the great safeguard against-pox, yet it should never +prevent the immediate isolation of those who are suffering from this +disease. + +3. To avoid the injurious effects of impure air, the following rules, +should be carefully observed. The admission of air which contains +anything that emits an unpleasant odor into closed rooms should be +avoided. The temperature of every apartment should be kept as near 70° +Fahr. as possible, and the air should not be overcharged with watery +vapor. Provisions should be made for the free admission into and escape +of air from the room at all times. When an apartment is not in use, it +should be thoroughly ventilated by opening the windows. Those who are +compelled to remain in an atmosphere tilled with dust, should wear a +cotton-wool respirator. + +4. To insure a healthy condition of the body, the diet of man ought to +be varied, and all excesses should be avoided. The total amount of solid +food taken in the twenty-four hours should not exceed two and a half +pounds, and not more than one-third of this quantity should consist of +animal food. Many persons do not require more than one pound and a half +of mixed food. To avoid parasitic diseases, meat should not be eaten +rare, especially pork. The amount of drink taken should not be more than +three pints in twenty-four hours. The excessive use of tea and coffee +should be avoided. Pickles, boiled cabbage, and other indigestible +articles should never be eaten. + +5. To avoid the evil effects of alcoholic liquors, perfect abstinence is +the only safe course to pursue. Although one may use spirituous liquors +in moderation for a long period of time and possibly remain healthy, yet +such an indulgence is unnecessary and exceedingly dangerous. A person +who abstains entirely from their use is safe from their pernicious +influence; a person who indulges ever so moderately is in danger; a +person who relies on such stimulants for support in the hour of need is +lost. + +6. While the use of tobacco is less pernicious than alcohol in its +effects, et it exerts a profound disturbing influence upon the nervous +system, and gives rise to various functional and organic diseases. This +is the verdict of those who have given the subject the most study, and +who have had the best opportunities for extensive observation. Suddenly +fatal results have followed excesses in the use of tobacco. Therefore, +the habit should be avoided, or if already acquired, it should be +immediately abandoned. + +7. The clothing should be light and porous, adapted in warmth to the +season. It is especially important that persons in advanced life should +be well protected against vicissitudes of heat and cold. Exposure is the +cause of almost all those inflammatory diseases which occur during +winter, and take off the feeble and the aged. The under-garments should +be kept scrupulously clean by frequent changes. Corsets or bands which +impede the flow of blood, compress the organs of the chest or abdomen, +or restrict the movements of the body, are very injurious, and should +not be worn. Articles of dress which are colored with irritating +dye-stuffs, should be carefully avoided. + +8. It matters not how varied a person's vocation may be, change, +recreation, and rest are required. It is an error to suppose that more +work can be done by omitting these. No single occupation which requires +special mental or physical work, should be followed for more than eight +hours out of the twenty-four. The physical organism is not constructed +to run its full cycle of years and labor under a heavier burden than +this. Physical and mental exercise is conducive to health and longevity, +if not carried too far. It is erroneous to suppose that excessive +physical exertion promotes health. Man was never intended to be a +running or a jumping machine. In mental work, variety should be +introduced. New work calls into play fresh portions of the brain, and +secures repose for those parts which have become exhausted. Idleness +should be avoided by all. Men should never retire from business as long +as they enjoy a fair degree of health. Idleness and inactivity are +opposed to nature. + +9. The average length of time which a person ought to sleep is eight +hours out of the twenty-four, and, as a rule, those who take this amount +enjoy the best health. The most favorable time for sleep is between the +hours of 10 P.M. and 6 A.M. All excitement, the use of stimulants, and +excessive fatigue tend to prevent sleep. Sleeping rooms should be well +ventilated, and the air maintained at a equable temperature of as near +60° Fahr. as possible. An inability to sleep at the proper time, or a +regular inclination to sleep at other than the natural hours for it, is +a certain indication of errors of habit, or of nervous derangement. + +10. Prominent among all other measures for the maintenance of Health, is +personal cleanliness. Activity in the functions of the skin is essential +to perfect health, and this can only be secured by thoroughly bathing +the entire body. Strictly, a person should bathe once every twenty-four +or forty-eight hours. The body should be habituated to contact with cold +water at all season of the year, so that warm water may not become a +necessity. The simplest and most convenient bath, is the ordinary +sponge-bath. An occasional hot-air, or Turkish bath, exerts a very +beneficial influence. It cleans out the pores of the skin and increases +its activity. + +11. The emotions and the passions exert a powerful influence over the +physical organism. It is important, therefore, that they be held under +restraint by the reasoning faculties. This rule applies equally to joy, +fear, and grief; to avarice, anger, and hatred; and, above all, to the +sexual passion. They are a prolific source of disease of the nervous +system, and have caused the dethronement of some of the most gifted +intellects. + + * * * * * + + + + +PART III. + +RATIONAL MEDICINE. + + + + +CHAPTER I. + +THE PROGRESS OF MEDICINE. + + +During the last half century a great change has taken place in the +treatment of disease. Medicine has advanced with rapid strides, from the +narrow limits of mere empiricism, to the broader realm of rationalism, +until to day it comprehends all the elements of an art and a science. +Scientific researches and investigations have added many valuable truths +to the general fund of medical learning, but much more has been effected +by observation and empirical discovery. It is of little or no interest +to the invalid to know whether the prescribed remedy is organic or +inorganic, simple, compound, or complex. In his anxiety and distress of +body, he seeks solely for relief, without regard to the character of the +remedial agents employed. But this indifference on the part of the +patient does not obviate the necessity for a thorough, scientific +education on the part of the practitioner. Notwithstanding all the laws +enacted to raise the standard of medicine, and thus protect the public +from quackery, there yet exists a disposition among many to cling to all +that savors of the miraculous, or supernatural. To insure the future +advancement of the healing art, physicians must instruct mankind in +Physiology, Hygiene, and Medicine. When the people understand the nature +of diseases, their causes, methods of prevention and cure, they will not +be easily deceived, and practitioners will be obliged to qualify +themselves better for their labors. The practice of medicine is every +year becoming more successful. New and improved methods of treating +disease are being discovered and developed, and the conscientious +physician will avail himself of _all_ the means, by a knowledge of which +he may benefit his fellow-men. The medical profession is divided into +three principal schools, or sects. + + +THE ALLOPATHIC, REGULAR, OR OLD SCHOOL OF MEDICINE. + + +This is the oldest existing branch of the profession. To it is due the +credit of collecting and arranging the facts and discoveries which form +the foundation of the healing art. It has done, and is doing, much to +place the science of medicine on a firm basis. To the text-books of this +school, every student who would qualify himself for medical practice +must resort, to gain that knowledge upon which depends his future +success. The early practice of this branch of the profession was +necessarily crude and empirical. Conservative in its character, it has +ever been slow to recognize new theories and methods of practice, and +has failed to adopt them until they have been incontrovertibly +established. This conservatism was manifested in the opposition to +Harvey when he propounded the theory of the circulation of the blood, +and to Jenner when he discovered and demonstrated the beneficial effects +of vaccination. Thus has it ever defended its established opinions +against innovation; yet out of this very conservatism has grown much +real good, for, although it has wasted no time or energy in the +investigation of theories, yet it has accepted them when established. In +this manner it has added to its fund of knowledge only those truths +which are of real and intrinsic value. + +The history of medicine may be divided into three eras. In the first, +the practice of medicine was merely empiricism. Ignorant priests or +astrologers administered drugs, concerning the properties of which they +had no knowledge, to appease the wrath of mythological deities. In the +second or heroic era, the lancet, mercury, antimony, opium, and the +blister were employed indiscriminately as the _sine qua non_ of medical +practice. The present, with all its scientific knowledge of the human +structure and functions, and its vast resources for remedying disease +may be aptly termed the liberal era of medicine. The allopathic differs +from the other schools, mainly in the application of remedies. In its +ranks are found men, indefatigable in their labors, delving deep into +the mysteries of nature, and who, for their scientific attainments and +humane principles are justly considered ornaments to society and to +their profession. + + +HOMOEOPATHY. + + +Although this school is of comparatively recent origin, yet it has +gained a powerful hold upon the public favor, and numbers among its +patrons very many intelligent citizens. This fact alone would seem to +indicate that it possesses some merit. The homeopathic differs from the +allopathic school principally in its _"law of cure,"_ which, according +to Hahnemann, its founder, was the doctrine of _"similia similibus +curantur"_ or "like cures like." Its method of treatment is founded upon +the assumption that if a drug be given to a healthy person, symptoms +will occur which, if transpiring in disease, would be mitigated by the +same drug. While it may be exceedingly difficult for a member of another +school to accept this doctrine and comprehend the method founded upon +it, yet no one can deny that it contains some elements of truth. + +Imbued with the spirit of progress, many of its most intelligent and +successful practitioners have resorted to the use of appreciable +quantities of medicine. This school associates hydropathy with its +practice, and usually inculcates rigid dietetic and hygienic +regulations. Many homoeopathic remedies are thoroughly triturated with +sugar of milk, which renders them more palatable and efficacious. +Whether we attribute their cures to the infinitesimal doses which many +homoeopathists employ, to their "law of cure," to good nursing, or to +the power of nature, it is nevertheless true that their practice is +measurably successful. No doubt the homoeopathic practice has modified +that of the other schools, by proving that diseases may be alleviated by +smaller quantities of medicine than were formerly employed. + + +THE ECLECTIC SCHOOL. + + +This school, founded by Wooster Beach, instituted the most strenuous +opposition to the employment of mercury, antimony, the blister, and the +lancet. The members of this new school proclaimed that the action of +heroic and noxious medicines was opposed to the operation of the vital +forces, and proposed to substitute in their place safer and more +efficacious agents, derived exclusively from the vegetable kingdom. The +eclectics have investigated the properties of indigenous plants and have +discovered many valuable remedies, which a kind and bounteous nature has +so generously supplied for the healing of her children. Marked success +attended the employment of these agents. In 1852, a committee on +"Indigenous Medical Botany," appointed by the "American Medical +Association," acknowledged that the practitioners of the regular school +had been extremely ignorant of the medical virtues of plants, even of +those of their own neighborhoods. The employment of podophyllin and +leptandrin as substitutes for mercurials has been so successful that +they are now used by practitioners of all schools. Although claiming to +have been founded upon liberal principles, it may be questioned whether +its adherents have not been quite as exclusive and dogmatic as those +whom they have opposed. It cannot be denied, however, that the eclectics +have added many important remedies to the Materia Medica. Their writings +are important and useful contributions to the physician's library. + + +THE LIBERAL AND INDEPENDENT PHYSICIAN. + + +After this brief review of the various medical sects, the reader may be +curious to learn to what sect the physicians of the Invalids' Hotel and +Surgical Institute belong. Among them are to be found graduates from the +colleges of all the different schools. They are not restricted by the +tenets of any one sect, but claim the right and privilege, nay, consider +it a duty, to select from all, such remedies as careful investigation, +scientific research, and an extensive experience, have proved valuable. +They resort to any and every agent which has been proved efficacious, +whether it be vegetable or mineral. + +And here arises a distinction between _sanative_ remedial agents and +those which are _noxious_. Many practitioners deplore the use of +poisons, and advocate innocuous medicines which produce only curative +results. We agree with them in one proposition, namely, that improper +medicines not only poison, but frequently utterly destroy the health and +body of the patient. Every physician should keep steadily in view the +final effects, as well as present relief, and never employ any agent +without regard to its ulterior consequences. However, an agent which is +noxious in _health_, may prove a valuable remedy in _disease_. When +morbid changes have taken place in the blood and tissues, when a general +diseased condition of the bodily organs has occurred, then an agent, +which is poisonous in health, may prove curative. For instance it is +admitted that alcohol is a poison; that it prevents healthful +assimilation, solidifies pepsin, begets a morbid appetite; that it +produces intoxication, and that its habitual use destroys the body. It +is, therefore, neither a hygienic nor a sanative agent, but strictly a +noxious one; yet, its very distinct antiseptic properties render it +valuable for remedial purposes, since these qualities promptly arrest +that fatal form of decomposition of the animal fluids which is +occasioned by snake-venom, which produces its deadly effects in the same +manner as a drop of yeast ferments the largest mash. Alcohol checks this +poisonous and deadly process and neutralizes its effects. Thus, alcohol, +although a noxious agent, possesses a special curative influence in a +morbid state of the human system; but its general remedial effects do +not entitle it to the rank of a hygienic agent. We believe that medicine +is undergoing a gradual change from the darkness of the past, with its +ignorance, superstition, and barbarism, to the light of a glorious +future. At each successive step in the path of progress, medicine +approaches one degree nearer the realm of an exact science. The common +object of the practitioners of all medical schools is the alleviation of +human suffering. The only difference between the schools is in the +remedies employed, the size of dose administered, and the results +attained. These are insufficient grounds for bitter sectarianism. We are +all fellow laborers in the same field. Before us lies a boundless +expanse for exploration. There are new conditions of disease to be +learned, new remedies to be discovered, and new properties of old ones +to be examined. + +We do not deplore the fact, that there are different schools in +medicine, for this science has not reached perfection, and they tend to +stimulate investigation. The remarks of Herbert Spencer on the +"Multiplication of Schemes of Juvenile Culture," may be pertinently +applied to the different schools in medicine with increased force. He +says: "It is clear that dissent in education results in facilitating +inquiry by the division in labor. Were we in possession of the true +method, divergence from it would, of course, be prejudicial; but the +true method having to be found, the efforts of numerous independent +seekers carrying out their researches in different directions, +constitute a better agency for finding it than any that could be +devised. Each of them struck by some new thought which probably contains +more or less of basis in facts--each of them zealous on behalf of his +plan, fertile in expedients to test its correctness, and untiring in its +efforts to make known its success--each of them merciless in its +criticism on the rest--there cannot fail, by composition of forces, to +be a gradual approximation of all towards the right course. Whatever +portion of the normal method any one of them has discovered, must, by +the constant exhibition of its results, force itself into adoption; +whatever wrong practices he has joined with it must, by repeated +experiment and failure, be exploded. And by this aggregation of truths +and elimination of errors, there must eventually be developed a correct +and complete body of doctrine. Of the three phases through which human +opinion passes--the unanimity of the ignorant, the disagreement of the +inquiring, and the unanimity of the wise--it is manifest that the second +is the parent of the third." + +We believe the time is coming when those maladies which are now +considered fatal will be readily cured--when disease will be disarmed of +its terrors. To be successful, a physician must be independent, free +from all bigotry, having no narrow prejudice against his fellow-men, +liberal, accepting new truths from whatever source they come, free from +restrictions of societies, and an earnest laborer in the interests of +the Great Physician. + + * * * * * + + + + +CHAPTER II. + +REMEDIES FOR DISEASE. + + +It will be our aim, throughout this book, to prescribe such remedies as +are within the easy reach of all, and which may be safely employed. Many +of those of the vegetable class are indigenous to this country, and may +be procured in their strength and purity, at the proper season, by those +residing in the localities where they grow, while all others advised may +be obtained at any good drug-store. We shall endeavor to recommend such +as can be procured and prepared with the least trouble and expense to +the patient, when it is believed that they will be equally as +efficacious as more expensive medicines. + + +PROPRIETARY MEDICINES. + + +Having the invalid's best interests in view, it will often happen that +we cannot prescribe better or cheaper remedies nor those which are more +effective or easily obtained, than some of our standard preparations, +which are sold by all druggists. We are aware that there is a popular, +and not altogether unfounded prejudice against "patent medicines," owing +to the small amount of merit which many of them possess. The term +"Patent Medicine" does not apply to Dr. Pierce's remedies, as no patent +has ever been asked or obtained for them, nor have they been urged upon +the public as "cure alls." They are simply favorite prescriptions, +which, in a very extensive practice, have proved their superior remedial +virtues in the cure of the diseases for which they are recommended. + +From the time of Hippocrates down to the present day, physicians have +classified diseases according to their causes, character or symptoms. It +has been proved that diseases apparently different may often be cured by +the same remedy. The reason for this singular fact is obvious. A single +remedy may possess a variety of properties. Quinine, among other +properties has a tonic which suggests its use in cases of debility; an +antiperiodic, which renders it efficient in ague; and an anti-febrile +property, which renders it efficacious in cases of fever. The result +produced varies with the quantity given, the time of its administration, +and the circumstances under which it is employed. Every practicing +physician has his favorite remedies, which he oftenest recommends or +uses, because he has the greatest confidence in their virtues. The +patient does not know their composition. Even prescriptions are usually +written in a language unintelligible to anybody but the druggist. As +much secrecy is employed as in the preparation of proprietary medicines. +Does the fact that an article is prepared by a process known only to the +manufacturer render that article less valuable? How many physicians know +the elementary composition of the remedies which they employ, some of +which never have been analyzed? Few practitioners know how morphine, +quinine, podophyllin, leptandrin, pepsin, or chloroform, are made, or +how nauseous drugs are transformed into palatable elixirs; yet they do +not hesitate to employ them. Is it not inconsistent to use a +prescription the composition of which is unknown to us, and discard +another preparation simply because it is accompanied by a printed +statement of its properties with directions for its use? + +Various journals in this country, have at different times published +absurd formulae purporting to be receipts for the preparation of "Dr. +Sage's Catarrh Remedy" and Dr. Pierce's standard medicines, which, in +most instances, have not contained a single ingredient which enters into +the composition of these celebrated remedies. + +In the manufacture of any pharmaceutical preparation, two conditions are +essential to its perfection, viz: purity and strength of the materials, +and appropriate machinery. The first is insured, by purchasing the +materials in large quantities, whereby the exercise of greater care in +selecting the ingredients can be afforded; and the second can only be +accomplished where the business is extensive enough to warrant a large +outlay of capital in procuring proper chemical apparatus. These facts +apply with especial force to the manufacture of our medicines, their +quality having been vastly improved since the demand has become so great +as to require their manufacture in very large quantities. Some persons, +while admitting that our medicines are good pharmaceutical compounds, +object to them on the ground that they are too often used with +insufficient judgment. We propose to obviate that difficulty by +enlightening the people as to the structure and functions of their +bodies, the causes, character, and symptoms of disease, and by +indicating the proper and judicious employment of our medicines, +together with such auxiliary treatment as may be necessary. Such is one +of the designs of this volume. + + +PROPERTIES OF MEDICINE. + + +It is generally conceded that the action of a remedy upon the human +system depends upon properties peculiar to it. The effects produced +suggest the naming of these qualities, which have been scientifically +classified. We shall name the diseases from their characteristic +symptoms, and then, without commenting upon all the properties of a +remedy, recommend its employment. Our reference to the qualities of any +remedy, when we do make a particular allusion to them, we shall endeavor +to make as easy and familiar as possible. + +DOSE. All persons are not equally susceptible to the influence of +medicines. As a rule, women require smaller doses than men, and children +less than women. Infants are very susceptible to the effects of +anodynes, even out of all relative proportion to other kinds of +medicines. The circumstances and conditions of the system increase or +diminish the effects of medicine, so that an aperient at one time may +act as a cathartic at another, and a dose that will simply prove to be +an anodyne when the patient is suffering great pain will act as a +narcotic when he is not. This explains why the same dose often affects +individuals differently. The following table is given to indicate the +size of the dose, and is graduated to the age. + + YEARS DOSE + 21. . . . . . . . . .full + 15. . . . . . . . . . 2-3 + 12. . . . . . . . . . 1-2 + 8 . . . . . . . . . . 1-3 + 6 . . . . . . . . . . 1-4 + 4 . . . . . . . . . . 1-6 + 2 . . . . . . . . . . 1-8 + 1 . . . . . . . . . . 1-12 + ½ . . . . . . 1-20 to 1-30 + +The doses mentioned in the following pages are those for adults, except +when otherwise specified. + +THE PREPARATION OF MEDICINES. The remedies which we shall mention for +domestic use are mostly vegetable. Infusions and decoctions of these +will often be advised on account of the fact that they are more +available than the tinctures, fluid extracts, and concentrated +principles, which we prefer, and almost invariably employ in our +practice. Most of these medical extracts are prepared in our chemical +laboratory under the supervision of a careful and skilled pharmaceutist. +No one, we presume, would expect, with only a dish of hot water and a +stew-kettle, to equal in pharmaceutical skill the learned chemist with +all his ingeniously devised and costly apparatus for extracting the +active, remedial principles from medicinal plants. Yet infusions and +decoctions are not without their value; and from the inferior quality of +many of the fluid extracts and other pharmaceutical preparations in the +market, it may be questioned whether the former are not frequently as +valuable as the latter. So unreliable are a majority of the fluid +extracts, tinctures, and concentrated, active principles found in the +drug-stores, that we long since found it necessary to have prepared in +our laboratory, most of those which we employ. To the reliability of the +preparations which we secure in this way we largely attribute our great +success in the treatment of disease. Tinctures and fluid extracts are +often prepared from old and worthless roots, barks, and herbs which have +wholly lost their medicinal properties. Yet they are sold at just as +high prices as those which are good. We manufacture our tinctures, fluid +extracts, and concentrated, active principles from roots, barks, and +herbs which are fresh, and selected with the greatest care. Many of the +crude roots, barks, and herbs found in the market are inactive because +they have been gathered at the wrong season. These, together with those +that have been kept on hand so long as to have lost all medicinal value, +are often sold in large quantities, and at reduced prices, to be +manufactured into fluid extracts and tinctures. Of course, the +preparations made from such materials are worthless. Whenever the dose +of fluid extracts, tinctures, and concentrated, active principles, is +mentioned in this chapter, the quantity advised is based upon our +experience in the use of these preparations, as they are made in our +laboratory, and the smallest quantity which will produce the desired +effect is always given. When using most of the preparations found in the +drug-stores, the doses have to be somewhat increased, and even then they +will not always produce the desired effect, for reasons already given. + +THE LIST OF MEDICINES which we shall introduce in this chapter will be +quite limited, as we cannot hope, by making it extensive, that the +non-professional reader would be able to prescribe with good judgment +any other than the simpler remedies. Hence, we prefer, since we have not +space in this volume to waste, to mention only a few of the most common +remedies under each head or classification. + +TINCTURES. Very uniform and reliable tinctures may be made of most +indigenous plants, by procuring the part to be employed, at the proper +season, while it is green and fresh, bruising it well, and covering it +with good strong whiskey, or with alcohol diluted with one part of water +to three of alcohol, corking tightly, and letting it stand about +fourteen days, when the tincture may be filtered or poured off from the +drugs, and will be ready for use. Prepared in this imperfect manner, +they rill be found to be much more reliable than any of the fluid +extracts found in the drug-stores. An excess of the crude drug should be +used in preparing the tincture to insure a perfect saturation of the +alcohol with its active principles. + +HOMOEOPATHIC TINCTURES. The tinctures prepared by several of the German +and French pharmaceutists, and called by them "Mother Tinctures," to +distinguish them from the dilutions made therefrom, we have found to be +very reliable, so much superior to any similar preparations made in this +country that we purchase from them all we use of Pulsatilla, +Staphisagria, Drosera and several others. They are prepared with great +care from the green, crude material, and although high in price, when +compared with other tinctures, yet the greater certainty of action which +we secure in our prescriptions by their employment more than repays for +the expense and trouble in procuring them, for of what account is +expense to the true physician when _life_ may depend upon the virtue of +the agent he employs? + +INFUSIONS. These are generally made by adding one-half ounce of the +crude medicine to a pint of water, which should be closely covered, kept +warm, and used as directed. Flowers, leaves, barks, and roots become +impaired by age, and it is necessary to increase or diminish the dose +according to the strength of the article employed. + +DECOCTIONS. The difference between a decoction and an infusion is, that +the plant or substance is boiled in the production of the former, in +order to obtain its soluble, medicinal qualities. Cover the vessel +containing the ingredients, thus confining the vapor, and shutting out +the atmospheric air which sometimes impairs the active principles and +their medicinal qualities. The ordinary mode of preparing a decoction is +to use one ounce of the plant, root, bark, flower, or substance to a +pint of water. The dose internally varies from a tablespoonful to one +ounce. + + +ALTERATIVES. + + +Alteratives are a class of medicines which in some inexplicable manner, +gradually change certain morbid actions of the system, and establish a +healthy condition instead. They stimulate the vital processes to renewed +activity, and arouse the excretory organs to remove matter which ought +to be eliminated. They facilitate the action of the secretory glands, +tone them up, and give a new impulse to their operations, so that they +can more expeditiously rid the system of worn-out and effete materials. +In this way they alter, correct, and purify the fluids, tone up the +organs, and re-establish their healthy functions. Alteratives may +possess tonic, laxative, stimulant, or diuretic properties all combined +in one agent. Or we may combine several alteratives, each having only +one of these properties in one remedy. We propose to enumerate only a +few alteratives, and give the doses which are usually prescribed; the +list which we employ in our practice is very extensive, but it cannot be +made available for domestic use. + +MANDRAKE (_Podophyllum Peltatum_), also called May-apple, is a most +valuable alterative. The root is the part used. _Dose_--Of decoction, +one to two teaspoonfuls; of tincture, six to eight drops; of fluid +extract, three to five drops; of its active principle, Podophyllin, +one-twelfth to one-eighth of a grain. + +POKE (_Phytolacca Decandra_), also called Skoke, Garget, or +Pigeon-berry, is a valuable alterative. The root is the part used. +_Dose_--Of decoction, one to three teaspoonfuls; of fluid extract, three +to ten drops; of concentrated principle, Phytolaccin, one-fourth to one +grain. + +YELLOW DOCK (_Rumex Crispus_), The part used is the root. _Dose_--Of the +infusion, one to three fluid ounces three times daily; of fluid extract, +ten to thirty drops; of tincture twenty to forty drops. + +[Illustration: Fig. 113. +Tag Alder. ] + +TAG ALDER (_Alnus Rubra_), This is otherwise known as the Smooth, +Common, or Swamp Alder. The bark is the part used. It is excellent in +scrofula, syphilis, cutaneous and all blood diseases. _Dose_--Of +decoction, one or two tablespoonfuls from three to five times daily; of +tincture, one or two teaspoonfuls; of fluid extract, one-half to one +teaspoonful; of concentrated principle, Alnuin, one-half to one grain. + +[Illustration: Fig. 114. +Black Cohosh. ] + +BLACK COHOSH (_Macrotys or Cimicifuga Racemosa_) The part used is the +root. Its other common names are Black Snake-root, or Squaw-root. Black +Cohosh is an alterative stimulant, nervine, diaphoretic, tonic, and a +cerebro-spinal stimulant. It is a useful remedy. _Dose_--Of decoction, +one-fourth to one ounce; of tincture, ten to fifteen drops; of fluid +extract, five to ten drops; of the concentrated principle, Macrotin, +one-eighth to one-half grain. + +[Illustration: Fig. 115. +Blood-root. ] + +BLOOD-ROOT (_Sanguinaria Canadensis_), is also known as Red Puccoon. The +part used is the root. In minute doses Blood-root is a valuable +alterative, acting upon the biliary secretion and improving the +circulation and digestion. _Dose_--Of powdered root, one-fourth to +one-half grain; of tincture, one to two drops; of the fluid extract, +one-half to one drop. When given in a fluid form it should be well +diluted. + +BURDOCK (_Arctium Lappa_). The root is the part used. Burdock is a +valuable alterative in diseases of the blood. _Dose_--Of tincture, from +one teaspoonful to a tablespoonful twenty minutes before meals; of fluid +extract, one to two teaspoonfuls. + +BLUE FLAG (_Iris Versicolor_). The part used is the root. _Dose_--Of the +tincture, five to ten drops; of fluid extract, three to ten drops; of +concentrated principle, Iridin, one-half to two grains. + +SWEET ELDER (_Sambucus Canadensis_). Sweet Elder-flowers are a valuable +alterative, diuretic, mucous and glandular stimulant, excellent in +eruptive, cutaneous, and scrofulous diseases of children. An infusion, +fluid extract, or syrup, may be used in connection with the "Golden +Medical Discovery." Both will be found valuable for cleansing the blood +and stimulating the functions to a healthy condition. _Dose_--Of the +infusion of the flowers, from one-half to one ounce, if freely taken, +will operate as a laxative; of fluid extract, one-fourth to one-half +teaspoonful. The flowers, or inner bark of the root, simmered in fresh +butter, make a good ointment for most cutaneous affections. + +IODINE. This agent, in the several forms of Iodide of Potassium, Iodide +of Ammonium, Iodide of Iron, and Iodide of Lime, is largely employed by +physicians, and often with most happy results. But for domestic use we +cannot advise its employment, as it is liable to injure the invalid, +when its action is carried too far, which is apt to be the case, when +not administered under the supervision of a competent physician. + +MERCURY. The various preparations of mercury have a profound, alterative +effect upon the system. When taken for some time, they change the +quality and composition of the blood; cause a diminution in the number +of red blood-corpuscles, and an increase in the various effete +materials. In the vast majority of cases we prefer the vegetable +alteratives, but in rare instances they exert a beneficial influence, in +small doses. None of the preparations of mercury should be taken +internally without the advice of a skillful physician, therefore, we +shall not give their doses. + + +THE COMPOUNDING OF ALTERATIVES. + + +The efficacy of this class of remedies can be greatly increased by +properly combining several of them into one compound. + +This requires a knowledge of Pharmaceutical Chemistry; i.e., the +preparation of compounds founded on the chemical relation and action of +their several remedial, active principles. Many practitioners make +combinations of remedies which neutralize each other's influence, +instead of extending their efficacy and curative power. + +DR. PIERCE'S "GOLDEN MEDICAL DISCOVERY," or Alterative Extract. This +compound is a highly nutritive and tonic preparation, combining the +remedial properties of the best vegetable alteratives at present known +to the medical profession. In perfecting this alterative compound, and +likewise other standard preparations of medicine, we have made an outlay +of many thousand dollars for chemical apparatus, and special machinery +by the aid of which these remedies have been brought to their present +perfection. Great pains are taken to obtain the materials at the right +season of the year, properly cured so that none of their remedial +qualities may be impaired. We, therefore, can with great confidence +recommend Dr. Pierce's "Golden Medical Discovery" as one of the best +preparations of the alterative class. Like all others of this type, its +action is insensible, producing gradual changes, arousing the excretory +glands to remove morbid materials, and at the same time toning the +secretory organs. The manufacture of this compound is under the special +supervision of a competent chemist and pharmaceutist, and it is now put +up in bottles wrapped with full directions for its use. We can +confidently recommend this compound whenever an alterative is required +to cleanse the blood, tone the system, increase its nutrition, and +establish a healthy condition. For these reasons we shall often advise +its employment. + +DR. PIERCE'S PLEASANT PURGATIVE PELLETS. These pellets combine the pure, +concentrated, active principles of several vegetable alteratives, and +the result is, that within the small compass of a few grains he has most +happily blended and chemically condensed these properties so that their +action upon the ANIMAL ECONOMY is sanative and universal. They awaken +the latent powers, quicken the tardy functions, check morbid deposits, +dissolve hard concretions, remove obstructions, promote depuration, +harmonize and restore the functions, equalize the circulation, and +encourage the action of the nervous system. They stimulate the glands, +increase the peristaltic movement of the intestines, tone the nutritive +processes, while aiding in evacuating the bowels. All this they +accomplish without corroding the tissues or vitiating the fluids. Their +assistance is genial, helping the system to expel worn out materials, +which would become noxious if retained. Having expended their remedial +powers upon the various functions of the body, they are themselves +expelled along with other waste matter, leaving behind them no traces of +irritation. This cannot be said of mercurials, or of other harsh, +mineral alteratives. These Pellets may be safely employed when the +system is feeble, frail, and delicate, by giving them in less +quantities. _Dose_--As an alterative, only one or two Pellets should be +taken daily. + + +ALKALIES. + + +ALKALIES. These constitute an important list of remedial agents, their +administration being frequently indicated. The employment of other +medicines frequently should be preceded by the administration of an +agent of this class, to neutralize excessive acidity in the stomach and +bowels. Unless this be done, many medicines will fail to produce their +specific effects. + +SULPHITE OF SODA (_Sodæ Sulphis_). This salt, as well as the +Hyposulphite of Soda, is not only generally preferable for +administration on account of its unirritating character and the +smallness of the dose required, but also because it is a valuable +antiseptic agent. The _Sulphite_ should not be confounded with the +_Sulphate_ of Soda (Glauber's Salt). _Dose_--This is from three to ten +grains. + +SALERATUS (_Potassæ Bicarbonas_). This is a favorite domestic antacid. +_Dose_--Five to fifteen grains is the amount. + + +ACIDS. + + +As alkalies are important and often indicated as remedial agents, acids, +so their re-agents, acids, are also frequently necessary to meet +opposite conditions of the fluids of the system. + +HYDROCHLORIC OR MURIATIC ACID. This agent may be administered in doses +of from five to ten drops, largely diluted in water or gruel. + +AROMATIC SULPHURIC ACID, or Elixir of Vitriol, is the most agreeable +form of Sulphuric Acid for administration, and may be given in doses of +from five to fifteen drops, largely diluted with water. + +In taking acids, they should be sucked through a straw, and not allowed +to come in contact with the teeth, as otherwise the latter organs will +be injured by their effects; or should the acid come in contact with the +teeth, the mouth should be immediately rinsed with a solution of +saleratus or soda, to neutralize the acid. + + +ANODYNES. + + +Anodynes are those medicines which relieve pain by blunting the +sensibility of the nerves, or of the brain, so that it does not +appreciate the morbid sensation. An anodyne may be a stimulant in one +dose, and a narcotic in a larger one. The properties of different +anodyne agents vary, consequently they produce unlike effects. The size +of the dose required, differs according to circumstances and condition. +An adult, suffering acute pain, requires a much larger dose to produce +an anodyne effect than one who is a chronic sufferer. An individual +accustomed to the use of anodynes, requires a much larger dose to +procure relief than one who is not. Doses may be repeated, until their +characteristic effects are produced, after an interval of thirty or +forty minutes. When the stomach is very sensitive and will not tolerate +their internal administration, one-sixth of a grain of Morphia can be +inserted beneath the skin, by means of a hypodermic syringe. Relief is +more quickly experienced, and the anodyne effect is much more lasting +than when taken into the stomach. + +OPIUM (_Papaver Somniferum)._ Opium is a stimulant, anodyne, or +narcotic, according to the size of the dose administered. _Dose_--Of the +dry powder, one-fourth to one grain; of tincture (Laudanum), five to +fifteen drops; of camphorated tincture (Paregoric), one-half to one +teaspoonful; of + +Morphine, one-eighth to one-fourth grain; of Dover's Powder three to +five grains. + +HYOSCYAMUS (_Hyoscyamus Niger_), commonly known as Henbane. The herb is +used. It is a powerful narcotic, and unlike Opium, does not constipate +the bowels, but possesses a laxative tendency. Therefore, it may be +employed as an anodyne for allaying pain, calming the mind, inducing +sleep and arresting spasms, when opiates are inadmissible. _Dose_--Of +alcoholic extract, one-half to two grains; of fluid extract, five to ten +drops; of the concentrated principle, Hyoscyamin, one-twelfth to +one-fourth of a grain. + +[Illustration: Fig. 116. +Poison Hemlock. ] + +POISON HEMLOCK (_Conium Maculatum_). The leaves are the parts used. +Poison Parsley, as it is sometimes called, is an anodyne, narcotic, and +an excellent alterative. _Dose_--Of fluid extract, two to six drops; of +solid extract, one-fourth to one-half grain. + +BELLADONNA (_Atropa Belladonna_) or Deadly Nightshade. The herb or +leaves are a valuable agent. In overdoses, it is an energetic, narcotic +poison. In medicinal doses it is anodyne, antispasmodic, diaphoretic, +and diuretic. It is excellent in neuralgia, epilepsy, mania, amaurosis, +whooping-cough, stricture, rigidity of the os uteri, and is supposed by +some to be a prophylactic or preventive of Scarlet Fever. Its influence +upon the nerve centers is remarkable. It relaxes the blood vessels on +the surface of the body and induces capillary congestion, redness of the +eye, scarlet appearance of the face, tongue, and body. _Dose_--Of fluid +extract, one-half to one drop; of tincture, one to two drops; of +concentrated principle, Atropin, one-thirtieth to one-sixteenth of a +grain; of the _Alkaloid, Atropia_, one-sixtieth of a grain. Even the +most skillful chemists are very cautious in compounding these latter +active principles, and the danger of an overdose is great. + +CAMPHOR. This drug is an anodyne, stimulant, and diaphoretic, and, in +large doses, a narcotic and an irritant. It is an excellent stimulant +for liniments. _Dose_--Of the powder, one to five grains; of the +tincture, ten to twenty drops, given in simple syrup. + +HOPS (_Humulus Lupulus_). This is an excellent remedy in wakefulness, +and may be used when opium is contra-indicated. A bag of the leaves, +moistened with whiskey and placed as a pillow under the head, acts as an +anodyne. _Dose_--Of the infusion of the leaves, from one to four ounces; +of the fluid extract, one-fourth to three-fourths of a teaspoonful; of +the concentrated principle, Humulin, one to three grains. + +DR. PIERCE'S COMPOUND EXTRACT OF SMART-WEED. This anodyne compound is +made by uniting several of the most valuable agents of this class, and +its medicinal qualities are rendered still more efficacious by the +addition of certain stimulating articles. It is free from narcotic +properties which are liable to produce deleterious results, and has been +found to be not only harmless in its action, but very genial and +effectual withal, and most reliable as a stimulant and diaphoretic +remedy. + + +ANTHELMINTICS. + + +Anthelmintic means "against a worm," and is a term employed to designate +those medicines which destroy or expel worms. It means the same as +_Vermifuge_. Little is understood concerning the origin of worms. There +are five distinct varieties described by authors as being more common +than others. There is the long worm, the short, or pin-worm, the +thread-worm, the tape-worm, and the broad tape-worm peculiar to some +countries of Europe. Irritation of the alimentary canal, from whatever +cause usually produces an abundant secretion of mucus, which is thought +to be a condition favorable for their production. Therefore, those +medicines which remove the cause of this irritation tend to diminish the +number, if not to entirely destroy the worms. Some medicines kill the +worms, others expel them alive. The remedies which successfully remove +one kind of worm, have little effect upon another, and to meet these +different conditions, we have a variety of worm-destroying medicines. +The pin-worm, inhabits the rectum, and may be destroyed by injecting +into it a strong solution of salt, or decoction of aloes, and when it is +allowed to pass away, the rectum should be anointed with vaseline, +butter, or lard. The eggs of this worm are developed around the orifice +of the large intestine, and when this latter precaution is not practiced +every time there is a passage from the bowels, they will multiply as +rapidly as they can be destroyed. Generally, vermifuge remedies should +be taken when the stomach is empty, and should be followed by the +administration of a cathartic in two hours after the last dose is +administered. + +SANTONIN. This is decidedly the most reliable anthelmintic known to the +medical profession. It is deservedly a popular remedy for worms, and +when combined with Podophyllin, is very efficacious in removing the +pin-worm. _Dose_--For an adult, two to three grains of the powdered +Santonin, repeated every three hours until four or five doses are taken, +when it should be followed by a cathartic. + +SAGE (_Salvia Officinalis_). Sage is a common and excellent domestic +remedy for worms. Make an infusion of Sage and Senna leaves, and drink +freely until it acts as a cathartic. + +[Illustration: Fig. 117. +Pink Root.] + +PINK-ROOT (_Spigelia Marilandica_). Pink-root is one of the most active +and certain anthelmintics for children. It is indigenous to the United +States. When taken in too large quantities, it is apt to purge, give +rise to vertigo, dimness of vision, and even to convulsions; therefore, +it should be combined with some cathartic. _Dose_--Of the infusion, one +ounce at night, followed by physic in the morning. + +COMMON SALT (_Chloride of Sodium_). Common table salt is an +anthelmintic, and may be used in an emergency. Salt water is a very +common domestic remedy for worms. _Dose_--In solution, one-quarter to +one-half teaspoonful. + +BALMONY (_Chelone Glabra_). This is also tonic and anthelmintic, and is +valuable in debility, dyspepsia, jaundice, and hepatic affections. It +also is known as Snake-head. _Dose_--Of the infusion, one to two ounces; +of the concentrated principle, Chelonin, from half to one grain. + +MALE FERN (_Aspidium Filix Mas_). Male Fern is the anthelmintic which is +considered especially effectual in removing the tape-worm. _Dose_--Of +the powder, one to two drachms, given morning and evening in syrup, +followed by a brisk cathartic. The dose of the tincture of the buds in +ether is from eight to thirty drops. + +[Illustration: Fig. 118. +Aspen.] + +POPLAR (_Populus Tremuloides_). The White or Aspen Poplar is a common +tree, and contains active principles termed Populin and Salicin, both of +which are tonic. An infusion of the bark is a remedy for worms. +_Dose_--Of the tea made from the bark, one to four ounces; of Populin, +from one-half to two grains. + + +ANTIPERIODICS. + + +It is well understood that malarial diseases are characterized by a +periodicity which indicates their nature. Antiperiodics prevent the +recurrence of the periodic manifestations, and hence their name. + +QUININE (_Sulphate of Quinia_). Quinine is a tonic, febrifuge, and +antiperiodic. It should generally be administered during the intervals +between the febrile paroxysms. It is beneficial also in all diseases +accompanied by debility. The dose varies from one to six grains +according to indications. Frequently it is given in much larger +quantities, but we cannot advise such for domestic use. + +PRUSSIAN BLUE (_Ferri Ferrocyanidum_). Ferrocyanide of Iron is an +excellent tonic and antiperiodic remedy, and often is combined with +quinine. _Dose_--From two to five grains. + +[Illustration: Fig. 119. +Boneset. ] + +BONESET (_Eupatorium Perfoliatum_), or Thoroughwort. This is tonic, +diaphoretic, aperient, and possesses some antiperiodic properties; the +warm infusion is emetic. _Dose_--Of the infusion, one to four ounces; of +the fluid extract, from half to one teaspoonful; of the active +principle, Eupatorin, one to three grains. + +THE "GOLDEN MEDICAL DISCOVERY" has gained an enviable reputation in +malarial districts for the cure of ague. From observing its action in +the cure of this and other miasmatic diseases, and knowing its +composition, we are thoroughly satisfied that it contains chemical +properties which neutralize and destroy the miasmatic or ague poison +which is in the system, and, at the same time, produces a rapid +excretion of the neutralized poisons. One strong proof of this is found +in the fact that persons who are cured with it are not so liable to +relapse as those in whom the chills are broken with Quinine or other +agents. No bad effects are experienced after an attack of ague which has +been cured with the "Golden Medical Discovery." This cannot be said of +Quinine, Peruvian Bark, Arsenic, and Mercurials, which comprise nearly +the whole list of remedies usually resorted to by physicians for +arresting ague. The "Golden Medical Discovery" not only has the merit of +being a certain antidote for miasmatic diseases, but is pleasant to the +taste, a matter of no small importance, especially when administered to +children. To break the chills, this medicine should be taken in doses of +four teaspoonfuls three times a day, and if this treatment pursued for +three days, does not entirely arrest the chills, these doses may be +repeated in alternation with five-grain doses of quinine for the three +succeeding days. But in no case should more than this amount of the +"Golden Medical Discovery" be given. + + +ANTISEPTICS AND DISINFECTANTS. + + +Antiseptics prevent, while disinfectants arrest putrefaction. Oxygen is +a natural disinfectant, but a powerful inciter of change. Although this +element is the cause of animal and vegetable decay, yet oxidation is the +grand process by which the earth, air, and sea are purified. A few +substances are both antiseptic and disinfectant. Heat up to a +temperature of 140° Fahr. promotes putrescence, but above that point, is +a drier or disorganizer, and destroys the source of infection. + +YEAST (_Cerevisiæ Fermentum_). Yeast is an antiseptic, and is effective +in all diseases in which there is threatened putridity. Used externally, +it is often combined with elm bark and charcoal, and applied to ulcers, +in which there is a tendency to gangrene. _Dose_--One tablespoonful in +wine or porter, once in two or three hours. + +CREASOTE. This is a powerful antiseptic. It is used in a solution of +glycerine, oil, water, or syrup. _Dose_--One to two drops, largely +diluted. + +CARBOLIC ACID is a crystalline substance resembling creasote in its +properties. It is an antiseptic, and is used both internally and +externally. _Dose_--One-fourth to one-half drop of the melted crystals, +very largely diluted. Externally, in solution, one to five grains of the +crystals to one ounce of the solvent. + +WHITE VITRIOL (_Zinci Sulphas_). White vitriol is a valuable +disinfectant, as it will arrest mortification. In solution it is +employed in ulcers and cancers and also as a gargle in putrid sore +throat. _Dose_--One-half to two grains in a pill; in solution, one to +ten grains in an ounce of water. + +PERMANGANATE OF POTASH (_Potassæ Permanganas_). This substance is an +energetic deodorizer and disinfectant. A solution containing from one to +twenty grains in an ounce of water is used as a lotion for foul ulcers. +_Dose_--One-eighth to one-fourth of a grain. + +WILD INDIGO (_Baptisia Tinctoria_). The root is the part used. This +plant possesses valuable antiseptic properties. It is an excellent +lotion for ill-conditioned ulcers, malignant sore throat, nursing +sore-mouth, syphilitic ophthalmia, etc. It is sometimes administered in +scarlet and typhus fevers, and in all diseases in which there is a +tendency to putrescence. _Dose_--Of the infusion, one-fourth to one-half +ounce; of the fluid extract, from three to ten drops, and of the +concentrated, active principle of the plant, Baptisin, from one to two +grains. + + +ANTISPASMODICS. + + +Antispasmodics are a class of remedies which relieve cramps, +convulsions, and spasms, and are closely allied to nervines. Indeed some +authors class them together. The following are a few of the most +important antispasmodics: + +ASSAFETIDA (_Assafetida Ferula_). This is a powerful antispasmodic. It +is employed in hysteria, hypochondria, convulsions, and spasms, when +unaccompanied by inflammation. _Dose_--Of the gum or powder, from three +to ten grains, usually administered in the form of a pill; of the +tincture, from one-half to one teaspoonful. + +[Illustration: Fig. 120. +Yellow Jessamine.] + +YELLOW JESSAMINE (_Gelseminum Sempervirens_). The root is the part used. +This is a valuable remedy in various + +diseases when associated with restlessness and a determination of the +blood to the brain; also in the neuralgia. _Dose_--Of the fluid extract, +three to eight drops; of the concentrated principle, Gelsemin, +one-fourth to one grain. The use of this drug by non-professional +persons should be attended with great caution. + +VALERIAN (_Valeriana Officinalis_). The root is the part used. Valerian +is an effective remedy in cases of nervousness and restlessness. +_Dose_--Of the infusion, (one-half ounce to a pint of water) one-half +ounce; of the tincture, one-half to two tablespoonfuls; of the +ammoniated tincture of valerian, from one-half to two teaspoonfuls in +sweetened water or milk; of the valerianate of ammonia, one-half to +three grains. + +YELLOW LADY'S SLIPPER (_Cypripedium Pubescens_). The root is the part +used. This is a useful remedy in hysteria, chorea, and all cases of +irritability. _Dose_--Of the powder, fifteen to thirty grains; of the +infusion, one ounce; of the fluid extract, fifteen to thirty drops; of +the concentrated principle, Cypripedin, one-half to two grains. + +WILD YAM (_Dioscorea Villosa_). The root is the part used. This is a +powerful antispasmodic, and has been successfully used in bilious colic, +nausea, and spasm of the bowels. _Dose_--Of the infusion (two ounces to +a pint of water), one to two ounces; of the fluid extract, five to +fifteen drops; of the concentrated principle, Dioscorein, one-half to +one grain. + +HIGH CRANBERRY (_Viburnum Opulus._) The bark is the part used. It is +also known as Cramp Bark. This is a powerful antispasmodic, and is +effective in relaxing spasms of all kinds. It is a valuable agent in +threatened abortion. _Dose_--Of the infusion, one-half to one ounce; of +the fluid extract, one-half to one teaspoonful; of the concentrated +principle, Viburnin, one-half to two grains. These doses may be +increased if necessary. + + +ASTRINGENTS. + + +Astringents are medicines which condense and coagulate the tissues, +thereby arresting discharges. When taken into the mouth, they produce +the sensation known as puckering. They are used internally and locally. +The term _styptic_ is used as a synonym of astringent, but is generally +employed to designate those astringents which arrest hemorrhage, or +bleeding. + +LOGWOOD (_Hæmatoxylon Campechianum_). Logwood is a mild astringent, +well adapted to remedy the relaxed condition of the bowels after cholera +infantum. _Dose_--Of powdered extract, five to ten grains; of the +decoction, one ounce; of the fluid extract, fifteen to thirty drops. + +BLACKBERRY ROOT (_Rubus Villosus_). This astringent is a favorite, +domestic remedy in affections of the bowels. _Dose_--Of the infusion +(bruised root), one-half to one ounce, sweetened. + +[Illustration: Fig. 121. +Witch-hazel. ] + +WITCH-HAZEL (_Hamamelis Virginica_). The parts used are the leaves and +bark. This is a most valuable astringent and exerts a specific action +upon the nervous system. It arrests many forms of uterine hemorrhage +with great promptness, is a valuable agent in the treatment of piles, +and is useful in many forms of chronic throat and bronchial affections. +_Dose_-Of the infusion, one-fourth to one-half ounce; of the fluid +extract, eight to fifteen grains; of the concentrated principle, +Hamamelin, one fourth to one grain. + +[Illustration: Fig. 122. +Cranesbill. ] + +CRANESBILL (_Geranium Maculatum_). The root is used. This plant is also +known as Crow-foot, and Spotted Geranium. It is a pleasant, but powerful +astringent. _Dose_--Of the fluid extract, ten to thirty drops; of the +concentrated principle, Geranin, one to two grains. + +[Illustration: Fig. 123. +Bugle-weed. ] + +[Illustration: Fig. 124. +Hardhack. ] + +HARDHACK (_Spirea Tomentosa_), Spirea, or Meadow Sweet. The stem and +leaves are used. It is a tonic and an astringent, and is used in +diarrhea and cholera-infantum. _Dose_--Of the infusion, one-half to one +ounce; of the fluid extract, three to six drops. + +BUGLE-WEED (_Lycopus Virginicus_). This is variously known as +Water-hoarhound and Water-bugle. It is sedative and tonic, as well as +astringent, and is employed in hemorrhages and in incipient phthisis. +_Dose_--Of the infusion, one to two ounces; of the fluid extract, +fifteen to twenty-five drops; of the concentrated principle, Lycopin, +one-half to one grain. + +[Illustration: Fig. 125. +Canada Fleabane. ] + +CANADA FLEABANE (_Erigeron Canadense_). The leaves and flowers are used. +This plant, sometimes known as Colt's-tail, Pride-weed, or Butter-weed, +is astringent, and has been efficiently employed in uterine hemorrhages. +_Dose_--Of the infusion (two ounces of the herb to one pint of water), +one to two ounces; of the oil, five to ten drops on sugar, repeated at +intervals of from one to four hours. + +CATECHU (_Acacia Catechu_). A tincture of this plant is a pure, powerful +astringent, and is especially useful in chronic diarrhea, chronic +catarrh, and chronic dysentery. _Dose_--Of the powder, five to twenty +grains; of the tincture, one-half to two teaspoonfuls. + +TANNIN (_Acidum, Tannicum_). This acid has a wide range of application. +It is used as an astringent. _Dose_--One to five grains. + +GALLIC ACID (_Acidum Gallicum_). This remedy is used chiefly in +hemorrhages. _Dose_--Three to five grains. In severe hemorrhages, this +quantity should be administered every half hour, until the bleeding is +checked. + + +CARMINATIVES. + + +Carminatives are medicines which allay intestinal pain, arrest or +prevent griping caused by cathartics and exert a general soothing +effect. They are aromatic, and to a certain extent, stimulant. + +ANISE-SEED (_Pimpinella Anisum_). Anise is a pleasant, aromatic +carminative, and is used in flatulent colic. _Dose_--Of the powdered +seed, ten to fifteen grains; of the infusion (a teaspoonful of seed to a +gill of water), sweetened, may be given freely; of the oil, five to ten +drops on sugar. + +FENNEL-SEED (_Anethum Foeniculum_). This is one of our most grateful +aromatics, and is sometimes employed to modify the action of senna and +rhubarb. _Dose_--Same as that of anise-seed. + +GINGER (_Zingiber Officinale_). The root is the part used. This is a +grateful stimulant and carminative. _Dose_--Of the powder, ten to twenty +grains; of the infusion, one teaspoonful in a gill of water; of the +tincture, twenty to thirty drops; of the essence, ten to fifteen drops; +of the syrup, one teaspoonful. + +WINTERGREEN (_Gaultheria Procumbens_). The leaves are used. This plant +possesses stimulant, aromatic, and astringent properties. The essence of +Wintergreen is carminative, and is used in colics. _Dose_--Of the +essence, one-half to one teaspoonful in sweetened water; of the oil, +three to five drops on sugar. + +PEPPERMINT (_Mentha Piperita_). Peppermint is a powerful stimulant, +carminative, and antispasmodic. It is used in the treatment of spasms, +colic, and hysteria. _Dose_--The infusion may be used freely. The +essence may be taken in doses of fifteen to thirty drops in sweetened +warm water; of the oil, one to five drops on sugar. + +SPEARMINT (_Mentha Viridis_). The carminative properties of spearmint +are inferior to those of peppermint, and its chief employment is for its +diuretic and febrifuge virtues. _Dose_--Same as that of peppermint. + +COMPOUND EXTRACT OF SMART-WEED. Dr. Pierce's Extract of Smart-weed is a +valuable carminative and aromatic stimulant, and has been employed with +marked success in all diseases in which this class of remedies is +required. + + +CATHARTICS. + + +_Cathartics_, or _Purgatives_ are medicines which act upon the bowels +and increase the secretions and evacuations. In many parts of the +country, these agents are known as purges, or physics. They have been +variously divided and subdivided, usually with reference to the energy +of their operations or the character of the evacuations produced. + +_Laxatives_, or _Aperients_, are mild cathartics. Purgatives act with +more energy and produce several discharges which are of a more liquid +character and more copious than the former. + +_Drastics_ are those cathartics which produce numerous evacuations +accompanied by more or less intestinal irritation. + +_Hydragogues_ are those purgatives which produce copious, watery +discharges. + +_Cholagogues_ are those purgatives which act upon the liver, stimulating +its functions. Cathartics constitute a class of remedies which are +almost universally employed by families and physicians. + +JALAP (_Ipomoea Jalapa_). The root is used. It is a drastic and a +hydragogue cathartic. Formerly it was combined with equal parts of +calomel. From this fact it received the name of "ten and ten." +_Dose_--Of the powder, five to twenty grains; of the fluid extract, ten +to fifteen drops; of the solid extract, two to four grains; of the +concentrated principle, Jalapin, one-half to two grains. + +[Illustration: Fig. 126. +Culver's-root. ] + +GAMBOGE (_Gambogia_). The gum is used. Gamboge is a powerful drastic, +hydragogue cathartic, which is apt to produce nausea and vomiting. It is +employed in dropsy. It should never be given alone, but combined with +milder cathartics. It accelerates their action while they moderate its +violence. _Dose_--Of the powder, one-half to two grains. This substance +combined with aloes and sometimes with scammony, constitutes the basis +of the numerous varieties of large, cathartic pills found in the market. + +CULVER'S-ROOT. (_Leptandra Virginica_). The root is used. This plant, +known under the various names of Culver's Physic, Black-root, Tall +Speedwell, and Indian Physic, is a certain cholagogue, laxative, and +cathartic. _Dose_--Of decoction, one to two fluid ounces; of fluid +extract, ten to twenty drops; of tincture, twenty to thirty drops; of +the concentrated, active principle, Leptandrin, which is but feebly +cathartic, as a laxative, two to five grains. + +RHUBARB (_Rheum Palmatum_). This is much used as a domestic remedy, and +by the profession, for its laxative, tonic, and astringent effects. It +is employed in bowel complaints. _Dose_--Of the powder, ten to thirty +grains; of the tincture, one-half to two teaspoonfuls; of the fluid +extract, ten to thirty drops; of the solid extract, three to five +grains; of the syrup, and aromatic syrup, an excellent remedy for +children, one-half to one teaspoonful. + +CASCARA SAGRADA (_Rhamnus Purshiana_), is a very efficient remedy in +chronic constipation. _Dose_--Of the fluid extract, from ten to twenty +drops taken in a tablespoonful of water. The unpleasant taste may be +disguised with the extract of liquorice. + +CASTOR OIL (_Oleum Ricini_). _Dose_--From one to four teaspoonfuls. It +may be disguised by rubbing it with an equal quantity of glycerine and +adding one or two drops of oil of anise, cinnamon, or wintergreen. + +BUTTERNUT (_Juglans Cinerea_). The bark is the part used. Butternut is a +mild cathartic, which resembles rhubarb in its property of evacuating +the bowels without irritating the alimentary canal. _Dose_--Of the +extract, as a cathartic, five to ten grains; of the fluid extract, +one-half to one teaspoonful; of the concentrated principle, Juglandin, +one to three grains. As a laxative, one-half of these quantities is +sufficient. + +ALOES (_Aloe_) The gum is used. This cathartic acts upon the lower part +of the bowels and sometimes causes piles; though some late authors claim +that in small doses it is a valuable remedy for piles. _Dose_--In powder +or pill, three to ten grains; as a laxative, one to three grains. + +EPSOM SALTS (_Magnesia Sulphas_). Its common name is "Salts." Much used +in domestic practice. _Dose_--One-fourth to one-half ounce. + +DR. PIERCE'S PLEASANT PELLETS, being entirely vegetable in their +composition, operate without disturbance to the system, diet, or +occupation. Put up in glass vials. Always fresh and reliable. As _a +laxative, alterative,_ or gently acting but searching _cathartic_, these +little Pellets give the most perfect satisfaction. Sick Headache, +Bilious Headache, Dizziness, Constipation, Indigestion, Bilious Attacks, +and all derangements of the stomach and bowels, are promptly relieved +and permanently cured by the use of Dr. Pierce's Pleasant Pellets. In +explanation of the remedial power of these Pellets over so great a +variety of diseases, it may truthfully be said that their action upon +the system is universal, not a gland or tissue escaping their sanative +influence. + +Everybody, now and then, needs a gentle laxative to assist nature a +little; or, a more searching and cleansing, yet gentle cathartic, to +remove offending matter from the stomach and bowels and tone up and +invigorate the liver and quicken its tardy action. Thereby the "Pleasant +Pellets" cure biliousness, sick and bilious headache, costiveness, or +constipation of the bowels, sour stomach, windy belchings, "heart-burn," +pain and distress after eating, and kindred derangements of the liver, +stomach and bowels. + +Persons subject to any of these troubles should never be without a vial +of the "Pleasant Pellets" at hand. In proof of their superior excellence +it can be truthfully said that they are always adopted as a household +remedy after the first trial. + +The "Pleasant Pellets" are far more effective in arousing the liver to +action than "blue pills," the old-fashioned compound cathartic pills, +calomel or other mercurial preparations, and have the further merit of +being purely vegetable in their composition and perfectly harmless in +any condition of the system. Furthermore, no particular care is required +while using them. + +Being composed of the choicest, concentrated vegetable extracts, their +cost of production is much more than that of most pills found in the +market, yet from forty to forty-four of them are put up in each glass +vial, as sold through druggists, and can be had at the price of the more +ordinary and cheaper made pills. Once used, they are always in favor. +Their secondary effect is to keep the bowels open and regular, not to +further constipate, as is the case with other pills. Hence, their great +popularity with sufferers from habitual constipation, piles and their +attendant discomfort and manifold derangements. + +For all laxative and cathartic purposes the "Pleasant Pellets" are +infinitely superior to all "mineral waters," sediltz powders, "salts," +castor oil, fruit syrups (so-called), laxative "teas," and the many +other purgative compounds sold in various forms. + +If people generally, would pay more attention to properly regulating the +action of their bowels, they would have less frequent occasion to call +for their doctor's services to subdue attacks of dangerous diseases. +Hence it is of great importance to know what safe, harmless agent best +serves the purpose of producing the desired action. + + +DIRECTIONS FOR USING DR. PIERCE'S PLEASANT PELLETS. + + +In all cases, the size of dose to be taken must be regulated somewhat by +the known susceptibility of the individual to the action of laxative and +cathartic medicines. Some persons' bowels are readily acted upon by +small doses, while others require more. As a general rule, the smaller +doses which we recommend, are quite sufficient, and produce the best +results if persisted in for a reasonable length of time. + +FOR A GENTLE APERIENT, OR LAXATIVE, take one or not more than two and +preferably in the morning, on an empty stomach. + +FOR A GENTLE CATHARTIC, two or three are generally sufficient, if taken +in the morning, on an empty stomach. + +FOR A VERY ACTIVE, SEARCHING CATHARTIC, four to six may be taken in the +morning, on an empty stomach. + +FOR A CHILD OF TWO TO FOUR YEARS, one-half of a Pellet given in a little +sauce of some kind, or soft candy, will be sufficient for a laxative, or +one for a mild cathartic. + +FOR A CHILD OF FOUR TO EIGHT YEARS, one for a laxative or two for a +cathartic will act nicely, if given on an empty stomach. + +AS A DINNER PILL.--To promote digestion and increase the appetite, take +only one Pellet each day after dinner. + +_To overcome the disagreeable effects of a too hearty meal_, take two +Pellets as soon as conscious of having overloaded the stomach. + +IN ALL CHRONIC DISEASES, it is of the utmost importance that the bowels +be kept _regular_, yet thorough purgation should be avoided, as it tends +to debilitate the system. Small laxative doses of one or at most two +Pellets, taken daily and continued for a long time, is the plan that we +would recommend to produce the best results. + +IN DROPSY, an occasional active cathartic dose of the Pellets of say 4 +to 6, taken once in a week or ten days, will do good, if, in the +interval between these doses, Dr. Pierce's Golden Medical Discovery be +taken to invigorate and regulate the system. + +TO BREAK UP SUDDEN ATTACKS OF COLDS, FEVERS, AND INFLAMMATIONS.--It is +only in these sudden and severe attacks of _acute_ diseases that we +recommend the Pellets to be taken in active purgative doses, and in +these cases _only one_ large or cathartic dose of say 5 or 6 Pellets +should be taken. + +In colds, fevers, and inflammatory attacks, warm sweating teas should be +taken freely, and hot foot baths, or a hot general bath, employed to +assist in equalizing the circulation of the blood and restoring the +equilibrium of the system. + +SUPPRESSED MENSTRUATION.--This combined treatment of an active dose of +Pellets, coupled with the use of a hot bath, foot bath, or, better +still, a hot sitz-bath, will bring on _menstruation_, when suppressed +from taking cold. In the latter case the effect will be insured if, in +addition to the use of the Pellets and baths, a full dose of Dr. +Pierce's Compound Extract of Smart-Weed, or Water Pepper, be also used. + + +CAUSTICS. + + +_Caustics_ are substances which have the power of destroying or +disorganizing animal structures. By their action they destroy the tissue +to which they are applied, and form a crust, which is thrown off by a +separation from the parts beneath. Their caustic property may be +destroyed by dilution with other substances, to such an extent that they +will only irritate or stimulate, and not destroy. Much care is necessary +in their employment, and it is not expected that the unprofessional +reader will have much to do with them; hence, we have deemed it best not +to give a list of these agents. + + +COUNTER-IRRITANTS. + + +_Counter-irritants_ are substances which produce irritation of the part +to which they are applied, varying in degree from a slight redness to a +blister or pustule. They are applied to the surface with a view of +producing an irritation to relieve irritation or inflammation in some +other or deeper seated part. They are a class of agents which we very +seldom employ, and, hence, we shall notice only a couple of the most +simple. + +MUSTARD (_Sinapis_). The flour of mustard, which is best adapted for +domestic use, is employed in the form of a paste spread on cloth. It +takes effect in a few moments; the length of time it remains in contact +with the skin and the strength of the mustard determine the effect +produced. + +HORSE-RADISH (_Cochlearia Armoracia_). The leaves are the parts used. +Let them wilt and bind them on the part affected. They act nearly as +energetically as mustard. + + +DIAPHORETICS. + + +_Diaphoretics_ are medicines which increase perspiration. Those which +occasion profuse sweating are termed _Sudorifics_. The two terms +indicate different degrees of the same operation. They constitute an +important element in domestic practice, on account of the salutary +effects which generally follow their action. Their operation is favored +by warmth externally, and warm drinks, when they are not given in hot +infusion. + +[Illustration: Fig. 127. +Pleurisy-root. ] + +PLEURISY-ROOT (_Asclepias Tuberosa_), is also known as White-root, and +Butterfly-weed. It is a valuable remedy, well adapted to break up +inflammations and disease of the chest. _Dose_--Of infusion, one to two +ounces; of fluid extract, one-fourth to one-half teaspoonful; of the +concentrated principle, Asclepin, one to three grains. + +SAFFRON (_Crocus Sativus_). Golden Saffron. _Dose_--Of infusion (one +drachm to a pint of water), one to two ounces. + +Sage (_Salvia Officinalis_). The warm infusion drunk freely is a +valuable, domestic diaphoretic. + +[Illustration: Fig. 128. +Virginia Snake-root. ] + +VIRGINIA SNAKE-ROOT (_Aristolochia Serpentaria_), is an efficient +agent. _Dose_--Of infusion, one to two ounces; of tincture, one-fourth +to one teaspoonful; of fluid extract, one-fourth to one-half +teaspoonful. + +JABORANDI (_Pilocarpus Pinnatus_). Jaborandi increases the flow of +saliva, causes profuse perspiration, and lowers the temperature of the +body. In doses of from twenty to sixty drops of the fluid extract, +administered in a cup of warm water or herb-tea on going to bed, we have +found it very effectual for breaking up recent colds. We have also found +it valuable in whooping-cough, in doses of from three to ten drops, +according to the age of the child, given three or four times a day. The +fluid extract may be obtained at almost any drug-store. + +[Illustration: Fig. 129. +May-flower. ] + +MAY-WEED (_Maruta Cotula_), is also known as Wild Chamomile, and +Dog-fennel. It is not much used, though it is a powerful diaphoretic. +_Dose_--Of infusion, one to two ounces. + +CATNIP (_Nepeta Cataria_). A deservedly popular, domestic remedy, always +acceptable, and certain in its action. The warm infusion is the best +form for its administration. It may be drunk freely. + +GINGER (_Zingiber Officinale_). The hot infusion may be sweetened and +drunk as freely as the stomach will bear. + +DR. PIERCE'S COMPOUND EXTRACT OF SMART-WEED. This is unsurpassed as a +diaphoretic agent, and is much more certain in its operation than any +simple diaphoretic. + + +DILUENTS. + + +Any fluid which thins the blood or holds medicine in solution is called +a diluent. Pure water is the principal agent of this class. It +constitutes about four-fifths of the weight of the blood, and is the +most abundant constituent of the bodily tissues. Water is necessary, not +only for digestion, nutrition, and all functional processes of life, but +it is indispensable as a menstruum for medicinal substances. It is a +necessary agent in depuration, or the process of purifying the animal +economy, for it dissolves and holds in solution deleterious matter, +which in this state may be expelled from the body. In fevers, water is +necessary to quench the thirst, promote absorption, and incite the skin +and kidneys to action. Its temperature may be varied according to +requirements. Diluents are the vehicles for introducing medicine into +the system. We shall briefly mention some which prove to be very +grateful to the sick. + +VARIOUS VEGETABLE ACIDS AND JELLIES may be dissolved in water, as apple, +currant, quince, grape, or cranberry. + +THE JUICE OF LEMONS, ORANGES, PINE-APPLES, AND TAMARINDS, is also found +to be refreshing to fever patients. + +SASSAFRAS-PITH, SLIPPERY-ELM BARK, FLAX-SEED, AND GUM ARABIC make good +mucilaginous drinks for soothing irritation of the bowels and other +parts. + +BREWERS' YEAST mixed with water in the proportion of from one-eighth to +one-fourth is a stimulant and antiseptic. + +THE WHITE ASHES OF HICKORY OR MAPLE WOOD dissolved in water make an +excellent alkaline drink in fevers, or whenever the system seems +surcharged with acidity. + + +DIURETICS. + + +_Diuretics_ are medicines which, by their action on the kidneys, +increase the flow of urine. + +[Illustration: Fig. 130. +Marsh-mallow. ] + +MARSH-MALLOW (_Althea Officinalis_) is used in irritable conditions of +the urinary organs. The infusion may be drunk freely. + +GRAVEL-PLANT (_Epigea Repens_), is also known as Water-pink, +Trailing-arbutus, or Gravel-root. _Dose_--Of decoction of the plant, one +to three ounces; of fluid extract, one-fourth to one-half teaspoonful. + +[Illustration: Fig. 131. +Stone-root. ] + +STONE-ROOT (_Collinsonia Canadensis_), is also known as Knot-root, +Horse-balm, Rich-weed, or Ox-balm. This is a mild diuretic, slow in +action, yet effective in allaying irritation of the + +FOXGLOVE (_Digitalis purpurea_) slows the action of the heart, lowers +the temperature, and acts indirectly as a diuretic. It is especially +valuable in the treatment of scarlet fever and in dropsy. _Dose_--Of +infusion, one-half drachm to one-half ounce; of the fluid extract or +strong tincture, from two to ten drops. It should be used with caution. +A poultice made of the leaves and placed over the kidneys is an +effectual method of employing the drug. + +QUEEN OF THE MEADOW (_Eupatorium Purpureum_), is also known as +Gravel-weed, Gravel-root, or Trumpet-weed. This is a most valuable +diuretic. _Dose_--Of the infusion, one to three ounces; of fluid +extract, one-fourth to one-half teaspoonful; of the concentrated +principle, Eupatorin (_Purpu_), one-half to two grains. + +BUCHU (_Barosma Crenata_). The leaves are used. This agent has been +extensively employed, generally in compounds. _Dose_--Of infusion, +(steeped for two hours or more) one to two ounces; of fluid extract, the +same; of the concentrated principle, Barosmin, one to three grains. + +PIPSISSEWA (_Chimaphila Umbellata_), or Prince's Pine. This is a tonic +to the kidneys, as well as a diuretic and alterative, and is a mild, but +very efficient remedy. _Dose_--Of decoction, one ounce from four to six +times a day; of fluid extract, one-fourth to one-half teaspoonful; of +the concentrated principle, Chimaphilin, one to two grains. + +WATER-MELON SEEDS (_Cucurbita Citrullus_). _Dose_--Of infusion, the +patient may drink freely until the desired effect is secured. + +PUMPKIN SEEDS (_Cucurbita Pepo_). They are mild, unirritating, yet +effective diuretics. An infusion of these may be drunk freely. + +SWEET SPIRIT OF NITRE (_Spiritus Ætheris Nitros_), is diuretic and +anodyne. _Dose_--One-fourth to one-half teaspoonful, diluted in water, +every two or three hours. + +SALTPETRE (_Potassæ Nitras_). _Dose_--Powdered, five to ten grains. + +ACETATE OF POTASH (_Potassæ Acetas_). _Dose_--Ten to fifteen grains, +largely diluted in water. It is more frequently used for this purpose +than the nitrate. It is a most valuable diuretic. + + +EMETICS. + + +These are medicines which cause vomiting and evacuation of the stomach. +Some of the agents of this class, termed irritant emetics, produce +vomiting by a local action on the stomach, and do not affect this organ +when introduced elsewhere. Others, which may be termed systemic emetics, +produce their effects through the nervous system, and, therefore, must +be absorbed into the circulation before they can produce vomiting. In +cases of poisoning, it is desirable to empty the stomach as quickly as +possible, hence irritant emetics should be employed, for they act more +speedily. Draughts of warm water favor the action of emetics. + +MUSTARD (_Sinapis_) acts promptly and efficiently as an emetic, and may +be employed in poisoning. _Dose_--From one to two teaspoonfuls of +powdered mustard, stirred up in a glass of tepid water. It should be +quickly swallowed and diluents freely administered. + +SULPHATE OF COPPER (_Cupri Sulphas_) is a prompt, irritant emetic. It +should be given in doses of ten grains dissolved in half a glass of +water, and its action assisted by the free use of diluents. + +SULPHATE OF ZINC (_Zinci Sulphas_) is similar in its effects to sulphate +of copper, but less powerful, and may be taken in the same manner, and +the dose repeated if necessary in fifteen minutes. + +YELLOW SUBSULPHATE OF MERCURY (_Hydrargyri Sulphas flava_), commonly +known as _Turpeth Mineral,_ is an efficient and most desirable emetic in +membranous croup. It is an active poison, but, as it is quickly thrown +up with the contents of the stomach, there is no danger from its +administration. _Dose_--It should be given to a child in doses of from +three to five grains, in the form of powder, rubbed up with sugar of +milk. + +IPECAC (_Cephælis Ipecacuanha)._In large doses Ipecac is a systemic +emetic. In small doses, it exerts a specific influence upon the mucous +membranes, relieves nausea and irritation, and subdues inflammation. In +cholera infantum it is an invaluable remedy, if given in very small +doses. By allaying irritation of the stomach and restoring tone and +functional activity to it and the bowels, it gradually checks the +discharges and brings about a healthy condition. It is also valuable in +dysentery, and is borne in large doses. As an emetic the dose is, of +powder, five to ten grains in warm water; of fluid extract, ten to +twenty drops. + +[Illustration: Fig. 132. +Lobelia. ] + +LOBELIA (_Lobelia Inflata_), sometimes known as Indian Tobacco, or +Emetic-weed. The herb and seeds are used. This is a powerful, systemic +emetic, but very depressing. _Dose_--Of the powdered leaves, fifteen to +twenty grains; of the infusion, one to three ounces; of the fluid +extract, ten to fifteen drops. + +BONESET (_Eupatorium Perfoliatum)._ _Dose_--Of the warm infusion or +decoction, two to three ounces; of the fluid extract, one teaspoonful in +hot water: of the concentrated principle, Eupatorin, two to five grains. + + +EMMENAGOGUES. + + +Emmenagogue is a term applied to a class of medicines which have the +power of favoring the discharge of the menses. We shall mention only a +few of those which are best adapted to domestic use. + +[Illustration: Fig. 133. +Pennyroyal. ] + +PENNYROYAL (_Hedeoma Pulegioides)._ Pennyroyal, used freely in the form +of a warm infusion, promotes perspiration and excites the menstrual +discharge when recently checked. A large draught of the infusion should +be taken at bed-time. The feet should be bathed in warm water previous +to taking the infusion. + +BLACK COHOSH (_Cimicifuga Racemosa)._ Black Cohosh, known also as Black +Snake-root, is an effective remedy in uterine difficulties. _Dose_--Of +the tincture, twenty drops; of the fluid extract, ten drops. + +TANSY (_Tanacetum Vulgare)._ Tansy is beneficial in suppressed +menstruation. _Dose_--Of the infusion, from one to four fluid ounces. + +ERGOT (_Secede Cornutum_) in very small doses acts as an emmenagogue, +and in large doses it checks hemorrhage. The dose as an emmenagogue, of +the fluid extract, is from two to five drops, and to arrest hemorrhage, +from half a drachm to two drachms, repeated in from one to three hours. + +LIFE-ROOT (_Senecio Gracilis._) Life-root exerts a peculiar influence +upon the female reproductive organs, and for this reason has received +the name of Female Regulator It is very efficacious in promoting the +menstrual flow, and is a valuable agent in the treatment of uterine +diseases. _Dose_--Of the decoction, four fluid ounces three or four +times a day; of the fluid extract, from one-fourth to one-half +teaspoonful. + +MOTHERWORT (_Leonurus Cardiaca_). Motherwort is usually given in warm +infusion, in suppression of the menses from cold. _Dose_--Of the +decoction, from two to three fluid ounces every one or two hours. + +DR. PIERCE'S FAVORITE PRESCRIPTION is an efficient remedy in cases +requiring a medicine to regulate the menstrual function. Full directions +accompany every bottle. + +DR. PIERCE'S COMPOUND EXTRACT OF SMART-WEED is an excellent emmenagogue. +Dr. Eberle, a very celebrated medical writer, and author of a work on +medicine which is very popular with the profession, says that he has +used the "Extract of Smart-weed" in twenty cases of amenorrhea +(suppressed menstruation), and affirms "with no other remedy or mode of +treatment have I been so successful as with this." Full directions +accompany every bottle. It is sold by all druggists. + + +EXPECTORANTS. + + +Expectorants are medicines which modify the character of the secretions +of the bronchial tubes, and promote their discharge. Most of the agents +of this class are depressing in their influence and thus interfere with +digestion and healthy nutrition. Their application is very limited, +hence we shall dismiss them without further consideration. + + +LINIMENTS. + + +Liniments are medicines designed for external application. The benefits +arising from their use depend upon their derivative power, as well as +upon the anodyne properties which many of them possess, rendering them +efficacious for soothing pain. We cannot mention a more valuable agent +of this class than + +DR. PIERCE'S COMPOUND EXTRACT OF SMART-WEED. As an external application +this preparation subdues inflammation and relieves pain. For all wounds, +bruises, sprains, bee-stings, insect and snake-bites, frost-bites, +chilblains, caked breast, swollen glands, rheumatism, and, in short, for +any and all ailments, whether afflicting man or beast, requiring a +direct external application, either to allay inflammation or soothe +pain, the Extract of Smart-weed cannot be excelled. + + +NARCOTICS. + + +A narcotic is a remedy which, in _medicinal_ doses, allays morbid +sensibility, relieves pain, and produces sleep; but which, in overdoses, +produces coma, convulsions, and death. The quantity necessary to produce +these results varies in different individuals. We shall mention a few of +those most frequently employed. + +[Illustration: Fig. 134. +Henbane.] + +HENBANE (_Hyoscyamus Niger_). The leaves and seeds are used. Henbane, in +large doses, is a powerful narcotic and dangerously poisonous. In +medicinal doses, it is anodyne and antispasmodic; it allays pain, +induces sleep, and arrests spasms. _Dose_--Of the fluid extract, five to +ten drops; of the solid extract, from one-half to one grain; of the +concentrated principle, Hyoscyamin, from one-twelfth to one-fourth of a +grain. + +INDIAN HEMP (_Cannabis Indica_). An East Indian plant. _Dose_--Of the +extract, from one-fourth to one-half grain, of the tincture, from three +to eight drops; of the fluid extract, from two to five drops. The plant +known as Indian Hemp, growing in this country, possesses very different +qualities. + +[Illustration: Fig. 135. +Stramonium. ] + +STRAMONIUM (_Datura Stramonium_). Stramonium, also known as Thorn-apple, +in large doses is a powerful narcotic poison. In medicinal doses it acts +as an anodyne and antispasmodic + +_Dose_--Of extract of the leaves, from one-half to one grain; of the +fluid extract, from three to six drops. + + +NERVINES. + + +These are medicines which act on the nervous system, soothing excitement +and quieting the condition known as "nervousness." + +HOPS (_Humulus Lupulus_). _Dose_--Of infusion, one to three ounces; of +the fluid extract, one-fourth to one-half teaspoonful of the +concentrated principle, Humulin, two to three grains. + +[Illustration: Fig. 136. +Scull-cap. ] + +SCULL-CAP. (_Scutellaria Lateriolia_). The herb is used. It is also +known as Mad-dog Weed. This is a valuable remedy. _Dose_--Of infusion, +one to two ounces, of the fluid extract, ten to twenty drops; of the +concentrated principle, _Scutellarin_, one to two grains. + +LADY'S SLIPPER (_Cypripedium Pubescens_). The root is used. _Dose_--Of +the infusion, one-half to one-ounce; of THE fluid extract, one-fourth to +one-half teaspoonful; of the concentrated principle, Cypripedin, one to +two grains. + +PULSATILLA (_Pulsatilla Nigricans)._ We employ the German tincture, +prepared from the green herb. In many of the distressing nervous +complications to which both males and females are subject in certain +diseases of the generative organs, we have found it very effectual. The +dose is from two to eight drops. + +DR. PIERCE'S FAVORITE PRESCRIPTION. This is a tonic nervine of +unsurpassed efficacy, combined in such a manner, that, while it quiets +nervous irritation, it strengthens the enfeebled nervous system, +restoring it to healthful vigor. In all diseases involving the female +reproductive organs, with which there is usually associated an irritable +condition of the nervous system, it is unsurpassed as a remedy. It is +also a uterine and general tonic of great excellence. It is sold by all +druggists. + + +SEDATIVES. + + +Sedatives are a class of agents which control excitation of the +circulation, and diminish irritability of the nervous system. + +ACONITE (_Aconitum Napellus_), The parts used are the root and leaves. +Aconite slows the pulse, diminishes arterial tension, and lowers the +temperature of the body in fevers. It is an effectual remedy in acute +inflammation of the tonsils and throat, in acute bronchitis, in +inflammation of the lungs, and pleurisy, in the hot stage of +intermittent and remittent fevers, in the eruptive fevers, in fever +arising from a cold, and in some forms of neuralgia. Acute suppression +of the menses from a cold, may be relieved by the tincture of aconite in +drop doses every hour. _Dose_--Of the tincture of the root, from +one-half of a drop to two drops, in a spoonful of water, in acute fevers +and inflammations, from one-half drop to one drop should be administered +every half hour or hour, according to the severity of the symptoms. + +PEACH TREE (_Amygdalus Persica_). Peach tree leaves and bark are +slightly sedative, but the chief use which we have found for these +articles is to control nausea and vomiting arising from irritability of +the stomach. It also possesses mild, tonic properties. _Dose_--Of +infusion at the bark of the small twigs or of the leaves, from two to +six teaspoonfuls. + +[Illustration: Fig. 137. +American Hellebore. ] + +AMERICAN HELLEBORE (_Veratrum Viride_) is also known as White Hellebore, +Indian Poke, or Swamp Hellebore. The root is the part used. It is a most +valuable agent with which to control the frequent, strong, bounding +pulse common to many febrile and inflammatory diseases. When the pulse +is hard, incompressible, and bounding, this remedy is more effectual +than aconite. _Dose_--Of the tincture and fluid extract, from one to two +drops, repeated every half hour to two hours, according to the severity +of the symptoms. This remedy should be given in very small doses, +frequently repeated, if we would secure its best effects. Our favorite +mode of administering both veratrum and aconite is to add ten drops of +the tincture to ten or fifteen teaspoonfuls of water, of which one +teaspoonful may be administered every hour. + +YELLOW JESSAMINE (_Gelseminum Sempervirens_). The root is the part used. +Through its controlling effect over the sympathetic nervous system, this +agent exerts a marked influence in controlling morbid excitability of +the circulatory organs. It allays irritation, and determination of blood +to the brain, indicated by flushed face, contracted pupils, +irritability, and restlessness, a frequent condition in diseases +incident to childhood. Its concentrated principle, Gelsemin, is an +efficient remedy in bloody-flux or dysentery. It should be administered +in very small doses to secure the best results. Only one-sixteenth to +one-eighth of a grain is required, repeated every two hours. It should +be triturated with sugar of milk or with common white sugar, in the +proportion of one grain to ten of sugar. _Dose_--Of tincture, from five +to fifteen drops; of fluid extract, three to six drops; of Gelsemin, as +a sedative, one-fourth to one-half grain. + + +STIMULANTS. + + +Stimulants are medicines which have the power of increasing the vital +activity of the body. Some have a very transient action, while others +are more permanent in effect. + +CAYENNE PEPPER (_Capsicum Annuum_). Cayenne Pepper is a powerful +stimulant. _Dose_--Of the powder, from one to six grains, administered +in milk; of the tincture, from five to ten drops, largely diluted in +milk or water. + +BLACK PEPPER (_Piper Nigrum_). Black Pepper is a warm, carminative +stimulant. _Dose_--From five to fifteen grains; of the fluid extract, +from ten to fifteen drops. + +[Illustration: Fig. 138. +Prickly-ash. ] + +PRICKLY-ASH (_Xanthoxylum Fraxineum)._ Prickly-ash bark is a stimulant +and tonic. The parts used are the bark and leaves. _Dose_--Of the fluid +extract, from five to fifteen drops; of the tincture, ten to twenty +drops; of the active principle, Xanthoxylin, one to two grains. + +ALCOHOL is a powerful stimulant. It is never used in its pure state in +medicine, but when diluted forms a useful remedy in many diseases. It is +generally employed in the form of whiskey, gin, rum, brandy, and wine. + +AMMONIA is an excellent stimulant. _Dose_--Of the carbonate, from three +to five grains; of the sesquicarbonate, from five to ten grains; this is +the same as the carbonate, which has been exposed to the air and slacked +(powdered hartshorn); of the aromatic spirit, from one-half to one +teaspoonful. The Aqua Ammonia and Liquor Ammonia are of such variable +strength that they are seldom employed internally, but may be applied +externally and taken by inhalation. + +DR. PIERCE'S COMPOUND EXTRACT OF SMART-WEED. This quickly diffusible +stimulant and genial anodyne we have spoken of under the head of +Anodynes. But its medicinal properties equally entitle it to a place and +mention under the class of stimulants. As a stimulant it spurs the +nervous system and arouses the circulatory forces. Congestion of the +lungs, liver, bowels, or uterus, embarrasses the functions of these +organs. Frequently this congestive difficulty may be entirely obviated, +and the circulation of the blood restored to the surface of the body, by +the administration of a few doses of this pleasant remedy. Thus it often +acts like magic in giving relief, promoting the circulation, and +restoring the organs to their accustomed functional activity. Full +directions accompany every bottle. + + +TONICS. + + +Tonics are remedies which moderately exalt the energies of all parts of +the body, without causing any deviation of healthy function. While +stimulants are transient in their influence, tonics are comparatively +permanent. + +[Illustration: Fig. 139. +White Poplar. ] + +WHITE POPLAR (_Liriodendron Tulipfera_), called also American Poplar, or +White Wood. The part used is the inner bark. This is a mild but valuable +tonic for domestic use. _Dose_--Of the infusion, from one-half to one +ounce; of tincture, from one to two teaspoonfuls. + +CHAMOMILE (_Anthemis Nobilis_). The part used is the flowers. This is a +mild, unirritating tonic. _Dose_--Of infusion (one-fourth ounce of +flowers to a pint of water) one-half to one ounce. + +GENTIAN (_Gentiana Lutead_). The root is the part used. This is a +favorite domestic tonic in many localities. _Dose_--Of powdered root, +five to ten grains; of the tincture, ten to twenty drops; of the fluid +extract, five to ten drops, four or five times a day. + +NUX VOMICA (_Strychnos Nux Vomica_), or Dog Button. This is a powerful +tonic. It increases innervation and is particularly valuable in cases +marked by feeble circulation and general impairment of muscular power. +In overdoses it is poisonous, and hence must be employed with much +caution. _Dose_--Of the tincture, three to five drops; of the fluid +extract, ONE TO THREE DROPS. + +WILLOW (_Salix Alba_). Willow is a tonic and an astringent. _Dose_--Of +the decoction, from one to two fluid ounces; of the concentrated +principle, Salicin, from two to four grains. + +[Illustration: Fig. 140. +Dogwood.] + +DOGWOOD (_Cornus Florida_). Dogwood, also known Boxwood, is tonic, +astringent, and slightly stimulant. _Dose_--Of the solid extract, from +three to five grains; of the infusion, from one to two ounces; of the +fluid extract, from ten to twenty drops. + +WAFER-ASH (_Ptelea Trifoliata_), also called Swamp Dogwood. The bark is +used. This is a pure, unirritating tonic. _Dose_--Of tincture, one-half +to one teaspoonful; of fluid extract ten to twenty drops; of the +infusion, one to two fluid ounces. + +[Illustration: Fig. 141. +Golden Seal. ] + +GOLDEN SEAL (_Hydrastis Canadensis_). Golden Seal is a powerful and most +valuable tonic. It is a valuable local remedy when used as a general +injection in leucorrhea. _Dose_--Of the powder, from ten to thirty +grains; of the tincture, from one-half to one fluid drachm; of the fluid +extract, from ten to twenty drops; of the concentrated principle, +Hydrastin, from two to three grains; of the muriate of hydrastia, from +one-half to one grain. + +[Illustration: Fig. 142. +American Colombo. ] + +AMERICAN COLOMBO (_Frasera Carolinensis_). American Colombo is a simple +tonic. _Dose_--Of the powdered root, from ten to fifteen grains; of the +infusion one-half to one fluid ounce, three or four times a day; of the +active principle, Fraserin, one to three grains. + +[Illustration: Fig. 143. +Gold Thread. ] + +GOLD THREAD (_Coptis Trifolia_). Gold Thread is a pure and powerful, +bitter tonic, and is also efficacious as a wash for sore mouth or as a +gargle. _Dose_--Of the decoction, from two to six fluid drachms; of the +tincture, from one-half to two teaspoonfuls; of fluid extract, from ten +to twenty drops. + +IRON (_Ferrum_). Different preparations of iron are frequently +prescribed by physicians. They are particularly valuable in anæmic +conditions of the system. The following are a few of the preparations of +this metal most generally used: + +IRON BY HYDROGEN (_Ferri Redactum_). _Dose_--One to two grains. + +CARBONATE OF IRON (_Ferri Carbonas_). _Dose_--One to three grains. + +CITRATE OF IRON (_Ferri Citras_). _Dose_--One to three grains. + +PYROPHOSPHATE OF IRON (_Ferri Pyrophosphas_). _Dose_--One to three +grains. + +TINCTURE OF MURIATE OF IRON (_Tinctura Ferri Chloridi)._ _Dose_--Three +to twenty drops. + +DR. PIERCE'S FAVORITE PRESCRIPTION. The Favorite Prescription, in +addition to those properties already described, likewise combines tonic +properties. In consequence of the never ceasing activities of the bodily +organs, the system requires support, something to permanently exalt its +actions. In all cases of debility, the Favorite Prescription +tranquilizes the nerves, tones up the organs and increases their vigor, +and strengthens the system. Directions for use accompany every bottle. + +DR. PIERCE'S GOLDEN MEDICAL DISCOVERY. In addition to the alterative +properties combined in this compound, it possesses important tonic +qualities. While the Favorite Prescription exerts a tonic influence upon +the digestive and nutritive functions, the Golden Medical Discovery acts +upon the excretory glands. Besides, it tends to retard unusual waste and +expenditure. This latter remedy tones, sustains, and, at the same time +regulates the functions. While increasing the discharge of noxious +elements accumulated in the system, it promptly arrests the wastes +arising from debility, and the unusual breaking down of the cells +incident to quick decline. It stimulates the liver to secrete, changes +the sallow complexion, and transforms the listless invalid into a +vigorous and healthy being. At the same time, it checks the rapid +disorganization of the tissues and their putrescent change, while it +sustains the vital processes. It is, therefore, and indispensable remedy +in the treatment of many diseases. + + * * * * * + + + + +CHAPTER III. + +BATHS AND MOTION AS REMEDIAL AGENTS. + + +The remedial effects of bathing are generally underrated. This want of +appreciation is more often due to the improper manner in which it is +performed than to an insufficiency of curative virtues. The term +_bathing_ not only implies a cleaning of the body or certain portions of +it, but also the application of water in such a manner as to influence +the nervous system, and regulate the functions of the secretory organs. +Cleanliness, while it preserves health and promotes recovery, has +reference only to the hygienic influences of water and not to its +curative effects. There are several kinds of baths, the names of which +indicate their character, manner of application, or the part of the body +to which they are applied. Among others, we have Cold, Cool, Temperate, +Tepid, Warm, Hot, Hot Air, Russian, Turkish, Vapor, Electric, Sea, +Shower, Sponge, Douche, Foot, Sitz, Head, Medicated, Alkaline, Acid, +Iodine, and Sulphur Baths. Temperature influences the properties of any +bath; thus the sponge, sitz, and alkaline baths may be employed warm or +cold, according to the effect desired. + +THE COLD BATH, used at a temperature of from 40° to 60° Fahr., is +powerfully sedative, and is employed for its tonic effects. If the vital +powers are low, or the individual remains in it too long (two or three +minutes should be the limit), the reaction is slow and its effects +injurious. While it is highly invigorating to robust persons, those who +have a low standard of vitality should be cautions in its employment. A +local bath may be followed by beneficial results, when a general bath +would be inadmissible. For these reasons we advise the general use of +the + +COOL BATH, at a temperature of from 60° to 75° Fahr. If, in any +instance, the _reaction_ is _slow_, we recommend the + +TEMPERATE BATH, at a temperature of from 75° to 80° Fahr. The time of +remaining in the bath should be regulated by the strength of the +invalid. As a rule, it should not exceed three _minutes_, and the colder +the water the less time should the patient be immersed. Immediately +after emerging from any bath, the body should be thoroughly dried and +rubbed with a moderately coarse towel until a glow is experienced and +reaction is fully established. The attempt to toughen children by +exposing them to low temperatures of either air or water, cannot be too +emphatically condemned. This caution, however, does not apply to the +employment of moderately cool water for ablutions. The cold or cool bath +should be taken in the early part of the day, but _never during +digestion_. Whenever reaction does not follow bathing, artificial means +must be resorted to, as stimulating drinks, dry warmth, or exercise. + +THE TEPID BATH, the temperature of which is from 85° to 92° Fahr., is +generally used for cleansing the body. It is prescribed in fevers and +inflammatory affections for its cooling effects. It is usually medicated +with some acid or alkali. The latter unites with the oily secretion of +the skin and forms a soapy compound easily removed by the water. The +temperature should be regulated according to the vitality of the +patient; and the bath may be repeated two or three times a day. It +removes superfluous heat, and keeps the skin in a condition favorable +for excretion. + +THE WARM BATH, at a temperature varying from 92° to 98° Fahr., is always +agreeable and refreshing. It equalizes the circulation and softens the +skin, by removing all impurities. It moderates pain and soothes the +whole system. It does not weaken or debilitate the person, but is in +every way beneficial. It is an efficient, remedial agent in many chronic +diseases, convulsions, spasmodic affections of the bowels, rupture, +rheumatism, and derangement of the urino-genital organs. It should be +employed immediately before going to bed unless urgent symptoms demand +it at other times. It may be medicated or not, as circumstances require, +but should always be taken in a warm room. + +THE HOT BATH at a temperature of from 98° to 110° Fahr. is a powerful +stimulant. It excites the nerves, and through them the entire system. It +causes a sense of heat and a constriction of the secretory organs; but +perspiration, languor, and torpor soon follow. In the sudden +retrocession of cutaneous diseases, it restores the eruptions to the +surface and gives speedy relief. The hot bath may be applied locally +when circumstances require. + +THE RUSSIAN BATH consists in the application of hot vapor, at a +temperature varying from 112° to 200° Fahr. The patient is first +subjected to a moderately warm temperature, which is gradually increased +as he becomes inured to it, the head being surrounded with cloths wet in +cold water. Upon emerging from it, the bather is plunged into cold water +or receives a cool, shower bath. In rheumatic and cutaneous diseases, +chronic inflammations, and nervous affections, the Russian bath is an +effective remedy. + +THE TURKISH BATH is a, dry, hot-air bath. The bather passes from one +apartment to another, each one being of a higher temperature than the +preceding. He undergoes a thorough shampooing, and, although the person +may be scrupulously clean, he will be astonished at the amount of effete +matter removed by this process. The bather then returns through the +various apartments, and, upon emerging from that of the lowest +temperature, he experiences a delightful sensation of vigor and +elasticity. + +As a hygienic agent, the hot-air bath has been' constantly growing in +favor. Its value is now recognized by all physicians throughout the +world. The judicious use of the Turkish bath serves to secure perfect +equalization of the circulation. Glandular activity is increased, +elasticity and power given to the muscles, and a permanent, stimulating +and tonic influence imparted to the system, a condition at once +conducive to the enjoyment and prolongation of life. Dr. Erasmus Wilson, +of England, says, in a paper read before the London Medical Association: +"The inhabitant of a large city would live as healthy, immured within +city walls, as amid the fields and meadows of the country. His bath +would be to him in the place of a country house or horse--it would give +him air, exercise, freshness, health, and life." + +"The bath that cleanses the inward as well as the outward man; that is +applicable to every age; that is adapted to make health healthier, and +alleviate disease, whatever its stage or severity, deserves to be +adopted as a national institution, and merits the advocacy of all +medical men; of those whose especial duty it is to teach how health may +be preserved, and how disease may be averted." + +The hot, _dry_ atmosphere of the Turkish bath promotes rapid evaporation +from the surface of the body, and it is well known that rapid +evaporation from the surface is a cooling process. A person's finger may +be frozen in one minute's time, by throwing upon it a constant, fine +spray of rhigolene or sulphuric ether. The rapid evaporation of the +light fluid congeals the liquids of the tissues and a film of ice is +rapidly formed upon the part. In a less intense degree the same cooling +process is carried on over the whole surface of a person, when in the +hot room, or _sudatorium_, of the Turkish bath. The evaporation from the +surface is so rapid that one can hardly appreciate the profuseness of +the perspiration going on. The evaporation from the surface so rapidly +carries off the heat from the body that one finds himself able, with +little or no inconvenience, to remain in a room heated to from 180° to +200° or even 220° Fahr. + +As a hygienic measure to be regularly or occasionally employed by +persons in fair health, the Turkish or hot dry-air bath is far superior +to the Russian or vapor-bath. (1.) It produces more profuse +perspiration, and is therefore more depurating, or cleansing, in its +effects. (2.) It does not relax the system, but rather produces a tonic +effect, and fewer precautions are, therefore, necessary to guard against +taking cold after employing it. (3.) The Turkish bath can be better +ventilated than the Russian. While the air is heated to a high +temperature, it can be readily kept pure by constant changes. In the +Turkish hot-rooms, or _sudatorium_, of the Invalids' Hotel and Surgical +Institute, provision is made for bringing underneath the floors a +current of fresh air from without. This column of fresh air is carried +under the centre of each room where it escapes from the conductor, is +warmed, and rises into the room, from which extraction of air is +constantly going on through registers opening into tubes, communicating +with large ventilated shafts which are kept hot, summer and winter, to +insure a draught through them. In this manner, thorough ventilation of +our Turkish hot-rooms is insured. + +The Turkish bath not only combines a most agreeable luxury with a +decidedly invigorating and tonic influence, but also, by its stimulating +power, induces proper glandular and cellular activity, producing a +healthy condition. + +Sallowness, tan, and freckles, the result of local or general increase +of the pigment granules of the skin, soon disappear under the +stimulating influence and regular use of the Turkish bath, which causes +rapid development of new and transparent cells. The colored granules are +thus gradually replaced and the skin assumes a beautiful clearness and +purity of appearance, which transcends immeasurably the unhealthy hue +that follows the frequent employment of the various cosmetics. + +The value of an agent which thus improves the general health, insures +immunity from coughs, colds, and other diseases, and at the same time +produces a healthy and permanent beauty of complexion, is at once +apparent. The purity of person, perfect circulation, increase of healthy +nutrition and glandular activity produced by the Turkish bath, serve to +make it of the most lasting utility. + +The eminent Dr. Madden has said, and his experience is confirmed by +every regular patron of the bath, that, "Wherever the Turkish bath was a +national institution the hair of the women was peculiarly luxurious and +beautiful. I can vouch for it that the use of the bath rendered the +complexion more delicate and brilliant; that the eyes became clearer and +brighter; all the personal charms were enhanced. I can recommend no +hygienic measure more beneficial or effectual in preserving the health +and an attractive personal appearance." + +Pimples, blotches, eruptions, and other disfigurations of the skin are +removed by the frequent use of the Turkish bath, leaving the integument +smooth and soft. + +[Illustration: Fig. 144. +First Hot-room of the Turkish Bath. ] + +HOW THE TURKISH BATH IS ADMINISTERED AT THE INVALID'S HOTEL AND SURGICAL +INSTITUTE. The hot-rooms, of which there are two, are exactly similar in +every respect except as regards temperature. The first room has a +temperature of from 110° to 120° Fahr. The bather is supplied by the +attendant every few minutes with copious draughts of cool water. +Gradually the relaxing influence of the elevated temperature manifests +itself. The capillaries slowly dilate, the veins enlarge under its +gentle stimulus, and small points of perspiration appear upon the +surface, which assumes a slight, rosy blush. A delightful calm, a +feeling of perfect rest and luxurious ease is imparted to the senses. +From this room, after an appropriate interval, the bather enters the +second room, in which the atmosphere is higher by from 20° to 30°, and +it may be made still higher, its regulation requiring but an instant. + +[Illustration: Fig. 145. +One of the Shampooing rooms.] + +A thorough sweating occurs while the subject remains in these rooms, +during a period of from ten to forty minutes. The secretions of the +skin, at first impure and loaded with the _débris_ of dead cells and +extraneous matter, gradually become purer, and clearer, until, finally, +all trace of color disappears and the pearly drops of sweat come full +and free. Soon the attendant appears and leads the way to the +shampooing-room, where, lying upon a warm marble slab, _massage_ is +applied most thoroughly to every portion of the body. + +By the _massage_, shampooing, or rubbing, the superficial veins are +thoroughly emptied of their contents, the muscles are given elasticity +and tone, and glandular activity is promoted. Innumerable dead +epithelial cells, together with other impurities, are rolled off in +flakes under the skillful manipulation of the attendant. + +After a thorough shampooing, the shower bath is applied, to secure a +contraction of the capillaries and a diminution of the perspiration. + +THE SPIRIT VAPOR-BATH is very effective when employed in the earlier +stages of acute, febrile, inflammatory, and painful diseases. In many +forms of chronic diseases the administration of a spirit vapor-bath once +in from three to fifteen days, is a valuable adjunct to the treatment of +these affections. It exerts an exceedingly beneficial influence upon the +entire system, and, when habitually employed, may ward off disease. + +The body should be moistened with an alkaline solution before the +administration of a spirit vapor-bath. After the perspiration which it +occasions has subsided, which will usually be in from three to four +hours, sponge the body with a mixture of the following ingredients: +water, three gills; alcohol, one gill; salt, one teaspoonful. By this +method the patient experiences none of the unpleasant effects which +generally follow the employment of diaphoretics. Various kinds of +apparatus have been devised to facilitate the application of the spirit +vapor-baths. Most of them are cumbersome and expensive, and, +consequently, are seldom used except in hospitals or sanitariums. + +The following method described by Dr. J. King, may be advantageously +employed. + +"The patient is undressed, ready for getting into bed, having removed +the clothing worn through the day and put on a night shirt or other +clothing to be worn while sweating, and during the night, if the bath is +taken at bed-time. He is then seated on a high Windsor or +wooden-bottomed chair, or instead thereof, a bench or board may be +placed on a common open-bottomed chair, care being taken that the bottom +is so covered that the flame will not burn him. After seating himself, a +large coverlet or blanket is thrown around him from behind, covering the +back of his head and body, as well as the chair, and another must be +passed around him in front, which last is to be pinned at the neck, +loosely, so that he can raise it and cover his face, or remove it down +from the face from time to time as occasion demands during the operation +of the bath. The blankets must reach down to the floor, and cover each +other at the side, so as to retain the vapor. This having been done, a +saucer or tin vessel, into which is put one or two tablespoonfuls of +whiskey, brandy, alcohol, or any liquor that will burn, is then placed +upon the floor, directly under the centre of the bottom of the chair, +raising a part of the blanket from behind to place it there; then light +a piece of paper, apply the flame to the liquor, and as soon as it +kindles let down the part of the blanket which has been raised, and +allow the liquor to burn until it is consumed, watching it from time to +time to see that the blankets are not burned. As soon as consumed, put +more liquor into the saucer, about as much as before, and again set it +on fire, being careful to put no liquor into the saucer while the flame +exists, as there would be danger of setting fire to the blanket, and +producing injury to the patient. Continue this until the patient +perspires freely, which, in a majority of cases, will be in five or ten +minutes." + +"If, during the operation the patient feels faint or thirsty, cold water +must be sprinkled or dashed in his face, or he may drink one or two +swallows of it,--and in some cases the head may be bathed with cold +water. As soon as free perspiration is produced, wrap the blankets +around him, place him in bed, and cover him up warm, giving him about a +pint of either some good store tea, ginger, or some diaphoretic herb tea +to drink, as warm as he can take it. After two or three hours, remove +the covering, piece by piece, at intervals of twenty or twenty-five +minutes each, that he may gradually cease perspiring." + +The above method may be improved by using an ordinary hoop skirt, ten to +twelve inches below the bottom of which is suspended a larger and +stronger hoop. The upper and smaller hoops should rest upon the +patient's shoulders. A woolen blanket, large enough to reach and rest +upon the floor, and envelop the whole person, is thrown over the hoops. +Unless the bath is employed to diminish the quantity of fluids in the +body (as in dropsy), the patient may drink some simple, diaphoretic +infusion, to hasten or facilitate perspiration. When he perspires +freely, small quantities of cold water may be frequently given. "There +is little or no danger of taking cold after this process, if ordinary +precaution is observed, and it is easy, agreeable, safe, and effectual." + +"Occasionally we will meet with patients, upon whom it is almost +impossible to produce the slightest moisture, much less perspiration. +The skin of such persons is generally dry and harsh, communicating an +unpleasant sensation to the touch. In most instances the skin may be +restored to its normal condition, by adopting the following course: 1st. +Anoint the whole surface of the body and limbs with olive oil every +night upon retiring to bed. 2nd. Every morning wash the whole surface +with a warm, weak, alkaline solution, employing considerable friction +while drying. 3rd. Every two weeks administer a spirit vapor-bath. A +perseverance in this course for a few months will accomplish the desired +result." + +Frequent reference to spirit vapor-baths will be made by the author of +this work, in speaking of those diseases in which its employment will +prove beneficial. + +SEA BATHING is an excellent, remedial agent in chronic disorders, +particularly in those of an atonic character, such as nervous +prostration, dyspepsia, and general debility. + +Much of the benefit attributed to this mode of bathing is undoubtedly +due to other influences, such as pure air, exercise, change of scenery, +diet, and associations which surround the patient during his sojourn at +the sea-shore. + +At first, the duration of a sea-bath should not exceed three or five +minutes, but it may be gradually prolonged to fifteen or twenty minutes. +If the patient is very feeble, one or two baths a week are sufficient, +and the most robust person should never take more than one a day. They +should always be taken in the earlier portion of the day, before +breakfast if possible, and _never during digestion_. + +Before entering this bath, a moderate degree of exercise should always +be taken, enough to arouse the vital energies, but not to produce +fatigue. Suitably dressed, the patient plunges into the water, in which +he remains during the prescribed time. Immediately after emerging from +the bath, the patient should be thoroughly dried and dressed and then +moderate exercise should be taken to induce reaction. If the reaction is +slow, a mild stimulant may be taken and the duration of the bath must be +diminished the next time. When sea-bathing is beneficial improvement is +soon manifested. The blood becomes richer, the whole system is +strengthened and the functions are performed with more regularity. To +the rich, sea-bathing is a luxury, but it is a remedy beyond the reach +of the poorer classes unless they live near the sea-shore. + +THE SHOWER BATH produces a shock to the nervous system by suddenly +coming in contact with the skin. Numerous streams of cold water fall +upon the neck, shoulders, and body of the patient who stands beneath the +hose or reservoir. When the patient is plethoric, feeble, or nervous, or +when some internal organ is diseased, the cold, shower bath should _not_ +be employed. In simple debility unaccompanied by inflammation or +symptoms of internal congestion, its use proves advantageous. By +moderating the force of the shower, and substituting tepid water, the +most delicate persons can endure it and profit thereby. The usual means +for inducing a good reaction, friction, and exercise, should be +employed. + +THE DOUCHE BATH consists of a stream of water, dashed or thrown upon the +patient from a moderate height or distance, with considerable force. The +size, temperature, and force of the stream may be modified to suit the +exigencies of the case. It is locally employed as a remedy for sprains, +weak or stiff joints, old swellings, etc. The cold, douche bath is more +powerful than the shower bath and should be given with the same +precautions which govern the application of the latter. + +THE SPONGE BATH admits of extensive employment in both acute and chronic +diseases, and its simplicity renders it of untold value. It consists in +a general or local application of water (medicated or not) at any +desired temperature. The quantity may be great or small to suit the +requirements of the case. If it is applied in acute diseases at a +temperature agreeable to the patient, it is exceedingly grateful and may +be repeated as often as necessary. It may be rendered alkaline by the +addition of some compound of soda, in the proportion of a teaspoonful to +a quart of water. A portion of the body may be bathed at a time, and +quickly dried, thus avoiding any exposure to cold. It removes excessive +animal heat, relaxes the capillaries, equalizes the circulation, and +produces comfort, tranquility, and sleep. + +Nothing is more conducive to the health and comfort of laboring men in +summer than a daily bath, and it is a matter of regret that there are so +few conveniences for the purpose in most homes, especially those in the +country. Farmers in particular need bathing facilities, and yet in most +cases they are almost entirely without them. For their benefit we will +describe a device which we can recommend to all who want a cheap, +convenient, and easily managed apparatus for sponge bathing in the +bed-room. + +The articles required are a piece of rubber-cloth a yard and a quarter +square, four slats, two inches wide and three feet long, notched at the +ends so as to lock together in the form of a square, and a large sponge. +The slats are placed upon the floor and the rubber cloth is spread over +them (there is no need of fastening it to the slats), forming a shallow +square vessel a yard wide. In this the bather stands and applies the +water with a sponge from a basin or bowl on a stand placed conveniently +near. There need be no danger of wetting the carpet, or spoiling the +furniture. + +When the bath is finished, gather three corners of the rubber cloth in +the left hand, take the fourth corner in the right in such a way as to +form a spout when lifted or held over the slop-jar or bucket. The water +may be poured out in a moment, when the cloth should be spread over the +back of a chair to dry, and the slats unlocked and set away in a closet. + +THE FOOT BATH is frequently employed, as a means of causing diaphoresis, +in colds, attacks of acute diseases, and also to draw the blood from the +head or some internal organ. It is a powerful auxiliary in the treatment +of those chronic diseases in which inflammation, congestion, and a +feeble circulation are prominent symptoms. The water should be as hot as +it can be borne and the temperature kept up by additions of hot water. +It may be made stimulating by the addition of salt, mustard, ginger, or +cayenne pepper. + +THE SITZ BATH. A tub is so arranged that the patient can sit down in it +while bathing. In this manner the lower part of the abdomen, hips, and +upper part of the thighs, are immersed in whatever fluid the bath is +composed of. It is applicable in diseases of the pelvic organs, and may +be hot, warm, cool, cold, or medicated, according to the effect desired. + +The bath tub should be large enough to permit a thorough rubbing and +kneading of the diseased parts, and the patient may remain in it from +ten to thirty minutes. The clothing may be wholly or partially removed, +as agreeable to the individual. A _warm_, sitz bath is an effective, +remedial adjunct in menstrual suppression and in painful menstruation, +gravel, spasmodic and acute inflammatory affections generally. The +_cold_, sitz bath is used as a tonic in cases of relaxed tissues of the +pelvis, in debility of the urino-genital organs, in piles, prolapsus of +the rectum, and in constipation. + +THE HEAD BATH. A shallow basin contains the fluid for the bath; and the +patient, assuming a recumbent position, immerses a portion of the head, +generally the back part. The temperature may be warm, cool, or cold, as +desired. + +MEDICATED BATHS are infusions of vegetable or other substances in water. +They are sometimes applied with the sponge, though generally the patient +is immersed. The temperature at which they are usually employed is that +of the tepid bath. The nature and strength of the medication depends +upon the character of the disease for which it is employed. + +THE ALKALINE BATH is prepared by dissolving half a pound of carbonate of +soda in sixty gallons of water. It is useful in those diseases in which +the fluids of the body are abnormally acid, as in rheumatism. + +THE ACID BATH is prepared by adding two pounds of muriatic or +hydrochloric acid to sixty gallons of water. A much smaller quantity of +the acid is sometimes used, and in some instances vinegar is +substituted. + +_Scott's Acid Bath_ is composed of nitro-muriatic acid (aqua regia) and +water. It should be prepared in a wooden tub, and a sufficient quantity +of acid used to give the water a sour taste. It is extensively used in +India as a remedy for disorders of the liver. + +THE IODINE BATH is composed of the following ingredients: tincture of +iodine, two drachms; iodide of potassium, four drachms; water, forty +gallons. It should be prepared in a wooden tub. It reddens the skin. For +children, a much weaker solution must be employed. Its use is generally +restricted to scrofulous and tubercular affections. + +THE SULPHUR BATH is prepared by dissolving eight ounces of sulphuret of +potassium and two ounces of dilute sulphuric acid in sixty gallons of +water. The acid may be omitted. + +A SULPHUR VAPOR-BATH is often employed in cities where the necessary +apparatus can be procured. It may be improvised by placing sulphur on a +shovel over hot coals. The patient should be prepared as in the spirit +vapor-bath, and burning sulphur substituted for the liquor. The patient +is then enveloped in the fumes of sulphurous oxide. Heating a mixture of +sulphur and sulphuric acid, produces the same result. If the gas is +inhaled in large quantities it causes irritation of the respiratory +passages, and suffocation. It is therefore necessary that the coverings +should be securely fastened at the neck, and that the room be one which +can be quickly filled with pure air This bath is used in cutaneous, +rheumatic, and syphilitic disorders. + +FOMENTATIONS consist of the general or local application of woolen +cloths wrung out of hot water. They should not be so light as to be +ineffectual, nor so heavy as to be burdensome. They should not be wet +enough to drip, nor applied so as to expose the body to the surrounding +air. A fresh cloth should be ready for application before the first one +is removed, and the change quickly effected. Fomentations are effectual +in relieving congestion and inflammation. + +THE WET SHEET PACK. As this remedial appliance will be frequently +recommended in the pages following, its mode of application is here +described. Take a pail half filled with cold water, gather together one +end of a common cotton sheet, and immerse it, allowing it to remain +while preparing the bed, which may be done as follows: remove all the +bed-clothes except a coverlet and the pillows, then spread upon it, in +the following order, two ordinary comforters, one woolen blanket, one +woolen sheet, (or two woolen sheets if a woolen blanket is not at hand); +then wring out one-half or two-thirds of the water from the wet sheet, +spread it smoothly upon the blanket, and the patient being undressed, +places himself on the sheet, with his arms extended, while an assistant +wraps him closely and tightly with it, as quickly as possible. Each arm +may be thus covered by the wet sheet, or may lie outside of it, and be +covered by wet towels, prepared in the same manner as the sheet. Then +quickly and tightly cover with the blankets and comforters, tucking +snugly from head to foot. The head should also be covered with a wet +towel, and a bottle of warm water placed to the feet, or near enough to +keep them warm. + +After the first shock of the chill is over, the pack is very pleasant +and refreshing, and the patient should go to sleep, if possible. The +ordinary time for a patient to remain in a pack is about sixty minutes. +Thirty or forty minutes is sufficient, if he is in a feeble condition. +Never wring the sheet out of warm water, for one of its principal +benefits comes from the vigorous reaction induced by its cold +temperature. After remaining in the pack from thirty to sixty minutes, +allow the patient to stand on his feet, if he is able, and have the +whole surface of his body bathed. Rub briskly, and dry with towels, or +by throwing over the body a dry sheet and then rubbing him. The dry +sheet retains the bodily warmth and is more comfortable, but interferes +with the completeness and vigor of the rubbing of the body. Be sure and +establish full reaction, which may be known by the warmth of the +surface. Frequently, when the patient is released from the pack, and is +being bathed, rolls of scales, scurf, and _skin-debris_ come off, thus +giving palpable evidence of the utility of the pack in freeing the +myriads of pores of the skin of effete matter. It is efficient in +fevers, and for breaking up colds, and is a very valuable, remedial +agent in most chronic diseases, assisting in removing causes which +depress the bodily functions. + + +MOTION IS A REMEDIAL AGENT. + + +The stability of the planetary system depends upon the converted motion +of its parts. So in the human system, motion is a fundamental principle +which underlies every vital process. Health consists in normal, +functional activity. The human system is the arena of various kinds of +motions, both of fluids and of solids, and life and health depend upon +these physiological movements. There are the movements incident to +_respiration_, the expansion and contraction of the walls of the chest, +bringing the oxygen of the air into contact with the blood as it +circulates through the lungs. Corresponding with the movements of the +chest are the _motions of the abdominal walls_, which promote the +functions of the organs of the abdominal cavity. + +There are _motions of the heart and arteries_, which urge the blood out +to the extremities and diffuse it through every part of the system, and +also _motion of the blood in the capillaries_, by which the blood is +circulated through the tissues, that the latter may be built up from its +nutritive constituents. Then there is the _motion of the vital current_ +in the veins returning towards the heart, and urged forward by the +muscular and pump-like action of the chest and abdominal walls. The +peristaltic _motions of the stomach and bowels_ urge onward digesting +materials, exposing them successively to different solvents and aiding +the absorption of nutritive matter. No less essential to life and health +are numerous other minute operations or _motions_, on which vital power +in all its manifestations of muscular and nervous energy depends. Many +other _motions_ are consequent upon decay, growth, and repair. Oxygen, +carbonic acid, watery vapors, and other gaseous matter are constantly +being exchanged between the system and atmosphere. Then, the human +system being a complex, chemical laboratory, there are _motions +consequent upon chemical action_, constantly going on within it. + +_Muscular motion_, under the direction of the will, is also absolutely +necessary for the maintenance of good health. + +Animal heat and muscular and nervous power are dependent upon motions of +the minutest particles composing the body. The body is composed of fluid +and semi-fluid matter, permitting great freedom of motion. Health +requires that there shall be _a constant change of place_, an active +transmission of material to and from vital organs and parts, through the +medium of blood-vessels, as well as outside such vessels; that is, +motion of interstitial fluids. + +NATURE'S MODE OF SUSTAINING HEALTH. The act of transforming latent, +non-vital force which exists pent-up in food, as heat is in coal, into +vital energy, requires the simultaneous elimination from the system of a +like amount of worn-out matter. Assimilation of nutritive materials is +impossible, unless a like amount of matter be eliminated from the +system. Muscular and nervous energy are dependent upon activities which +cause waste. Not only is this true in a general way, but it is also true +that the energy produced by the operations of the vital system has a +strict relation to the wasting products--that _full_ energy is only +attained by _perfected_ waste. Use, waste, and power, then, sustain +definite and dependent or corresponding relations, since waste is as +essential to health as is supply. + +Without waste, disturbance is at once produced in the system similar to +that resulting from the introduction of foreign matter. These +disturbances constitute disease. The more obvious effects of lack of +waste and elimination are mechanical. The circulation is loaded with +effete and useless matter, the vessels being thereby weakened and +distended, and the circulation retarded. The capillaries become clogged +and vital action is diminished. Local congestions, inflammations, +effusions, morbid growths, and other pathological results follow. + +Deranged or suppressed action characterizes, and, indeed, constitutes +all departures from health which we call disease. Suffering indicates +action, but action which is perverted into wrong channels, or action in +one part at the expense of motion in other parts, constituting a +disturbance in the equilibrium of forces, from which the system suffers. + +VALUE OR MECHANICAL MOVEMENTS AND MANIPULATIONS FOR THE TREATMENT OF +CHRONIC DISEASES. To correct and restore deranged movements, thereby +producing normal, functional activity of every organ and part of the +system, must therefore be the chief object of the physician. All +remedies, of whatever school or nature, imply motion, and depend for +their efficacy upon their ability to excite motion in some one or more +elements, organs, or parts of the system. + +While we do not wish to detract from the real merits of medicine as a +curative agent, yet we must admit that the remedial power of motion, +transmitted either manually or mechanically, is founded upon rational +and physiological principles. All systems of medicine, however much they +may differ superficially, propose, as the chief end to be attained by +the administration of medicine, or by other treatment, that _motions_ +identical with physiological activity should be incited or promoted. How +best to accomplish this result, and with least cost to vitality, is an +important consideration. Bearing in mind the conservation of forces, +that energy or power is as indestructible as matter, that it may be +changed into other forms but never lost, it is plain that mechanical +force may be applied to the living system and transformed into vital +energy; that chemical action, animal heat, and magnetism may represent +in the system the mechanical force transmitted to the body. Keeping in +view the transformable nature of force, and the need that our systems +have of auxiliary power in different departments, when normal activity +is impaired by disease, we can readily understand how undoubted, +curative effects result from either the manual or the mechanical +administration of motion. + +RUBBING is a process universally employed by physicians of every school +for the relief of a great diversity of distressing symptoms, is +instinctively resorted to by sympathizers and attendants upon the sick, +and constitutes one of the chief duties of the nurse. Uncivilized people +resort to this process as their principal remedy in all forms of +disease. + +The difficulty in administering motion as a remedial agent by manual +effort, such as rubbing, kneading, oscillating, flexing, and extending +the limbs, lies in the impossibility of supplying the _amount, +intensity_, and _variety_ of movement required to make it most +effective. The power of the arm and the strength of the operator are +exhausted before the desired effect is produced. Inventive genius has at +last overcome the obstacles to the successful and perfect administration +of motion as a curative agent. We have now a series of machines +propelled by mechanical power, by the use of which we rub, knead, +manipulate, and apply in succession a great variety of movements to all +parts of the body. These machines transmit motion to the body from +inexhaustible sources, never tire, but are ever ready for new, remedial +conquests. The movements administered by their use, _while entirely +under the control of the patient_, are never disagreeable, and are far +more rapid and intense than can possibly be given by the hands. By the +application of short, quick movements of from _twelve to fifteen hundred +vibrations a minute_, deep-seated organs and parts are reached, to which +motion is transmitted and in which vital energy is thereby generated. +The hands have not the power, by kneading, manipulating, or rubbing to +impress the system except in a very mild degree, and deep-seated organs +and parts are scarcely influenced by the comparatively slow movements +thus administered. Among the most important, mechanical inventions +devised for administering motion as a remedial agent, is one which has +received the name of the _manipulator_. + +THE MANIPULATOR. With this machine motion can be applied to any organ or +part of the system, and intensity of the application regulated to a +nicety. The rapidity of motion necessary to produce active exhilaration +of any part of the body is easily secured by the use of the manipulator, +but is far beyond the power of the hands. The degree of circulation +given to the fluids, both inside and outside of the vessels, and of +energy imparted to the organs and parts operated upon by the +manipulator, is also unapproachable by the application of manual power. + +EFFECTS UPON THE CIRCULATION AND NUTRITION. The influence of motion on +these functions is as follows: The contents of the blood-vessels are +moved onward by the pressure and motion transmitted by the manipulator, +all backward movement of the blood being prevented by the valves of the +veins and by the propelling power of the heart and arteries. Fluids +outside these vessels pass through their walls, to take the place of the +stagnant blood that has been moved onward. Other blood flows into the +part, and thus active and healthy circulation is induced, and nutritive +material, capable of affording vital support is also brought to refresh +the local part. + +We have found mechanical movements especially effectual in paralysis, +neuralgia, sleeplessness, and other nervous affections; in derangements +of the liver, constipation, and dyspepsia; in displacements of the +uterus, and congestion, and inflammation of the pelvic organs. + +For a complete description of the mechanical movements and the machinery +employed in the treatment of diseases at the Invalids' Hotel and +Surgical Institute, the reader is referred to the appendix to this work. + + * * * * * + + + + +CHAPTER IV. + +HYGIENIC TREATMENT OF THE SICK. + + +There are two essentials requisite to the successful treatment of the +sick: (1.) Medical skill; (2.) Good nursing. The former is necessary in +order that the condition of the patient be fully understood, and the +proper means be employed to effect his recovery. The latter is +essential, in order that all influences favoring the production and +development of disease may be removed, the tendencies to restoration be +promoted by every possible means, and the directions of the physician be +properly observed. + +Success in the treatment of the sick requires good nursing. Without it, +the most skillful physicians fail to effect a cure; with it, the most +unqualified may succeed. If certain hygienic agencies are essential to +the maintenance of health, how much more necessary it is that they be +employed in sickness! If certain conditions cause disease, how great the +necessity is that such conditions be obviated and hygienic ones +substituted! + +Notwithstanding the importance of good nursing, in the rural districts +it is frequently difficult to find a professional nurse, or, if one can +be obtained, it is often impossible for the invalid to procure such +services, on account of the expense which must necessarily be incurred. +Hence, this office usually devolves upon some relative who is considered +to be the best qualified for the position; or, as is often the case, +necessity demands that the patient be left to a change of nurses. A +woman is generally selected for this important position. Her soft hand +and soothing voice, her kindly, sympathetic, and provident nature, +together with her scrupulous cleanliness, render her man's equal, if not +his superior, in the capacity of nurse. There are circumstances, +however, in which the services of a man are indispensable; hence the +necessity that all should be qualified to care for the sick. + +A nurse should be attentive to the requirements of physician and +patient, for she sustains an intimate relation to both. She should +observe the directions of the physician, and faithfully perform them. +She should note all the symptoms of the patient, and do everything in +her power to promote comfort and recovery. She should anticipate the +wishes, and not cause the patient to ask for everything which is +desired. So far as practicable, let the wishes be gratified. The senses +of the sick often become morbidly acute, and those things which in +health would pass unnoticed, in sickness are so magnified as to occasion +annoyance and vexation. Sick persons are not all alike, and the +peculiarities of each must be studied separately. The nurse must be +_kind_, but _firm_, and not yield to such whims of the patient as may be +detrimental to recovery; neither must she arouse dislike or anger by +opposition, but endeavor to _win_ the patient from all delusions. The +feelings of the patient should never be trifled with, for idealities +become realities. + +The nurse should possess an inexhaustible store of patience. Disease +affects the mind of the patient and fills it with strange delusions. The +sick are often querulous, fretful, and unreasonable, and should be +treated with kindness, forbearance, and sympathy. The nurse should +always be cheerful, look on the bright side of every circumstance, +animate them with encouragement, and inspire them with hope. Hope is one +of the best of tonics. It stimulates the flagging, vital energies, and +imparts new life to the weak and exhausted forces. Gloom, sadness, and +despondency depress the vital forces and lead to death. We have seen +patients rapidly sinking, who had given up all hope, and were quietly +awaiting the coming of death, snatched, as it were, from its grasp, and +restored to health, by words of cheer and encouragement. + +The nurse should possess _moral principles_, which alone can win the +confidence of the patient. She should have judgment, circumspection, +intelligence, forethought, alacrity, carefulness, and neatness. In a +word she should exercise _common sense_. + +We deem it but justice to say a word in behalf of the nurse. She, too, +is a human being, subject to disease, and, unless hygienic conditions be +observed, will soon be stricken low by its presence. She must be +relieved occasionally and get rest, or she cannot long withstand the +combined influence of fatigue and disease. Her office is an arduous one +at best, and the long, weary hours of night-watching should be +compensated by exercise in the open air, as well as by sleep during the +day. Unless this be done, the system will become exhausted, and sleep +will intrude itself upon her at the time when the greatest diligence is +required for the welfare of the patient, when the vital powers are at +their lowest ebb. She should be supplied with plenty of suitable food +during the night, to sustain her and to serve as a safeguard against the +invasion of disease. She should be treated with kindness and respect, +else her disposition may become morose and reflect itself upon the +patient, causing peevishness and despondency. + +THE SICK-ROOM should be as comfortable, cheerful, and pleasant, as +circumstances will allow. Let the room be large and airy, and furnished +with a stove, or better still, a fireplace. All articles of clothing and +furniture, not necessary to the comfort of the patient, should be +removed from the room, and in _malignant_ or _contagious_ diseases the +carpets, even, should not be permitted to remain. The surroundings beget +happiness or gloom, in proportion as they are pleasant or disagreeable. +A tidy attendant, a few flowers and books, wonderfully enhance the +cheerfulness of the room. Permit no unnecessary accumulation of bottles, +or any thing that can in any way render the room unpleasant. Medicines, +drink, or nourishment should never be left uncovered in the sick-room, +since they quickly absorb the gaseous emanations from the patient, and +become unfit for the purpose which they were intended to serve. Their +presence gives the room an untidy appearance, suggestive of filth and +slovenliness, and imparts to the patient a feeling of loathing and +disgust for articles of diet. + +THE BED should not be of feathers, on account of their undue warmth, +which causes a sensation of languor throughout the system. A husk or +sea-grass mattress, or even a straw bed, covered with a cotton quilt, is +far preferable. The bedding should be changed frequently. It is better +that the bed should be away from the wall, so as to admit of greater +freedom of movement about it. + +PURE AIR. The air in the sick-room should be kept as pure as possible. +That which is so necessary in health, is indispensable in sickness. The +importance, therefore, of a perfect and free ventilation of the +sick-room cannot be too thoroughly impressed; and yet to properly secure +this end, may call forth a considerable amount of ingenuity on the part +of the nurse. A window should be open, but the current of air must not +be allowed to blow directly upon the patient. One window may be raised +from the bottom and another lowered from the top. This will permit the +entrance of pure air from without, and the exit of the vitiated air from +within. The patient, if sufficiently covered in bed, is not liable to +take cold from a proper ventilation of the room. Especially is this +true, when the bodily temperature is raised by febrile or inflammatory +affections. The _temperature_ of a room is no indication of the _purity_ +of the air. It is a prevalent, but mistaken notion, that when a room is +cold, the air must be pure. Cold air is as readily contaminated with +impurities as warm air, therefore, it is not sufficient that the room be +kept cool, but the air should be frequently changed. During +convalescence, great care is necessary to protect the patient from +taking cold. Air which is admitted into the sick-room should not be +contaminated by passing over foul drains, privies, or other sources of +infection, since, instead of invigorating, it depresses the physical +forces and generates disease. + +LIGHT is as necessary to health as is pure air. Banish either for any +continuous period of time, and serious results follow. The strong, +robust man, when deprived of light, soon degenerates into a feeble, +sickly being, and finally dies. + +According to the investigations of the Massachusetts Medical Society, it +was found that absence of sunlight, together with moisture, not only +favor the development of tubercular consumption, but act as an exciting +cause. It is well known that persons living in shaded dwellings often +suffer from forms of disease which resist all treatment until proper +admission of light is secured. + +The physician to the Emperor of Russia found upon examination that +patients confined in well lighted wards, were four times as liable to +recover as were those in poorly lighted rooms. Children reared away from +the sunlight are apt to be deformed and idiotic, while those partially +deformed have been restored by being admitted to the light. + +Patients sometimes wish to have their rooms darkened, because the light +is painful to their weak and sensitive eyes. It is far better to shade +the eyes and admit the sunlight into the room, since its rays cause +chemical changes to take place, which favor the return of health. Many +invalids can ascribe their recovery to the influence of a sun bath. +There are, however, conditions in which the patients should be screened +from the light. In such cases a little arrangement of the curtains or +shutters will accomplish all that is to be desired. + +Patients convalescing from acute, or suffering from chronic diseases, +should receive the influence of light in the open air, and be in it +several hours every day. Light and pure air stimulate a healthful +development, induce cheerfulness, hope, and recovery, while darkness +begets gloom, sadness, despondency, disease, and ultimately death. + +WARMTH is essential to the well-being of the patient, and it is +necessary that a proper temperature be maintained in the room. Except in +very warm weather, a little fire should be kept in the room, and at the +same time fresh air should be admitted from without, and a uniform +temperature thus preserved. This arrangement is especially necessary in +localities where great variations in temperature are experienced during +the day and night. + +The normal temperature of the body ranges from 98° to 99° Fahr. The +minimum occurs from 2 to 6 A.M.; the maximum, from 1 to 6 P.M. The +deviation of a few degrees from this standard indicates disease, and the +greater the deviation, the greater is its severity. During the early +stages of acute diseases, the animal heat is generally increased, and +should be allayed by bathing, and cooling or acidulated drinks. In the +latter stages, the temperature becomes diminished and the condition of +the system is favorable to congestions, which are most likely to occur +between the hours of 2 and 6 A.M., when the vital powers are lowest. The +patient then becomes feeble, his extremities grow cold, and he has what +is termed a "sinking spell," and perhaps dies. It is during these hours +that additional covering, the application of hot bricks to the feet, and +bottles of hot water to the limbs and body, friction upon the surface, +stimulating drinks, and increased vigilance on the part of the nurse +will often save the patient's life. But, unfortunately, at these hours +the nurse is apt to get sleepy and inattentive, the demands of the +patient go unheeded, and a sacrifice of life is the result. + +Persons suffering from chronic diseases, or those in feeble health, +should preserve their vital energies by dressing warmly, by wearing +flannels next to the skin, and by carefully protecting the feet from +cold and moisture. + +CLEANLINESS cannot be too thoroughly impressed upon the minds of those +who have the care of the sick. Filthiness is productive of disease and +favorable to its development. Bathing at least once a day, with pure, +soft water and toilet-soap, is strongly urged, and as this is designed +for cleanliness, the temperature of the bath should be made agreeable to +the patient. + +THE CLOTHING AND BEDDING OF THE PATIENT in acute diseases, should be +changed frequently and thoroughly aired, if not washed. As soon as +removed, these articles should be taken from the room, replaced by +others _well aired and warmed._ The hands and face of the patient should +be bathed frequently, the hair combed, the teeth brushed, the nails +cleaned, the lips moistened, and everything about him kept clean and +tidy. These observances, although in themselves trifling, promote +comfort and cheerfulness, and contribute largely to the recovery of the +sick. All excretions from the patient should be buried, and not +committed to privies to communicate disease to those who frequent them. + +THE DIET contains a very important relation to health. During the +process of acute disease, the appetite is generally much impaired, if +not entirely absent. It should then be the study of the nurse to devise +such articles of nourishment as will be acceptable to the patient and +suitable to the condition. The food should be light, nutritious, and +easy of digestion. + +Each individual disease requires a diet adapted to its peculiarities. +Those of an inflammatory character require an unstimulating diet, as +gruel, barley-water, toast, etc. An exhausted or enfeebled condition of +the brain, unattended by irritability, demands a stimulating diet, as +beef, eggs, fish, Graham bread, oysters, etc. In wasting diseases, in +which the temperature of the system is low, beef, fatty substances, rich +milk, sweet cream, and other carbonaceous articles of diet are +recommended. In the various forms of chronic ailments, the diet must be +varied according to the nature of the disease and the peculiarities of +the patient. Deranged digestion is generally an accompaniment of chronic +disease. A return to normal digestion should be encouraged by selecting +appropriate articles of food, paying due regard to its quantity and +quality, as well as to the manner and time of eating. The appearance of +food, and the manner in which it is offered, have much to do with its +acceptance, or rejection by the patient. Let the nourishment be +presented in a nice, clean dish, of a size and shape appropriate to the +quantity. More food than can be eaten by the patient should not be +placed before him at one time, since a great quantity excites disgust +and loathing. In taking nourishment, drink, or medicine, the patient, if +feeble, should not be obliged to change his position. + +MILK is one of the most important foods in fevers and acute diseases +attended with great prostration, and in which the digestive powers are +enfeebled. It contains within itself all the elements of nutrition. + +BEEF TEA furnishes an excellent nourishment for the sick, but there are +few, even among professional nurses who know how to properly prepare it. +We give three good recipes. One method is to chip up lean beef, put it +in a porcelain or tin saucepan, cover it with _cold_ water, and bring it +up to just below the boiling point, at which temperature _retain it_ for +ten minutes, then season and serve. Another method is similar to the +foregoing, with this difference, that the juices of the meat are +squeezed through a piece of muslin or crash, making the tea richer. +Another way, which we consider preferable to either of the above, is to +take lean beef, cut it into fine bits, put them in a tightly covered +vessel, which is placed in a kettle of water kept boiling. Thus the +whole strength of the juice will be obtained from the meat without +losing any of its properties. It can be seasoned to the taste, and +reduced with water to suit the needs of the patient. + +SLEEP is "Nature's grand restorer, a balm to all mankind; the best +comforter of that sad heart whom fortune's spite assails." It is +necessary in health, and doubly so in sickness. During sleep, the vital +energies recuperate, the forces are less rapidly expended, and the +strength increases. It is the great source of rest and refreshment. +Often a day's rest in bed, free from the cares and anxieties of an +active life, is sufficient to ward off the approach of disease. If quiet +and rest are essential to recuperation in health, their necessity in +disease must be apparent. Life frequently depends on tranquility and +repose, and the least noise or confusion disturbs the sufferer and +diminishes the chances of recovery. Nothing annoys sick or nervous +persons more than whispering and the rustling of newspapers. If +conversation be necessary, let the tones be modified, but never whisper. +In sickness, when the vital forces are low, the more natural rest and +sleep the patient obtains, the greater is the prospect for recovery. As +a rule, _a patient should never be awakened when sleeping quietly_, not +even to take _medicine_, unless in _extreme cases_. If the patient does +not sleep, the cause should be ascertained and the appropriate remedies +employed; if it arise from rush of blood to the head, cooling lotions +should be applied, and warmth to the feet; if, from restlessness or +general irritability, a sponge bath, followed by friction should be +administered; if the wakefulness is due to noise or confusion, quiet is +the remedy. When these means fail, anodynes, or nervines, should be +employed. Lying on the side instead of on the back should be practiced. +Patients afflicted with chronic diseases, on rising, should take a cold +bath, dry the surface quickly with a coarse towel, followed by friction +with the hand. Great benefit may be derived by following these +suggestions when the nature of the disease is not such as to forbid it. + +EXERCISE and rest necessarily alternate with each other. Exercise, so +necessary to health, in many forms of disease greatly contributes to +recovery. It sends the sluggish blood coursing through the veins and +arteries with increased force and rapidity, so that it reaches every +part of the system, supplying it with nourishment. It increases the +waste of old material and creates a demand for new. + +Convalescing patients, or those suffering from chronic diseases, +whenever the weather will permit, should take exercise every day in the +open air. This should be done with regularity. The amount of exercise +must be regulated by the strength of the patient; never take so much as +to produce fatigue, but, as the strength increases, the exercise may be +increased proportionately. Some interesting employment, commensurate +with the patient's strength, should be instituted, so that the mind may +be agreeably occupied with the body. + +When unable to take active exercise, the invalid, properly protected by +sufficient clothing, should ride in a carriage or boat, and each day a +new route should be chosen, so that a change of scenery may be observed, +thus arousing new trains of thought, which will be exhilarating and +prove beneficial to him. + +SEXUAL INFLUENCES. During the progress of disease or convalescence, +entire continence must be observed. It is then necessary that all of the +vital energies should be employed in effecting a recovery from disease, +without having the additional tax imposed of overcoming the debilitating +effects of sexual expenditure. This holds true with regard to all +diseases, and especially those of the nervous system and genitourinary +organs. + +VISITING THE SICK may be productive of good or evil results. Mental +impressions made upon the sick exert a powerful influence upon the +termination of disease. The chances of recovery are in proportion to the +elevation or depression of spirits. Pleasant, cheerful associations +animate the patient, inspire hope, arouse the vital energies, and aid in +his recovery; while disagreeable and melancholy associations beget +sadness and despondency, discourage the patient, depress the vital +powers, enfeeble the body, and retard recovery. + +Unless persons who visit the sick can carry with them joy, hope, mirth, +and animation, they had better stay away. This applies equally in acute +and chronic diseases. It does not matter what a visitor may _think_ with +regard to the patient's recovery, _an unfavorable opinion should never +find expression in the sick-room_. Life hangs upon a brittle thread, and +often that frail support is _hope_. Cheer the sick by words of +encouragement, and the hold on life will be strengthened; discourage, by +uttering such expressions as, "How bad you look!" "Why, how you have +failed since I saw you last!" "I would have another doctor; one who +knows something!" "You can't live long if you don't get help!" etc., and +the tie which binds them to earth is snapped asunder. The visitor +becomes a _murderer!_ Let all persons be guided by this rule: _Never go +into the sick-room without carrying with you a few rays of sunshine!_ + +If the patient is very weak the visitor may injure him by staying too +long. The length of the visit should be graduated according to the +strength of the invalid. Never let the sufferer be wearied by too +frequent or too lengthy visits, nor by having too many visitors at once. +Above all things, do not confine your visitations to Sunday. Many do +this and give themselves credit for an extra amount of piety on account +of it, when, if they would scrutinize their motives more carefully, they +would see that it was but a contemptible resort to save time. The sick +are often grossly neglected during the week only to be visited to death +upon Sunday. + +THE USE OF TOBACCO AND OPIUM. The recovery of the sick is often delayed, +sometimes entirely prevented, by the habitual use of tobacco or opium. +In acute diseases, the appetite for tobacco is usually destroyed by the +force of the disease, and its use is, of necessity, discontinued; but in +chronic ailments, the appetite remains unchanged, and the patient +continues his indulgence greatly to the aggravation of the malady. + +The use of tobacco is a pernicious habit in whatever form it is +introduced into the system. Its active principle, Nicotin, which is an +energetic poison, exerts its specific effect on the nervous system, +tending to stimulate it to an unnatural degree of activity, the final +result of which is weakness, or even paralysis. The horse, under the +action of whip and spur, may exhibit great spirit and rapid movements, +but urge him beyond his strength with these agents, and you inflict a +lasting injury. Withhold the stimulants, and the drooping head and +moping pace indicate the sad reaction which has taken place. This +illustrates the evils of habitually exciting the nerves by the use of +tobacco, opium, narcotic or other drugs. Under their action, the tone of +the system is greatly impaired, and it responds more feebly to the +influence of curative agents. Tobacco itself, when its use becomes +habitual and excessive, gives rise to the most unpleasant and dangerous +pathological conditions. Oppressive torpor, weakness or loss of +intellect, softening of the brain, paralysis, nervous debility, +dyspepsia, functional derangement of the heart, and diseases of the +liver and kidneys are not uncommon consequences of the excessive +employment of this plant. A sense of faintness, nausea, giddiness, +dryness of the throat, tremblings, feelings of fear, disquietude, and +general nervous prostration must frequently warn persons addicted to +this habit that they are sapping the very foundation of health. Under +the continued operation of a poison, inducing such symptoms as these, +what chance is there for remedies to accomplish their specific action? +With the system already thoroughly charged with an influence +antagonistic to their own, and which is sure to neutralize their effect, +what good can medicine do? + +Dr. King says, "A patient under treatment should give up the use of +tobacco, or his physician should assume no responsibility in his case, +further than to do the best he can for him." In our own extensive +experience in the treatment of chronic diseases, we have often found it +necessary to resort to the same restriction. + +The opium habit, to which allusion has also been made, is open to the +same objections, and must be abandoned by all who would seek recovery. + + * * * * * + + + + +PART IV. + +DISEASES AND THEIR REMEDIAL TREATMENT. + + + + +INTRODUCTION. + + +Knowledge which is conducive to self-preservation is of _primary_ +importance. That great educator, profound thinker, and vigorous writer, +Herbert Spencer, has pertinently said that, "As vigorous health and its +accompanying high spirits, are larger elements of happiness than any +other things whatever, the teaching how to maintain them is a teaching +that yields to no other whatever. And therefore we assert that such a +course of physiology as is needful for the comprehension of its general +truths and their bearings on daily conduct is an all-essential part of a +rational education." + +Believing that the diffusion of knowledge for the prevention of disease +is quite as noble a work as the alleviation of physical suffering by +medical skill, we have devoted a large portion of this volume to the +subjects of physiology and hygiene. These we have endeavored to present +in as familiar a style as possible, that they may be understood by every +reader. Freely as we have received light upon these subjects have we +endeavored to reflect it again, in hopes that a popular presentation of +these matters made plain and easy of comprehension to all people, may +lead the masses into greater enjoyment of life--the result of a better +preservation of health. This we do in part as a public acknowledgment of +our obligations to society, to whom every professional man is a debtor. +He belongs to it, is a part of its common stock, and should give as well +as receive advantages, return as well as accept benefits. We know of no +better way to signify our appreciation of the public confidence and +patronage, so generously accorded to us, than to offer this volume to +the people at a price less than the actual cost for an edition of +ordinary size. This we do as a token of the cordial reciprocation of +their good will. In giving to the people wholesome advice, by which they +may be enabled to ward off disease and thus preserve the health of +multitudes, we believe we shall receive their hearty approval, as well +as the approbation of our own conscience, both of which are certainly +munificent rewards. We believe that good deeds are always rewarded, and +that the physician who prevents sickness manifests a genuine and earnest +devotion to the common interests of humanity. + +We have no respect for the motives of those medical men who would +withhold that information from the people which will direct the masses +how to take care of themselves, and thereby prevent much sickness and +suffering. Nor is the diffusion of such knowledge antagonistic to the +best interests of the true and competent physician. The necessity for +his invaluable services can no more be set aside by popularizing +physiological, hygienic, and medical truths, than we can dispense with +those of the minister and lawyer by the inculcation of the principles of +morality in our public schools. The common schools do not lessen the +necessity for colleges or universities, but rather contribute to their +prosperity. Nor are we so presumptuous as to anticipate that we could +possibly make this volume so instructive as to render "every man his own +physician." No man can with advantage be his own lawyer, carpenter, +tailor, and printer; much less can he hope to artfully repair his own +constitution when shattered by grave maladies, which not only impair the +physical functions, but weaken and derange the mental faculties. What +physician presumes to prescribe for himself, when suddenly prostrated by +serious illness? He very sensibly submits to the treatment of another, +because he realizes that sickness impairs his judgment, and morbid +sensations mislead and unfit him for the exercise of his skill. If this +is true of the physician, with how much greater force does it apply to +the unprofessional! If a sick sea-captain is unfit to stand at the helm +and direct his ship, how utterly incompetent must the raw sailor be when +similarly disqualified! Nor is the physician as competent to treat those +near and dear to him, when they are suffering from dangerous illness, as +another medical man not similarly situated, whose judgment is not liable +to be misled by intense anxiety and affectionate sympathy. + +Notwithstanding all these facts, however, a knowledge on the part of the +unprofessional, of something more than physiology and hygiene, and +appertaining more closely to medicine proper, will many times prove +valuable. + +In the first stage of many acute affections which, if unheeded, +gradually assume a threatening aspect, endangering life and demanding +the services of the most skilled physician to avert fatal results, the +early administration of some common domestic remedy, such as a +cathartic, or a diaphoretic herb, associated with a warm bath, a spirit +vapor-bath, or a hot foot-bath, will very often obviate the necessity +for calling a family physician, and frequently save days and weeks of +sickness and suffering. + +So, likewise, are there numerous, acute diseases of a milder character +which are easily and unmistakably recognized without the possession of +great medical knowledge, and which readily yield to plain, simple, +medical treatment which is within the ready reach of all who strive to +acquaint themselves with the rudiments of medical science. But in sudden +and painful attacks of acute disease, life may be suddenly and +unexpectedly jeopardized, and immediate relief prove necessary. While +under these circumstances the prompt application of such domestic +treatment as good common-sense may dictate, guided by a knowledge of +those first principles of medical learning which we shall hereafter +endeavor to make plain, may result in speedy and happy relief, yet at +the same time there should be no delay in summoning a competent +physician to the bedside of the sufferer. + +Then, and not the least important, there are the various chronic or +lingering diseases, from all of which few individuals indeed, who pass +the meridian of life, entirely escape. In this class of ailments there +is generally no immediate danger, and, therefore, time may be taken by +the invalid for studying his disease and employing those remedies which +are best suited for its removal. Or, if of a dangerous or complicated +character, and, therefore, not so readily understood, he may consult +either personally or by letter, some learned and well-known physician, +who makes a specialty of the treatment of such cases, and whose large +experience enables him to excel therein. + +In consideration, therefore, of the foregoing facts, we deem it most +profitable for our readers that Part Fourth of this volume should be +arranged in the following manner: + +The milder forms of uncomplicated, acute diseases, which may be readily +and unmistakably recognized, and successfully managed without +professional aid, will receive that attention which is necessary to give +the reader a correct idea of them, and their proper remedial treatment. + +We shall devote only such attention to the severe and hazardous forms of +acute diseases as is necessary in order to consider their initial stage, +with their proper treatment, not attempting to trace their numerous +complications, or portray the many pathological conditions which are +liable to be developed. For, even by devoting much space to the latter, +we could not expect to qualify our unprofessional readers for +successfully treating such obscure and dangerous conditions. + +We shall devote the largest amount of space to a careful and thorough +consideration of those chronic diseases, which, by a little study, may +be readily recognized and understood by the masses, and for the cure of +which we shall suggest such hygienic treatment and domestic remedies as +may be safely employed by all who are in quest of relief. In the more +dangerous, obscure, or complicated forms of chronic diseases, the +correct diagnosis and successful treatment of which tax all the skill +possessed by the experienced specialist, the invalid will not be misled +into the dangerous policy of relying upon his own judgment and +treatment, but will be counseled not to postpone until too late, the +employment of a skillful physician. + +The apportionment of space which is made in considering the various +diseases and their different stages, as well as the course which the +people are advised to pursue under the different circumstances of +affliction, is not always in accordance with the plans and +recommendations which have been made by others who have written works on +domestic medicine. Most of these authors have attempted, by lengthy +disquisitions, to teach their readers how to treat themselves without +the services of a physician, even in the most hazardous forms of +disease. In such dangerous maladies as typhoid, typhus, yellow, and +scarlet fevers, typhoid pneumonia, and many others, in which life is +imminently imperiled, such instruction and advice is decidedly +reprehensible, as it may lead to the most serious consequences. We are +confident, therefore, that the manner of disposing of the different +subjects which are discussed in the succeeding chapters, and the course +of action which is advised, will commend themselves to our readers as +being such as are calculated to promote and subserve their best +interests. + + +MEDICAL DIAGNOSIS. + + +Skill in the art of healing is indicated in three ways: (1.) by +ascertaining the _symptoms, seat_, and _nature_ of the disease, which is +termed _diagnosis_; (2.) by foretelling the probable termination, which +is termed _prognosis_; (3.) by the employment of efficacious and +appropriate remedies, which is called _treatment_. Of these three +requisites to a prosperous issue, nothing so distinguishes the expert +and accomplished physician from the mere pretender as his ready ability +to interpret correctly, the location, extent, and character of an +affection from its symptoms. By medical diagnosis, then, is understood +the discrimination between diseases by certain symptoms which are +distinguishing signs. Every malady is accompanied by its characteristic +indications, some of which are _diagnostic, i.e._, they particularize +the affection and distinguish it from all others. + +Medical diagnosis is both a _science_ and an _art_; a science when the +causes and symptoms of a disease are understood, and an art when this +knowledge can be applied to determine its location and exact nature. +Science presents the general principles of practice; art detects among +the characteristic symptoms the differential signs, and applies the +remedy. Da Costa aptly remarks: "No one aspiring to become a skillful +observer can trust exclusively to the light reflected from the writings +of others; he must carry the torch in his own hands, and himself look +into every recess." + +The critical investigation of symptoms, with the view of ascertaining +their signs, is essential to successful practice. Without closely +observing them, we cannot accurately trace out the diagnosis, and a +failure to detect the right disease is apt to be followed by the use of +wrong medicines. + +General diagnosis considers the surroundings of the patient as well as +the actual manifestations of the disease. It takes into account the +diathesis, _i.e._, the predisposition to certain diseases in consequence +of peculiarities of constitution. We recognize constitutional +tendencies, which may be indicated by the contour of the body, its +growth, stature, and temperament, since all these facts greatly modify +the treatment. Likewise the sex, age, climate, habits, occupation, +previous diseases, as well as the present condition, must be taken into +account. + +Auscultation, as practiced in detecting disease, consists in listening +to the sounds which can be heard in the chest. + +Percussion consists in striking upon a part with the view of +appreciating the sound which results. The part may be struck directly +with the tips of the fingers, but more generally one or more fingers of +the other hand are interposed between the points of the fingers and the +part to be percussed, that they, instead of the naked chest, may receive +the blow; or, instead of the fingers, a flat piece of bone or ivory, +called a _pleximeter_, is placed upon the chest to receive the blow. + +Latterly, improved instruments greatly assist the practitioner of +medicine in perfecting this art. The _microscope_ assists the eye, and +helps to reveal the appearance and character of the excretions, +detecting morbid degenerations; _chemistry_ discloses the composition of +the urine, which also indicates the morbid alterations occurring in the +system; by percussion we can determine the condition of an internal +organ, from the sound given when the external surface is percussed; the +ear, with the aid of the _stethoscope_, detects the strange murmurs of +respiration, the fainter, more unnatural pulsations of life, and the +obscurer workings of disease; with the _spirometer_ we determine the +breathing capacity of the lungs, and thus ascertain the extent of the +inroads made by disease; the _dynamometer_ records the lifting ability +of the patient; the _thermometer_ indicates the morbid variation in the +bodily temperature; various instruments inform us of the structural +changes causing alterations in the specific gravity of fluids, _e.g_., +the _urinometer_ indicates those occurring in the urine; and thus, as +the facilities for correct diagnosis increase, the art of distinguishing +and classifying diseases becomes more perfect, and their treatment more +certain. While physiology treats of all the natural functions, pathology +treats of lesions and altered conditions. + +[Illustration: Fig. 146. +Dr. Brown's Spirometer.] + +By the term _symptoms_ we mean the evidence of some morbid effect or +change occurring in the human body, and it requires close observation +and well-instructed experience to convert these symptoms into diagnostic +signs. Suppose "Old Probabilities" (as we commonly designate the +invaluable Signal Department) hangs out his warning tokens all along our +lake borders and ocean coasts; our sailors behold the fluttering symbols +indicating an approaching storm, but if no one understood their meaning, +a fearful disaster might follow. But if these signals are understood, a +safe harbor is sought and the mariner is protected. So disease may hang +out all her signals of distress, in order that they may be seen, but +unless correctly interpreted, and a remedial harbor is sought, these +symptoms are of little practical value. + +Undoubtedly the reason why so many symptom-doctors blunder is because +they prescribe according to the apparent symptoms, without any real +reference to the nature of the affection. They fail to discover how far +a symptom points out the seat, and also the progress of a disease. They +do not distinguish the relative importance of the different symptoms. +The practical purpose of all science is to skillfully apply knowledge to +salutary and profitable uses. The patient himself may carefully note the +indications, but it is only the expert physician who can tell the import +of each symptom. + +_Symptoms_ are within every one's observation, but only the physician +knows the nature and value of _signs_. We have read an anecdote of +Galen, who was a distinguished physician in his day, which illustrates +the distinction between sign and symptom. Once, when dangerously ill, he +overheard two of his friends in attendance upon him recount his +symptoms, such as "Redness of the face, a dejected, haggard, and +inflamed appearance," etc. He cried out to them to adopt every necessary +measure forthwith, as he was threatened with delirium. The two friends +saw the _symptoms_ well enough; but it was only Galen himself, though +the _patient_, who was able to deduce the _sign_ of delirium--that is, +he alone was able to translate those symptoms into signs. To determine +the value of symptoms, as signs of disease, requires close observation. + + +INTERPRETATION OF SYMPTOMS. + + +We shall refer to a few symptoms which any unprofessional reader may +readily observe and understand. + +POSITION OF PATIENT. When a patient is disposed to lie upon his back +continually during the progress of an acute disease, it is a sign of +_muscular debility_. If he manifests no desire to change his position, +or cannot do so, and becomes tremulous at the least effort, it indicates +_general prostration_. When this position is assumed, during the +progress of continued fever, and is accompanied by involuntary twitching +of the muscles, picking of the bed-clothes, etc., then danger is +imminent and _the patient is sinking_. Fever, resulting from local +inflammation, does not produce muscular prostration, and the patient +seldom or never assumes the supine position. If this inflammation is in +the extremities, those parts are elevated, in order to lessen the +pressure of the blood, which a dependent, position increases. + +For example, let us change the scene, and introduce a patient with head +and shoulders elevated, who prefers to sit up, and who places his hands +behind him and leans back, or leans forward resting his arms and head +upon a chair. The next week he is worse, and no longer tries to lie in +bed, but sits up all the time; note the anxious expression of +countenance, the difficult or hurried breathing, the dry and hacking +cough, and observe that the least exertion increases the difficulty of +respiration and causes palpitation of the heart. These plain symptoms +signify thoracic effusion, the collection of water about the lungs. + +THE COUNTENANCE displays diagnostic symptoms of disease. In simple, +acute fevers, the eyes and face are red and the respiration is hurried; +but in acute, sympathetic fever, these signs are wanting. We cannot +forget the pale, sharp, contracted, and pinched features of those +patients whose nostrils contract and expand alternately with the acts of +respiration. How hard it was for them to breathe. The contraction and +expansion of the nostrils indicate active congestion of the lungs. + +As a general rule, chronic inflammation of the stomach, duodenum, liver, +and adjacent organs, imparts a gloomy expression to the countenance, at +the same time the eye is dull, the skin dusky or yellow, and the motions +are slow. But in lung diseases, the spirits are buoyant, the skin is +fair, and the cheeks flushed with fever and distinctly circumscribed +with white, for delicacy and contrast, almost exceed the hues of health +in beauty. Note, too, the pearly lustre and sparkling light of the eye, +the quivering motion of the lips and chin, all signs of pulmonary +disease. + +THE STORY OF SEXUAL ABUSE is plainly told by the downcast countenance, +the inability to look a person fairly in the face, the peculiar lifting +of the upper lip and the furtive glance of the eye. The state of the +mind and of the nervous system corroborates this evidence, for there +seems to be a desire to escape from conversation and to elude society. +The mind seems engrossed and abstracted, the individual appears absorbed +in a constant meditation, he is forgetful and loses nearly all interest +in the ordinary affairs of life. The whole appearance of a patient, +suffering from spermatorrhea, is perfectly understood by the experienced +physician, for the facial expressions, state of mind, and movements of +the body, all unconsciously betray, and unitedly proclaim his condition. + +TONGUE. Much may be learned from the appearance, color, and form of the +tongue, and the manner of its protrusion. If pale, moist, and coated +white, it indicates a mild, febrile condition of the system. If coated +in the center, and the sides look raw, it indicates gastric irritation. +If red and raw, or dry and cracked, it is a sign of inflammation of the +mucous membrane of the stomach. If the inflammation is in the large +intestine, the tip of the tongue presents a deep red color, while the +middle is loaded with a dark brown coating. When the tongue is elongated +and pointed, quickly protruded and withdrawn, it indicates irritation of +the nerve-centers, as well as of the stomach and bowels. If tremulous, +it denotes congestion and lack of functional ability; this may be +observed in congestive fevers. + +PULSE. Usually the pulse beats four times during one respiration, but +both in health and disease its frequency may be accelerated or retarded. +In adults, there are from sixty-five to seventy-five beats in a minute, +and yet in a few instances we have found, in health, only forty +pulsations per minute. But when the heart beats from one hundred and +twenty to one hundred and forty times a minute, there is reason to +apprehend danger, and the case should receive the careful attention of a +physician. + +Irregularity of the pulse may be caused by disease of the brain, heart, +stomach, or liver; by the disordered condition of the nervous system; by +lack of muscular nutrition, as in gout, rheumatism, or convulsions; by +deficiency of the heart's effective power, when the pulse-wave does not +reach the wrist, or when it intermits and then becomes more rapid in +consequence of septic changes of the blood, as in diphtheria, +erysipelas, and eruptive fevers. + +PAIN. The import of pain depends on its seat, intensity, nature, and +duration. An acute, intense pain usually indicates inflammation of a +nerve as well as the adjacent parts. Sharp, shooting, lancinating pains +occur in inflammation of the serous tissues, as in pleurisy. A smarting, +stinging pain attends inflammation of the mucous membrane. Acute pain is +generally remittent and not fixed to one spot. Dull, heavy pain is more +persistent, and is present in congestions, or when the substance of an +organ is inflamed, and it often precedes hemorrhage. Burning pain +characterizes violent inflammations involving the skin and subjacent +cellular tissue, as in case of boils and carbuncles. Deep, perforating +pain accompanies inflammation of the bones, or of their enveloping +membranes. Gnawing, biting, lancinating pain attends cancers. + +The location of pain is not always at the seat of the disease. In +hip-disease, the pain is not first felt in the hip, but in the +knee-joint. In chronic inflammation of the liver, the pain is generally +most severe in the right shoulder and arm. Disease of the kidneys +occasionally produces numbness of the thigh and drawing up of the +testicle, and commonly causes colicky pains. Inflammation of the +meninges of the brain is often indicated by nausea and vomiting before +attention is directed to the head. These illustrations are sufficient to +show that pain often takes place in some part remote from the disease. + +In chronic, abdominal affections, rheumatic fevers, gout, and syphilis, +the entire system is thrown into a morbid state, the nervous system is +disturbed, and wandering pains manifest themselves in different parts of +the body. Fixed pain, which is increased by pressure, indicates +inflammation. If it be due only to irritation, pressure will not +increase it. Some rheumatic affections and neuralgia not only bear +pressure, but the pain diminishes under it. Permanent pain shows that +the structures of an organ are inflamed, while intermittent pain is a +sign of neuralgia, gout, or rheumatism. Absence of pain in any disease, +where ordinarily it should be present, is an unfavorable sign. Internal +pain, after a favorable crisis, is a bad omen. Or, if pains cease +suddenly without the other symptoms abating, the import is bad. If, +however, pain and fever remit simultaneously and the secretions +continue, it is a favorable sign. + +A dull pain in the head indicates fullness of the blood-vessels from +weakness, low blood, or general debility. It may be caused by taking +cold, thus producing passive congestion of the brain. It may proceed +from gastric disturbance, constipation of the bowels, or derangement of +the liver. Heaviness of the head sometimes precedes inflammation of the +brain, or chronic disease of its membranes. A dull, oppressive pain in +the head indicates softening of the brain, and is generally accompanied +by slowness of the pulse and of the speech. A pulsating pain of the head +occurs in heart disease, hysteria, and frequently accompanies some forms +of insanity. + +THE EYE indicates morbid changes and furnishes unmistakable signs of +disease. Sinking of the eye indicates waste, as in consumption, +diarrhea, and cholera. In fevers it is regarded as a fatal symptom. A +dark or leaden circle around the eye, seen after hard work, indicates +fatigue and overdoing. If the mucous covering of the inner surface of +the lids and the ball of the eye is congested and inflamed, it exhibits +redness, and may indicate congestion or even inflammation of the brain. + +A dilated pupil is often observed in catarrhal consumption, congestion +of the brain, low fevers, and chlorosis. + +The pupil contracts in inflammation of the meninges, when there is +increased sensibility and intolerance of light, also in spinal +complaints. In some diseases the lustre of the eye increases, as in +consumption. But if it decreases with the attack of violent disease, it +indicates great debility and prostration. + +EXAMINATION OF THE URINE. All medical authors and physicians of +education, freely admit and even insist upon the importance of +critically examining the patient's urine, in all cases in which there is +reason to suspect disease of the kidneys or bladder. In chronic +affections it is particularly serviceable, especially in derangements of +the liver, blood, kidneys, bladder, prostate gland, and nervous system. +Many scholarly physicians have sadly neglected the proper inspection of +the urine, because they were afraid of being classed with the illiterate +"uroscopian" doctors, or fanatical enthusiasts, who ignorantly pretend +to diagnose correctly _all_ diseases in this manner, thus subjecting +themselves and their claims to ridicule. Nothing should deter one from +giving to this excretion the attention it deserves. + +The urine which is voided when the system is deranged or diseased is +altered in its color and composition, showing that its ingredients vary +greatly. So important an aid do examinations of the urine furnish in +diagnosing many chronic ailments, that at the Invalids' Hotel and +Surgical Institute, where many thousands of cases are annually treated, +a chemical laboratory has been fitted up, and a skillful chemist is +employed, who makes a specialty of examining the urine, both chemically +and microscopically, and reporting the result to the attending +physicians. His extended experience renders his services invaluable. +With his assistance, maladies which had hitherto baffled all efforts put +forth to determine their true character, have frequently been quickly +and unmistakably disclosed. + +MICROSCOPICAL EXAMINATION. This method of examination affords a quicker +and more correct idea of a deposit or deposits than any other method. +The expert, by simply looking at a specimen, can determine the character +of the urine, whether blood, mucus, pus, uric acid, etc., are present or +not. But when no deposit is present, then it is necessary to apply +chemical tests, and in many cases the quantity of the suspected +ingredient must be determined by analysis. As a detailed account, of the +various modifications which the urine undergoes in different diseases, +would be of no practical use to the masses, since they could not avail +themselves of the advantages which it would afford for correct +diagnosis, except by the employment of a physician who does not ignore +this aid in examining his patients, we shall omit all further details +upon the subject. For the same reason we shall not often, in treating of +the different diseases in which examinations of the urine furnish such +valuable aid in forming a diagnosis, make mention of the changes which +are likely to have occurred. + + +INFLAMMATION. + + +The term _Inflammation_ signifies a state in which the infected part is +hotter, redder, more congested, and more painful than is natural. +Inflammation is limited to certain parts, while fever influences the +system generally. Inflammation gives rise to new formations, morbid +products, and lesions, or alterations of structure. The morbid products +of fever, and its modification of fluids are carried away by the +secretions and excretions. + +The susceptibility of the body to inflammation maybe _natural_ or +_acquired_. It is natural when it is constitutional; that is, when there +is an original tendency of the animal economy to manifest itself in some +form of inflammation. We may notice that some children are far more +subject to boils, croups, and erysipelatous diseases than others. This +susceptibility, when innate, may be lessened by careful medication, +although it may never be wholly eradicated. When acquired, it is the +result of the influence of habits of life, climate, and the state of +mind over the constitution + +Phlegmonous inflammation is the active inflammation of the cellular +membrane, one illustration of which is a common boil. The four principal +symptoms are redness, swelling, heat, and pain; and then appears a +conical, hard, circumscribed tumor, having its seat in the dermoid +texture. At the end of an indefinite period, it becomes pointed, white +or yellow, and discharges pus mixed with blood. When it breaks, a small, +grayish, fibrous mass sometimes appears, which consists of dead, +cellular tissue, and which is called the _core_. + +There are certain morbid states of the constitution which lead to local +inflammation, subsequent upon slight injury; or, in some cases, without +any such provocation, as in gout, rheumatism, and scrofula. One of the +first results of the inflammation, in such cases, is a weakening of the +forces which distribute the blood to the surface and extremities of the +body. It is generally admitted that in scrofulous persons the vascular +system is weak, the vessels are small, and because nutrition is faulty, +the blood is _imperfectly organized_. The result is failure in the +system, for if nutrition fails, there may be lacking earthy matter for +the bones, or the unctious secretions of the skin; the sebaceous +secretion is albuminous and liable to become dry, producing inflammation +of the parts which it ought to protect. + +Disorder of the alimentary canal and other mucous surfaces are sometimes +reflected upon the skin. We have occasionally observed cutaneous +eruptions and erysipelas, when evidently they were distinct signs of +internal disorder. + +Inflammation may be internal as well as external, as inflammation of the +brain, lungs, or stomach, and it is frequently the result of what is +called a _cold_. No matter how the body is chilled, the blood retreats +from the surface, which becomes pale and shrunken, there is also nervous +uneasiness, and frequently a rigor, accompanied with chattering of the +teeth. After the cold stage, reaction takes place and fever follows. The +sudden change from a dry and heated room to a cool and moist atmosphere +is liable to induce a cold. Riding in a carriage until the body is +shivering, or sitting in a draft of air when one has been previously +heated, or breathing a very cold air during the night when the body is +warm, especially when not accustomed to doing so, or exposing the body +to a low temperature when insufficiently clothed, are all different ways +of producing inflammation. + +Inflammation may result in consequence of local injury, caused by a +bruise, or by a sharp, cutting instrument, as a knife or an axe, or it +may be caused by the puncture of a pin, pen-knife blade or a fork-tine, +or from a lacerated wound, as from the bite of a dog, or from a very +minute wound poisoned by the bite of a venomous reptile. Local +inflammations may arise from scalds, burns, the application of caustics, +arsenic, corrosive sublimate, cantharides, powerful acids, abrasions of +the surface by injuries, and from the occurrence of accidents. + +The _swelling_ of the part may be caused by an increase of the quantity +of blood in the vessels, the effusion of serum and coagulating lymph, +and the interruption of absorption by the injury, or by the altered +condition of the inflamed part. + +The character of the _pain_ depends upon the tissue involved, and upon +the altered or unnatural state of the nerves. Ordinarily, tendon, +ligament, cartilage, and bone are not very sensitive, but when inflamed +they are exquisitely so. + +The heat of the inflamed part is not so great, when measured by the +thermometer, as might be supposed from the patient's sensations. + +TERMINATION OF INFLAMMATION. Inflammation ends in one of six different +ways. Inflammation may terminate in _resolution, i.e_., spontaneous +recovery; by _suppuration_, in the formation of matter; by _effusion_, +as the inflammation caused by a blister-plaster terminates by effusion +of water; by _adhesion_, the part inflamed forming an attachment to some +other part; by _induration_, hardening of the organ; or by _gangrene_, +that is, death of the part. + +Thus, inflammation of the lungs may terminate by recovery, that is, by +resolution, by suppuration and raising of "matter," by hardening and +solidification of the lung, or by gangrene. Inflammation of the +endocardium, the lining membrane of the heart, may cause a thickening of +it, and ossification of the valves of the heart, thus impairing its +function. Inflammation of the pericardium may terminate in effusion, or +dropsy, and inflammation of the liver may result in hardening and +adhesion to adjacent parts. + + +SEVERAL PRINCIPLES FOR TREATMENT OF INFLAMMATION. + + +Remove the exciting causes as far as practicable. If caused by a +splinter or any foreign substance, it should be withdrawn, and if the +injury is merely local, apply cold water to the parts to subdue the +inflammation. If caused by a rabid animal, the wound should be enlarged +and cupped, and the parts cleansed or destroyed by caustic. The patient +should remain quiet and not be disturbed. The use of tincture of aconite +internally, will be found excellent to prevent the rise of inflammation. +A purgative is also advised, and four or five of Dr. Pierce's Pleasant +Purgative Pellets will be sufficient to act upon the bowels. If there is +pain, an anodyne and diaphoretic is proper. Dr. Pierce's Compound +Extract of Smart-weed will fulfill this indication. In local +inflammation cold water is a good remedy, yet sometimes hot water, or +cloths wrung out of it, will be found to be the appropriate application. +When the inflammation is located in an organ within a cavity, as the +lungs, hot fomentations will be of great service. Bathing the surface +with alkaline water must not be omitted. Whenever the inflammation is +serious the family physician should be early summoned. + + +FEVER. + + +In fever all the functions are more or less deranged. In every +considerable inflammation there is sympathetic fever, but in essential +fevers there are generally fewer lesions of structure than in +inflammation. Fever occasions great waste of the tissues of the body, +and the refuse matter is carried away by the organs of secretion and +excretion. The heat of the body in fever is generally diffused, the +pulse is quicker, there is dullness, lassitude, chilliness, and +disinclination to take food. We propose to give only a general outline +of fevers, enough to indicate the principles which should be observed in +domestic treatment. + +Most fevers are distinctly marked by four stages: 1st, the forming +stage; 2d, the cold stage; 3d, the hot stage; 4th, the sweating or +declining stage. During the first stage the individual is hardly +conscious of being ill, for the attack is so slight that it is hardly +perceptible. True, as it progresses, there is a feeling of languor, an +indisposition to make any bodily or mental effort, and also a sense of +soreness of the muscles, aching of the bones, chilliness, and a +disposition to get near the fire. There is restlessness, disturbed +sleep, bad dreams, lowness of spirits, all of which are characteristic +of the formative stage of fever. + +The next is the cold stage, when there is a decided manifestation of the +disease, and the patient acknowledges that he is really sick. In typhus +and typhoid fever the chills are slight; in other fevers they are more +marked; while in ague they are often accompanied by uncontrollable +shaking. When the chill is not so distinct the nails look blue and the +skin appears shriveled, the eye is sunken and a dark circle +circumscribes it, the lips are blue, and there is pain in the back. The +pulse is frequent, small, and depressed, the capillary circulation +feeble, the respiration increased, and there may be nausea and vomiting. +These symptoms vary in duration from a few minutes to more than an hour. +They gradually abate, reaction takes place, and the patient begins to +throw off the bed-clothes. + +Then follows the hot stage, for with the return of the circulation of +the blood to the surface of the body, there is greater warmth, freer +breathing, and a more comfortable and quiet condition of the system. The +veins fill with blood, the countenance brightens, the cheeks are +flushed, the intellect is more sprightly, and if the pulse is frequent, +it is a good sign; if it sinks, it indicates feeble, vital force, and is +not a good symptom. If there is considerable determination of blood to +the head it becomes hot, the arteries of the neck pulsate strongly, and +delirium may be expected. During the hot stage, if the fever runs high, +the patient becomes restless, frequently changes his position, is +wakeful, uneasy, and complains of pain in his limbs. In low grades, the +sensibility is blunted, smell, taste, and hearing are impaired. + +The patient in the hot stage is generally thirsty, and if he is allowed +to drink much, it may result in nausea and vomiting. Moderate indulgence +in water, however, is permissible. There is aversion to food, and if any +is eaten, it remains undigested. The teeth are sometimes covered with +dark _sordes_ (foul accumulations) early in the fever, and the +appearance of the tongue varies, sometimes being coated a yellowish +brown, sometimes red and dry, at other times thickly coated and white. +The condition of the bowels varies from constipation to diarrhea, +although sometimes they are quite regular. The urine is generally +diminished in quantity, but shows higher color. + +The sweating stage in some fevers is very marked, while in others there +is very little moisture, but an evident decline of the hot stage, the +skin becoming more natural and soft. The pulse is more compressible and +less frequent, the kidneys act freely, respiration is natural, the pains +subside, although there remains languor, lassitude, and weariness, a +preternatural sensibility to cold, an easily excited pulse, and a pale +and sickly aspect of the countenance. The appetite has failed and the +powers of digestion are still impaired. + +DOMESTIC MANAGEMENT OF FEVERS. It is proper to make a thorough study of +the early, insidious symptoms of fever, in order to understand what +ought to be done. If it arises in consequence of malaria, the treatment +must be suited to the case. If from irritation of the bowels and +improper articles of diet, then a mild cathartic is required. If there +is much inflammation, a severe chill, and strong reaction, then the +treatment should be active. If the fever is of the congestive variety +and the constitution is feeble, the reaction imperfect, a small, weak +pulse, a tendency to fainting, a pale countenance, and great pain in the +head, apply heat and administer diaphoretics, and procure the services +of a good physician. + +As a general rule, it is proper to administer a cathartic, unless in +typhoid fever, and for this Dr. Pierce's Purgative Pellets answer the +purpose, given in doses of from four to six, according to the state of +the bowels. If these are not at hand, a tea of sage and senna may be +drunk until it produces a purgative effect, or a dose of Rochelle salts +taken. In nearly all fevers we have found that a weak, alkaline tea, +made from the white ashes of hickory or maple wood, is useful, taken +weak, three or four times daily, or if there be considerable thirst, +more frequently. Some patients desire lemon juice, which enters the +system as an alkali and answers all purposes. + +Diaphoretic medicines are also indicated, and the use of Dr. Pierce's +Extract of Smart-weed will prove very serviceable. Drinking freely of +pleurisy-root tea, or of a strong decoction of boneset is frequently +useful. After free sweating has been established, then it is proper to +follow by the use of diuretic teas, such as that of spearmint and +pumpkin seed combined, or sweet spirits of nitre, in doses of twenty to +thirty drops, added to a teaspoonful of the Extract of Smart-weed, +diluted with sweetened water. + +To lessen the frequency of the pulse, fluid extract or tincture of +aconite or veratrum may be given in water, every hour. During the +intermission of symptoms, tonic medicines and a sustaining course of +treatment should be employed. If the tongue is loaded and the +evacuations from the bowels are fetid, a solution of sulphite of soda is +proper; or, take equal parts of brewer's yeast and water, mix, and when +the yeast settles, give a tablespoonful of the water every hour, as an +antiseptic. Administering a warm, alkaline hand-bath to a fever patient +every day, is an excellent febrifuge remedy, being careful not to chill +or induce fatigue. If there is pain in the head, apply mustard to the +feet; if it is in the side, apply hot fomentations. + +The symptoms which indicate danger are a tumid and hard abdomen, +difficult breathing, offensive and profuse diarrhea, bloody urine, +delirium, or insensibility. Favorable symptoms are a natural and soft +state of the skin, eruptions on the surface, a natural expression of the +countenance, moist tongue, free action of the kidneys, and regular +sleep. If the domestic treatment which we have advised does not break +the force of the disease and mitigate the urgency of the symptoms, it +will be safer to employ a good physician, who will prescribe such a +coarse of treatment as the case specially requires. It is our aim to +indicate what may be done before the physician is called, for frequently +his services cannot be obtained when they are most needed. Besides, if +these attacks are early and properly treated with domestic remedies, it +will often obviate the necessity of calling upon a physician. If, on the +other hand, fevers are neglected and no treatment instituted, they +become more serious in character and are more difficult to cure. + +To recapitulate, our treatment recommends evacuation through nature's +outlets, the skin, kidneys, and bowels, maintaining warmth, neutralizing +acidity, using antiseptics, tonics, and the hand-bath, and the fluid +extract or tincture of aconite, or veratrum to moderate the pulse by +controlling the accelerated and unequal circulation of the blood. It is +a simple treatment, but if judiciously followed, it will often abort a +fever, or materially modify its intensity and shorten its course. + + +FEVER AND AGUE. (INTERMITTENT FEVER.) + + +The description of fever already given applies well to this form of it, +only the symptoms in the former stage are rather more distinct than in +the other varieties. Weariness, lassitude, yawning, and stretching, a +bitter taste in the mouth, nausea, less of appetite, the uneasy state of +the stomach and bowels are more marked in the premonitory stages of +intermittent fevers. The cold stage commences with a chilliness of the +extremities and back, the skin looks pale and shriveled, the blood +recedes from the surface, respiration is hurried, the urine is limpid +and pale, sometimes there is nausea and vomiting, and towards the +conclusion of the stage, the chilly sensations are varied with flushes +of heat. The hot stage is distinguished by the heat and dryness of the +surface of the body and the redness of the face; there is great thirst, +strong, full, and hard pulse, free and hurried respiration and increased +pain in the head and back. The sweating stage commences by perspiration +appearing upon the forehead, which slowly extends over the whole body, +and soon there is an evident intermission of all the symptoms. In the +inflammatory variety of intermittent fever, all these symptoms are +acute, short, and characterized by strong reaction. Gastric fever, the +most frequent variety of intermittent fever, is marked by irritation of +the stomach and bowels, and a yellow appearance of the white of the eye. + +CAUSES. The cause of the malarial fevers, intermittent, remittent, and +congestive, is supposed to be _miasm_, a poisonous, gaseous exhalation +from decaying vegetation, which is generally most abundant in swamps and +marshes, and which is absorbed into the system through the lungs. + +TREATMENT. During the entire paroxysm the patient should be kept in bed, +and in the cold stage, covered with blankets and surrounded with bottles +of hot water. The Compound Extract of Smart-weed should be administered +in some diaphoretic herb-tea. During the hot stage, the extra clothing +and the bottles of hot water should be gradually removed and cold drinks +taken instead of warm. During the sweating stage the patient should be +left alone, but as soon as the perspiration ceases, from two to four of +the Purgative Pellets should be administered, as a gentle cathartic. A +second paroxysm should, if possible, be prevented. To accomplish this, +during the intermission of symptoms, the Golden Medical Discovery should +be taken in doses of from two to three teaspoonfuls every four hours in +alternation with three-grain doses of the sulphate of quinine. If the +attack is very severe, and is not relieved by this treatment, a +physician should be summoned to attend the case. + + +REMITTENT FEVER. (BILIOUS FEVER.) + + +The distinction between _intermittent_ and _remittent_ fever does not +consist in a difference of origin. In the former disease there is a +complete intermission of the symptoms, while in the latter there is only +a remission. + +TREATMENT. The treatment should consist in the employment of those +remedial agents advised in intermittent fever, the Golden Medical +Discovery and quinine being taken during the remission of symptoms. +During the height of the fever, tincture of aconite maybe given and an +alkaline sponge-bath administered with advantage. As in intermittent +fever, should the course of treatment here advised not promptly arrest +the disease, the family physician should be summoned. + + +CONGESTIVE FEVER. (PERNICIOUS FEVER.) + + +This is the most severe and dangerous form of malarial fever. It may be +either intermittent or remittent in character. In some instances the +first paroxysm is so violent as to destroy life in a few hours, while in +others it comes on insidiously, the first one or two paroxysms being +comparatively mild. It is frequently characterized by stupor, delirium, +a marble-like coldness of the surface, vomiting and purging, jaundice, +or hemorrhage from the nose and bowels. In America this fever is only +met with in the Mississippi valley, and in other localities where the +air contains a large quantity of malarial poison. + +TREATMENT. This fever is so dangerous that a physician should be +summoned as soon as the disease is recognized. For the benefit of those +who are unable to obtain medical attendance, we will say that the +treatment should be much the same as in intermittent fever, but more +energetic. Quinine should be taken in doses of from five to fifteen +grains every two or three hours. If it be not retained by the stomach, +the following mixture may be administered by injection: sulphate of +quinine, one-half drachm; sulphuric acid, five drops; water, one ounce; +dissolve, and then add two ounces of starch water. + + +CONTINUED FEVERS. + + +The symptoms of these fevers do not intermit and remit, but _continue_ +without any marked variation for a certain period. They are usually +characterized by great prostration of the system, and are called +_putrid_ when they manifest septic changes in the fluids, and +_malignant_ when they speedily run to a fatal termination. _Typhoid_ and +_typhus_ fevers belong to this class. We shall not advise treatment for +these more grave disorders which should always, for the safety of the +patient, be attended by the family physician, except to recommend some +simple means which may be employed in the initial stage of the disease, +or when a physician's services cannot be promptly secured. + + +TYPHOID FEVER. (ENTERIC FEVER.) + + +In typhoid fever there is ulceration of the intestines and mesenteric +glands. This diseased condition of the bowels distinguishes this fever +from all others, and is readily detected by sensitiveness to pressure, +especially over the lower part of the abdomen on the right side. The +early disposition to diarrhea is another characteristic symptom of it, +and there is also no intermission of symptoms as in intermittent fever. +The disease comes on insidiously, with loss of appetite, headache, +chilliness, and languor. It is usually a week or more before the disease +becomes fully developed. + +CAUSE. Typhoid fever is a specific form of fever developed from the +action of a specific germ upon a susceptible system. The poison of +typhoid fever is eliminated mainly through the bowels. The germs of +typhoid can maintain life for months in water, and thus it happens that +ponds, lakes, rivers and streams which receive sewage can spread the +germs of typhoid fever. Well water often swarms with these poisonous +germs. In some cases it has been found that privies, though twenty or +forty feet away from a well, have yet drained into it--through a clay +soil covered with gravel--and carried the germs to those drinking the +water from the well. Next to water, milk is the most prominent carrier +of contagion. Milk is apt to get infected with the germs if cooled in +tanks of water which may receive drainage from outhouses and barns. + +TREATMENT. Scientific support has been given the treatment by cold tub +baths (70° Fahrenheit) and it is advised by many physicians. Experience +has proved that sponge baths and tub baths are of the utmost importance, +when the temperature of the patient is at or above 102.5° Fahrenheit. +Every three hours the tub bath is given for twenty minutes at 70° +Fahrenheit. These may be tepid at first, gradually cooling to 70°. +Frictions are applied to patient in the bath, and he is wrapped in +blankets when taken out to avoid danger of chill, and then given a warm +drink or stimulant. Treatment should be directed by an experienced +physician to suit the symptoms. The evacuations from the bowels should +be thoroughly disinfected with chloride of lime or carbolic acid, that +they may not convey the disease to others. All the sewerage and drain +pipes in the house should likewise be disinfected. + + +SCARLET FEVER. (SCARLATINA.) + + +This fever takes its name from the scarlet color of the eruption on the +surface of the body. Sometimes it is comparatively mild, and is then +called _Scarlatina Simplex_; when it is accompanied by a sore throat, it +is termed _Scarlatina Anginosa_; and when the disease is of a low, +putrid type, it is called _Scarlatina Maligna._ This disease has three +distinct stages: (1), the stage of invasion; (2), the stage of eruption; +and (3), the stage of desquamation. In the first stage there is pain in +the head, increased heat of the skin, redness and soreness of the +throat, and sometimes nosebleed, diarrhea, or vomiting. The average +duration of this stage is twenty-four hours. The eruptive stage +generally begins on the second day, though sometimes it is delayed +longer, and the scarlet rash rapidly diffuses itself over the whole +body. The redness is vivid and has been compared to the appearance of a +boiled lobster. The stage of eruption reaches its maximum of intensity +on the third day, and it is important that it does not recede. Redness +of the tonsils and throat is one of the early symptoms which precedes +any cutaneous eruption. The tongue also is finely spotted with numerous +red points which mark its papillae, presenting an appearance which has +been compared to that of a strawberry. + +The thirst is urgent, there is no appetite, and vomiting and mild +delirium are common. This stage continues from four to six days, and +sometimes longer. Desquamation (scaling off of the skin) commences at +the decline of the eruption, in the form of minute, branny scales. The +duration of this stage is indefinite, and may end in five or six or may +continue ten or twelve days. + +If the inflammation in the throat is very severe, it may terminate in an +abscess, which may also occur in the glands of the neck, and sometimes +the inflammation extends to the lips, cheeks, and eyelids. Gangrene +within the throat occurs in rare instances. The disease is easily +communicated, and usually develops in two to five days after exposure. +It occurs most frequently in the third and fourth years of life. There +is no other disease so simple, and yet so often liable to prove fatal, +as scarlet fever; and for this reason we shall advise the attendance of +the family physician. + +Domestic treatment may be given as follows, until a physician can be +obtained: Catnip, pennyroyal, or pleurisy-root tea, containing one +teaspoonful of the Extract of Smart-weed, may be given, to drive the +rash to the surface. Cold drinks are suitable to allay the thirst, +nausea, and fever. The sick-room should be kept at a temperature of +about 65° Fahr., and fresh air admitted freely. The patient ought not to +be overloaded with bed-clothes; and the skin should be sponged over +twice daily with tepid water, different parts being exposed +successively, and carefully dried with soft cloths. Soda may be added to +the water, but no soap should be used. The diet should consist of milk, +extract of beef, and soups. Injections may be employed to relieve +constipation, but purgatives should be avoided. We repeat that this +disease is one which requires the attendance of the family physician, +and great care should be exercised during recovery, that no bad results +may follow. + + +SMALL-POX. (VARIOLA.) + + +Small-pox is produced by a specific poison, which is reproduced and +multiplied during the progress of the disease. It is contained in the +pustules, and in the excretions and exhalations of affected individuals. +It is established after a period of incubation varying from nine to +thirteen days after infection. + +There are two varieties of this disease, known as _confluent_ and +_distinct_ variola; in the former, the vesicles run together, in the +latter, they are separate. + +This fever has three stages. The first is that of _invasion_, distinctly +marked by a chill or a series of chills, which alternate with flushes of +heat. In this stage the tongue becomes coated, there is also nausea and +vomiting, pain in the limbs, back, and particularly in the loins, the +latter symptom being of diagnostic importance. This stage continues +about two days, and if the symptoms are light, it may be expected that +the disease will be comparatively mild, and of the _distinct_ variety. + +_The stage of eruption._ The eruption begins to appear on the skin, +generally on the third day following the attack, though in the throat +and mouth may be discovered round, whitish, or ashy spots, several hours +previous to the appearance of vesicles on the surface of the body. These +are first seen on the face and neck, then on the trunk and upper +extremities, and, lastly, on the lower extremities. The eruption at +first appears in the form of small, red or purple spots, which change +the texture of the skin by becoming more hard, pointed, and elevated. On +the fifth day of the eruption they attain their full size, being +softened and depressed in the center, and hence are called +_umbilicated_. Now a change takes place, and the vesicles fill with +"matter" and become pointed, and there is a rise in the fever. + +_The stage of suppuration_ commences thus: the pulse quickens, the skin +becomes hotter, and in many cases of the confluent variety, swelling of +the face, eyelids, and extremities occurs. Frequently there is passive +delirium in this stage, and if diarrhea sets in, it is an unfavorable +sign. The duration of this stage of the eruption is four or five days. + +_The stage of desication_, or of the drying of the pustules, commences +between the twelfth and fourteenth day of the disease. In the confluent +variety, patches of scab cover all the space occupied by the eruption, +and the skin exhales a sickening odor. + +THE TREATMENT should have reference to the determination of the eruption +to the surface. If there is thirst, allow cold drinks, ice-water, or +lemonade. Bathing the surface with cold water, breathing plenty of fresh +air, using disinfectants in the room, and taking antiseptic medicine +internally, are proper. Add one part of carbolic acid to six parts of +glycerine, mix from two to three drops of this with an ounce of water, +and of this preparation administer teaspoonful doses frequently. A few +drops of carbolic acid and glycerine may be rubbed up with vaseline, and +the surface anointed with it to prevent pitting. The malady is so grave +that it should be intrusted to the care of the family physician. + + +VARIOLOID. (MODIFIED SMALL-POX.) + + +Varioloid is a modified form of small-pox. There is less constitutional +disturbance, and very little or no pitting of the skin. Varioloid +generally occurs in persons who have not been fully protected by +vaccination. A person suffering from this modification of the disease +may, by contagion, communicate to another genuine small-pox. The +_treatment_ is the same as that recommended in variola. + + +VACCINIA. (COW-POX.) + + +The important discovery of vaccination is due to Dr. Jenner, who +ascertained that when the cow was affected by this disease and it was +then communicated to man, the affection was rendered very mild and +devoid of danger, and at the same time it proved a very complete +protection against small-pox. Like most other valuable discoveries +introduced to the world, it encountered bitter prejudice and the most +unfair opposition. Now its inestimable value is generally known and +admitted. + +In a few cases, in which the quality of the vaccine virus was +deteriorated, its effect is only to slightly-modify small-pox, and then +the disease resembles that caused by inoculation. The operation of +infecting the blood with the _kine virus_ is called _vaccination_. All +that we know is that when the cow becomes affected with this disease, +and it is then transferred to man, it loses its severity and serves as a +protection against small-pox. In a great majority of cases this +protection is absolute, and only in a very few does it leave the subject +susceptible to small-pox, materially modified. The protection it affords +against small-pox is found to diminish after the lapse of an indefinite +number of years, and hence it is important to be re-vaccinated once or +twice, for instance, after an interval of five years. Between the second +and third months of infancy is the best period for vaccination, and the +place usually selected is the middle of the arm above the elbow-joint. + + +CHICKEN-POX. (VARICELLA.) + + +Chicken-pox is an eruptive disease, which affects children, and +occasionally adults. It is attended with only slight constitutional +disturbance, and is, therefore, neither a distressing nor dangerous +affection. The eruption first appears on the body, afterwards on the +neck, the scalp, and lastly on the face. It appears on the second or +third day after the attack, and is succeeded by vesicles containing a +transparent fluid. These begin to dry on the fifth, sixth, or seventh +day. This disease may be distinguished from variola and varioloid by the +shortness of the period of invasion, the mildness of the symptoms, and +the absence of the deep, funnel-shaped depression of the vesicles, so +noticeable in variola. + +TREATMENT. Ordinarily very little treatment is required. It is best to +use daily an alkaline bath, and, as a drink, the tea of pleurisy-root, +catnip, or other diaphoretics, to which may be added from one-half to +one teaspoonful of the Extract of Smart-weed. If the fever runs high, a +few drops of aconite in water will control it. + + +MEASLES. (RUBEOLA.) + + +This is generally a disease of less severity and importance than the +other eruptive fevers, but it is sometimes followed by serious +complications. The stage of invasion is marked by the symptoms of a +common cold, sneezing, watery eyes, a discharge from the nostrils, a dry +cough, chilliness, and headache. This stage may last four days. Then +follows an eruption of red dots or specks, which momentarily disappear +on pressure. On the fourth day of the eruption the redness of the skin +fades, the fever diminishes, and the vesicles dry into scales or little +flakes. The eyes may be inflamed and the bowels may be quite lax at this +stage. + +TREATMENT. The great object in the treatment is to bring out the +eruption. To effect this, sweating teas are beneficial. The free use of +the Extract of Smart-weed is recommended, and the skin should be bathed +every day with tepid water. Sometimes when warm drinks fail to bring out +the eruption, drinking freely of cold water and keeping warmly covered +in bed, will accomplish the desired result. + +FALSE MEASLES (_Rose Rash_) is an affection of very little importance +and may be treated similarly to a case of ordinary measles. + + +ERYSIPELAS. + + +There are few adult persons in this country who have not, by observation +or experience, become somewhat familiar with this disease. Its +manifestations are both constitutional and local, and their intensity +varies exceedingly in different cases. The constitutional symptoms are +usually the first to appear, and are of a febrile character. A distinct +chill, attended by nausea and general derangement of the stomach is +experienced, followed by febrile symptoms more or less severe. There are +wandering pains in the body and sometimes a passive delirium exists. +Simultaneously with these symptoms the local manifestations of the +disease appear. A red spot develops on the face, the ear, or other part +of the person. Its boundary is clearly marked and the affected portion +slightly raised above the surrounding surface. It is characterized by a +burning pain and is very sensitive to the touch. It is not necessary for +the benefit of the popular reader that we should draw a distinction +between the different varieties of this malady. The distinctions made +are founded chiefly upon the _depth_ to which the morbid condition +attends, and not on any difference in the _nature of the affection_. + +Suppuration of the tissues involved is common in the severer forms. +Should the tongue become dark and diarrhea set in, attended with great +prostration, the case is very serious, and energetic means must be +employed to save life. A retrocession of the inflammation from the +surface to a vital organ is an extremely dangerous symptom. The disease +is not regarded as contagious, but has been known to become epidemic. + +TREATMENT. The treatment during the initial stage of this disease should +correspond with the general principles laid down for the treatment of +fever. The spirit vapor-bath, with warm, diaphoretic teas, or the +Compound Extract of Smart-Weed may be given to favor sweating. The whole +person should be frequently bathed in warm water rendered alkaline by +the addition of saleratus or soda. The bowels should be moved by a full +dose of the Purgative Pellets. Fluid extract of aconite in small and +frequent doses will best control the fever. The specific treatment, +which should not be omitted, consists in administering doses of ten +drops of the tincture of the muriate of iron in alternation with +teaspoonful doses of the Golden Medical Discovery, every three hours. As +a local application, the inflamed surface may be covered with cloths wet +in the mucilage of slippery elm. Equal parts of sweet oil and spirits of +turpentine, mixed and painted over the surface, is an application of +unsurpassed efficacy. + + +DIPHTHERIA. + + +This is an exceedingly grave, constitutional disease characterized by a +rapid breaking down of the powers of life, together with a peculiar +affection of the throat, in which a disposition to the formation of +false membranes is a prominent feature. The formation of these +membranes, however, is not limited to the throat, but may occur on +mucous surfaces elsewhere. + +CAUSE. Infection with the specific germ of the disease by contagion or +inoculation. It can be carried in milk or water, and the germs can +attach themselves to furniture, walls, clothing, etc. A person with +chronic diphtheretic sore throat can infect children or susceptible +persons with the disease in its most acute type by kissing. All persons +with sore throat should avoid kissing--as this disease is commonly +spread in this way. + +SYMPTOMS. The symptoms vary in different cases. In some the disease +comes on gradually, while in others it is malignant from the first. The +throat feels sore, the neck is stiff and a sense of languor, lassitude, +and exhaustion pervades the system. Sometimes a chill is experienced at +the outset. Febrile disturbance, generally of a low, typhoid character, +soon manifests itself. The skin is hot; there is intense thirst; the +pulse is quick and feeble, ranging from 120 to 150 per minute. The +tongue is generally loaded with a dirty coat, or it may be bright red. +The odor of the breath is characteristic, and peculiarly offensive, and +there is difficulty in swallowing and sometimes in breathing. Vomiting +is sometimes persistent. If we examine the throat, we find more or less +swelling of the tonsils and surrounding parts, which are generally +bright red, and shining, and covered with a profuse, glairy, tenacious +secretion. Sometimes the parts are of a dusky, livid hue, and, in rare +instances, pallid. The false membrane, a peculiar tough exudation, soon +appears and may be seen in patches, large or small, or covering the +entire surface from the gums back as far as can be seen, its color +varying from a whitish yellow to a gray or dark ashen tint. When it is +thrown off, it sometimes leaves a foul, ulcerating surface beneath. The +prostration soon becomes extreme, and small, livid spots may appear on +the surface of the body. There may be delirium, which is, in fatal +cases, succeeded by stupor, or coma. The extremities become cold; +diarrhea, and in some cases convulsions, indicate the approach of death. +Sometimes the patient dies before the false membrane forms. + +TREATMENT. The extremely dangerous character of this disease demands +that the services of a skillful physician be obtained at once; and that +his efforts should be aided by the most thorough hygienic precautions, +good fresh air, bathing, and a supporting diet. Prior to the arrival of +the physician, lose no time in using plenty of good brandy or whiskey to +offset the extremely weakening effect of the disease. The employment of +alcoholic stimulation in this disease is almost always used by +physicians. Control the vomiting and allay the thirst by allowing the +patient to suck small pieces of ice every five or ten minutes. Hot +fomentations or spirits of turpentine should be applied to the throat. +If the physician does not take charge of the patient by this time, the +use of permanganate of potash, triturated, in strength of one grain to +the ounce, in a mixture of fine sugar of milk and gum acacia, and blown +over the parts with an insufflater every few hours, brings the best +results if thoroughly carried out; or the throat can be swabbed out with +the following mixture: chlorate of potash, four drachms; tincture of +muriate of iron, three drachms, syrup of orange, two ounces; water +sufficient to make four ounces; administered every two or three hours. +Inhaling steam or lime-water from a steam atomizer is especially good. +The use of blisters, caustics, active purges, mercurials, or bleeding, +should be condemned. Throughout the whole course of the disease the +strength must be supported by the most nourishing diet, as well as by +tonics and stimulants. Beef tea, milk, milk punch, and brandy should be +freely administered. A competent physician should be called in as early +as possible. The general results of the treatment with antitoxin, if +given on the first, second or third day of the disease, are usually +favorable. There are rarely any immediately bad results from the +injections, and the published testimony of careful observers would tend +to prove that recovery has followed its use in a larger percentage of +cases than under former methods of treatment. + + +QUINSY. (TONSILLITIS.) + + +This is an acute inflammation of the tonsils, which generally extends +to, and involves adjacent strictures, and is attended with general +febrile disturbance. Its duration varies from four to twenty days. It +sometimes terminates by a gradual return to health (resolution); or by +the formation of "matter" within the gland (suppuration.) When this +latter is the case, the swelling sometimes becomes so great before it +breaks as to require lancing. + +CAUSES. It most frequently results from a cold. In some persons there is +a predisposition to it, and the individual is liable to recurring +attacks. Persons of a scrofulous diathesis are more liable to it than +others. + +SYMPTOMS. Difficulty of swallowing, soreness, and stiffness of the +throat, are the first monitions of its approach. There is fever, quick, +full pulse, and dryness of the skin; the tongue is furred, and the +breath offensive. The tonsils are intensely red, swollen, and painful, +the pain often extending to the ear. Sometimes but one tonsil is +affected, though generally both are involved. In severe cases the +patient cannot lie down, in consequence of the difficulty of breathing. + +TREATMENT. In the early stage of the disease, the spirit vapor-bath is +invaluable. The sweating which it produces should be kept up by the use +of the Compound Extract of Smart-weed in some diaphoretic infusion. Hot +wet-packs to the throat, covered with dry cloths, are useful. The +inhalation of the hot vapor of water or vinegar, or peppermint and +water, is beneficial. A carthartic should be given at night. When the +disease does not show a disposition to yield to this treatment, the +services of a physician should be obtained. When pus, or "matter," is +formed in the tonsil, which may be known by the increased swelling and +the appearance of a yellowish spot, the services of a physician will be +required to lance it. + + +ENLARGED TONSILS. + + +[Illustration: Fig. 147. +_A A._--Enlarged Tonsils. B.--Elongated +Uvula.] + +Chronic enlargement of the tonsils, as shown in Fig. 147, _A A_, is an +exceedingly common affection. It is most common to those of a scrofulous +habit. It rarely makes its appearance after the thirtieth year, unless +it has existed in earlier life, and has been imperfectly cured. Both +tonsils are generally, though unequally enlarged. A person affected with +this disease is extremely liable to sore throat, and contracts it on the +slightest exposure; the contraction of a cold, suppression of +perspiration, or derangement of the digestive apparatus being sufficient +to provoke inflammation. + +CAUSES. Repeated attacks of quinsy, scarlet fever, diphtheria, or +scrofula, and general impairment of the system, predispose the +individual to this disease. + +SYMPTOMS. The voice is often husky, nasal or guttural, and disagreeable. +When the patient sleeps, a low moaning is heard, accompanied with +snoring and stentorian breathing, and the head is thrown back so as to +bring the mouth on a line with the windpipe, and thus facilitate the +ingress of air into the lungs. When the affection becomes serious, it +interferes with breathing and swallowing. The chest is liable to become +flattened in front and arched behind, in consequence of the difficulty +of respiration, thus predisposing the patient to pulmonary disease. On +looking into the throat, the enlarged tonsils may be seen, as in the +figure. Sometimes they are so greatly increased in size that they touch +each other. + +TREATMENT. The indications to be carried out in the cure of this malady +are: + +(1.) To remedy the constitutional derangement. + +(2.) To remove the enlargement of the tonsil glands. + +The successful fulfillment of the first indication may be readily +accomplished by attention to hygiene, diet, clothing, and the use of the +Golden Medical Discovery, together with small daily doses of the +Pleasant Purgative Pellets. This treatment should be persevered in for a +considerable length of time after the enlargement has disappeared, to +prevent a return. + +To fulfill the second indication, astringent gargles may be used. +Infusions of witch-hazel or cranesbill should be used during the day. +The following mixture is unsurpassed: iodine, one drachm; iodide of +potash, four drachms; pure, soft water, two ounces. Apply this +preparation to the enlarged tonsils twice a day, with a probang, or soft +swab, being careful to paint them each time. A persevering use of these +remedies, both internal and local, is necessary to reduce and restore +the parts to a healthy condition. + +Sometimes the enlarged tonsils undergo calcareous degeneration; in this +case, nothing but their removal by a surgical operation is effectual. +This can be readily accomplished by any competent surgeon. We have +operated in a large number of cases, and have never met with any +unfavorable results. + + +ELONGATION OF THE UVULA. + + +Chronic enlargement or elongation of the uvula, or palate, as shown at +B, Fig. 147, may arise from the same causes as enlargement of the +tonsils. It subjects the individual to a great deal of annoyance by +dropping into and irritating the throat. It causes tickling and frequent +desire to clear the throat, change, weakness, or entire loss of voice, +and difficulty of breathing, frequently giving rise to the most +persistent and aggravating cough. + +TREATMENT. The treatment already laid down for enlarged tonsils, with +which affection, elongation of the uvula is so often associated, is +generally effectual. When it has existed for a long time and does not +yield to this treatment, it may be removed by any competent surgeon. + + +ANÆMIA. + + +When the blood contains less than the ordinary number of red corpuscles, +the condition is known as _anæmia_, and is characterized by every sign +of debility. A copious hemorrhage, in consequence of a cut, or other +serious injury, will lessen the quantity of blood and may produce +anæmia. After sudden blood-letting, the volume of the circulation is +quickly restored by absorption of fluid, but the red corpuscles cannot +be so readily replaced, so that the blood is poorer by being more +watery. This is only one way in which the blood is impoverished. + +The blood may be exhausted by a drain upon the system, in consequence of +hard and prolonged study. Severe mental employment consumes the red +corpuscles, leaving the blood thin, the skin cool and pale, and the +extremities moist and cold. + +Anæmia may arise from lack of exercise, or it may be occasioned by +mental depression, anxiety, disappointment, trouble, acute excitement of +the emotions or passions, spinal irritation; in fact, there are many +special relations existing between the red corpuscles of the blood and +the various states of the mind and the nervous system. The latter +depends directly upon the health and quantity of these red corpuscles +for its ability to execute its functions. + +Anæmia may arise in consequence of low diet, or because the alimentary +organs do not properly digest the food, or when there is not sufficient +variety in the diet. No matter how anæmia is occasioned, whether by +labor and expenditure, by hemorrhages, lead poisoning, prolonged +exposure to miasmatic influences, deprivation of food, indigestion, +imperfect assimilation, frequent child-bearing, or lactation, the number +of the red corpuscles in the blood is materially diminished. + +The diagnostic symptoms of anæmia are pallor of the face, lips, tongue, +and general surface, weakness of the vital organs, hurried respiration +on slight exercise, swelling or puffiness of the eyes, and a murmur of +the heart, resembling the sound of a bellows. + +This disorder of the blood tends to develop low inflammation, dropsical +effusion, tubercular deposits, Bright's disease, derangements of the +liver, diarrhea, leucorrhea, and is a precursor of low, protracted +fevers. This condition of the blood predisposes to the development of +other affections, providing they are in existence, and often it is found +associated with Bright's disease, cancer, and lung difficulties. + +TREATMENT. (1.) Prevent all unnecessary waste and vital expenditure. + +(2.) Place the patient under favorable circumstances for recovery, by +regulating the exercise and clothing entertaining the mind, and +furnishing plenty of pure air. + +(3.) Prescribe such a nutritious diet as will agree with the enfeebled +condition of the patient. + +(4.) Regular habits should be established in regard to meals, exercise, +recreation, rest, and sleep. + +(5.) The use of tonics and stimulants, as much as the stomach will bear, +should be encouraged. Bathe the surface with a solution of a drachm of +quinine in a pint of whiskey. + +(6.) Iron, in some form, is the special internal remedy in anæmia. +Meantime, it is proper to treat the patient with gentle, manual +friction, rubbing the surface of the body lightly and briskly with the +warm, dry hand, which greatly stimulates the circulation of the blood. +Anæmia occurs more frequently in the female than in the male, because +her functions and duties are more likely to give rise to it. + + +APNOEA. + + +Apnoea, or short, hurried, difficult respiration, is occasioned by +certain conditions of the blood. When anything interferes with the +absorption of oxygen, or the elimination of carbonic acid, the blood is +not changed from venous to arterial, and becomes incapable of sustaining +life. This morbid condition is termed _asphyxia_. We often read of +persons going into wells where there are noxious gases, or remaining in +a close room where there are live coals generating carbonic acid gas and +thus becoming asphyxiated, dying for want of oxygen. + +Deficiency of oxygen is the cause of apnoea, and sometimes the red +corpuscles themselves are so few, worn out, or destroyed, that they +cannot carry sufficient oxygen, and the consequence is that the patient +becomes short of breath, and when a fatal degeneration of the corpuscles +ensues, he dies of asphyxia. Many a child grows thin and wan and +continues to waste away, the parents little dreaming that the slow +consumption of the red corpuscles of the blood is the cause which is +undermining the health. Sometimes this disease is the result of +starvation, irregular feeding, improper diet, want of care, and, at +other times, want of fresh air, proper exercise, and sunlight. + +TREATMENT. The first essential to success in the treatment of this +disease, is the removal of the exciting cause. Exercise in the outdoor +air and sunlight, with good, nutritious food, and well-ventilated +sleeping apartments, are of the greatest importance. The bitter tonics, +as hydrastin, with pyrophosphate of iron, should be employed to enrich +the blood and build up the strength. + + +LEUCOCYTHÆMIA. + + +This term is used to designate a condition in which there is an excess +of colorless blood-corpuscles. In health, the colorless corpuscles +should exist only in the proportion of one, to one or two hundred of the +red corpuscles. These colorless corpuscles increase when there is +disease of the lymphatic glands, but whether this is the cause of their +increase or perversion is not known. + +They have been found abundant in the blood in diseases of the spleen and +of the liver. Diarrhea usually attends this complaint, together with +difficult breathing, loss of strength, gradual decline, fever, +diminution of vital forces, and finally death. The recovery of a +well-marked case of this disease is very doubtful. Its average duration +is about one year. + + +DROPSIES. + + +_Transudation_ is the passage of fluid through the tissue of any part of +the body without changing its liquid state, while _exudation_ means, +medically, the passage of matter which coagulates and gives rise to +solid deposits. When transudations are unhealthy, they may accumulate in +serous cavities or in cellular structures, and constitute _dropsy_. +Exudation is the result of inflammation, and the product effused +coagulates and becomes the seat of a new growth of tissue. Exosmosis +means the passage of fluid from within outward, and is a process +constantly taking place in health; while transudation takes place +because the blood is watery and the tissues are feeble and permeable, +permitting the serum and watery elements of the blood to pass into +certain cavities, where they accumulate. + +The cause of dropsies may be low diet, insufficient exercise, +indigestion, hemorrhages, wasting diseases, in fact, any thing which +impoverishes the blood and increases the relative amount of serum. The +tardy circulation of blood in the veins, or its obstruction in any way, +is a condition highly favorable to the development of dropsy. + +General dropsy is called _anasarca_, and is readily distinguished by +bloating or puffiness of the skin all over the body. This condition is +also called _oedema_. The skin is pale, yields under the finger without +pain, and preserves the impression for some time. The oedema usually +appears first in the lower extremities, next in the face, and from +thence extends over the body. + +General dropsy is commonly due to an impoverished condition of the +blood, and this may be the result of _albuminuria_, a disease of the +kidneys. Albuminuria is frequently the sequel of scarlatina. Hence, the +utmost care should be taken against exposure of a patient recovering +from scarlatina, and the same caution should be exercised during +convalescence from measles, erysipelas, and rheumatism. Dropsies may be +general, as in anasarca, or local, as dropsy of the heart, called +_cardiac_ dropsy: dropsy of the peritoneum, the serous membrane which +lines the abdominal cavity, called _ascites_; dropsy of the chest, +called _hydrothorax_; dropsy of the head, called _hydrocephalus_; dropsy +of the scrotum, called _hydrocele_. + +Dropsy is not, therefore, of itself a disease, but only the symptom of a +morbid condition of the blood, kidneys, liver, or heart. Thus disease of +the valves of the heart, may obstruct the free flow of blood and thus +retard its circulution. In consequence the pulse grows small and weak, +and the patient cannot exercise or labor as usual, and finally the lower +limbs begin to swell, then the face and body, the skin looks dusky, the +appetite is impaired, the kidneys become diseased, there is difficulty +in breathing, and the patient, it is said, dies of dropsy, yet dropsy +was the result of a disease of the heart, which retarded the circulation +and enfeebled the system, and which was actually the primary cause of +death. + +TREATMENT. Dropsy being only a symptom of various morbid conditions +existing in the system, any treatment to be radically beneficial must, +therefore, have reference to the diseased conditions upon which the +dropsical effusion, in each individual case, depends. These are so +various, and frequently so obscure, as to require the best diagnostic +skill possessed by the experienced specialist, to detect them. There +are, however, a few general principles which are applicable to the +treatment of nearly all cases of dropsy. Nutritious diet, frequent +alkaline baths to keep the skin in good condition and favor excretion +through its pores, and a general hygienic regulation of the daily +habits, are of the greatest importance. There are also a few general +remedies which may prove more or less beneficial in nearly all cases. We +refer to diuretics and hydragogue cathartics. The object sought in the +administration of these is the evacuation of the accumulated fluids +through the kidneys and bowels, thus giving relief. Of the diuretics, +queen of the meadow, buchu, and digitalis generally operate well. As a +cathartic, the Purgative Pellets accompanied with a teaspoonful or two +of cream of tartar, will prove serviceable. Beyond these general +principles of treatment it would be useless for us to attempt to advise +the invalid suffering from any one of the many forms of dropsy. The +specialist skilled by large experience in detecting the exact morbid +condition which causes the watery effusion and accumulation, can select +his remedies to meet the peculiar indications presented by each +individual case. Sometimes the removal of the watery accumulation by +tapping becomes necessary, in order to afford relief and give time for +remedies to act. We have found it necessary to perform this operation +very frequently in cases of _hydrocele_, and also quite often in cases +of abdominal dropsy. The chest has also been tapped and considerable +quantities of fluids drawn off, and this has been followed by prompt +improvement and a final cure. + + +CASES TREATED. + + CASE I. A Canadian gentleman, aged 68, applied at the Invalids + Hotel and Surgical Institute, for examination and treatment. + He had been dropsical for over two years, and had become so + badly affected as to be unable to lie down at night. His legs + were so filled with water and enlarged as to render it almost + impossible for him to walk, and there was a general anasarca. + The least exertion was attended with the greatest difficulty + of breathing. He had been under the treatment of several + eminent general practitioners of medicine in Canada but found + no relief. They were unable to discover the real cause of his + ailment, but to the specialist who has charge of this class of + diseases at our institution, and who annually examines and + treats hundreds of such cases, it was at once apparent that + the dropsy was caused from a weakened condition of the heart, + which rendered it unable to perform its functions. He was put + upon a tonic and alterative course of treatment, which also + embraced the use of such medicines as have been found to exert + a specific, tonic action upon the muscular tissues of the + heart. He improved so rapidly that in less than two months he + was able to lie down and sleep soundly all night. The bloating + disappeared, his strength improved, and in three month's more + he was discharged perfectly cured. + + CASE II. A man aged 42, consulted us by letter, stating that + he was troubled with general bloating which had made its + appearance gradually and was attended by general debility and + other symptoms which have been enumerated as common to general + dropsy. He had been under the treatment of several home + physicians without receiving any benefit; he had steadily + grown worse until he felt satisfied that if he did not soon + get relief he could not live very long. He was requested to + send a sample of his urine for examination, as we had + suspicions, from the symptoms which he gave, that the cause of + his dropsy was _albuminuria_, or Bright's disease of the + kidneys. On examination of the urine, albumen in very + perceptible quantities was found to be present. We had, about + this time, come into possession of a remedy said by very good + authority, to be a specific in degeneration of the kidneys + when not too far advanced, and we determined to test it upon + this well-marked case. We accordingly prescribed it, together + with other proper tonics and alteratives, at the same time + giving the patient important hygienic advice, which must be + complied with if success is attained in the management of this + very fatal malady. Our patient gradually improved, and in a + few months' time was restored to perfect health, which he has + continued to enjoy ever since. From our subsequent experience, + embracing the treatment of quite a large number of cases of + Bright's disease of the kidneys, we are satisfied that it is, + in its early stage, quite amenable to treatment. + + CASE III. A man aged 35, single, consulted us for what he + supposed to be enlargement of the testicles. The scrotum was + as large as his head, and it was with difficulty that he could + conceal the deformity from general observation. The disease + was immediately recognized by the attending surgeon as + hydrocele. The liquid was promptly drawn oft by tapping, and a + stimulating injection was made into the scrotum to prevent + re-accumulation. We mention this case only because it is one + among a very large number who have consulted us supposing that + they were suffering from enlargement of the testicles, cancer, + or some other morbid growth within the scrotum, when a slight + examination has shown the affection to be hydrocele, a disease + which is speedily cured by tapping, with a little after + treatment. The operation is perfectly safe and almost entirely + painless. + + CASE IV. A lady, aged 24, consulted us by letter enumerating a + long list of symptoms which clearly indicated abdominal + dropsy, resulting from suppression of the menses. A + well-regulated, hygienic treatment was advised, and medicines + to restore the menstrual function by gradually toning up and + regulating the whole system, were forwarded to her by express. + After four months' treatment, perfect recovery resulted. Cases + like this latter are very common and generally yield quite + readily to proper management. No harsh or forcing treatment + for restoring the menstrual function should be employed, as it + will not only fail to accomplish the object sought, but it is + also sure to seriously and irreparably injure the system. The + most difficult cases which we have had to deal with, have been + those which had been subjected by other physicians to the + administration of strong emmenagogues in the vain effort to + bring on the menses. + + + +RHEUMATISM. + + +Prominent among constitutional diseases is the one known as +_rheumatism_. It is characterized by certain local symptoms or +manifestations in fibrous tissues. This term has been applied to +neuralgic affections and to _gout_, but it differs from each in several +essential particulars. Rheumatism may be divided into (1) _Acute_, (2) +_Chronic_, (3) _Muscular_. + +ACUTE ARTICULAR RHEUMATISM. Acute articular rheumatism implies an +affection of the articulations or joints. It usually commences suddenly; +sometimes pain or soreness in the joints precedes the disclosure of the +disease. The symptoms are pain in the joints, tenderness, increased +heat, swelling and redness of the skin. The pain varies in its intensity +in different oases, and is increased by the movement of the affected +parts. Swelling of the joints occurs, especially those of the knee, +ankle, wrist, elbow, and the smaller joints of the hands and feet. The +swelling and redness are generally in proportion to the acuteness of the +attack. Acute articular rheumatism is always accompanied with more or +less fever. Sweating is generally a prominent symptom, being strongly +acid and more profuse during the night. The appetite is impaired, the +tongue is coated, the bowels are constipated, or there is diarrhea. + +THE DURATION OF THIS DISEASE. Unlike fevers, its course is marked by +fluctuations; frequently after a few days the pain subsides, the fever +disappears, and convalescence is apparently established, when, suddenly, +all the symptoms are renewed with even greater intensity than before. +This disease rarely proves fatal, unless the heart is involved. + +CAUSES. Rheumatism is frequently supposed to be occasioned by a +suppression of the functions of the skin, and is generally attributed to +the action of cold upon the surface of the body. But this acts only as +an exciting cause. It is a disease of the blood. This form of rheumatism +usually occurs between the age of fifteen and thirty, and prevails most +extensively in changeable climates. Acute articular rheumatism seldom +terminates in the chronic form. + +CHRONIC ARTICULAR RHEUMATISM. Articular rheumatism, in the subacute or +chronic form, is frequently observed in medical practice. The symptoms +are pain and more or less swelling of the joints, although not of as +grave a character as in acute rheumatism. There is frequently an absence +of increased heat and redness. As in the acute form, the different +joints are liable to be affected successively and irregularly, until, +after a time, the disease becomes fixed in a single joint, and the +fibrous tissues entering into the ligaments and tendons are liable to be +affected. The appetite, digestion, and nutrition are often good, and, in +mild cases, patients are able to pursue their daily vocations. The +disease is supposed to be the same as in the acute form, but milder, +and, strange to say, more persistent. A diseased condition of the blood +is supposed to be involved in both instances, but this morbid state is +less extended, and, at the same time, more obstinate in the chronic than +in the acute form. Sub-acute articular rheumatism is not always chronic, +and may disappear in a shorter time than in the acute form. Chronic +articular rheumatism is not generally fatal, but there is danger of +permanent deformities. + +MUSCULAR RHEUMATISM. This affection is closely allied to _neuralgia_, +and may properly be called _myalgia_. It exists under two forms, acute +and chronic. In acute muscular rheumatism, there is at first a dull pain +in the muscles, which gradually increases. When the affected muscles are +not used the pain is slight, and certain positions may be assumed +without inducing it constantly; but in movements which involve +contraction of the muscles the pain is very violent. In some cases, the +disease is movable, changing from one muscle to another, but usually it +remains fixed in the muscle first attacked. The appetite and digestion +are not often impaired, and there is no fever. The duration of this form +of rheumatism varies from a few hours to a week or more. + +In subacute or chronic muscular rheumatism, pain is excited only when +the affected muscles are contracted with unusual force, and then it is +similar to that experienced in the acute form. The chronic form is more +apt to change its position than the acute. The duration of this form is +indefinite. In both the acute and chronic forms some particular parts of +the body are more subject to the affection than others. + +The muscles on the posterior part of the _neck_ are subject to rheumatic +affection. It is termed _torticollis_ or _cervical_ rheumatism in such +cases, and should be distinguished from ordinary neuralgia. When the +muscles of the loins are affected, it is commonly known as _lumbago_. In +case the thoracic muscles are affected, it is known as _pleurodynia_. In +coughing, sneezing, and the like, the pain produced is not unlike that +in pleuritis and intercostal neuralgia. + +One of the most marked features of muscular rheumatism, is the +cramp-like pain, induced by the movements of the affected muscles, +whereas the pain is slight when those muscles are uncontracted. This +feature is very serviceable in distinguishing muscular rheumatism, or +myalgia, from neuralgic affections. Another trait which distinguishes +muscular rheumatism from neuralgia, is that the former is characterized +by great soreness, while the latter is not. There is also a distinction +between inflammation of the muscles and muscular rheumatism. In the case +of the former, there is continued pain, swelling of the parts, +occasional redness, and the presence of more or less fever, which +conditions do not exist in the latter. Persons subject to rheumatism of +the muscles, are apt to suffer from an attack, after exposure of the +body to a draught of air during sleep, or when in a state of +perspiration. + +TREATMENT OF ACUTE RHEUMATISM. Administer the spirit vapor-bath to +produce free perspiration, which should be maintained by full doses of +the Compound Extract of Smart-weed. The anodyne properties of the latter +also prove very valuable in allaying the pain. Tincture or fluid extract +of aconite root may also be employed, to assist in equalizing the +circulation, and also to secure its anodyne action. Black cohosh seems +to exert a specific and salutary influence in this disease, and the +tincture or fluid extract of the root of this plant may be +advantageously combined with the aconite. Take fluid extract of +aconite-root, thirty drops; fluid extract of black cohosh, one drachm; +water, fifteen teaspoonfuls; mix. The dose is one teaspoonful every +hour. The whole person should be frequently bathed with warm water, +rendered alkaline by the addition of saleratus or soda. The painful +joints may be packed with wool or with cloths wrung from the hot +saleratus water, and the patient kept warm and quiet in bed. The acetate +of potash taken in doses of five grains, well diluted with water, every +three or four hours, is very valuable in acute rheumatism. Its alkaline +qualities tend to neutralize the acid condition of the fluids of the +system, and it also possesses diuretic properties which act upon the +kidneys, removing the offending blood-poison from the system through +these organs. If the joints are very painful, cloths wet with the +Compound Extract of Smart-weed and applied to them, and covered with hot +fomentations, very frequently relieve the suffering. The majority of +cases yield quite promptly to the course of treatment already advised, +if it is persevered in. The disease, however, sometimes proves obstinate +and resists for many days the best treatment yet known to the medical +profession. + +TREATMENT OF CHRONIC RHEUMATISM. The general alkaline baths recommended +in the acute affection are also valuable in the chronic. The spirit +vapor-bath, the Turkish, as well as the sulphur vapor-bath, are all +worthy of a trial in this obstinate and painful disease. Alternatives +are a very valuable class of agents in chronic rheumatism. The following +mixture, in teaspoonful doses three times a day, in alternation with the +Golden Medical Discovery, has proved very successful in this disease: +acetate of potash, one ounce; fluid extract of black cohosh, one ounce; +fluid extract of poison hemlock, two drachms; simple syrup, six ounces. +This thorough alterative course, if well persevered in, together with +the use of alkaline and vapor-baths, will generally prove very +successful. The specialist, however, dealing with chronic diseases +exclusively, will occasionally meet with a case which has been the +rounds of the home physicians without benefit, that will tax his skill +and require the exercise of all his perceptive faculties to determine +the exact condition of the patient's system, upon which the obstinacy of +the disease depends. When this is ascertained, the remedies will +naturally suggest themselves, and the malady will generally yield to +them. But, although the treatment of this disease has entered largely +into our practice at the Invalid's Hotel, and has been attended by the +most happy results, yet the cases have presented so great a diversity of +abnormal features, and have required so many variations in the course of +treatment, to be met successfully, that we frankly acknowledge our +inability to so instruct the unprofessional reader as to enable him to +detect the various systemic faults common to this ever-varying disease, +and adjust remedies to them, so as to make the treatment uniformly +successful. If the several plans of treatment which we have given do not +conquer the disease, we can not better advise the invalid than to +recommend him to employ a physician of well-known skill in the treatment +of chronic diseases. If such a one is not accessible for personal +consultation, a careful statement of all the prominent symptoms, in +writing, may be forwarded to a specialist of large experience in this +disease, who will readily detect the real fault, in which the ailment +has its foundation. Particularly easy will it be for him to do so, if he +be an expert in the analysis of urine. A vial of that which is first +passed in the morning, should be sent with the history of the case, as +chronic rheumatism effects characteristic changes in this excretion, +which clearly and unmistakably indicate the abnormal condition of the +fluids of the body upon which the disease depends. + + * * * * * + + + + +DISEASES OF THE SKIN. + + +ECZEMATOUS AFFECTIONS. + + +Eczematous affections constitute a very important class of skin +diseases, the prominent characteristics of which are _eruption_ and +_itching_. They are progressive in character, passing through all the +successive stages of development, from mere redness of the skin to +desquamation, or thickening of the cuticle. The affections belonging to +this group are _eczema, psoriasis, pityriasis, lichen, impetigo, gutta +rosacea,_ and _scabies_, or _itch_. A careful examination of each of +these diseases shows it to be a modified form of eczema, and, therefore, +they demand similar treatment. + +ECZEMA. (_Humid Tetter, Salt-rheum, Running Scall_, or _Heat Eruption_.) +The term _eczema_ is used to designate the commonest kind of skin +diseases. + +In this disease, the minute blood-vessels are congested causing the skin +to be more vascular and redder than in its natural state. There is an +itching or smarting in the affected parts. The skin is raised in the +form of little pimples or vesicles, and a watery lymph exudes. Sometimes +the skin becomes detached and is replaced by a crust of hardened lymph, +or it may be partially reproduced, forming _squamæ_, or scales. There +are three stages of this disease; the inflammatory, accompanied by +swelling, and the formation of pimples or vesicles; that of exudation, +which is succeeded by incrustation; and that of desquamation, in which +the skin separates in little scales and sometimes becomes thickened. +Rarely, if ever, does the disease pass through these successive stages, +but it is modified by its location and the temperament of the patient. + +The many varieties of eczema are designated according to their +predominating characteristics. Thus, when pimples or vesicles are +abundant, it is termed, respectively, _eczema papulosum_ and _eczema +vesiculosum,_ a fine illustration of which may be seen in Colored Plate +I, Fig. 1. Again, when characterized by the eruption of pustules, it is +termed _eczema pustulosum_, a representation of which may be seen in +Plate I, Fig. 2; and, when the prominent feature is the formation of +scales, it is termed _eczema squamosum_. + +Eczema may be general or partial; in other words, the eruption may +appear in patches or be distributed over the entire surface of the body. +The latter form often appears in infants, but rarely occurs in adults. +Two or more varieties of the eruption may be associated, or one form may +gradually develop into another. + +[Illustration: Plate I. +Fig. 1. Fig. 2. Fig. 3. Fig. 4. Fig. 5.] + +Infants and young children are peculiarly subject to this disorder, and, +if the disease be not promptly arrested, it will assume the severest +form and eventually become chronic. The muscles are soft, the eyes are +dull and expressionless, and the little sufferer experiences the most +excruciating torments. Frequently the whole body is covered with patches +of eczema, the secretions are arrested, and, where the scales fall off, +the skin is left dry and feverish. + +Eczema has no symptoms proper, since the morbid feelings are due to +constitutional debility, of which eczema is the result. The _signs_ of +eczema are redness, heat, an itching or smarting sensation, the +formation of pimples or vesicles, exudation, incrustation, the +separation of the cuticle into scales and a gradual thickening of the +skin. + +CAUSES. Three forms of constitutional derangement predispose the system +to eczema; nutritive, assimilative, and nervous debility. In the former, +there is a diminution of nutritive power, so that the patient becomes +weak and emaciated. Assimilative debility is indicated by an impaired +digestion and a consequent suppression, or an abnormal state of the +secretions. Eczema occasioned by nervous debility, is accompanied by all +the morbid conditions incident to irritation and exhaustion of the +nervous system. Eczema may be excited by a violation of the rules of +hygiene, as undue exposure, or sudden transition from heat to cold, +deficient or excessive exercise, impure air, or improper clothing. + +PSORIASIS. Psoriasis may be defined as a _chronic form of eczema_. The +transition of the last stage of eczema into psoriasis is indicated by a +tendency of the inflamed, thickened, scaly skin to become moist when +rubbed. It usually appears in patches on various portions of the body. +The skin is parched and highly discolored. The hairs are harsh and +scanty. The patient is constantly tormented by an unbearable itching +sensation and, if the skin is rubbed, it exudes a viscous or sticky +fluid. These are the characteristic signs of psoriasis. It generally +appears on the flexures, folds and crooks of the joints, the backs and +palms of the hands, the arms, and the lower portions of the legs. + +PITYRIASIS. (_Branny Tetter_, or _Dandruff_.) This affection is a mild +form of psoriasis, from which it may be distinguished by a more +superficial congestion or inflammation of the affected parts, the +absence of swelling, and the formation of smaller scales, having the +form and appearance of _fine bran_. It generally appears on the scalp, +sometimes extends over the face, and, in rare instances, affects the +entire surface of the body. The signs peculiar to this disease are +slight inflammation, itching, and the formation of minute scales. + +CAUSES. Pityriasis is caused by nutritive debility, and is often +associated with erysipelas, rheumatism, and bronchitis. + +LICHEN. (_Papular Rash_.) Lichen is a term used to designate an eruption +of minute conical pimples, which are more or less transparent, red, and +occasion great annoyance. The eruption is attended with a severe, hot, +prickling sensation, as if the flesh were punctured with hot needles. +The pimples contain no pus, but if opened, they exude a small quantity +of blood and serum. This disease more frequently occurs between the ages +of twelve and fifty, but occasionally appears during dentition, when it +is called "tooth rash." The lichen pimples are sometimes dispersed +singly over the skin and gradually subside, forming a minute scale, +corresponding in position with the summit of the pimple. When the +pimples appear in clusters, there is a diffused redness in the affected +part, and, if they are irritated, minute scabs will be formed. Lichen +generally appears on the upper portion of the body, as on the face, +arms, hands, back, and chest. + +The various forms of lichen are designated according to their causes, +signs, location, manner of distribution, and the form of the pimples. + +_Lichen Simplex_ is the simplest form of this disorder, and is indicated +by the appearance of minute pimples, which, when the distribution is +general, are arranged like the blotches of measles. Sometimes the +eruption is local and bounded by the limits of an article of clothing, +as at the waist. In eight or ten days, the cuticle separates into minute +scales, which are detached and thrown off; but a new crop of pimples +soon appears and runs the same course, only to be succeeded by another, +and thus the affection continues for months and even years. + +_Lichen circumscriptus_ is an aggravated form of _lichen simplex_, and +is characterized by a circular arrangement of the pimples. The +circumference which marks the limit of the patch is sharply defined. +This form of lichen usually appears on the chest, hips, or limbs, and is +not unfrequently mistaken for ringworm. + +_Lichen strophulosus_ is a variety peculiar to infants. Dermatologists +recognize several subdivisions of this species, but the general +characteristics are the same in all. The pimples are much larger than in +the other forms of lichen, of a vivid red color and the duration of the +eruption is limited to two or three weeks. + +_Lichen urticatus_ is also an infantile affection and begins with +inflammation, which is soon succeeded by the eruption. In a few days the +pimples shrink, the redness disappears, and the skin has a peculiar +bleached appearance. The eruption is attended by an intense itching +sensation and, if the skin is ruptured, a small quantity of blood is +discharged and a black scab formed. This variety of lichen is very +obstinate and of long duration. + +_Lichen tropicus_, popularly known as _prickly heat_, is an affection +which attacks Europeans in hot climates. It is characterized by the +appearance of numerous red pimples of an irregular form, distributed +over those portions of the body usually covered by the clothing. It is +attended with a fierce, burning, itching sensation, which is aggravated +by warm drinks, friction of the clothing, and the heat of the bed. The +eruption indicates a healthy condition of the system; its suppression or +retrocession is an unfavorable symptom, denoting some internal affection +such as deranged nutrition. + +[Illustration: Plate II. +Fig. 6. Fig. 7. +Fig. 8. Fig. 9. +Fig. 10. Fig. 11. +Fig. 12. Fig. 13.] + +In _lichen planus_, as the term indicates, the pimples are flattened. +There is no sensation of itching or formation of scabs. The pimples are +solitary and have an angular base, and the fresh pimples formed appear +on the spaces between the former eruptions. This affection usually +attacks some particular region, such as the abdomen, hips, or chest. +Instances are recorded in which it has appeared on the tongue and the +lining membrane of the mouth. Sometimes it appears in patches, but even +then, the margin of each pimple can be discerned. + +_Lichen pilaris_ and _lividus_ are modifications of lichen simplex, the +former being so named to describe the location of the pimples, _i.e._, +surrounding the minute hairs which cover the body, especially the lower +limbs. The term _lichen lividus_ indicates the dark purplish hue caused +by a torpid circulation and the consequent change of arterial into +venous blood before leaving the pimples. _Lichen circinatus_ is a +modified form of _lichen circumspectus_. The pimples in the center of +the circular patch subside and a ring is formed which gradually +increases in size. When the rings become broken or extend in regular +forms, the affection is termed _lichen gyratus_. + +CAUSES. Constitutional debility predisposes the system to this eruption. +The exciting causes are irritation of the skin, strumous diathesis, +dentition, and any violation of hygienic rules. Although lichen is not a +fatal disease, yet it tends to reduce the vitality of the system. + +IMPETIGO. (_Crusted Tetter_ or _Scall_.) Impetigo is a term applied to +an inflammation of the skin, more severe and energetic in its character +than the preceding affection. We have found the predominating +characteristics of eczema and lichen to be the presence of exudation in +the former, and the absence of it in the latter. + +Impetigo is marked by the formation of yellow pus, which raises the +cuticle into pustules. There is a slight swelling, redness, and the pus +gradually dries up, forming an amber-colored crust, a representation of +which is given in Colored Plate I, Fig. 5. It soon falls, leaving the +skin slightly inflammed, but with no scar. The pustules are sometimes +surrounded by a cluster of smaller ones. + +The varieties of impetigo are designated according to the distribution +of the pustules. _Impetigo figurata_, is characterized by the appearance +of large clusters upon an inflamed and swollen surface, generally upon +the face, but sometimes upon the scalp. This form is represented in +Colored Plate I, Fig. 4. In _impetigo sparsa_ the pustules are scattered +over the whole body. + +CAUSES. The predisposing cause of impetigo is nutritive debility, and +the exciting causes are irritation, impure air, and errors of diet. + +GUTTA ROSACEA is a _progressive_ disease, and its successive stages of +development mark the several varieties, such as _gutta rosacea, +erythematosa, papulosa, tuberculosa, pustulosa_, according as they are +characterized by redness, pimples, tubercles, or pustules. This +affection is attended with heat, itching, and throbbing. The pustules +contain serous lymph, which exudes if the cuticle be broken, and forms a +crust at the summit of the pustule. + +This eruption often appears on the face of persons addicted to +intemperate habits, and has thus received the name of "_rum blossom_." + +CAUSE. It is essentially a chronic affection, and depends upon +constitutional causes. + +SCABIES. (_Itch_.) This disease is characterized by a profuse scaliness +of the skin, by an eruption of pimples, vesicles, and, in rare +instances, of pustules. Its prominent feature is an intense itching, so +aggravating that, in many instances, the skin is torn by the nails. +Unlike other diseases of the skin, it is not due to inflammation, but is +caused by animalculæ, or little parasites, termed by naturalists the +_acarus scabiei_. This minute animal burrows in the skin, irritating it, +and thus producing the scaliness and itching. The vesicles are +comparatively few in number, and contain a transparent fluid. The +pustules are only present in the severest forms or when the skin is very +thin and tender. It is then termed _pustular itch_. + +The parts usually affected are the hands, flexures of the joints, and +the genital organs. Cases are recorded, in which scabies appeared upon +the face and head, but they are of rare occurrence. The activity of the +animalculæ, is modified by the vitality of the victim. In persons of a +vigorous constitution, they will rapidly multiply, and, in a few days +after their first appearance, will be found in almost every part of the +body. + +Scabies is not confined to any age or sex, but chiefly affects persons +of filthy habits. This disease can only be communicated by contact, or +by articles of clothing worn by an infected person. There are certain +indications which predispose the system to infection, such as robust +health, a hot climate, and uncleanliness. + +TREATMENT. In all the varieties of eczematous affections, except +scabies, the treatment of which will hereafter be separately considered, +remedies employed with a view to the removal of the constitutional fault +are of the greatest importance. The eruption upon the skin is but a +local manifestation of a functional fault, which must be overcome by +alterative remedies. All the excretory organs should be kept active. To +open the bowels, administer a full cathartic dose of Dr. Pierce's +Pleasant Pellets. Afterwards they should be used in broken doses of one +or two daily, in order to obtain their peculiar _alterative_ effects. +The use of Dr. Pierce's Golden Medical Discovery is also necessary to +secure its constitutional remedial benefits. As a local corrective to +relieve the itching and disagreeable dryness of the skin, add half an +ounce of blood-root to half a pint of vinegar, steep moderately for two +hours, strain and paint the affected parts once or twice daily with the +liquid. Every night before retiring, apply glycerine freely to all the +affected parts, or dissolve one drachm of oxalic acid in four ounces of +glycerine and anoint the skin freely. The white precipitate ointment, +obtainable at any drug store, is an excellent application is most forms +of eczema. A tea, or infusion, of black walnut leaves, applied as a +lotion to the affected parts, has also proved beneficial. The surface of +the body should be kept clean by frequent bathing, and thus stimulating +its capillary vessels to healthy activity. The eczematous surfaces +should not be bathed frequently, and never with harsh or irritating +soaps. All varieties of eczematous affections, except scabies, are only +temporarily relieved by external applications, while the _radical cure_ +depends upon a protracted use of alterative, or blood-cleansing +medicines. Therefore, we would again remind the reader of the necessity +of keeping the bowels regular, and removing all morbid taints of the +blood and faults of the secretory organs by the persistent use of Dr. +Pierce's Golden Medical Discovery. _The successful treatment of +scabies_, or common itch, generally requires only local applications, +for the object to be obtained is simply the destruction of the little +insects which cause the eruption. Happily, we possess an _unfailing +specific_ for this purpose. Numerous agents have been employed with +success, but _Sulphur_ enjoys the greatest reputation for efficacy, and, +since it is perfectly harmless, we advise it for this class of disease. +Take a quantity of pulverized sulphur and mix with sufficient vaseline +or lard to form an ointment. Having first divested the body of clothing, +anoint it all over freely, and rub the ointment thoroughly into the +pores of the skin while standing before a hot fire. The application +should be made at night before retiring, and the patient should wear +woolen night-clothes or lie between woolen blankets. In the morning +after the application, the patient should take a warm bath, washing the +skin thoroughly and using _plenty of soap_. This treatment should be +repeated two or three times to be _certain_ of a _perfect eradication_ +of the disease. After this course of treatment, the wearing apparel as +well as the bed-clothes should be thoroughly cleansed, as a precaution +against a return of the disease. + + * * * * * + + + + +ERYTHEMATOUS AFFECTIONS. + + +The prominent features, eruption, and itching of _eczematous_ affections +are purely local. _Erythematous_ affections are, however, remarkable for +their symptoms of constitutional disorder. Each of these affections is +preceded by intense febrile excitement and nervous debility. In brief, +the local manifestations are simply signs of general internal disorders; +hence, the treatment should be directed to the restoration of the +system. This group includes _erythema, erysipelas_, and _urticaria_. + +ERYTHEMA. A vivid and partial flushing of the face is produced by a +superficial inflammation of the skin, termed _erythema_. There are many +stages of this disease, from the instantaneous transient flush caused by +emotional excitement, to the protracted inflammation and swelling of +_erythema nodosum_. + +The affection is characterized by a flush which is at first a bright +vivid scarlet, but which changes to a deep purplish tint. There is a +slight elevation of the skin, sometimes accompanied by itching. In the +second stage of development, the flush subsides, the skin has a +yellowish or bruised appearance, and a few minute scales are formed. In +_erythema papulosum_, a fine representation of which is given in Colored +Plate III, Fig. 18, there is an eruption of red pimples or pustules. The +prominent feature of _erythema nodosum_, a variety of erythema which +affects those portions of the skin exposed to the sun, is the appearance +of a large swelling, usually lasting four or five days and attended by +constitutional symptoms, such as nausea, fever, languor, and +despondency. The disease is associated with the symptoms incident to a +disordered nervous system and sometimes results fatally, in other cases, +it terminates in melancholy and mania. + +CAUSES. The predisposing causes of erythema are constitutional debility, +changes of climate and temperature, and irritating food or medicines. +Locally, it may be produced by friction and the heat of the sun. + +[Illustration: Plate III. +Fig. 14. +Fig. 15. +Fig. 16. +Fig. 20. +Fig. 17. +Fig. 19. +Fig. 18.] + +ERYSIPELAS. There are few adult persons in this country who have not, by +observation or experience, become somewhat familiar with this disease. +Its manifestations are both constitutional and local, and their +intensity varies exceedingly in different cases. The constitutional +symptoms are usually the first to appear, and are of a febrile +character. A distinct chill, attended by nausea and general derangement +of the stomach is experienced, followed by febrile symptoms more or less +severe. There are wandering pains in the body and sometimes a passive +delirium exists. Simultaneously with these symptoms the local +manifestations of the disease appear. A red spot develops on the face +the ear, or other part of the person. Its boundary is clearly marked and +the affected portion slightly raised above the surrounding surface. It +is characterized by a burning pain and is very sensitive to the touch. +It is not necessary for the information of the general reader that we +should draw a distinction between the different varieties of this +malady. The distinctions made are founded chiefly upon the _depth_ to +which the morbid condition extends, and not on any difference in the +_nature of the affection_. + +Suppuration of the tissues involved is common in the severer forms. +Should the tongue become dark and diarrhea set in, attended with great +prostration, the case is very serious, and energetic means should be +employed to save life. A retrocession of the inflammation from the +surface to a vital organ is an extremely dangerous symptom. + +The disease is not regarded as contagious, but has been known to become +epidemic. + +URTICARIA. (_Hives, or Nettle-Rash._) This word is derived from +_urtica_, signifying a nettle; it is a transient affection of the skin, +indicated by a fierce, burning, itching sensation and a development of +pustules, or white blotches of various forms. A representation of this +eruption is given in Colored Plate III, Fig. 17. It is appropriately +named nettle-rash, from its resemblance to the irritation caused by the +sting of a nettle. There is the same sharp, tingling sensation and a +similar white wheal or blotch, caused by the muscular spasm of the +corium, a layer of the skin. + +Urticaria may be either acute or chronic. Acute urticaria is always +preceded by febrile symptoms and the attack is indicated by a sudden +congestion of the skin, followed by a slight swelling or elevation of +the affected part. When the congestion subsides, the skin has a bruised +appearance. In chronic urticaria, the febrile symptoms are absent. + +CAUSES. The exciting causes of urticaria are gastric disorder, +irritation of the mucous membrane, or a sudden nervous shock. The +predisposing causes are conceded to be assimilative and nervous +debility. Hence, it frequently accompanies purpura or land scurvy and +rheumatism. The skin in some persons is so susceptible to irritation +that urticaria can be kindled at any moment by excitement, as an +animated conversation, or by the simple pressure of the hand. + +TREATMENT. The proper treatment for simple erythema consists in applying +to the affected parts a little lime-water, or sweet-oil, or glycerine, +with the use of warm baths and mild cathartics. This is generally +sufficient to effect a cure, if followed up with the persistent use of +Dr. Pierce's Golden Medical Discovery taken three times a day. + +In _erysipelas_ a hot bath, with warm, sweating teas, or, better still. +Dr. Pierce's Compound Extract of Smart-weed may be given to favor +sweating. The whole person should be frequently bathed with warm water +rendered alkaline by the addition of saleratus or soda. The whole should +be moved by a full dose of the "Pleasant Pellets." Fluid extract of +veratrum viride, in doses of a drop or two every hour will best control +the fever. The specific treatment, that which antidotes the poison in +the blood, consists in administering fifteen-drop doses of the tincture +of the muriate of iron in one teaspoonful of the "Golden Medical +Discovery," every three hours. As a local application, the inflamed +surface may be covered with cloths wet in the mucilage of slippery elm. +A preparation of equal parts of sweet oil and spirits of turpentine, +mixed and painted over the surface, is an application of great efficacy. + +_For urticaria_, the "Pleasant Pellets" should be administered in +sufficient doses to move the bowels, the skin bathed with warm water +rendered alkaline by the addition of common baking soda or saleratus, +and, if there be any febrile symptoms, a little tincture of aconite or +veratrum may be administered in one drop doses once each hour. In the +chronic form of the disease, the diet should be light, unstimulating, +and easily digested, the skin kept clean by frequent bathing, and fresh +air and outdoor exercises freely taken. The somewhat protracted use of +Dr. Pierce's Golden Medical Discovery will result in the greatest +benefit in this form of disease. + + +BULLOUS AFFECTIONS. + + +The distinguishing feature of this group of cutaneous affections is the +formation of _bullæ_, or blebs, which are defined as "eminences of the +cuticle, containing a fluid." + +HERPES is an inflammation of the skin in which the eruption appears in +patches of a circular form. On the second day, minute, transparent +vesicles appear and gradually develop, becoming opalescent. On the +succeeding days, they shrink and produce reddish brown scabs, which soon +become hard and fall off, leaving deep, purplish pits. In adults, these +vesicles sometimes terminate in painful ulcers, caused by an irritation +of the eruption. By some practitioners, herpes is regarded as a purely +nervous disorder, from the fact that it is frequently accompanied by +severe neuralgic pains. These pains are not _constant_, but +_occasional_, and do not appear at any definite stage of the disease. +Sometimes they precede and accompany the eruption. Other instances are +recorded in which they remained many years after the disease had +disappeared. The local and constant pain of herpes is a severe burning, +prickling, itching sensation, which remains after the scabs fall. + +The three _general_ forms of this disease are _herpes zoster_, +_phlyctoenodes_ and _circinatus_. + +In _herpes zoster_, or _shingles_, the clusters of vesicles encircle +one-half of the body, frequently at the waist; hence, it has received +the name of _zona_ or _girdle_. The vesicles often develop into bullæ, +and sometimes ulcerate. In _herpes phlyctoenodes_, the vesicles are +small, round, and irregularly distributed over the face, neck, arms, and +breast. This form is accompanied by febrile symptoms and offensive +excretions. + +In _herpes circinatus_, or _ringworm_, the vesicles appear in circular +patches, or rings. This is the mildest form of herpes, and is not +attended by symptoms of constitutional disorder. The various forms of +herpes are represented in Colored Plate I, Fig. 3. + +CAUSES. Herpes is not contagious. It is caused by vicissitudes of heat +and cold, violent emotions, excessive exertion, irritation of the skin, +and a general atony of the system. + +MILIARIA is the name given to an eruption of vesicles which are larger +than those of eczema, but smaller than the bullæ of herpes. At first, +the serum contained in the vesicles is perfectly transparent, and +reflects the red tint of the underlying skin, hence the name _miliaria +rubra._ But gradually it becomes milky and opalescent, hence, the term +_miliaria alba_. The vesicles of miliaria are generally solitary, and +appear on those portions of the body most liable to become heated and to +perspire. The eruption is preceded by chills, languor, slight fever, +intense thirst, a sharp prickling sensation of the skin, and profuse +perspiration. The vesicles soon desiccate and are replaced by a new +crop. + +CAUSES. Miliaria is almost universally an accompaniment of febrile +disease, and all disorders in which there occurs a profuse perspiration. +The causes to which it may be traced in each instance are improper diet, +impure air, burdensome clothing, or strong emotions. + +PEMPHIGUS is a peculiar eruption which appears upon the limbs and +abdomen. The affected part is of a bright red color, and, in a few +hours, small vesicles appear containing a transparent fluid. The +vesicles soon develop into bullæ, entirely covering the inflamed +portion. The fluid becomes opaque and in a few hours escapes. The patch +is then covered with a yellow scab. Pemphigus may be either acute or +chronic. The acute form is subdivided according to the degree of +inflammation, as _pemphigus pompholyx_ in which it is severe, and +_pemphigus benignus,_ when it is mild. The bullæ of pemphigus are +illustrated in Colored Plate III, Fig. 19. + +CAUSE. Pemphigus is always caused by a vitiated state of the system. + +RUPIA is indicated by an eruption as large as a chestnut containing a +watery fluid, which desiccates into a yellowish-brown crust. A fine +representation of rupia vesicles in both stages of development, is given +in Colored Plate II, Fig. 13. + +TREATMENT. In all forms of herpes, the administration of a small dose of +Dr. Pierce's Pleasant Pellets, with the use of his "Golden Medical +Discovery" in one to two teaspoonful doses three times a day, will be +followed by the happiest results. The skin should be kept clean by the +use of the sponge-bath, rendered alkaline by the addition of common +baking soda or saleratus. The portion of the body covered by the +eruption, should be bathed with a solution of sulphate of zinc, one +ounce to a pint of water. + +Miliaria is generally associated with certain febrile diseases, and its +proper treatment consists in overcoming the febrile and other +constitutional symptoms which accompany the disease. A hot foot-bath and +small doses of tincture of aconite, say one drop in water each hour, +will suffice to remove the fever. If the stomach and bowels are in a +vitiated condition, as they are apt to be, a mild cathartic dose of +"Pellets" should be given. + +_The treatment of pemphigus_ should consist in frequent alkaline +sponge-baths, and in covering the affected parts with poultices of +slippery elm, which should be kept moist with vinegar, The +constitutional treatment should embrace the persistent use of the +"Golden Medical Discovery." When the disease occurs in children, it is +most generally dependent upon deficient nutrition, and special attention +should be given to the diet of the patient, which should be nutritious. +Fresh air and outdoor exercise ought not to be neglected. + +The proper treatment of rupia does not differ from that suggested for +pemphigus. + + +NERVOUS AFFECTIONS OF THE SKIN. + + +In nervous affections of the skin, the natural sensibility may be +increased, diminished, or perverted. These morbid impressions arise from +the nervous system. Although there are several varieties of these +affections, yet, being of minor importance, we shall omit their +consideration and only speak of one of them in this work. + +PRURIGO affects the entire surface of the body and imparts to the skin a +parched, yellowish appearance. It is characterized by pimples, and an +intense burning, itching sensation. Rubbing and scratching only irritate +the skin, which becomes covered with thin black scabs. A good +representation of _prurigo_ may be seen in Colored Plate II, Fig. 6. The +itching sensations are sometimes caused by chilling the body, by violent +exercise, and heat; allowing the mind to dwell upon the affection +aggravates it. Prurigo is recognized under two forms; _vulgaris,_ which +is a mild form, and _senilis_, which chiefly occurs in old age, and is +more severe. The external genital parts of females are frequently +affected with this disease, and it is aggravated by menstruation and +uncleanliness. + +This affection may be due to a vitiated condition of the blood, and is +common among those who are greatly debilitated. It is frequently +occasioned by uncleanliness, intemperance, the use of unwholesome food, +or by an impure atmosphere. + +TREATMENT. To allay the itching, take glycerine, one ounce, add to it +one drachm of _sulphite_ of soda, and one ounce of rose-water, and apply +this to the affected parts. A solution made with borax, two drachms, and +morphine, fire grains, dissolved in six ounces of rose-water, makes an +excellent lotion to allay the itching. If the disease be severe, it will +be necessary to correct the vitiated condition of the blood by a +protracted use of Dr. Pierce's Golden Medical Discovery, and to aid its +effects, give one "Pleasant Pellet" every day, not to operate as a +cathartic, but only to exert an alterative influence. + + +ALPHOUS AFFECTIONS. + +(SCALY SKIN DISEASES.) + + +Differences of opinion exist with regard to the proper classification of +these affections. We shall briefly consider _alphos_, which is sometimes +confounded with _lepra_. + +ALPHOS, which from its Greek derivation signifies _white_, is +characterized by circular, slightly raised white spots. These eruptions +vary in size from one line to two inches in diameter, and may be +scattered over the entire surface of the body, although they most +frequently appear upon the elbows and knees. Alphos may consist of a +single tubercle, or of large clusters constituting patches. The scales +vary in color and thickness. In Colored Plate III, Figs. 14 and 15, are +fine illustrations of alphos. When a person begins to recover from this +affection, the scales fall off, leaving a smooth red surface, which +gradually returns to its natural color. + +This disease is more liable to occur in winter than in summer, although +in some cases the reverse holds true. It may disappear for a time, only +to return again with renewed vigor. It is not regarded as contagious. + +TREATMENT. Thorough and protracted constitutional treatment is required +to overcome this disease. Dr. Pierce's Golden Medical Discovery should +be taken internally and also applied locally to the affected parts. To +every other bottle of the "Discovery" which is taken, one-half ounce of +the iodide of potash may be added. One or two of the "Pellets" taken +daily will prove a useful adjunct to the "Discovery." + +Locally, we have sometimes applied a lotion made of oxide of zinc, +one-half drachm; benzoic acid, two drachms; morphine, five grains; +glycerine, two ounces. Tincture of the chloride of iron, one drachm in +one ounce of glycerine, makes an excellent local application. Whatever +the local treatment may be, however, we chiefly rely upon the +_persistent_ use of the best alteratives, or blood-cleansing medicines. + + +AFFECTIONS OF THE HAIR-FOLLICLES. + + +FAVUS (_Scald Head_) is a disease peculiar to the hair-follicles, and is +indicated by the formation of small yellow crusts, having the form of an +inverted cup. The eruption has a very offensive odor. When it appears in +isolated cups, it is termed _favus dispersus_, but it often occurs in +large clusters, as represented in Colored Plate II, Fig. 12, and is then +termed _favus confertus_. It generally affects the scalp, but sometimes +extends to the face and neck. + +CAUSE. Favus is caused by nutritive debility, which results in a +perverted cell-growth. + +SYCOSIS (_Barber's Itch_) is an inflammatory affection of the hair +follicles of the face. The prominent features of the disease are redness +and the formation of scales. It is peculiar to males. It has received +various names, according to its predominating characteristics, such as +_sycosis papulosa, tuberculosa_, and _fungulosa_. Colored Plate II, Fig. +10, is a line illustration of sycosis as it appears on the cheek. + +CAUSES. Various causes induce the appearance of sycosis. The general +causes are nutritive debility, vicissitudes of heat and cold, and an +exhausted state of the nervous system. It may also result from various +chronic diseases, such as syphilis and dyspepsia. + +COMEDONES, or _grubs_, are due to a retention of the sebaceous matter in +the follicles. The sebaceous substance undergoes a change, becoming +granular and somewhat hardened. It gradually extends to the mouth of the +follicle, where it comes in contact with the atmosphere, and assumes a +dark color, as represented in Plate II, Fig. 8. This fact, together with +its peculiar form when squeezed out of the skin, has caused it to be +termed _grub_. They often appear in great numbers on the face of persons +whose circulation is not active, or those who are of a particularly +nervous temperament. Stimulating baths and friction will prove very +efficacious in removing these cylinders of sebaceous matter. If they are +allowed to remain, they will produce an irritation of the skin causing +an inflammatory disease known as acne, or stone-pock. + +ACNE OR STONE-POCK. In the earliest stage of congestion, acne is +characterized by minute hardened elevations of the skin, as shown in +Plate II, Fig. 9, and is termed _acne punctata_. As the affection +progresses, a bright red pimple, Plate II, Fig. 11, appears, having a +conical form, hence the name _acne coniformis_. The pimple develops into +a pustule containing yellow "matter," and is then known as _acne +pustulosa_. This is followed by a thickening of the tissues, termed +_acne tuberculata_. When the thicker skin is removed, it leaves a deep +scar, hence the term _acne indurata_. + +CAUSES. The remote cause of acne is nutritive debility. The immediate +causes are rapid growth, anæmia, improper food, errors of hygiene, +mental exhaustion, and various chronic diseases. + +TREATMENT. The treatment of favus or scald-head should be commenced by +shaving the hair off close to the scalp and washing the head thoroughly +with soap and water. In some severe cases, it may be necessary to soften +the incrustations with poultices, following these with a free use of +soap and water. Having thus exposed the scalp and thoroughly divested it +of incrustations, apply to it the ointment of iodide of sulphur, which +may be procured at any good drug store. It should be gently rubbed over +the parts night and morning. The scalp ought to be kept perfectly clean +throughout the treatment. Instead of the foregoing, the following may be +applied: Take oxalic acid, ten grains; creosote, twenty drops; water, +two ounces; mix. Half an hour after using this lotion, anoint the head +freely with butter or lard; it will add greatly to the efficacy of the +treatment. But while local applications will relieve many skin diseases +and mitigate suffering, we cannot too strongly impress upon the minds of +our readers the importance, in this as in all other chronic diseases of +the skin, of perseverance in the use of the best alteratives. In this +class of agents Dr. Pierce's Golden Medical Discovery stands +pre-eminent. Its efficacy may be increased in this disease by adding to +each bottle one ounce of the acetate of potash, and, when thus modified, +it may be administered in the same manner as if no addition had been +made to it. + +_The Treatment of Sycosis_ should be essentially the same as that +suggested for favus, and it will result in prompt relief and a permanent +cure. + +_Treatment of Acne._ In the treatment of this, as in that of other +diseases, we should seek to ascertain the cause, and, when possible, +remove it. Outdoor exercise, a spare, unstimulating diet, and perfect +cleanliness are of the first importance. The affected parts should be +bathed with warm water and Castile, or, what is better, carbolic soap. +Washing the face in cold water generally aggravates the disease. As a +local application to the pustules, we have used with good results the +following lotion: Oxide of zinc, twenty grains; morphine, five grains; +glycerine, two ounces: mix. First having washed the affected parts +thoroughly, apply this compound. Our chief reliance, however, as in the +preceding diseases, should be upon the persistent use of alteratives and +mild cathartics or laxatives. + + +FURUNCULAR AFFECTIONS. (BOIL-LIKE AFFECTIONS.) + + +Under this head properly belong boils, carbuncles, and styes. + +BOILS. These annoying affections are hard, prominent, circumscribed, +inflamed, suppurating tumors, having their seat in the cellular tissue +beneath the skin. They vary in size from a pea to a hen's egg, and may +occur on any part of the body. The color of a boil varies from deep red +to mahogany. It is painful, tender, advances rapidly to maturity, +becomes conical, and finally bursts and discharges bloody "matter." +Through the opening, and filling the cavity, may be seen a piece of +sloughing cellular tissue which is called the _core_. In from four to +fifteen days, it is all expelled and the sore rapidly heals. The causes +are an impure condition of the blood, which generally arises from +imperfect action of the liver or kidneys. + +TREATMENT. Spirits of turpentine applied to a boll _in its earliest +stage_ will almost always cause it to disappear; but when suppuration +has commenced it should be favored by the application of poultices. Next +purify the blood to prevent subsequent returns to other parts of the +body. For this purpose take Dr. Pierce's Golden Medical Discovery. One +or two "Pleasant Pellets" each day will aid in the cure. + + +CARBUNCLE. (ANTHRAX.) + + +These are more violent, larger, and more painful than boils, which they +resemble. They may spring from several small pimples which extend deep +into the tissues, and on the surface frequently several small vesicles +appear and break. They may discharge, through one or several openings, a +thin acrid, bloody, or dark-colored fluid. They most frequently appear +upon the back of the neck, back, back part of the limbs, and under the +arms. Their presence is evidence of a depressed condition of vitality. +These tumors vary in size from one-half an inch to six inches in +diameter, and rapidly proceed to a gangrenous condition, a grayish +slough being detached from the healthy tissue. + +TREATMENT. Invigorate the system by every possible means. The bitter +tonics, such as Golden Seal, Gentian, or Willow, together with quinine +and iron should be used. Nutritious diet, pure air, etc., are necessary. +Purify the blood to remove the causes of the disease. For this purpose, +give the "Golden Medical Discovery" in as large doses as can be borne +without acting too freely on the bowels. Anodynes may be necessary to +overcome the pain. Poultices are useful to encourage the separation of +the dead from the living tissues. Antiseptic dressings are beneficial, +of which carbolic acid is to be preferred; yeast, however, may be +employed. + +Sometimes powerful caustics or free incisions are productive of +gratifying results, if followed by appropriate dressings, but these +extreme measures should only be resorted to by the direction of a +physician. + +For a considerable time after the urgent symptoms have subsided, the +"Golden Medical Discovery" should be used, to purify and enrich the +blood, and the bitter tonics and iron may be alternated with it, or be +used conjointly to good advantage. + + * * * * * + + + + +SCROFULA. + + +It is estimated that about one fifth of the human family are afflicted +with scrofula. A disease so prevalent and so destructive to life, should +enlist universal attention and the best efforts of medical men in +devising the most successful treatment for its cure. It varies in the +intensity of its manifestation, from the slightest eruption upon the +skin (scrofulous eczema), to that most fatal of maladies, pulmonary +consumption. + +THE SCROFULOUS DIATHESIS. The existence of a certain disposition or +habit of body designated as the _scrofulous_ or _strumous diathesis_, is +generally recognized by medical practitioners and writers as a +constitutional condition predisposing many children to the development +of this disease. Enlargement of the head and abdomen, fair, soft and +transparent or dark, sallow, greasy or wax-looking skin, and precocious +intellect are supposed to indicate this diathesis. + +The characteristic feature of this disease, in all the multifarious +forms that it assumes, is the formation of tubercle, which, when the +malady is fully developed, is an ever-present and distinguishing +element. + +_Tuberculous_ is therefore almost synonymous with _scrofulous_, and to +facilitate an acquaintance with a large list of very prevalent maladies, +we may generalize, and classify them all under this generic term. As +_tubercle_ is frequently spoken of in works treating on medicine and +surgery, playing, as it does, a conspicuous part in an important list of +diseases, the reader may very naturally be led to inquire: + +WHAT IS TUBERCLE? As employed in pathology, the term is usually applied +to a species of degeneration, or morbid development of a pale yellow +color, having, in its crude condition, a consistence analogous to that +of pretty firm cheese. The physical properties of tubercle are not +uniform, however. They vary with age and other circumstances. Some are +hard and calcareous, while others are soft and pus-like. The color +varies from a light yellow, or almost white, to a dark gray. + +It is almost wholly composed of albumen united with a small amount of +earthy salts, as phosphate and carbonate of lime, with a trace of the +soluble salts of soda. + +The existence of tubercular deposits in the tissues of the body, which +characterizes scrofula, when fully developed, must not, however, be +regarded as the primary affection. Its formation is the result of +disordered nutrition. The products of digestion are not fully +elaborated, and pass into the blood imperfected, in which condition they +are unable to fulfill their normal destiny--the repair of the bodily +tissues. Imperfectly formed albuminous matter oozes out from the blood, +and infiltrates the tissues, but it has little tendency to take on +cell-forms or undergo the vital transformation essential to becoming a +part of the tissues. Instead of nutritive energy, which by assimilation +produces perfect bodily textures, this function, in the scrofulous +diathesis, is deranged by debility, and there is left in the tissues an +imperfectly organized particle, incapable of undergoing a complete vital +change, around which cluster other particles of tubercular matter, +forming little grains, like millet seed, or growing, by new accretions +of like particles, to masses of more extensive size. As tubercle is but +a semi-organized substance, of deficient vitality, it is very prone to +disintegration and suppuration. Being foreign to the tissues in which it +is embedded, like a thorn in the flesh, it excites a passive form of +inflammation, and from lack of inherent vital energy it is apt to +decompose and cause the formation of pus. Hence, infiltration of the +muscles, glands, or other soft parts with tuberculous matter, when +inflammation is aroused by its presence, and by an exciting cause, give +rise to abscesses, as in lumbar or psoas abscesses. When occurring in +the joints, tubercles may give rise to chronic suppurative inflammation, +as in white swellings and hip-joint disease. Various skin diseases are +regarded as local expressions of, or as being materially modified by, +the scrofulous diathesis, as eczema, impetigo, and lupus. The disease +popularly known as "_fever-sore_" is another form of scrofulous +manifestation, affecting the shafts of the bones, and causing +disorganization and decay of their structure. Discharges from the ear, +bronchitis, chronic inflammation of the intestinal mucous membrane, and +chronic diarrhea are frequently due to scrofula, while pulmonary +consumption is unanimously regarded as a purely scrofulous affectation. +Scrofula shows a strong disposition to manifest itself in the lymphatic +glands, particularly in the superficial ones of the neck. The most +distinguishing feature of this form of the disease is the appearance of +little kernels or tumors about the neck. These often remain about the +same size, neither increasing nor diminishing, until finally, without +having caused much inconvenience, they disappear. After a time these +glands may again enlarge, with more or less pain accompanying the +process. As the disease progresses, the pain increases, and the parts +become hot and swollen. At length the "matter" which has been forming +beneath, finds its way to the surface and is discharged in the form of +thin pus, frequently containing little particles or flakes of tubercular +matter. During the inflammatory process there may be more or less +febrile movement, paleness of the surface, languor, impaired appetite, +night sweats, and general feebleness of the system. The resulting open +ulcers show little disposition to heal. + +SYMPTOMS. There is a train of symptoms characteristic of all scrofulous +disease. The appetite may be altogether lost or feeble, or in extreme +cases, voracious. In some instances there is an unusual disposition to +eat fatty substances. The general derangement of the alimentary +functions is indicated by a red, glazed or furrowed appearance of the +tongue, flatulent condition of the stomach, and bloated state of the +bowels, followed by diarrhea or manifesting obstinate constipation. +Thirst and frequent acid eructations accompany the imperfect digestion. +The foul breath, early decay of the teeth, the slimy, glairy stools, +having the appearance of the white of eggs, and an intolerable fetor, +all are indicative of the scrofulous tendencies of the system. + +CAUSES. Scrofula may be attributed to various causes. Observation has +shown that ill-assorted marriages are a prolific source of scrofula. +Both parents may be not only healthy and free from hereditary taints, +but robust, well-formed physically, perfectly developed, and yet not one +of their children be free from this dire disease. It may present itself +in the form of hip disease, white swelling, "fever-sore" suppurating +glands, curvature of the spine, rickets, ulcers, pulmonary consumption, +or some skin disease, in every case showing the original perversion of +the constitution and functions. Scrofula is hereditary when the disease, +or the diathesis which predisposes to its development, is transmitted +from one or both parents who are affected by it, or who are deficient in +constitutional energy, showing feeble nutrition, lack of circulatory +force, and a diminished vitality. All these conditions indicate that a +few exposures and severe colds are often sufficient to produce a train +of symptoms, which terminate in pulmonary or other strumous affections. +Whatever deranges the function of nutrition is favorable to the +development of scrofula, therefore, irregularities and various excesses +tend to inaugurate it. Depletion of the blood by drastic and poisonous +medicines, such as antimony and mercurials, hemorrhages and +blood-letting, syphilis, excessive mental or physical labor, as well as +a too early use and abuse of the sexual organs, all tend to waste the +blood, reduce the tone of the system, and develop scrofula. + +[Illustration: Fig. 1. +A Scrofulous Tumor] + +Scrofula may be the consequence of insufficient nourishment, resulting +from subsisting upon poor food, or a too exclusively vegetable diet, +with little or no animal food. + +Want of exercise and uncleanliness contribute to its production. It is +much more prevalent in temperate latitudes, where the climate is +variable, than in tropical or frigid regions. The season of the year +also greatly influences this disease, for it frequently commences in the +winter and spring, and disappears again in the summer and autumn months. + +TREATMENT. The skin should be kept clean by means of frequent baths. +These assist the functional changes which must take place on the surface +of the body, permit the stimulating influence of the light and air and +facilitate the aeration of the blood, as well as the transpiration of +fluids through the innumerable pores of the skin. All exposure to a low +temperature, especially in damp weather, and the wearing of an +insufficient amount of clothing should be avoided. Then the food should +be generous and of the most nourishing character. Steady habits and +regular hours for eating and sleep must be observed, if we would restore +tone and regularity to the functions of nutrition. Moderate exercise in +the open air is essential, in order that the blood may become well +oxygenated, that the vital changes may take place. It is no doubt true +that the occasion of the prevalence of scrofula among the lower classes +may be ascribed to frequent and severe climatic exposures, irregular and +poor diet, or want of due cleanliness. Every well-regulated family can +avoid such causes and live with a due regard to the conditions of +health. The proper treatment of scrofula is important, because we meet +with its symptoms on every side, showing its slow actions upon different +parts of the body and its influence upon all the organs. After this +disease has been existing for an indefinite length of time, certain +glands enlarge, slowly inflame, finally suppurate, and are very +difficult to heal. These sores are very liable to degenerate into +ulcers. All of these symptoms point to a peculiar taste of the blood, +which continually feeds and strengthens this morbid outbreak. All +authors agree that the blood is not rich in fibrinous elements, but +tends to feebleness and slow inflammation, which ends in maturation. +Thus we may trace back this low and morbid condition of the blood to +debility of the nutritive organs, defective digestion, which may be +induced by irregular habits, a lack of nourishing food, or by the +acquirement of some venereal taint. + +The matter that is discharged from these glands is not healthy, but is +thin, serous, and acrid; a whey-like fluid containing little fragments +of tuberculous matter, which resembles curd. The affected glands +ulcerate, look blue and indolent, and manifest no disposition to heal. +We have thus traced this disorder back to weak, perverted and faulty +nutrition, to disordered and vitiated blood, the products of which +slowly inflame the glands, which strain out unhealthy, irritating, +poisonous matter. The medicines to remedy this perverted condition of +the blood and fluids must be alteratives which will act upon the +digestive organs and tone the nutritive functions, thus enriching and +purifying the blood. As this affection is frequently a complication in +chronic diseases, it is eminently proper for us to refer to a few +considerations involved in its general treatment. + +An alterative medicine belongs to a class which is considered capable of +producing a salutary change in a disease without exciting any sensible +evacuation. In scrofula, remedies should be employed which will improve +digestion and also prevent certain morbid operations in the blood. + +It is well known to medical men that nearly all medicines belonging to +the class of alteratives, are capable of solution in the gastric and +intestinal secretions, and pass without material change, by the process +of absorption, through the coats of the stomach and intestines, as do +all liquids, and so gain an entrance into the general circulation; that +these same alteratives act locally to tone and strengthen the mucous +surfaces, and thus promote and rectify the process of digestion before +being absorbed; that alterative medicines, when in the blood, must +permeate the mass of the circulation, and thus reach the remote parts of +the body and influence every function; that these medicines, while in +the blood, may combine with it, reconstruct it, and arrest its morbid +tendencies to decomposition. + +We should use those alteratives which give tone to the digestive and +nutritive functions, in order to curtail the constant propagation of +scrofula in the system; which alter and purify the blood through the +natural functions, thus reconstructing it; and which check the septic, +_disorganizing_ changes which are evinced by the irritating and +poisonous matter discharged from the ulcers. + +These are the three ways in which medicines operate upon the nutritive +functions and the blood. + +Thus alteratives may be specifics, in so far as they are particularly +useful in certain disorders, and the combination which has been made in +Dr. Pierce's Golden Medical Discovery, excels all others with which we +are acquainted, for scrofulous diseases, particularly in fulfilling the +foregoing indications. It works out peculiar processes in the blood, not +like food, by supplying merely a natural want, but by strengthening the +nutritive functions and counteracting morbid action, after which +operations it passes out of the system by excretion. + +From what has been said upon the importance of blood medicines and their +modes of action, the reader must not infer that we account for all +diseases by some fault of the humors of the body, for we do not. But +that scrofula, in its varied forms, results from imperfect nutrition and +disorders of the blood, is now universally conceded. It is for this +reason that neither time nor pains have been spared in perfecting an +alterative, tonic, nutritive, restorative, and antiseptic compound, to +which Dr. Pierce has given the name of "Golden Medical Discovery." Not +only is it an alterative and a nutritive restorative, acting upon the +secretions, but it opposes putrefaction and degenerative decay of the +fluids and solids. Hence its universal indication in all scrofulous +diseases. It will intercept those thin, watery discharges which are the +result of weakness, degeneration, and putrescent decay of the blood, +perpetuated by a low grade of scrofulous inflammation. By an adult it +can be taken in doses of from one to two teaspoonfuls three or four +times per day. + +The bowels should be properly regulated. When constipation exists one or +two of Dr. Pierce's Pleasant Pellets taken daily, will fulfill the +indication. The patient ought not to neglect to carry out all the +hygienic recommendations heretofore given. The treatment of running +sores is very simple. Cleanse them every day with Castile-soap and +water, being careful not to rub or touch the surface of the sores. Use a +clean sponge or a piece of clean muslin and saturating it with the warm +water, hold it a few inches above the affected part, and squeeze out the +fluid, allowing the cleansing stream to fall gently upon the open sore. +After thoroughly cleansing the sore, apply to it Dr. Pierce's +All-Healing Salve. 25 cents in postage stamps sent to us will secure a +box by return post if your druggist does not have it in stock. + + +HIP-JOINT DISEASE. + +(COXALGIA.) + + +_Hip-joint disease_, also known as Coxalgia, is frequently a scrofulous +affection of the hip-joint. It usually attacks children, but may occur +at any period of life. The causes of this affection are imperfectly +understood, yet all the indications point to a scrofulous state of the +system. Dampness, cold, improper diet, severe injuries from blows or +falls are all numbered among the exciting causes which are conducive to +the establishment of this disease. + +THE SYMPTOMS are usually developed gradually; at first there is severe +pain in the knee, but finally it is located in the hip-joint. +Occasionally it is noticed in the hip and knee at the same time. As the +disease progresses, the general health becomes impaired, there is +wasting of the muscles, wakefulness, disturbed sleep, high fever, +profuse and offensive perspiration, the hair falls out, and there is an +inability to move the limb without producing excruciating pain. +Frequently pus will be formed and discharged at different points, and +the limb will become greatly emaciated. Since pain in the knee-joint may +mislead as to the location of the disease, to determine the seat of the +affection, place the patient in a chair and percuss the knee lightly, by +giving it a slight blow with the knuckle; if the hip be affected, the +pain will be readily felt in that joint; if it be simply neuralgia of +the knee-joint, it will excite no pain whatever. If the disease be +allowed to progress and dislocation of the joint takes place, the +affected limb becomes shortened. + +TREATMENT. The treatment of this disease should consist in rest for the +hip-joint, cleanliness of the person and plenty of fresh air and light, +a nutritious diet and the use of tonics and sustaining alterative, or +blood-cleansing medicines. Dr. Pierce's Golden Medical Discovery has, +unaided by other medicines, cured many cases of this disease. This class +of medicines should be persistently employed, in order to obtain their +full effects. It is a disease which progresses slowly and which is not +easily turned from its course, and its fatality should warn the +afflicted to employ the best treatment. + +Many poor, unfortunate victims know too well, from sad experience, that +the course of treatment frequently recommended and employed by +physicians and surgeons is ineffectual, and cruel; they deplete the +system, apply locally liniments, lotions, iodine, and hot applications; +confine the patient in bed and strap his hips down immovably, thus +preventing all exercise; then they attach that cruel instrument of +torture, the weight and pulley, to the diseased limb. + +After many years of practical experience in the treatment of hundreds of +cases, we have developed a system of treatment for this terrible malady +which is based upon common sense. Instead of depleting, we, by proper +constitutional treatment, strengthen and fortify the system. We do not +confine the patient in bed, but permit him to go around and take all +necessary exercise. We adjust an ingeniously devised and perfectly +fitting appliance or apparatus, by which a gentle extension of the limb +is maintained, thereby relieving the tension of the muscles, and +preventing the friction and wearing of the inflamed surfaces of the +joint, which, without the use of our new and improved appliance, are a +source of constant irritation. The appliances required in the successful +treatment of this disease are numerous and varied in their construction, +and require skill and experience on the part of the surgical mechanic as +well as on the part of the surgeon, to take accurate and proper +measurements of the diseased limb, and to construct the appliances so +that they will be adapted to the various requirements of different +cases. There are no definite rules for taking these measurements, and +only a thorough examination of the case can indicate to the eye of the +experienced surgeon what measurements are required, and what kind of an +appliance is suitable for each individual case. At the Invalids' Hotel +and Surgical Institute these measurements are all taken by the surgeon +in person, and each appliance is constructed under his immediate +supervision. It is utterly impossible for physicians who have but a +limited experience in the treatment of such cases to take correct +measurements and send off for an apparatus which fulfills the +requirements of the case. + +In the light of our vast experience at the Invalids' Hotel and Surgical +Institute, we feel that we cannot too strongly urge the employment of a +suitable apparatus for supporting the hip-joint, giving it perfect rest, +and enabling the patient to exercise and get the outdoor air. As much of +the pain in this disease is due to the pressure of the head of the +_femur_, or thigh-bone, in the _acetabulum_, or socket, steadily-applied +mechanical extension, to relieve the inflamed and sensitive joint of the +pressure, is of the greatest importance. By such application the patient +is enabled to move about without pain, while the joint is kept perfectly +at rest--a condition favorable to the reduction of inflammation within +it. The surgeon specialist of the Invalids' Hotel and Surgical Institute +is frequently sent for to visit cases of this disease hundreds of miles +away and by the employment of suitable apparatus he has been enabled, in +scores of cases, to relieve the suffering at once. In cases in which the +head of the thigh bone, or the bony socket of the joint has become so +diseased as to cause it to ulcerate and break down, all portions of +diseased bone should be _thoroughly removed_ by a surgical operation. If +this be neglected or delayed, a fatal termination of the disease may be +expected. Parents should not put off the employment of a competent +specialist in this terrible, distressing, and fatal disease. As treated +by general practitioners, it very often proves fatal; or, after causing +intense suffering for a series of years, if the active condition of the +disease subsides, the patient is left with a ruined and broken +constitution, a result which more prompt and earlier relief would have +prevented. + +The records of practice at the Invalids' Hotel and Surgical Institute +abound in reports of cases, demonstrating the fact, that by careful and +judicious management, hip-joint disease in its earlier stages, may be +promptly arrested, and that cures may be effected even when the bony +structure of the joint is seriously diseased. + + +WHITE SWELLING + + +White Swelling, otherwise known as _Hydrarthrus_, or _Synovitis_, more +frequently affects the knee-joint than any other part. The joints of the +elbow, wrist, ankle, or toes, may, however, be affected with this +disease, but we shall speak of it in this connection as affecting only +the knee-joint. Synovitis may be acute or chronic. The latter form is +sometimes induced by blows, sprains, falls, etc., or from exposure to +cold; more frequently it is the result of rheumatism or scrofula. + +THE SYMPTOMS of this affection are generally slow in their appearance, +being sometimes months in manifesting themselves. The joint at first +presents only a slight degree of swelling, which gradually increases. +Pain is soon felt, mild at first, but augmenting until it becomes +severe. The skin has a smooth, glistening appearance, and there is an +increased amount of heat in the parts. The affected limb becomes wasted, +and is sometimes permanently flexed. There is more or less fever about +the body, impairment of the digestive organs, and sleeplessness. The +pulse is low but quick, and night-sweats and diarrhea often appear. +Under this irritation, the patient is liable to waste away and finally +die. + +A _post-mortem_ examination reveals the effects of the disease upon the +parts attacked. The cartilages of the joint are soft, the synovial +membrane is thickened, the ligaments are inflamed and often destroyed, +the synovial fluid is increased in amount, sometimes normal in +appearance, at others thick and viscous. If the bones be diseased, their +articular extremities may be distended and fatty matter deposited in +them. The conditions depend upon the form, severity, and duration of the +disease. + +Synovitis may be considered under three heads; Rheumatic, Scrofulous, +and Syphilitic. + +_Rheumatic Synovitis_ may arise from exposure to cold, from some injury, +or from intemperance in eating. The beginning of the disease may be +distinctly marked, or it may come on so gradually that the time of its +commencement cannot be noted. The pain is of a dull, steady character, +and less severe in the night. This form of the disease sometimes +terminates favorably, but in scrofulous systems it is liable to end in +the destruction of the joint. It is more common in early life, rarely +occurring after the thirtieth year. + +_Scrofulous Synovitis_, or _Tuberculosis of the Knee-joint_, when of a +chronic character, shows a wasting of the limb, and the swelling is of a +pulpy consistence. This form of the disease is more liable to occur in +children, though occasionally it is met with in adults. But little pain +accompanies this form, although the limb is liable to become permanently +affected. In its earlier stages this disease may be checked. + +_Syphilitic Synovitis_ is the result of syphilis. The pain is more +severe during the night. It, however, generally terminates unfavorably, +especially in scrofulous constitutions. + +THE TREATMENT of white swelling should be both constitutional and local. +Alterative medicines are indicated to purify the blood. Doctor Pierce's +Golden Medical Discovery is unequaled for this purpose. + +As local treatment, in the active stage of the disease, the knee-joint +should be steamed, and hot fomentations applied. This should be followed +by applications over the joint of solid extract of stramonium or +belladonna, mixed with glycerine. The joint should be wrapped in cotton +or wool to keep it uniformly warm. If there are openings about the +joint, discharging pus, syringe them out once a day with Castile +soap-suds, which may be improved by adding a little bicarbonate of +potash (common saleratus). See that the bowels are kept regular, and +that the diet is nourishing. + +Cases of this disease which have been treated at the Invalids' Hotel and +Surgical Institute with uniform success might be cited to the extent of +filling a very large number of pages like these. When treated by a +skilled specialist, this otherwise formidable and dangerous disease is +readily amenable to treatment, and good and serviceable limbs can be +promised, even in the extreme cases in which amputation is usually +advised by general practitioners and surgeons, who desire the glory that +they imagine they will receive by performing a capital operation. + + +RICKETS. (RACHITIS.) + + +Rickets is a scrofulous disease, in which there is derangement of the +entire system, and it finally manifests itself in disease of the bones. +It is characterized by a softening of the bony tissue, due to a +deficiency of earthy or calcareous matter in their composition. It +appears to be a disease incident to cold, damp places, ill-lighted and +imperfectly ventilated rooms, and it especially attacks those who are +uncleanly in their habits. + +THE SYMPTOMS of rickets are severe pains in the bones, especially during +the night, febrile excitement and profuse perspiration, paleness of the +face, a sallow and wrinkled appearance of the skin, and derangement of +the digestive organs. After a time the body becomes emaciated, the face +pale, and the head unusually large. The bones become soft and unable to +support the body; various distortions appear; the extremities of the +long bones are enlarged, while the limbs between the joints are very +slender. Rickets is a disease peculiar to childhood, though it may not +be developed until a more advanced period of life. It rarely proves +fatal, unless the lungs, heart, or other vital organs, become involved. +In some instances the softening and other symptoms continue to increase +until every function is affected, and death ensues. + +_Post-mortem_ examinations of those who have died of rickets have +disclosed morbid changes in the brain, liver, and lymphatic glands. The +lungs are often compressed or displaced, and the muscles of the body +become pale and wasted. Sometimes the bones are so soft, on account of +the deficiency of the calcareous deposit, that they can be easily cut +with a knife. + +TREATMENT. The use of Dr. Pierce's Golden Medical Discovery is indicated +in this affection. It is a disease usually developed during childhood, +in consequence of insufficient exercise, deprivation of the sunlight, +low, innutritious diet, and lack of cleanliness. Therefore, it is +essential to obviate all known causes, and, at the same time supply the +patient with food rich in those elements which the system seems to +demand. Under any plan of treatment the general directions given for the +hygienic management of scrofula should be followed. We might cite many +cases that have entirely recovered from this disease, under our advice +and the use of "Golden Medical Discovery." We shall merely say, for the +encouragement of the afflicted, that this form of scrofula yields +readily to this medicine. + + +OLD SORES. (CHRONIC ULCERS.) + + +Under this head we may properly consider that class of affections known +as Fever-sores, Running-sores, Ulcers, etc. These sores have common +characteristics, yet each possesses certain peculiarities, which have +led to their division into _irritable, indolent_, and _varicose_. These +peculiarities are not constant, one form of ulcer often changing into +another. One feature common to all, however, is their slowness in +healing, which has sometimes led to the belief that they are incurable. +Another popular notion is that their cure is detrimental to the health +of the patient. With equal propriety we might say that it is dangerous +to cure diarrhea, dysentery, consumption, or cancer. As a result of +these erroneous impressions, many people suffer from chronic ulcers for +years, and even for a life-time, without attempting to obtain relief. +Chronic ulcers usually appear upon the lower extremities. The depth and +appearance of the ulcer depend upon its character and the thickness of +the tissues where it is situated. Fig. 2 shows a chronic ulcer, or +fever-sore, as it appears upon the ankle. + +[Illustration: Fig. 2. +A Chronic Ulcer.] + +THE IRRITABLE ULCER is painful and tender, the slightest injury causing +it to bleed. It is of a dark purplish hue, and filled with spongy, +sensitive granulations. It discharges a thin, bloody matter which is +sometimes very fetid and acrid, and excoriates the tissues if it comes +in contact with them. The edges of this species of ulcer are shelf-like +and ragged, and turn inward. The adjacent structures are red and +swollen. Very often they are attended by severe constitutional +disturbances, such as chills, fever, and great nervous prostration and +irritability. + +IN THE INDOLENT ULCER the edges are not undermined, but turned outward, +and are rounded, thick, glossy, and regular. The granulations are broad, +flat, pale, insensible, and covered with a grayish, tenacious matter. +The surrounding parts are not very sensitive, but the limb on which it +is located is apt to be swollen. This is the commonest form of ulcer, +and often remains for years. + +VARICOSE ULCER. This species of ulcer occasions a swollen or enlarged +condition of the neighboring veins, which are very much enfeebled. It +almost invariably appears below the knee, and may be either indolent or +irritable. It is generally sensitive to the touch, and sometimes +excessively painful. Knots of superficial veins may often be seen +beneath the skin. + +As we have before remarked, these various species of ulcers are merely +modifications of one form of chronic sore. The patient may assert that +he enjoys excellent health, but if we question him closely, we find that +the sore irritates him, and that there is sufficient constitutional +disturbance to prevent the healing powers of nature from effecting a +cure. + +TREATMENT. The cure of these sores is necessarily slow, and who ever +expects to obtain _immediate_ relief will be disappointed. + +Constitutional treatment is of the utmost importance, and should, +therefore, be thoroughly and persistently applied. The nutritive system, +especially the absorbents, should be kept active, as these are the +channels by which the broken-down tissue surrounding the sore is +replaced by that of a higher grade of vitality. For this purpose, the +best alteratives or blood cleansing remedies are required. If secretion +and excretion are not normally performed, the blood becomes poisoned by +the absorption of unhealthy "matter" from the sore, and various +constitutional disturbances occur. If, at any time during treatment, +constitutional disturbances are manifested by fullness or disagreeable +sensations in the head, nausea, pain, cough, chills, or fever, a +thorough cathartic should be given. If the patient be robust, a +repetition of the same once a week will be very beneficial. Dr. Pierce's +Golden Medical Discovery, and "Pellets" will be productive of the best +results. + +The local treatment should depend upon the character of the ulcer. If +the sore be _irritable_ or painful, soothing applications, such as warm +poultices or steaming in a vapor of bitter herbs, as hops, boneset or +smart-weed or water pepper, will be found highly beneficial. A poultice +of powdered slippery elm is also very soothing, and hence well adapted +to this purpose. If the ulcer be _indolent_, a stimulating application +is necessary. The hardened, callous state of the edges should be removed +by alkaline applications. A strong solution of saleratus, or even a +caustic, prepared by boiling the lye from hard-wood ashes to the +consistence of syrup, will prove of great utility. One or two +applications of the latter are generally sufficient. + +The foregoing course of treatment is intended to put the open sore or +ulcer in what is known to surgeons as a healthy condition--a condition +most favorable for the healing process. + +But the open surface of the sore needs something more. It needs the +cleansing or antiseptic and soothing influence of such a dressing as is +found in Dr. Pierce's All-Healing Salve. If your dealer in medicines +does not have this Salve in stock, 25 cents in stamps sent to World's +Dispensary Medical Association, Buffalo, N.Y., will secure a box of this +unequaled dressing. It will be sent to your address by return post. +Therefore, do not allow the dealer to put you off with some inferior +preparation. If he has not the All-Healing Salve in stock you can easily +obtain it by sending to us as above directed. + +No matter how good the local dressing applied to the open sore, or +ulcer, do not discontinue the internal use of the "Golden Medical +Discovery" until the affected parts are completely healed. + + +FEVER-SORE. (NECROSIS.) + + +By the term _necrosis_ we mean mortification, or the state of a bone +when it is deprived of life. Dunglison says: "This condition is to the +bone what _gangrene_ is to the soft parts." It is popularly known as +_fever-sore_, there being no distinction made between this species of +sore and those ulcers which affect only the soft tissues of the body. +When any part of a bone becomes _necrosed_, it is treated as a foreign +body. Nature makes an effort for its removal, and at the same time +attempts to replace it with new and healthy materials. In consequence of +this process, the dead portion is often inclosed in a case of new, sound +bone, termed the _involucrum_; when this is the case the dead portion is +termed the _sequestrum_. If, however, it be superficial, and separate +from the parts beneath, it is called an _exfoliation_. This healing +process, by which the involucrum is formed, cannot be completed while +the dead portion remains. Hence, numerous openings are made through the +involucrum, to permit the escape of the sequestrum. When a surgical +operation is performed for the removal of the necrosed bone it is called +_sequestrotomy_. The instruments which our specialists usually employ +for this practice are represented in Figs. 3, 4, and 5. + +[Illustration: Fig. 3. +Hand drill for boring bone. ] + +[Illustration: Fig. 4. +The osteotrite, for enlarging openings and cutting carious bone.] + +[Illustration: Fig. 5. +Gouge forceps for excavating bone.] + +CAUSES. Fever-sore may be due to inflammation, injuries, working in +phosphorus, or from the inordinate and protracted use of mercury. + +SYMPTOMS. The pain frequently commences in the night, and all the +different stages succeed, until, finally, the result is frequently +mortification or death. The entire bone, or only a part of it, may be +affected; the parts become swollen, "matter" forms, and unless it be +artificially evacuated, it will in time work its way out through a +fistulous opening. As the disease progresses, the adjacent tissues +become thickened and numerous openings are formed, which communicate +with the bone, and often with each other, so that a probe may be passed +from one to another, as represented in Fig. 6, copied from a drawing by +Dr. Howe. The discharge from fever-sores varies in character, and +usually has a fetid odor. The surgeon can readily distinguish between +healthy and unhealthy bone by the use of a probe. The pus discharged in +necrosis contains minute particles of bone, which may be felt by rubbing +it between the fingers. Sometimes large pieces present themselves at the +openings. The general health is seriously impaired, and the patient +becomes debilitated, anæmic, and hectic. + +[Illustration: Fig. 6. +Necrosis of the tibia. A common +probe is passed through the sinuses, or openings.] + +TREATMENT. The process of repair is necessarily tedious, and nature +should be assisted to remove the old bone and promote the formation of +the new. An alterative course of treatment is indicated and must be +persistently followed. Give Dr. Pierce's Golden Medical Discovery and +Pleasant Pellets in sufficient doses to keep the bowels regular. +However, all efforts to heal the sores, as long as dead bone remains, +will prove fruitless. The sores should he throughly cleansed with +injections of an alkaline solution, after which bandages, moistened with +glycerine, may be applied. If they emit a fetid odor, add a few drops of +carbolic acid to the glycerine. The dead bone can be but slowly removed +by suppuration, therefore time, and, indeed, sometimes life itself, may +be saved by removing it with surgical instruments. In the operation of +sequestrotomy, the surgeon must exercise great judgment. Carelessness +may prolong the disease and subsequently necessitate another operation, +or, perhaps, an amputation. + +Usually the dead bone is easily removed by the skilled specialist +surgeon, and, when thoroughly taken out, the parts readily heal and the +patient rapidly recovers. The removal, therefore, of the dead bone which +is a constant source of irritation, and the cause of protracted +suffering, should not be delayed, for very rarely indeed can it be +removed at all without the assistance of the surgeon. Besides, delay +often results in the loss of the limb, and not unfrequently occasions +the death of the patient. Under the influence of a reliable local +_anæsthetic_, carefully applied, the operation of removing the decayed +and offensive bone is speedily and painlessly performed, the use of +chloroform or ether not generally being required. + + * * * * * + + +TESTIMONIALS. + + +If the following letters had been written by your best known and most +esteemed neighbors they could be no more worthy of your confidence than +they now are, coming, as they do, from well known, intelligent and +trustworthy citizens, who, in their several neighborhoods, enjoy the +fullest confidence and respect of all who know them. + +Out of thousands of similar letters received from former patrons, we +have selected these few at random, and have to regret that we can find +room only for this comparatively small number in this volume. + + +BLOOD DISEASE. + +RAW SORES FROM KNEE TO ANKLE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Master Amasa Peck] + +_Dear Sirs_--My little boy, Amasa Claude Peck, was severely stricken +with what the doctors called erysipelas. We had employed two doctors for +months without any effect, until he commenced taking your Dr. Pierce's +Golden Medical Discovery. Two bottles effected a cure. His leg was raw +from his knee to his ankle; it has never broken since, which has been +several years. The same medicine also did great things for my now +deceased husband in a case of erysipelas of long standing. Respectfully +yours, + + MRS. A.B. PECK, + Ranger, Eastland Co., Texas. + +My daughter Mrs. Jennie Rice, was cured of catarrh in her head by using +the "Discovery" with Dr. Sage's Catarrh Remedy. She derived great +benefit from your medicines and gives the privilege of using her name. + + A.B.P. + + +ANÆMIA--IMPOVERISHED BLOOD. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, NO. 663 Main St.. Buffalo, N.Y.: + +[Illustration: Mrs. Knight.] + +_Dear Sirs_--Ten or twelve years ago I had a combination of diseases. +Our family physician said I was bloodless and there was no hopes of my +recovering. My mother advised me to consult you, which I did. After one +month's treatment I was on foot again; it was truly astonishing how +speedily I found relief after taking your preparations. I have also used +your "Favorite Prescription" and "Golden Medical Discovery," which +proved very beneficial. + + MRS. ADDIE R. KNIGHT, + Carapeake, Gates Ce., + North Carolina. + + +ERYSIPELAS. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: J. Smith, Esq.] + +_Gentlemen_--I am glad to say that the use of your medicine has saved me +many doctors' bills, as I have for the past eleven years been using it +for the erysipelas and also for chronic diarrhea, and am glad to say +that it has never failed. I have also recommended it to many of my +neighbors, as it is a medicine worth recommending. + +I give you the privilege of using my name + + Yours truly, + JOSEPH SMITH + Mineral Point, Tuscarawas Co., O + + +BLOOD AND KIDNEY DISEASE. + +DR. R.V. PIERCE, Buffalo, N.Y.: + +[Illustration: Mr. Edmundson.] + +_Dear Sir_--I had been an invalid for nineteen years and had all the +doctors in our country prescribe for me, but they could not say just +what ailed me. When I wrote you giving the history and symptoms, you +diagnosed my case as disease of the blood and kidneys, and advised me to +try your "Golden Medical Discovery" and "Pellets" and I feel confident +your medicines _saved my life_, and I hope all sufferers from kidney and +blood diseases will try your valuable medicine. + + Respectfully yours, + T.H. EDMUNDSON, Postmaster, + Home, Marshall Co., Kans. + + +ECZEMA--SUFFERINGS INTENSE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y. + +[Illustration: J.P. Delano, Esq. ] + +_Gentlemen_--About five years ago I was taken with a discoloration of +the skin on my legs and arms, which in a short time terminated in the +most aggravated eczema. My sufferings were intense, and no relief did I +experience, until I commenced the use of your preparations. I have taken +five bottles of the "Golden Medical Discovery," and more than that +number of the "Pellets," and believe that I am entirely cured. I never +feel the least itching, or burning, which was at one time so unbearable. +My appetite and digestion are splendid, and, although I will be seventy +years old my next birthday, I am as hearty and strong as most men of +fifty. + + Very truly yours, + JOSEPH P. DELANO, + Warsaw, Richmond Co., Va. + + +Mr. G. MILTON SYDNOR, Druggist, of _Warsaw, Richmond Co., Va._, writes: +"My friend, Mr. J.P. Delano, has requested me to write you in +confirmation of his statement, which I cheerfully do. I know Mr. Delano +well personally, and can testify to the correctness of his statement. + +His case of eczema was the worst that I had ever seen. I saw him often +during the time he was afflicted, as he came to my store often after +medicine. He purchased the "Discovery" and "Pellets" from me, and has +been one of the strongest champions of your medicines, and thus aided me +very much in their sale. I am quite sure that he has been the means of +my selling several dozens of that preparation." + + +BOILS CURED. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Wm. Ramich, Esq.] + +_Gentlemen_--I was troubled with boils for thirty years. Four years ago +I was so afflicted with them that I could not walk. I bought Dr. +Pierce's Pleasant Pellets, and took one "Pellet" after each meal. The +boils soon disappeared and have had none since. I have also been +troubled with sick headache. When I feel the headache coming on, I take +one or two "Pellets," and am relieved of it." + + Respectfully yours, + WILLIAM RAMICH, + Minden, Kearney Co., Neb. + + +A TERRIBLE SKIN DISEASE. + +Jackson, N.C. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +_Dear Sirs_--I had been troubled with skin disease all my life. As I +grew older the disease seemed to be taking a stronger hold upon me. I +tried many advertised remedies with no benefit, until I was led to try +your "Golden Medical Discovery." When I began taking it my health was +very poor; in fact, several persons have since told me that they thought +I had the consumption. I weighed only about 125 pounds. The eruption on +my skin was accompanied by severe itching. It was first confined to my +face, but afterwards spread over the neck and head, and the itching +became _simply unbearable_. This was my condition when I began taking +the "Discovery." When I would rub the parts affected a kind of branny +scale would fall off. + +For a while I saw no change or benefit from taking the "Discovery," but +I persisted in its use, keeping my bowels open by taking the "Pellets," +and taking as much outdoor exercise as was possible, until I begun to +gain in flesh, and gradually the disease released its hold. I took +during the year somewhere from fifteen to eighteen bottles of the +"Discovery." It has now been four years since I first used it, and +though not using scarcely any since the first year, my health continues +good. My average weight being 155 to 160 pounds, instead of 125, as it +was when I began the use of the "Discovery." + +Many persons have reminded me of my improved appearance. Some say I look +younger than I did six years ago when I was married. I am now +forty-eight (48) years old, and stronger, and enjoy better health than I +have ever done before in my life. Yours truly, + + J.A. Buxton. + + +BAD CASE OF ECZEMA OR SALT-RHEUM. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Foster.] + +_Gentlemen_--I was troubled with eczema, or salt-rheum, seven years. I +doctored with a number of our home physicians and received no benefit +whatever. I also took treatment from physicians in Rochester, New York, +Philadelphia, Jersey City, Binghamton, and received no benefit from +them. In fact I have paid out hundreds of dollars to the doctors without +benefit. My brother came to visit us from the West and he told me to try +Dr. Pierce's Golden Medical Discovery. He had taken it and it had cured +him. I have taken ten bottles of the "Discovery" and am entirely cured +and if there should be any one wishing any information I would gladly +correspond with them. If they enclose return stamped envelope. + + Very truly yours, + MRS. JOHN G. FOSTER, + 83 Chapia Street, Canandaigua, N.Y. + + +ERYSIPELAS AND WOMB DISEASE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.: + +[Illustration: Mrs. White.] + +_Gentlemen_--I am forty-eight years old, and have had four children. +Three years ago the doctor said I had womb trouble, which was +accompanied with backache and a tired and miserable feeling all over; +left side hurt me very much, and could not lie on that side, and the +doctor said it came from affection of the spleen; had a great deal of +headache; was costive, and suffered terribly from erysipelas; it nearly +set me crazy, so great was the burning and itching; sometimes +experienced severe burning in the stomach. I took twelve bottles of your +medicines, six bottles of Dr. Pierce's Golden Medical Discovery and the +same amount of his "Favorite Prescription." Was using them for about six +months, and can say that they did their work well. I have ever since +felt like another person, and do not think I can say enough in their +praise. I have no more weakness, and all evidence of erysipelas has +disappeared. + + Respectfully yours, + MRS. SARAH E. WHITE, + Kennon, Belmont Co., Ohio. + + +ECZEMA. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Miss Harris. ] + +_Gentlemen_--About four years ago my daughter, Helen G. Harris, was +afflicted with Eczema in a distressing form. She tried medicines too +numerous to mention, but they did no good. I told her that I would write +to Dr. Pierce, which I did, and after a few months' use of his medicines +she was entirely cured. I believe your medicines unequaled. + +MRS. JNO. H. RICHARDSON, a widow living near Wakefield, Va., a few years +ago, was in extremely bad health, and used your proprietary medicines +with entire success. + + Respectfully yours, + THOMAS HARRIS, + Wakefield Station, Sussex Co., Va. + + +SALT-RHEUM--FLESH CRACKED OPEN AND BLED. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Miss Clark. ] + +_Gentlemen_--It gives me pleasure to express my faith in the virtue of +Dr. Pierce's Golden Medical Discovery. Having suffered for three years +from salt-rheum and after having been unsuccessfully treated by a good +physician, I began the use of the "Discovery." The humor was in my +hands. I was obliged to keep a covering on them for months at a time, +changing the covering morning and night. The stinging, burning and +itching sensation would be so intense that at times it seemed as if I +would go crazy. When I bent the fingers the flesh would crack open and +bleed. It is impossible for me to describe the intense pain and +suffering which I endured night and day. After taking six bottles of the +"Discovery" I was entirely cured. + + Respectfully yours, + MISS LOTTIE CLARK, + River Falls, Pierce Co., Wis. + + +INVETERATE SKIN DISEASE WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main +St., Buffalo, N.Y.: + +[Illustration: M. Allen, Esq.] + +_Gentlemen_--I desire to state that I am perfectly well and very +thankful to you for curing me. The medicines which I used for two months +only have effected a perfect and permanent cure of my case. My face +looks as well as ever. + +I was six weeks under treatment at the Invalids' Hotel and Surgical +Institute, and I got first-class accommodation. + +The case was a strange one. The pimples did not break out on my chin +where I had let my beard grow, they broke out on my cheeks, forehead and +nose. A doctor in San Francisco told me it was blood poison and said it +was very hard to cure it. I think if it were blood poison it would run +all through my system. When I first felt the disease coming on in +winter--my face used to be very cold. I worked under the sun fourteen +years every summer. I wore no hat--nothing but a skull cap. I thought I +was sun-proof. The doctor in San Francisco stopped the disease for one +year but it came back again. I had it for five years. It came on from +hard work and exposure in the sun. + +When my face would break out in the fall it got so itchy, and then +little pimples would break out on my face, nose and forehead. I think +parasites were in my face. If I would drink a glass of beer, I would +feel the effects of it in my face, and tobacco would affect me just the +same. My face, nose and forehead would be spotted all over like a +"fiddler's note book," every fall for five years. I never saw a case +like mine. The doctor said if I would get tanned with the sun I would be +all right. + +In the kind of work I had to do, I could wear no hat. + + Respectfully yours, + MICHAEL ALLEN, + Oro Fino, Siskiyou Co., Cal. + + +CURES BROWN SPOTS. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, NO. 663 Main St., Buffalo, N.Y.: + +[Illustration: Mrs. Johnson. ] + +_Gentlemen_--I can say that my health is better now than for the last +fifteen years. I cannot say what my disease was, but I was as spotted as +a leopard with brown spots; I was so miserable and nervous, and could +not sleep. I took Dr. Pierce's Golden Medical Discovery one year, and +the brown spots all disappeared and I am well. Have not taken any +medicine in two years. I think the "Golden Medical Discovery" a splendid +medicine for stomach, liver and skin disease. I got no help from the +other doctors. I used only the "Golden Medical Discovery." + + Yours truly, + MRS. WILLIAM JOHNSON, + P.O. Box 188, Owosso, Shiawassee Co., Mich. + + +SCROFULOUS DISEASE. + +[Illustration: Mrs. Nichols. ] + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, No. 663 Main St., Buffalo, N.Y.: + +_Dear Sirs_--I was sick eight long years with the scrofulous humor and I +used Dr. Pierce's Golden Medical Discovery and it cured me. I used five +bottles and I have used it since for other troubles. It has helped me +wonderfully, in fact cured me, and I recommend it to all my friends + + Yours most gratefully, + MRS. MARY E. NICHOLS + Bay Shore, Suffolk Co., N.Y. + + +"HEART-RENDING TO BEHOLD". + +Terrible Suffering from Skin Disease. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration] + +_Gentlemen_--My baby when about three months old began to have little +sores come out on his face; did not amount to much until six months old, +then they began to spread all over his face and head until his face, +head and ears were one solid sore. Our family physician was summoned at +the early stages of the disease and tried everything he knew of for the +cure of the same, but nothing did him any good. The disease baffled the +skill of the doctor in every way, and I was advised by friends to try +certain remedies, which I did, with very little effect. The child by +this time was a heart-rendering sight to behold, and suffered unknown +agonies with the torturing itching and burning of the sores, and so +things ran on until my brother, who resides in Buffalo, visited me. As +soon as he saw the child he advised me to have him treated at the +Invalids' Hotel and Surgical Institute in Buffalo. I wrote to them +stating my baby's case, asking them if they could help him, and they +thought they could, so began their treatment at once by using salves +externally and medicine internally and as soon as they began their +treatment the child began to improve and continued so until he was +entirely cured in six months' time. He is now two years and six months +old and is as tough as any child you ever saw; weighs thirty-five pounds +and is perfectly well, thanks to Dr. Pierce and his wonderful medicines. + + Yours truly, MRS. A.L. PAYNE, + Box 147; Oxbow, Jefferson Co., N.Y. + + +SCROFULOUS ABSCESSES. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y. + +[Illustration: Mrs. Sweeney.] + +_Gentlemen_--About four years ago I took scrofula, and did everything +that doctors and others prescribed, but only got worse. Several +abscesses formed about my neck and breast, discharging a quantity of +matter. I got so weak I could scarcely walk about the house. I read all +the medical works I could get hold of, and, among the rest, read some of +your works. You described my case, and recommended Dr. Pierce's Golden +Medical Discovery with his "Pleasant Pellets." So I procured some and +commenced using them and soon began to mend. In six months my sores were +all healed up, and in twelve months _I was entirely well_. I am +forty-five years old and believe I am as stout as I ever was in my life. +I used about one dozen bottles of the "Golden Medical Discovery" with +the "Pellets," and used nothing else after I began using your medicines. +So I must give your medicine all the praise for curing me, and I am +bound to recommend it. + + Yours truly MRS. BELLE SWEENEY, + Flat Top, Mercer Co., W. Va. + + +CROSS EYES. + +CONVERGENT STRABISMUS. INSTANT AND PAINLESS CURE. + +[Illustration: D. Crane, Esq.] + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +_Gentlemen_--I am happy to certify to your skill. I had been afflicted +with badly crossed eyes from my birth, and my sight was impaired, and I +was badly disfigured. By a painless operation my eyes were +instantaneously restored to a proper position and my sight much +improved. + +Your Hotel and skillful surgery merit every recommendation. + + Yours truly, + DAVID CRANE, + Spring Creek, Warren Co. Pa. + + +SCROFULOUS SORE EYES. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.: + +[Illustration: Miss Gardner.] + +_Gentlemen_--When I was two years old my eyes broke out in little white +pimples and itching all the time in the mornings; when I awakened my +eyes would have to be washed open; I could not see and when they were +washed open the corruption would run down my face and drop off. I have +tried all of our physicians and their medicine did me no good. A +physician attended them from Ellicott City and did them no good. He said +it was the running scrofula in the eyelids and could never be cured; it +had continued fourteen years, and I had given up all hopes of ever being +cured until I saw your advertisement of the "People's Common Sense +Medical Adviser," and I sent and got one, and I saw a great deal in it +about the eyes. I wrote to you about them and you prescribed for me. Now +my eyes are quite well. Some advised me to wear glasses, but you said +not. I have been a great sufferer but am glad to say you did me all the +good that I have received. + + Respectfully yours, + MISS VIRGINIA M. GARDNER, + Mayo, Anne Arundel Co., Md. + + +WEAK AND SORE EYES. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: John Casserly. ] + +_Gentlemen_--After taking Dr. Pierce's Golden Medical Discovery for four +weeks, at a cost of only $1.50, I am more than pleased to announce that +my eyes are perfectly well and strong as ever. I doctored and fussed +with quack medicines for about one year and a half and found no relief. +Finally I consulted your "Medical Adviser" and found a case similar to +mine so I wrote and got a speedy reply. I followed directions, which +resulted in a speedy cure as above. + + Yours truly, + JOHN CASSERLY, JR., + Westline, Redwood Co., Minn. + + +RUNNING SCROFULOUS SORES. + +[Illustration: H.M. Holleman, Esq.] + +DR. R.V. PIERCE: _Dear Sir_--When about three years old I was taken with +mumps, also had fever, finally I had that dreaded disease Scrofula. The +most eminent physicians in this section treated me to no avail. I had +running scrofulous sores on left side of neck and face. I was small and +weakly when eight or nine years old, and in fact was nearly a skeleton. +Six bottles of Dr. Pierce's Golden Medical Discovery wrought marvelous +changes. Although the sores were healed in eight months, I did not quit +taking it until I was sure it had been entirely routed from my system. +The only signs left of the dreadful disease are the scars which ever +remind me of how near death's door I was until rescued by the +"Discovery." I am now eighteen years old and weigh 148 pounds; and have +not been sick in five years. + + Respectfully, HARVEY M. HOLLEMAN, + Wilmington, Newbern & Norfolk Railway Co., + Wilmington, New Hanover Co., N.C. + + +"FEVER SORES." + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration] + +_Gentlemen_--My daughter who is now 18 years of age was attacked with a +severe pain and swelling in her ankle, which soon caused her to have +high fever. We employed some of the best physicians in this locality who +pronounced it rheumatism, did everything for her they could do, but she +kept getting worse from day to day, and in about five weeks after she +was first taken sick her ankles and legs came open and discharged a lot +of yellow matter and finally slivers of bones came out of the openings +in her ankles. All the doctors we consulted said that we would have to +have an operation performed on her and have the dead bones taken out, or +else she could not get well, with the exception of one of the doctors +who said that if her health could be improved the dead bones would come +out and be replaced with new ones, for the dead pieces would brake loose +from the sound bone and come out through the opening with the matter; +but he could not do anything to improve her health. + +After doctoring her three months she was reduced to a mere skeleton and +had to be tended to like a mere baby and have her feet elevated, or else +she would scream with pain. We commenced giving her Dr. Pierce's Golden +Medical Discovery. After using it for one month we could see, for the +first time, that she was getting no worse, and after using about five +bottles her health began to improve a little; but she still suffered +with pain and could not have her feet down until she had taken twelve +bottles. When she had taken fifteen bottles--she began to walk on +crutches, and later with a cane, for about two or three months, when she +could walk without a crutch or cane. The diseased bones gradually came +out in pieces, some of them an inch to two inches long and one-fourth of +an inch thick; the sores healed as soon as the last dead bone was out. +She is now a strong healthy young lady as her photograph plainly shows. + + Respectfully yours, + D.R. SCHROER. + Holstein, Warren Co., Mo. + + +GENERAL DECLINE, RUNNING SORE ON LEG. + +Fort Coulonge, Pontiac Co., Quebec. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +_Gentlemen_--Thanks be to God, and you, I have the best of health since +I have taken your special medicine and one bottle of "Favorite +Prescription." I was as weak as any person could be without dying, and I +am as healthy as any person can be to-day, and I have gained ten pounds +since, and a great many people remark to me how much better I look. + +Also, I can mention to you another person who was cured by your "Golden +Medical Discovery." His name is John McCoy. For near two years he never +walked. He suffered from a running sore on his leg, and after using +twelve bottles, he could walk all right and is well to-day The doctors +wanted to have it taken off. You say in your letter you would like to +have a photograph. I have none and there is no photograph gallery in +this village or I would have one taken. + + Yours truly, + Mrs Isaac Brady + + +ECZEMA. + +DR. R.V. PIERCE, Buffalo, N.Y.: + +_Dear Sir_--When I was married I weighed 125 pounds. I was taken sick +with a disease which my doctor said was eczema. He failed to do me any +good, and I fell away to 90 pounds. I had dyspepsia so bad that I could +not eat anything. My husband got me "sarsaparillas" and "cures" and +"bitters," and nothing did me any good. Finally he got two bottles of +Dr. Pierce's Golden Medical Discovery. I began using it, and, thank God +and you, I improved; now I weigh 140 pounds, and my skin is as smooth as +a baby's. My husband says I look younger than I did the first time he +saw me. I have better health than ever, and I owe it all to you. It is a +miracle that I am cured. I cannot say too much about the medicine. + + Very respectfully, + Rebecca F. Gardner + + +"FEVER SORES" OR INDOLENT ULCERS--DROPSY AND TORPID LIVER. + +Dr. R.V. PIERCE, Buffalo, N.Y.: + +[Illustration: Mr Fred Pestline.] + +_Dear Sir_--I write in regard to your great "Golden Medical Discovery." +I cannot be thankful enough to you for what it has done for me. As a +result of the grippe I had dropsy, and ulcers formed on my legs with a +most intolerable itching at night after going to bed. My circulation was +very poor and liver inactive. I feel perfectly well since I took the +medicine. The old sores on my legs are all healed up, and I feel like a +new man. I highly recommend your "Golden Medical Discovery" to any +inquiring person, for it has saved my life. + + Yours very truly, + FRED. PESTLINE, + Alexander, Genesee Co., N.Y. + + +RUNNING SORE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Kuhn.] + +_Gentlemen_--It pleases me to state that I had a running sore up on my +neck, and had it operated upon three times, and still it was not cured. +I was also run down very much. There was a decided change after using +Dr. Pierce's Golden Medical Discovery. I took a few bottles and was soon +cured Later my husband had a lump behind his ear; he tried your +medicine, and one bottle cured him. I shall always recommend your +medicines. + + Yours respectfully, + MRS. L. KOHN, + No. 618 E. 16th St., + New York City. + + +"OLD SORES" ON LEGS. + +Alexander, N.C. + +DR. R.V. PIERCE, Buffalo, N.Y.: + +_Dear Sir_--Your "Golden Medical Discovery" has proven a blessing to me. +It was recommended to me by Rev. P.A. Kuykendall. I have been a sufferer +with old sores on my legs for four years. I used three bottles of it, +and my legs are sound and well and my health is better than it has been +for some time. I had THE best doctors of this country treat my case and +they failed to effect a cure. + + Yours respectfully, + J.N. Kery Kendall + + +HIP-JOINT DISEASE. + +PHYSICIANS FAIL TO BENEFIT. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: E.J. Rush.] + +_Gentlemen_--At the age of eight years I became afflicted with +"Hip-joint Disease." For a year I suffered as much as it was possible +for a human being to suffer. My physicians told me I would have to wait +patiently, but my father procured me some of Doctor Pierce's Golden +Medical Discovery, and I found my falling health restored. + +I can cheerfully say that I believe I owe my life to the use of that +valuable medicine. + + Your true friend, + EDWARD J. RUSH, + Elizabeth, Harrison Co. Ind. + + +HIP-JOINT DISEASE CURED. + +[Illustration: Mrs. Ridgley.] + +MISS MARY E. RIDGLEY, of _Gales Creek, Washington Co., Oregon_, when +only three years old, had lameness in one of her lower limbs but the use +of liniment and Dr. Pierce's Pellets relieved her, and she got better. +When six years old the trouble developed into hip-joint disease, so +pronounced by her physician. She lost the use of the limb. Was three +months under the doctors, but got no better. She complained of great +pain in the limb, especially in the knee and hip. The limb wasted away, +becoming small and short, and her back became crooked. She had no +appetite; was very weak. Hip and knee were very tender to the touch. +Physician's treatment not helping her, her mother began to give her +"Golden Medical Discovery." Four months afterwards she wrote Dr. Pierce +as follows: "She is growing fast, and never complains of any pain or +ache. She sleeps well, and eats heartily. Her leg has filled up, and is +as big as the other. She plays around all day with the other children. +Everybody is astonished to see how she has improved." + +In the margin we print Miss Ridgley's picture as she appears twelve +years after this treatment, at the age of eighteen. The young lady +herself, writes Dr. Pierce as follows: "Your medicines are worth their +weight in gold. I was cured of hip-joint disease by the "Golden Medical +Discovery" and "Pellets," and I feel sure that they can cure the worst +cases if given a chance." + + +HIP-JOINT DISEASE OF 11 YEARS' STANDING. + +P.O. Box 128, Gagetown, Tuscola Co., Mich. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +_Gentlemen_--When I began taking your medicines I was in bed, nothing +would relieve me, my hip being swelled seemingly ready to burst. When I +began to take Dr. Pierce's Golden Medical Discovery and "Pellets," the +swelling gradually decreased; when I had taken one bottle I was able to +be up. I don't know how long I will remain well, but I am satisfied that +it is the medicine that did the work: I take it right along; as long as +I can keep the way I am now, I am satisfied. I have recommended your +remedies, and will continue to do so. + + Yours truly, + H.F. Giron + + +THICK NECK (GOITRE). + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.: + +[Illustration: Master Sumner.] + +_Gentlemen_--I am willing and pleased to have you publish anything I +have written in regard to the cure of my little son of Goitre (that a +surgeon of N. Adams said could never be cured). + +I do hope that by so doing some little one may escape the misery my +little one suffered for over a year until I began the use of the "Golden +Medical Discovery." I followed your directions found in the little book +around the bottles. Before the first bottle was gone, he could eat and +sleep without that coughing and choking that, before the use of the +"Discovery," was impossible. + +The tumor began to lessen in size, and after the third bottle I would +never have known he ever had a tumor there. He is now hearty and +healthy. Sleeps as good as any child and is full of life. He does not +take anything to prevent a return, and has not for over a year. + +I have one of your Common Sense Medical Advisers, and found it worth +five times what I gave for it; I have helped others to get it and the +"Medical Discovery" and "Favorite Prescription" have brought relief to +many through me I use the "Prescription" off and on; it has given me +strength; I think I should have been an invalid long ago without it. + +Every one here knows the truth of this letter, and I would tell it to +the world if I could. Respectfully, + + MRS. ANNIE SUMNER, Heartwellville, Bennington Co., Va. + + +THICK NECK (GOITRE), + +NERVOUS DEBILITY AND WEAKNESS CURED. + +[Illustration: Miss Rachel Mann.] + +Miss ELLA A. HOUGHTON, of _Theresa, Jefferson Co., N.Y._, was cured of +Thick Neck, Nervous Prostration, Weakness and a complication of ailments +by Dr. Pierce's "Discovery" and "Favorite Prescription." She says: "My +health is now as good as it was before I was sick. The swelling (goitre) +has all gone from my neck. I don't have any bad feelings. My gratitude +for the benefit I have received from your treatment has induced me to +recommend you to all whom I know to be sick." "I have known of two or +three middle aged ladies residing near here, who have been cured by your +'Favorite Prescription.'" + + +GOITRE CURED. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Miss Rachel Mann.] + +_Dear Sirs_--I can say that your medicine has done its work well in the +case of my sister, Miss Rachel Mann. She is entirely well of Goitre and +throat trouble. I am glad to say that we can recommend your medicines +very highly. + + Very truly yours, + MARY J. MANN, + for sister Rachel Mann, + Romola, Center Co., Pa. + + +CARBUNCLES LARGE AS HEN'S EGGS! + +EIGHT OR TEN YEARS AFFLICTED. TWO BOTTLES ONLY, CURE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Col. T.U. Fogg.] + +_Gentlemen_--For about eight or ten years my father was laid up with +carbuncles, the worst that I ever saw. He tried everything he heard of, +and his doctor did everything he could for him, but nothing did him any +good. Had six or seven carbuncles at a time, as large as a hen's egg; he +got so weak and suffered so much he could not walk a step. It was in the +summer of '72 or '73 that he had his bed put in the middle of his +chamber and got on it to die. No one expected him to get well. Looking +over the newspapers, he saw your "Golden Medical Discovery" advertised, +and the good it had done. There was not any sold then in the country, so +he sent to Richmond--forty-five miles--and got a bottle. When he began +to take it he was nearly covered with carbuncles--little and big +together. Before he had taken half-a-bottle they began to go away. +Before he had taken two bottles he was entirely cured, and he has never +been bothered with them since. Every time he sees any sign of them, he +gets a bottle of "Golden Medical Discovery" and it cures them. My +father, Col. T.U. Fogg, lives in West Point, King William Co., Va. He is +now seventy-eight years old, and enjoys good health. + + Yours truly, + Mrs. NANNIE GOULDMAN, + Beulahville, King William Co., Va. + + + * * * * * + + + + +THICK NECK. (GOITRE.) + + +Thick neck, or goitre, also sometimes called bronchocele, consists of an +enlargement of the thyroid gland, which lies over and on each side of +the trachea, or windpipe, between the prominence known as "Adam's apple" +and the breast bone. The tumor gradually increases in front and +laterally, until it produces great deformity, and often interferes with +respiration and the act of swallowing. From its pressure on the great +blood-vessels running to and from the head, there is a constant +liability to engorgement of blood in the brain, and to apoplexy, +epilepsy, etc. When the enlargement once makes its appearance, it +continues to increase in size as long as the person lives, unless +appropriate treatment be resorted to. It never disappears spontaneously. +These tumors are much larger than those not familiar with them would +suppose from their outward appearance, as they extend under and are +bound down by the muscles on each side of the neck, so that they become +embedded in the cellular tissues underneath, while the sides of the neck +retain, to a considerable extent, their round and even appearance, +whereby the real magnitude of the tumor is not apparent. Figure 7 +represents the appearance of the neck of a person afflicted with this +disease. The form of protuberance varies materially with different +persons, that shown in the engraving being the shape which it ordinarily +assumes. + +[Illustration: Fig. 7.] + +The causes of the affection are not well understood. The use of +snow-water, or water impregnated with some particular saline or +calcareous matter, has been assigned as a cause. It has also been +attributed to the use of water in which there is not a trace of iron, +iodine, or bromine. A writer in a Swiss journal, _Feuilles d' Hygiene_, +states that the disease is often due to an impeded circulation in the +large veins of the neck, from pressure of the clothing, or from the head +being bent forward, a position which is often seen in school children, +when the muscles of the back of the neck have become fatigued. + +TREATMENT. We have obtained wonderful results by a new method of +treatment, which consists in the employment of electrolysis in +conjunction with other therapeutic means. There is scarcely a case in +which this treatment, properly carried out, will not effect a radical +cure. It is attended with no danger whatever. + +Those who are afflicted with this disease and unable to avail themselves +of special treatment, cannot do better than to take Dr. Pierce's +Alterative Extract, or Golden Medical Discovery, and apply to the skin +over and around the tumor, night and morning the following solution +which may be prepared at any drug store: iodine, one drachm; iodide of +potassium, four drachms; dissolve in three ounces of soft water. Apply +to the tumor twice a day, with a feather or hair pencil. + + +MUMPS. (PAROTITIS.) + + +This is an inflammation of the parotid glands and generally occurs in +childhood. It is often epidemic, and is manifestly contagious. It +usually, though not always, appears on both sides of the neck at the +same time. + +SYMPTOMS. An external, movable swelling, just below and in front of the +ear, near the angle of the jaw, is the prominent symptom. The +enlargement is not circumscribed, but hard and painful, and attended +with more or less fever, derangement of the secretions, and difficulty +in swallowing. The swelling increases until the fourth and fifth day, +when it gradually diminishes, and by the eighth or tenth is entirely +gone. Sometimes the disease is accompanied by swelling of the breasts in +the female, or the testicles in the male. + +TREATMENT. Usually but little treatment is necessary. Exposure to cold +should be avoided. If severe or painful, with febrile symptoms, a hot +foot-bath and small doses of the "Compound Extract of Smart-Weed," in +some diaphoretic infusion, to induce sweating, together with small doses +of aconite, will produce good results. If swelling of the testicles +threatens (which seldom happens except on taking cold), resort should be +had to mild cathartics, the spirit vapor-bath, stimulating liniments to +the neck, and warm fomentations to the part attacked If delirium occurs, +a physician should be summoned. + + +INFLUENZA, OR LA GRIPPE. + + +This is an infectious disease, characterized by depression, and usually +associated with a catarrhal condition of the mucous membrane. It may +affect the respiratory organs or the intestinal canal. There is a marked +liability to serious complications, of which pneumonia is the most +dangerous. The disease is evidently due to a specific virus of great +infectiveness, and is more active and contagious at certain seasons and +under certain conditions of the atmosphere. By some it has been supposed +that it is due to a miasma in the air, but the character of its +infection indicates that the true virus is of a germinal nature. + +Uncomplicated cases recover, but in the aged and in the delicate we may +see fatal results, due usually to the profound depression or the high +temperature to which the individual is subjected. There is much redness +and swelling of the mucous membranes of the nose and throat--a +bronchitis--and a catarrhal state of the stomach and intestines. These +may all be present, or the disease may center upon one particular +portion of the animal economy, and manifest its ravages there alone. + +SYMPTOMS. The attack usually resembles an ordinary catarrh of cold. In +some cases the nasal catarrh is absent, or very mild, and the infection +invades the general system, with much fever. A very striking +manifestation of the disease is the severe nervous troubles which are +present at the outset, consisting of headache, pain in the back and +legs, and a general soreness of the muscles and bones as if bruised or +beaten. The pulse is usually feeble and small--intermittent. The disease +may center in the brain, producing delirium. Mental disorders are not +uncommon, and there is usually following the disease more or less +inaptitude for mental work and a tendency to depression of spirits. In +many cases there is a severe diarrhea, and the individual suffers much +from pain and discomfort in the abdomen. This is a gastro-intestinal +irritation, and apparently favors an early recovery, and usually there +are less severe sequels in such cases. + +The most dangerous complication is pneumonia. These cases may follow +bronchitis, or the grip may begin with well-characterized symptoms of +this disease, for which see the chapters upon this trouble. The sputa +may not be rusty until after several days. The crisis is usually slow, +and a considerable proportion recover, the disease frequently showing a +sudden change for the better, and the patient being up and around in a +few days. Cases complicated with pneumonia are the most indefinite in +their symptoms, and require the closest attention. + +TREATMENT. In every case the disease must be regarded as a dangerous +one, and the patient be confined to bed and indoors until all fever has +disappeared, otherwise sudden and serious manifestations are liable to +appear at any time. The patient must be well fed and nourished from the +outset. The bowels should be acted upon by mild laxatives, such as +castor oil or Dr. Pierce's Pleasant Pellets, using from one to three. It +is also of advantage afterward to move them twice each day, by the +injection of warm water, to which has been added a teaspoonful of table +salt to each pint. This injected into the rectum, using the water +slightly tepid, or cool if the patient is feverish, will tend to soften +the actions from the bowels and favor the escape of poisonous matter. +The cool water has also a soothing effect upon the fever and nervous +system. If the fever is high, and there is delirium, small doses of +aconite, with water, should be used every half hour or hour, but all +depressing agents of this kind must be used with caution, as profound +prostration sometimes develops. Warm baths, repeated frequently, and +followed by hot lemonade, are of the greatest benefit in reducing the +feverish condition and quieting the patient. The bed should be warmed +after these are administered and the patient given hot lemonade to bring +on free action of the skin, kidneys, and bowels. Where the pulse is +weak, the free use of stimulants, as wine, coffee, tea, and brandy or +whiskey, are required, as the great danger of the disease is a +depression of the heart. In severe bronchitis, pneumonia, and other +complications, appropriate treatment should be applied. + + * * * * * + + + + +ACUTE NASAL CATARRH. + + +Acute Nasal Catarrh, or cold in the head, is an acute inflammation of +the mucous membrane lining the nasal passage which may confine itself to +these parts or extend to the pharynx, larynx, and air-passages below, or +affect the auxiliary sinuses or cavities communicating with the nasal +passages. + +The most frequent cause of cold in the head is exposure to sudden +changes in temperature, or draughts of cool air, without taking proper +precaution to protect the body so as to prevent the rapid radiation of +animal heat. In most cases there is an inherited tendency or acquired +weakness, which frequently may be associated with a scrofulous condition +of the whole system, that render these points less resistant, and +consequently invite the morbid changes which result from exposure and +cold. Acute Catarrh also occurs during the initial stage of such +eruptive diseases as measles, typhus, typhoid, erysipelas, etc. + +Seldom do we meet with an otherwise healthy individual, who is subjected +to a frequent cold in the head. Impure blood, inherited scrofulous +taints, enfeebled circulation, debility, either general or nervous, are +all advance agents, inviting catarrhal disease, and preventing rapid +recovery from an acute attack, so that a low grade of Chronic Catarrh is +generally the sequence. + +SYMPTOMS. The attack is visually ushered in by a chill, or chilly +sensation, feeling of lassitude, followed by a slight fever. These +symptoms are not as distressing as the sense of fullness about the eyes +and frontal region, and prickling dry heat, with more or less +obstruction in the nostrils. A few hours later follows a copious, acrid +watery discharge, which gradually becomes thick and yellow. Often the +inflammatory action may extend to the orifice of the eustachian tube, +causing obstruction with temporary deafness, or ringing in the ears. +Severe facial neuralgia may be caused by the pressure from the swollen +parts upon the branches of sensitive nerves. + +TREATMENT. In the mild forms of acute catarrh, or coryza, only simple +treatment is required. A hot foot-bath on retiring at night, with a full +dose of Dr. Pierce's Compound Extract of Smart-weed, to produce free +perspiration will generally break up the attack. Should the discharge +from the nostrils continue, Dr. Sage's Catarrh Remedy should be freely +used four to six times each day, until the symptoms are controlled. In +case the bowels do not act, a full dose of Dr. Pierce's Pleasant Pellets +may he taken at bed-time. Avoidance of exposure to cold, and light +vegetable diet, are advisable. In the more severe attacks, especially +when complicated by laryngeal or bronchial symptoms, the most decisive +measures should be employed. The Compound Extract of Smart-weed should +be taken freely, together with hot drinks, or a hot general bath. The +patient should be warmly covered in bed to encourage a continued +perspiration, to equalize the circulation, and subdue the inflammation. +Dr. Pierce's Golden Medical Discovery should be taken in teaspoonful +doses four times each day in all cases that are complicated or +protracted. + +Individuals suffering from frequent colds will do wisely to fortify +their systems by taking a few bottles of the "Golden Medical Discovery" +to improve nutrition, purify the blood, and thus aid nature in +overcoming such inherited tendency or required weakness as may be their +misfortune to possess. Remember frequent attacks of Acute Catarrh +prepare fertile soil for the chronic form which oftentimes is so +loathsome and destructive. + + * * * * * + + + + +CHRONIC NASAL CATARRH. + + +OZAENA. + + +In consequence of repeated attacks of acute catarrh, or "cold in the +head," as it is usually termed, the mucous membranes of the nose and the +air-passages of the head become permanently thickened, the mucous +follicles or glands diseased, and their functions either destroyed or +very much deranged. Although chronic catarrh is most commonly brought on +in the manner above stated, it sometimes makes its appearance as a +sequel of typhoid fever, scarlet fever, measles, or other eruptive +fevers, or shows itself as a local manifestation of scrofulous or +syphilitic taints in the system. + +Injury to the nose may result in a displacement of one or more of the +bony structures, setting up a chronic inflammation with catarrh at that +point. In the early stages of the disease, the patient may be annoyed +with "only a slight dropping into the throat," as many express it, the +amount of the discharges from the air-passages of the head at this stage +of the disease being only slightly in excess of health. In some cases +the discharge is thick, ropy, and tough, requiring frequent and strong +efforts in the way of blowing and spitting, to remove it from the +throat, in which it frequently lodges. In other cases, or in other +stages of the same case, the discharge is thin, watery, acrid, +irritating, and profuse. The nose may be "stopped up" from the swollen +and thickened condition of the lining mucous membrane, so as to +necessitate respiration through the mouth, giving to the voice a +disagreeable nasal twang. From the nature of the obstruction in this +condition, it is useless for the sufferer to endeavor to clear the +passage by blowing the nose; this only tends to render a bad matter +worse, by increasing the irritation and swelling of the already +thickened lining membrane. The swelling of the mucous membrane does not +in all cases become so great as to cause obstruction to respiration +through the affected passages. In some cases, the patient suffers from +head ache a great portion of the time, or experiences a dull, heavy, +disagreeable fullness or pressure in the head, with a confusion of his +ideas, which renders him quite unfit for business, especially such as +requires deep thought and mental labor. Memory may be more or less +affected, and the disposition of those who are otherwise amiable is +often rendered irritable or morose and despondent. The mental faculties +suffer to such an extent in some cases as to result in insanity. The +sense of smell is in many cases impaired, and sometimes entirely lost, +and the senses of taste and hearing are not unfrequently more or less +affected. + +OZÆNA. The ulcerous or more aggravated stage of the disease, from the +offensive odor that frequently attends it, is denominated _Ozæna_. + +The secretion which is thrown out in the more advanced stages of chronic +catarrh becomes so acrid, unhealthy, and poisonous, that it produces +severe irritation and inflammation, which are followed by excoriation +and ulceration of the delicate membrane which lines the air-passages in +the head. Although commencing in this membrane, the ulceration is not +confined to it, but gradually extends in depth, until it frequently +involves all the component structures of the nose--cartilage and bone, +as well as fibrous tissues. As the ulceration extends up among the small +bones, the discharge generally becomes profuse and often excessively +fetid, requires the frequent use of the handkerchief, and renders the +poor sufferer disagreeable to both himself and those with whom he +associates. Thick, tough, brownish incrustations, or hardened lumps, are +many times formed in the head, by the evaporation of the watery portion +of the discharge. These lumps are sometimes so large and tough that it +is with great difficulty that they can be removed. They are usually +discharged every second, fourth, or fifth day, but only to be succeeded +by another crop. Portions of cartilage and bone, or even entire bones, +often die, slough away, and are discharged, either in large flakes, or +blackened, half-decayed, and crumbly pieces; or, as is much more +commonly the case, in the form of numerous minute particles, that escape +with the discharge and are unobserved. It is painfully unpleasant to +witness the ravages of this terrible disease, and observe the extent to +which it sometimes progresses. Holes are eaten through the roof of the +mouth, and great cavities excavated into the solid bones of the face; in +such cases only the best and most through treatment will check the +progress and fatal termination of the disease. + + +COMPLICATIONS. + + +Catarrh, or ozaena, is liable to be complicated, not only by the system, +blood, and fluids, suffering from scrofulous or other taints, as has +already been pointed out, but also by an extension of the diseased +conditions to other parts beyond the air-passages of the head. + +Occasionally deformities of the septum or other internal structures also +polypi or tumors, are sources of constant irritation and accelerate +catarrhal disease. + +DISEASE OF THE THROAT. The acrid, irritating and poisonous discharge, +which, in some stages of disease, almost constantly runs down over the +delicate lining membrane of the _pharynx_ (throat), is liable to produce +in this sensitive membrane a diseased condition similar to that existing +in the air-passages of the head. The throat may feel dry, husky, and at +times slightly sore or raw; or, from the muco-purulent discharge that is +almost constantly dropping down over its surface, the patient may feel +very little inconvenience from the disease of the throat until it is far +advanced--the moistening and lubricating effect of the matter that drops +on the surface tending to blunt the sensibility of the parts. (_See +pharyngitis for symptoms and treatment_.) + +THE EXTENSION OF THE DISEASE TO THE LARYNX. The larynx, situated +directly below the pharynx (throat), is subjected to the influence of +the same irritation from acrid and poisonous discharges dropping into +the throat from the head. More or less of it is removed by hawking and +spitting, but some remains and is drawn into the larynx, or still lower +into the trachea (windpipe), with the inspired air. Thus the disease +creeps along the continuous mucous surfaces of the air-passages, the +acrid poisonous discharge arousing in its track the irritation, +inflammation, ulceration, and thickening of the lining membrane which +characterize the disease in other portions of the air-passages. The +symptoms and treatment of laryngitis will be found under its appropriate +classification. + +BRONCHITIS AND CONSUMPTION. We have already detailed the manner in which +the throat, larynx, and trachea, in succession, become affected from +catarrh, or ozaena. By the same process of extension, the bronchial +tubes, and lastly, the _parenchyma_, or substance of the lungs, in their +turn, become diseased, and bronchitis and consumption are firmly +established. Tightness in the chest, with difficulty of breathing; +soreness; darting, sharp, or dull, heavy pain, or a prickly, distressing +sensation, accompanied with more or less cough and expectoration--are +evidences that the bronchial tubes have become affected, and they should +admonish the sufferer _that he is now standing on the stepping-stone to_ +CONSUMPTION, over which thousands annually tread, in their slow journey +to the grave. + +[Illustration: Fig. 8. +Internal and external ear. _1_, External ear. +_2_, Internal auditory meatus. _3_, Tympanum. _4_, Labyrinth. +_5_, Eustachian tube.] + +DEAFNESS. By means of a small canal, called the _eustachian tube_, an +air-passage and communication between the throat and middle ear is +formed. (See Fig. 8.) This passage is lined by a continuation of the +mucous membrane which covers the throat and nasal passages. The +catarrhal inflammatory process, by continuity of surface, follows the +mucous membrane, thickening its structure, until the eustachian tube is +closed, and the beautiful mechanism of the internal ear is rendered +useless. While the thickening of the mucous membrane is going on, and +the passage is gradually becoming closed (and the process sometimes +extends through several years), the patient will occasionally, while +blowing the nose, experience a crackling in one or both ears, and +hearing becomes dull, but returns suddenly, accompanied with a snapping +sound. This may be repeated many times, until, finally, hearing does not +return, but remains permanently injured. In other cases the hearing is +lost so gradually that a considerable degree of deafness may exist +before the person is really aware of the fact. Either condition is often +accompanied with noises in the head of every conceivable description, +increasing the distress of the sufferer. The delicate bones of the ear +are sometimes detached from their articulations, the drum is ulcerated +and perforated, and through the orifice thus made, the bones or small +_spiculæ_ may escape with the thick, purulent, and offensive discharge. + +CLOSURE OF THE TEAR DUCT. The lachrymal duct, or passage (tear duct), +which, when in a healthy condition, serves to convey the tears from the +eye into the nose, may be closed by the same inflammatory and thickening +process which we have already explained. This condition is usually +attended with watery and weak eyes, the tears escaping over the cheeks, +and sometimes producing irritation and excoriation. The nasal branch of +the ophthalmic nerve sometimes participates in the ulceration going on +in the head, so that the eyes are sympathetically affected. They +sometimes become congested or inflamed, and sharp pain in the eyeballs +may be experienced. + +INDIGESTION, DYSPEPSIA, ETC. A large portion of the acrid, poisonous, +purulent discharge, which drops into the throat during sleep, is +swallowed. This disturbs the functions of the stomach, causing weakness +of that organ, and producing indigestion, dyspepsia, nausea, and loss of +appetite. Many sufferers complain of a very distressing "gnawing +sensation" in the stomach, or an "all gone," or "faint feelings," as +they often express it. + +SYMPTOMS. Dull, heavy headaches through the temples and above the eyes; +indisposition to exercise; difficulty of thinking or reasoning, or +concentrating the mind upon any subject; lassitude; indifference +respecting business, lack of ambition or energy; obstruction of nasal +passages; discharges voluntarily falling into the throat, sometimes +profuse, watery, acrid, thick and tenacious, mucous, purulent, +muco-purulent, bloody, concrete blood and pus, putrid, offensive, etc. +In others, a dryness of the nasal passages: dry, watery, weak, or +inflamed eyes; ringing in the ears, deafness, discharge from the ears, +hawking and coughing to clear the throat, ulcerations, death and decay +of bones, expectoration of putrid matter, _spiculæ_ of bones, scabs from +ulcers leaving surface raw, constant desire to clear the nose and +throat, voice altered, nasal twang, offensive breath, impairment or +total deprivation of the sense of smell and taste, dizziness, mental +depression, loss of appetite, nausea, indigestion, dyspepsia, enlarged +tonsils, raw throat, tickling cough, difficulty in speaking plainly, +general debility, idiocy, and insanity. + +All the above symptoms, as well as some others which have been +previously given, and which it is not necessary here to repeat, are +common to this disease in some of its stages or complications; yet +thousands of cases annually terminate in consumption or chronic +bronchitis, and end in the grave, without ever having manifested +one-half of the symptoms enumerated. + +VARIETIES. People often suppose that there are a great many varieties or +species of catarrh. This is an error. The nature of the disease is the +same in all cases, the symptoms only varying with the different stages +of the disorder, and the various complicated conditions which are liable +to arise, and which have already been pointed out. + +CAUSES. Anything which debilitates the system, or diminishes its powers +of evolving animal heat and withstanding cold or sudden changes of +atmospheric temperature, and other disease-producing agencies, renders +the individual thus enfeebled very liable to catarrh. Among the most +common debilitating agencies are a scrofulous condition of the system, +or other impurities of the blood, exhaustive fevers, and other +prostrating acute diseases, or those badly treated; exhaustive and +unnatural discharges, intemperance, excessive study, self-abuse, +adversity, grief, want of sleep, syphilitic taints of the system, which +may have been contracted unknowingly, or may have been inherited, having +perhaps been handed down even unto the third or fourth generation, to an +innocent posterity from infected progenitors; too sudden rest after +great and fatiguing exercise, and living in poorly-ventilated +apartments. These are among the most fruitful causes of those feeble, +deranged, or impure conditions of the system to which catarrh so +frequently owes its origin. Although the immediate or exciting cause is +generally repeated attacks of "cold in the head," which, being neglected +or improperly treated; "go on from bad to worse," yet the predisposing +or real cause of the disease is in the majority of cases, an enfeebled, +impure, or otherwise faulty condition of the system, which invites the +disease, and needs only the irritation produced in the nasal passages by +an attack of cold, to kindle the flame and establish the loathsome +malady. Some people are convinced with difficulty that there exists in +their system a weakness, impurity, or derangement of any kind, which +permitted the disease to fasten itself upon them. They may not feel any +great weakness, may not have any pimples, blotches, eruptions, +swellings, or ulcers, upon their whole person; in fact, nothing about +them that would, except to the skilled eye of the practical and +experienced physician, indicate that their system is weakened or +deranged with bad humors; and yet such a fault may, and GENERALLY DOES, +exist. As an ulcer upon the leg, or a "fever-sore," or an eruption upon +the skin, may be the only outward sign of a fault in the system, so +frequently chronic catarrh is the only sign by which a bad condition of +the system manifests itself in a manner that is perceptible to the +sufferer himself, or to the non-professional observer. The +finely-skilled physician, whose constant practice makes his perceptive +faculties perfect in this direction, would detect the constitutional +fault, as an experienced banker detects a finely-executed and dangerous +bank-note which the unpracticed eye would pronounce genuine. + +[Illustration: Fig. 9. +Examination of the Nasal Passages by means of the Rhinoscope +and Head Mirror.] + +TREATMENT. If you would remove an evil _strike at its root_. As the +predisposing or real cause of catarrh is, in the majority of cases, some +weakness, impurity, or otherwise faulty condition of the system, in +attempting to cure the disease our chief aim must be directed to the +removal of that cause. The more we see of this odious disease, the more +so we the importance of combining; with the use of a local, soothing and +healing application, a thorough and persistent internal use of +blood-cleansing and tonic medicines. + +As a local application for healing the diseased condition in the head, +Dr. Sage's Catarrh Remedy is beyond all comparison the best preparation +ever invented. It is mild and pleasant to use, producing no smarting or +pain, and containing no strong, irritating, or caustic drug, or other +poison. Its ingredients are simple and harmless, yet when scientifically +and skillfully combined, in just the right proportions, they form a most +wonderful and valuable healing medicine. Like gunpowder, which is formed +of a combination of saltpeter, sulphur, and charcoal, the ingredients +are simple, but the product of their combination is wonderful in its +effects. The Remedy is a powerful antiseptic, and speedily destroys all +bad smell which accompanies so many cases of catarrh, thus affording +great comfort to those who suffer from this disease. + +The reader's mind cannot be too strongly impressed with the importance +of combining thorough constitutional with the local treatment of this +disease. Not only will the cure be thus more surely, speedily, and +permanently, effected, but you thereby guard against other forms of +disease breaking out, as the result of humors in the blood or +constitutional derangement or weakness. + +In curing catarrh and all the various diseases with which it is so +frequently complicated, as throat, bronchial, and lung diseases, weak +stomach, catarrhal deafness, weak or inflamed eyes, impure blood, +scrofulous and syphilitic taints, the wonderful powers and virtues of +the "Golden Medical Discovery" cannot be too strongly extolled. It has a +specific effect upon the lining mucous membranes of the nasal and other +air passages, promoting the natural secretion of their follicles and +glands, thereby softening the diseased and thickened membrane, and +restoring it to its natural, thin, delicate, moist, healthy condition. +As a blood-purifier, it is unsurpassed. As those diseases which +complicate catarrh are diseases of the lining mucous membranes, or of +the blood, it will readily be seen why this medicine is so well +calculated to cure them. + +The "Golden Medical Discovery" is the natural "helpmate" of Dr. Sage's +Catarrh Remedy. It not only cleanses, purifies, regulates, and builds up +the system to a healthy standard, and conquers throat, bronchial, and +lung complications, when any such exist, but, from its specific effects +upon the lining membrane of the nasal passages, it aids materially in +restoring the diseased, thickened, or ulcerated membrane to a healthy +condition, and thus eradicates the disease. When a cure is effected in +this manner it is permanent. The system is so purified, regulated, and +strengthened, as to be strongly fortified against the encroachments of +catarrh and other diseases. The effects of the "Golden Medical +Discovery" upon the system will be gradual, and the alterative changes +of tissue and function generally somewhat slow. They are with however, +less complete, radical, and lasting; and this constitutes its great +merit. Under its influence all the secretions are aroused to carry the +blood-poisons out of the system, the nutrition is promoted, and the +patient finds himself gradually improving in flesh; his strength is +built up, his lingering ailments dwindle away, and by and by he finds +his whole person has been entirely renovated and repaired he feels like +a new man--a perfect being. + +[Illustration: Fig. 10. +Atomizer. ] + +THE CLOTHING. With most persons suffering from chronic nasal catarrh, +there is a great disposition to take cold, even slight cause being +sufficient to produce an acute attack, which greatly aggravates the +chronic affection and operates to render it permanent. To obviate the +bad effects that are liable to result from this predisposition, great +attention should be paid to the clothing, that it thoroughly protects +the person from sudden changes of temperature. For more particular and +practical suggestions in regard to this matter, the reader is referred +to the article on Clothing, in Part Two, Chapter II, of "The People's +Common Sense Medical Adviser." + +THE DIET has an important influence with this disease, as with +consumption and many other chronic ailments. It should be largely +composed of those articles rich in the non-nitrogenized or carbonaceous +elements. Fat meats, rich, sweet cream, good butter, and other similar +articles of food, should comprise a large part of the diet. These +elements, which are prolific in the production of animal heat counteract +the predisposition to take cold, and thus become most valuable remedial +agents--not less essential than the medical treatment that has been +advised. The patient, suffering from chronic catarrh, should study well +the hygienic teachings to be found in Part Two of "The People's Common +Sense Medical Adviser," and govern himself accordingly. + +TREATMENT OF COMPLICATIONS. There are various complications of this +disease that require modifications of the treatment to meet them +successfully. The rules cannot be made that would enable +non-professional readers to vary the treatment to suit peculiarities of +constitution, or complications of the disease. When consulted, either +the person or by letter, we have been able to so modify the treatment as +to be adopt it to peculiar individuals which rejected the ordinary +treatment, and have thus cured hundreds who had otherwise failed to find +relief. + +[Illustration: Fig. 11. +Steam Atomizer, illustrating position of head during treatment.] + +TIME REQUIRED IN EFFECTING A CURE. Reader, if you suffer from chronic +nasal catarrh, do not expect to be very speedily cured, especially if +your case is one of long standing. Unprincipled quacks and charlatans, +who possess no knowledge of disease, or medicine either, and whose sole +design is to palm off upon you a bottle or two of some worse than +worthless strong, caustic solution, irritating snuff, or drying +"fumigator," "dry up," "annihilator," "carbolated catarrh cure," +"catarrh specific," or other strong preparation, will tell you that the +worst cases can be _speedily_ cured by these unreasonable means. It is +true that such strong, irritating, and drying preparations will many +times suddenly arrest the discharge from the nose, but the thickened or +ulcerated condition of the lining mucous membrane, which really +constitutes the disease, is not removed by such treatment, and the +discharge soon comes on again. Besides, there is danger attending the +employment of such strong, irritating, or drying preparations. The +disease, by their use, is frequently driven to the throat, bronchial +tubes, lungs, or brain, and thus a bad matter is made worse. Not less +irrational and unsuccessful is the plan of treating the disease with +inhalations of "carbolized iodine," and other drags, administered +through variously-devised pocket and other inhalers. Such treatment may +mask or cover up catarrh for a time; but, by reason of the +constitutional nature of the disease, it cannot effect a perfect and +permanent cure. Dr. Sage's Catarrh Remedy, on the other hand, cures the +disease on common-sense, rational, and scientific principles, by its +mild, soothing, and healing properties, to which the disease gradually +yields, when the system has been put in perfect order by the use of +"Golden Medical Discovery." This is the only perfectly safe, scientific, +and successful mode of acting upon and healing it. Without, we trust, +being considered egotistical, we can say that this opinion is based upon +a large experience and a perfect familiarity with the nature and +curability of the disease. For many years our whole time and attention +has been given to the study and cure of catarrh and other chronic +diseases treated of in "The People's Common Sense Medical Adviser." +Cases of catarrh have been treated by thousands, and our medicines for +the cure of this loathsome disease, and of other chronic diseases, have +met with an extensive sale in all parts of the United States, and have +found their way into many foreign countries. The universal satisfaction +with which their use has been attended, and the grateful manifestations +received from the cured, have afforded one of the greatest pleasures of +our lives. Scarcely a mail arrives that does not bring new testimony of +cures effected by the treatment here recommended. + + +DIRECTIONS FOR USING DR. SAGE'S CATARRH REMEDY. + + +To prepare the medicine ready for use, put the whole quantity of powder +contained in the package, as put up for sale, into a bottle; pour into +it one pint of cool, soft water. Rain water or melted snow is good. +Ordinary lake, river, well or spring water will do if only _slightly_ +hard. Cork the bottle tightly and shake it thoroughly, after which allow +it to stand six or eight hours to settle. Two of the ingredients of +which the remedy is composed do not entirely dissolve, but their +medicinal properties are completely and speedily extracted and taken up +by the water. These settlings have lost their medicinal properties and +should not be allowed to enter the nasal cavity. It should be kept +tightly corked, not allowing it to freeze in winter, or be kept where it +is very warm in summer. This we term the "Catarrh Remedy Fluid." + +Use the fluid, prepared according to the above directions, not less than +three or four times a day, the last time just before retiring, in the +following manner: Without shaking the bottle to roll the fluid, pour out +a teaspoonful or more into the hollow of the hand, hold it there until +warmed; first gently, and afterwards forcibly, snuff the fluid up one +nostril and then the other, until the nose is well filled and it passes +back into the throat. No fears need be entertained that it will produce +strangling or any unpleasant effect in thus using it, for, unlike any +other fluids (simple tepid water not excepted), it does not produce the +slightest pain or disagreeable feeling, but, on the contrary, leaves +such a cooling, pleasant sensation that its use soon becomes a pleasure +rather than a task. In a few minutes after thus using the remedy, it +should be blown out gently (never forcibly), to clear the nose and +throat of all hardened crusts and offensive accumulations, if any such +exist. Never blow the nose violently, as it irritates the passages and +counteracts, to some extent, the curative effects of the remedy. This +process should be repeated until the remedy has been thoroughly applied +two or three times, not blowing it out the last time of using it, but +retaining the medicine in contact with the affected parts for a +considerable length of time. No harm can result if the fluid be +swallowed, as it contains nothing poisonous or injurious. + +A BETTER WAY. The manner of using Dr. Sage's Catarrh Remedy, advised +above, is somewhat imperfect and not nearly so thorough a mode as the +one to which the reader's attention will now be directed. + +In a very large number of bad cases of catarrh, or those of long +standing, the disease has crept along and extended high up in the nasal +passages, and into the various sinuses or cavities, and tubes +communicating therewith. The act of snuffing the fluid _carries it along +the floor of the nose and into the throat_, but does not carry it _high +enough_, or fill the passages _full enough_, to reach all the chambers, +tubes, and surfaces, that are affected with the disease. + +The fluid may seem, from the sensation produced, to pass high up between +the eyes, or even above them, but it does not. It is only a sensation +transmitted to these parts by nerves, the filaments of which are +distributed to that portion of the mucous membrane which the fluid does +not reach, just as a sensation is transmitted to the little finger by a +blow upon the elbow. + +Now, in order to be most successful in the treatment of catarrh, it is +necessary that _the remedy should reach and be thoroughly applied to all +the affected parts_. This can be accomplished in only one way, which is +by _hydrostatic pressure_. The anatomy of the nasal passages, and the +various chambers and tubes that communicate therewith, is such that they +cannot be reached with fluid administered with any kind of syringe or +inhaling tube, or with any instrument, except one constructed to apply +it upon the principle above stated. Such an instrument is Dr. Pierce's +Nasal Douche. + +By the use of this instrument, the fluid enters every portion of the +air-passages of the head by its own weight, no snuffing being required. + + +DIRECTIONS FOR USING DR. SAGE'S CATARRH REMEDY WITH THIS INSTRUMENT. + + +[Illustration: Fig. 12. +This cut illustrates the manner of using Dr. Pierce's Nasal Douche.] + +To cleanse out the passages previous to applying the Catarrh Remedy +fluid, take one quart of soft water, add to it two large tablespoonfuls +of common salt, and shake it up occasionally until all is dissolved. +Before use heat it until blood warm, or, in other words, until it gives +a pleasant, mild warmth to the inserted finger. Put the reservoir on a +shelf, or hang it up, so that it will be a little higher than the head: +fill the reservoir with salt and water, pressing the tube between the +thumb and finger so as to prevent the fluid from escaping through it; +introduce the nozzle at the end of the tube into one nostril, pressing +it in far enough to close the entrance of the passage so that no fluid +can escape by the side of the tube, breathe through the mouth, avoid +swallowing, and allow the fluid to flow. The soft palate, by the act of +breathing through the mouth, is elevated so as to completely close the +passage into the throat, and thus the fluid is made to flow up one +nostril in a gentle stream, to pass into and thoroughly cleanse all the +sinuses, or cavities, connected with the nasal passages, and to flow out +of the other nostril. The douche should not be employed unless both +nostrils are open and the flow is free. If the head is "stopped up," +snuff up the warm liquid from the hand occasionally, until the passages +are open and you can breathe freely through both nostrils. + +Do not forget that the instrument will not work properly unless you +_breathe through the mouth and avoid swallowing_ while the fluid flows. + +Fill the reservoir a second time with the simple salt and water, and, +inserting the nozzle into the nostril out of which the fluid flowed on +using it the first time, pass the current through in the opposite +direction; that is, so that it will flow out of the nostril into which +it flowed the first time of using it. + +After having thus thoroughly cleansed the passages, fill the instrument +half full or more with the "Catarrh Remedy Fluid," prepared as +heretofore directed, and warmed to a moderate temperature, and pass this +through the nose in the same manner as directed for the salt water. The +salt water is not curative, but is milder than simple water, and is, +therefore, preferable for cleansing the passages. + +On first commencing the use of the instrument, it is best to hang it +only a very little higher than the forehead, but after using it a few +times, put it up about as high as the length of the tube will admit. + +Let no one entertain any feeling of timidity on commencing the use of +this instrument, as its operation is perfectly simple and harmless, and, +with the fluids which we recommend, is never attended with any +strangling, choking, pain, or other disagreeable sensations. The +medicine should be applied with the Douche at least twice a day, in the +morning and at night on retiring. There is no advantage in using the +medicine oftener than three times a day, when used with the instrument, +but a _sufficient_ quantity should be used each time to medicate all the +diseased parts. If any remains in the Douche it may be poured back into +the stock solution for subsequent use, but a liquid that has once passed +through the nasal cavity contains the germs of the disease and must not +be used a second time. + + * * * * * + + + + +NASAL POLYPUS. + + +The term Nasal Polypus is usually given to a variety of growths which +are met with in the nasal passages far more frequently than any other +tumors. They are thus designated because of their fancied resemblance to +the aquatic polypus. They occur singly, or in clusters, as illustrated +in Fig. 13. In the early stages the mucous membrane is swollen and +irregularly dilated, presenting a rough and mottled appearance not +unlike chronic catarrh with which they are usually associated. Gradually +these mound-like tumors enlarge, usually becoming pendulant, and +presenting a grayish opaque glistening surface, similar to the pulp of a +grape. Occasionally they become massive at the point of attachment, and +assimilate a warty or cauliflower growth. The latter variety is better +supplied with blood vessels and presents a red or dark pink surface and +may bleed on slight irritation. The favorite location is beneath or +behind the middle or superior turbinated bodies, oftentimes nearly or +quite concealed. However, no portion of the mucous membrane lining the +upper air passages is exempt. Sometimes they grow from the roof of the +nostril and pharnyx in pendulous masses, assuming the shape of the +cavities, filling the entire nostril and upper portion of pharnyx. The +mucous membrane covering the turbinated bodies may become dilated and +swollen, finally developing by catarrhal processes into a polypus at +that point. (See _H_, Fig. 13.) + +[Illustration: Fig. 13. +NASAL POLYPI. + +_A_. Anterior opening of the nostril. +_B_. Soft Palate, _C_. Orifice of the +Eustachian tube. _D, D_. Superior +and inferior turbinated bodies. _E_. +Large Polypus. _F_. Several small +Polypi. G. Throat. _H_. Polypoid +growth on turbinated body.] + +CAUSES. Nothing definitely is known regarding their causation. They are +generally supposed to originate in some constitutional derangement, +impairing the nutrition of the mucous membranes. Other cases are closely +associated with chronic nasal catarrh, and frequent attacks of cold in +the head. + +SYMPTOMS. These may vary considerably in different cases due to the +character and location of the polypus. In the early stages before the +tumor is well developed, the symptoms may be those of nasal catarrh, and +the diagnosis of polypus be possible only after a personal examination +by a skillful specialist. Neither is the size of the polypus always in +proportion to the severity of the symptoms. The nasal discharge is +generally increased and of a variable character. As the tumors enlarge +they cause a sense of fullness and weight between and below the eyes, +with more or less headache and facial neuralgia. There is partial or +complete obstruction of one or both nostrils. In some cases the +obstruction changes from one nostril to the other when lying down; the +stoppage generally being on the side toward the pillow. A polypus +located at the junction of the nasal passages and throat by force of +gravity always causes obstruction to the lower nasal cavity when lying +down. Polypi often attain considerable size and by pressure upon and +displacement of the surrounding structures occasion hideous facial +deformity. Changes in the weather often aggravate the symptoms. By +blowing the nostril the tumor sometimes may be forced forward, so that +it may be seen a short distance from the anterior opening of the +nostril. The _voice_ is often affected, being muffled or harsh in tone, +similar to that which accompanies a cold in the head. _Respiration_ may +be considerably embarrassed, due to the obstruction in the nasal +passages, and the patient necessarily resorts to mouth breathing. In +advanced cases the Larnyx is usually much congested, being constantly +irritated, not only reflexly through the nervous system, but directly by +the inspired air, and excoriating discharges dropping in the throat from +behind the palate. Thus it is plain to understand how chronic +Pharyngitis, Laryngitis, Bronchitis, and Asthma may result from a small +polypus in the nasal cavity. + +TREATMENT. In mild cases correcting the constitutional derangement may +check the morbid process in the nostrils and cause absorption of the +polypus growth. For this purpose Dr. Pierce's Golden Medical Discovery +is unequaled. The removal of the polypus may sometimes be accomplished +by snuffing powdered blood-root. When these measures fail it is +necessary to seek surgical assistance. After the removal of the polypus +Dr. Sage's Catarrh Remedy should be used to prevent a recurrence. + + +OUR OPERATION FOR NASAL TUMORS. + + +Having operated with unvarying success upon a very large number and +variety of nasal tumors at the Invalids' Hotel and Surgical Institute we +are positively assured that the means and methods which we employ are +neither severe or dangerous; _no pain_, consequently _no shock_; +recovery rapid and permanent. Many forms of injection and local +treatment are in use for the removal of nasal polypi, none of which have +proven to be curative; recurrence of the tumor many times following such +treatment. Many cases have presented themselves after having been +treated by the heroic method of seizing the polypus with a pair of +forceps and forcibly tearing it loose, bringing with it segments of +healthy tissue, leaving bone exposed, and a ragged, uneven surface of +diseased membrane. It is much easier to properly treat a case from the +beginning than to undertake it in such a rendition. + +Owing to the fact that these nasal tumors grow directly from the lining +membranes it is necessary not only to thoroughly remove the tumor but to +treat the diseased membrane at the point from which the polypus springs; +otherwise another tumor may develop at the same point. The nasal passage +having been thoroughly anæsthetized, or benumbed, by the use of +cocaine, the nasal speculum is introduced, and by means of reflected +light from the head mirror worn by the operator, the interior of the +nostril is brought into view. (See Fig. 9, p. 479.) + +Often the attachment of the growth is entirely hidden behind the +irregular bony structures of the nostril so that it requires the skill +of an expert specialist, deft in the manipulation of these parts, to +operate properly. + +Many styles and shapes of delicately devised instruments are necessary +to completely remove the growth without doing injury to the adjacent +structures. By our newly devised operation the tumor is at once removed, +without pain, and with the loss of only a few drops of blood. Further, +because the tumor is entirely removed and the base properly treated +there is not the offensive discharge for a long time afterward and the +danger from infection and blood-poison to which the patient is subjected +in other forms of treatment. + +In conclusion we would say that we claim for our operation the following +points that are worthy of the careful consideration of every one who may +be so unfortunate as to require the services of a specialist for the +removal of growths in the nasal or upper air passages. + +1st. Our operation is absolutely painless. + +2d. No chloroform or ether is required. + +3d. We insure perfect removal of growth. + +4th. There is no injury to other adjacent structures. + +5th. The operation is bloodless. + +6th. The recovery is rapid. + +7th. There is no slough to produce pus that may be absorbed and cause +blood-poisoning. + + * * * * * + + + + +DEFORMITY OF THE NASAL SEPTUM. + + +In health the nasal septum is a bony or cartilaginous plate, as shown in +_A_, Fig. 14, dividing the nasal passages into two cavities of the same +size and shape. This plate or partition is also a support to which the +flexible structures which form the tip of the nose are attached. In +early life the septum is flexible and may be bent or doubled by injury +to the nose; but owing to its elasticity usually resumes its natural +position and shape. After maturity any dislocation or change in this +bony plate usually remains permanent unless some means are employed for +its correction. In a limited number of cases supposed to be chronic +nasal catarrh, we have found upon examination that one or both nasal +cavities were more or less obliterated and obstructed by the deformed +and thickened septum. (See _A_, Fig. 15.) Many of these cases date from +an injury to the external parts, causing only bleeding from the nose and +a slight pain for a short time. Chronic inflammation develops at the +point where the bone is bent or cracked, resulting in thickening, often +producing nodules or spur-like projections which not only interfere with +nasal breathing, but also act as irritants to the adjacent delicate +membranes and produce many of the symptoms common to nasal catarrh. + +[Illustration: Fig. 14. +Anterior view of the healthy nasal passages as +seen with the projecting portion of +the nose removed. + +_A._ Vertical septum or bony plate separating +nostrils. _B, B._ Turbinated bodies. _C, C._ Nasal +passages.] + +Among other common causes are unequal or imperfect development of the +nasal bones, due to an inherited strumous tendency and local ulcerative +disease, weakening or destroying the bone. + +SYMPTOMS. The location and extent of the deformity of the nasal septum +necessarily gives opportunity for a variety of symptoms. In aggravated +cases the nose appears to be bent toward one side. In the earlier stages +there is an excess of mucous secretion, often dropping into the throat +from behind the palate. The discharge is variable as in nasal catarrh +with more or less difficult nasal breathing, the stoppage changing from +one nostril to the other. Sneezing and frequent attacks of nose bleed +are often common symptoms. The tendency of the disease is to extend +backward often causing headache, deafness, roaring in the ears and +post-nasal disease which results in a chronic sore throat, the latter +disease often being the one for which the patient seeks advice. If +allowed to progress uninterruptedly the throat gradually becomes more +irritable, associated with an annoying cough, and the voice becomes +harsh and has a nasal tone. The general health is impaired, the nervous +system excitable; laryngitis, asthma, and lung disease become +complications, which render the existence of the individual miserable. + +TREATMENT. In mild cases where the deformity is slight, and the +obstruction is not a constant symptom, the nasal cavities should be +cleansed (See treatment of nasal catarrh) after inhaling dust, and +special attention given to the prompt treatment of cold in the head. +Should there be irritability, sneezing, or a constant discharge, it is +advisable to use Dr. Sage's Catarrh Remedy as directed on p. 483 to +soothe the excitability and lessen the inflammatory action in and about +the thickened and deformed septum. As an auxiliary to promote the +absorption of the thickened tissues and restore them to a healthy +activity, a number of bottles of the "Golden Medical Discovery" should +be taken while using the local treatment. Any dormant condition of the +liver or digestive tract may be corrected by taking Dr. Pierce's +Pleasant Purgative Pellets. In advanced cases after the structures are +so diseased and thickened that it renders local treatment hopeless, only +surgical interference can prove curative. + + +OUR PAINLESS OPERATION. + + +By the application of a few drops of a solution of cocaine in the +nostril, at the point to be treated, we are now able to produce such +local anæsthesia as to render the operation entirely painless without +the administration of either chloroform or ether. This is an important +consideration as many are adverse to taking chloroform or ether, and now +that we possess an agent that produces, locally, complete insensibility +to pain, we are very glad to dispense with their use in all such minor +operations. There is no pain caused even by the application of the +cocaine to deaden the sensibility of the part. Many examinations of the +upper air-passages heretofore very annoying and even painful to the +patient and sometimes unsatisfactory, are rendered entirely painless, +and carried out with a thoroughness that would be impossible without the +use of this wonderful agent. Not only in surgery of the nose and throat, +but alike in other departments, our surgeon-specialists employ the same +local anæsthetic in all minor operations, none of which are attended +with the least pain. + +Our specialists were among the first surgeons in this country to employ +this newly-discovered anæsthetic. We regard it as a great boon to our +patients, and never withhold it in any case where it can be employed to +prevent suffering. Its use is attended with no danger, nor is it +followed by bad or disagreeable results. + + +OUR OPERATION. + + +[Illustration: Fig. 15. +Anterior view of deformed nasal passages as +seem with the projecting portion of the nose removed. +_A._ Deformed and thickened septum or bony +plate separating nostrils. _B,B._ Irregular and +obstructed nasal passages. _C._ Diseased and swollen +turbinated body. _D,D._ Turbinated bodies +crowded back by septum.] + +The nostrils being the entrance to and the beginning of the air passages +no dexterity and skill can be spared in treating and properly correcting +any deformity that may exist. Mutilation of these sensitive structures +is sure to be followed by serious reflex symptoms in adjacent parts. + +Consequently cases of this nature should only be entrusted to the care +of a competent and experienced specialist. Our resources and appliances +are unlimited and seldom do we use the surgeon's knife in a case of this +nature. + +As in the treatment of other pathological growths in the upper air +passages the rhinoscope is indispensable. The parts can only be brought +into the view of the operator by means of this instrument and sets of +mirrors to reflect light on all sides of the deformed and hidden parts. + +By our operation both nasal cavities are restored to their normal size +and contour (compare Figs. 14, 15), unhealthy and diseased tissues are +removed, and free nasal respiration established. + +All treatments are carried out under strict aseptic precautions, thus +reducing the danger from absorption of poisonous secretions to the +minimum. By our skillful and ingenious management of these cases we +never have had a single patient manifest any serious symptoms after +operation. In such cases we consider this the only safe, practical, and +permanent cure. Every year hundreds pass out of existence the victims of +incurable disease of the air-passages resulting from morbid nasal +conditions, who might be saved by proper and timely treatment. + + * * * * * + + + + +PHARYNGITIS AND POST-NASAL CATARRH. + + +[Illustration: Fig. 16. +Use of the Post-nasal Syringe in the treatment +of Post-nasal Catarrh. + +_A_. Tongue. _B_. Epiglottis. _C_. Soft palate. _D_. Anterior opening of +the nostril. +_E,E,E._ Turbinated bodies. _F_. Junction of the nasal passage and +throat. _G_. Diseased and roughened mucous membrane. _H_. Throat or +Pharynx. _I, I_. Interior +of nasal passage.] + +Simple chronic pharyngitis seldom exists alone and uncomplicated; most +cases being the result of previous existing disease of the nasal or +post-nasal passages. Many cases are associated with hypertrophy, or +enlargement, of the tonsils. Usually the disease is located in the upper +part of the pharynx, or throat, behind and above the uvula and soft +palate, and is thus hidden from view when looking into the throat +through the mouth. When not associated with nasal catarrh the common +symptoms are dropping of tenacious mucous in the throat, causing a +constant desire to hawk and spit; sense of dryness in this region; cough +and expectoration on rising in the morning, which is due to the +irritability of the throat, and may invade the lower air-passages. The +throat may be studded with red and thickened patches of its mucous +membrane. Respiration may be embarrassed, the voice affected and the +general health gradually decline. The membrane above and behind the +palate is angry, reddened, thickened and roughened, as represented in +_G_, Fig. 16. + +TREATMENT To rationally treat a disease, attack the cause. Therefore, in +an uncomplicated case of post-nasal disease of the pharynx the medicine +should be applied at this point. For this purpose we recommend the +regular and continuous use of Dr. Sage's Catarrh Remedy administered +preferably by means of the post-nasal syringe as illustrated in Fig. 16. + +The efficacy of Dr. Sage's Catarrh Remedy as a curative agent in catarrh +of mucous membranes is unequaled if the medicine be properly and +thoroughly applied. The Catarrh Remedy fluid should be prepared as +directed in the pamphlet which accompanies the medicine. Warm enough of +the medicine to fill the syringe twice. After the syringe is filled with +the warm medicine, introduce the curved tip behind the soft palate, +holding the syringe as seen in Fig. 16, then incline the head forward +over a wash bowl and empty the syringe by pressing the plunger quickly. +The medicine will immediately come in contact with the diseased surfaces +and pass out through the nostrils, thoroughly medicating, disinfecting +and cleansing the upper part of the throat and the posterior region of +the nostrils. Two syringes of the medicine should be used for each +treatment, and two or more applications made every day until a cure is +effected. + +At the same time the local treatment is being used, Dr. Pierce's Golden +Medical Discovery should be taken to act through the blood upon the +diseased tissues. + +The Catarrh Remedy may be administered by means of the Nasal Douche, if +the case is complicated by nasal catarrh. Should tumors or deformities +exist, it is advisable to consult a specialist. + + * * * * * + + + + +ENLARGED TONSILS. + + +Chronic enlargement of the tonsils, as shown in Fig. 17, _A A_, is an +exceedingly common affection. It is most common to those of a scrofulous +habit. It rarely makes its appearance after the thirtieth year, unless +it has been imperfectly cured. Both tonsils are generally, though +unequally enlarged. A person affected with this disease is extremely +liable to sore throat, and contracts it on the slightest exposure; the +contraction of a cold, suppression of perspiration, or derangement of +the digestive apparatus being sufficient to provoke inflammation. + +CAUSES. Repeated attacks of quinsy, scarlet fever, diphtheria, or +scrofula, and general impairment of the system, predispose the +individual to this disease. + +SYMPTOMS. The voice is often husky, nasal or guttural, and disagreeable. +When the patient sleeps, a low moaning is heard, accompanied with +snoring and stentorian breathing, and the head is thrown back so as to +bring the mouth on a line with the windpipe, and thus facilitate the +ingress of air into the lungs. When the affection becomes serious it +interferes with breathing and swallowing. The chest is liable to become +flattened in front and arched behind, in consequence of the difficulty +of respiration, thus predisposing the patient to pulmonary disease. On +looking into the throat, the enlarged tonsils may be seen, as in the +Fig. 17. Sometimes they are so greatly increased in size that they touch +each other. + +[Illustration: Fig. 17. +_A. A._ Enlarged Tonsils. _B_. Elongated +Uvula.] + +TREATMENT. The indications to be carried out in the cure of this malady +are: + +(1.) To remedy the constitutional derangement. + +(2.) To remove the enlargement of the tonsilar glands. + +The successful fulfillment of the first indication may be readily +accomplished by attention to hygiene, diet, clothing, and the use of Dr. +Pierce's Golden Medical Discovery, together with small daily doses of +his "Pleasant Pellets." This treatment should be persevered in for a +considerable length of time after the enlargement has disappeared, to +prevent a return. + +To fulfill the second indication, astringent gargles may be used. +Infusions of witch-hazel or cranesbill should be used during the day. +The following mixture is unsurpassed: iodine, one drachm; iodide of +potash, four drachms; pure, soft water, two ounces. Apply this +preparation to the enlarged tonsils twice a day, with a probang, or soft +swab, being careful to paint them each time. A persevering use of these +remedies, both internal and local, is necessary to reduce and restore +the parts to a healthy condition. + +Sometimes the enlarged tonsils undergo calcareous degeneration; in this +case, nothing but their removal by a surgical operation is effectual. +This can be readily accomplished by any competent surgeon. We have +operated in a large number of cases, and have never met with my +unfavorable results. + +The method we adopt at the Invalids' Hotel and Surgical Institute for +the removal of diseased tonsils is, like other minor operations, +painless. The patient is not required to take chloroform or ether. When +the enlarged gland is once thoroughly removed the disease seldom +returns. + + +ELONGATION OF THE UVULA. + + +Chronic enlargement, or elongation of the uvula or soft palate, as shown +at _B_ in Fig. 17, may arise from the same causes as enlargement of the +tonsils. It subjects the individual to a great deal of annoyance by +dropping into or irritating the throat. It causes tickling and frequent +desire to clear the throat, also change, weakness and loss of voice, and +often gives rise to a very persistent and aggravating cough. +Constriction of the throat, cough and difficult breathing are more +prominent symptoms in complicated cases. + +TREATMENT. The treatment already laid down for enlarged tonsils, with +which affection, elongation of the uvula is so often associated, is +generally effectual. When it has existed for a long time, and does not +yield to this treatment it may be removed by any competent surgeon. + + * * * * * + + + + +CHRONIC LARYNGITIS. + + +This is of much more frequent occurrence than the acute form, and is +often associated with tubercular affections, and constitutional +syphilis. It is characterized by an inflammatory condition, ulceration, +or hardening of the mucous membrane of the larynx, most frequently the +latter. There is also a chronic form, known as _follicular laryngitis_, +or _clergymen's sore throat_, to which public speakers are subject. + +THE CAUSES of chronic laryngitis are various, as prolonged use of the +vocal organs in reading or speaking; using them too long on one pitch or +key, without regard to their modulation; improper treatment of acute +diseases of the throat; neglected nasal catarrh; the inordinate use of +mercury; syphilis; repeated colds which directly cause sore throat, +injuries, etc. It is also frequently due to tubercular deposits, and in +these cases it generally terminates in consumption. + +SYMPTOMS. The affection often comes on insidiously. There is soreness of +the throat, noticeable particularly when speaking, and immediately +thereafter; a "raw" and constricted feeling, leading to frequent +attempts to clear the throat, in order to relieve the uneasy sensation. +The voice becomes altered, hoarse, and husky, and there is a slight, +peculiar cough, with but little expectoration. At first, the matter +expectorated is mucus, but as the disease advances, and ulceration +progresses, it becomes muco-purulent, perhaps lumpy, bloody, or is +almost wholly pure pus. The voice becomes more and more impaired, and is +finally lost. In the latter stages, it resembles consumption, being +attended with hectic fever, night-sweats, emaciation, cough, profuse +expectoration, and sometimes hemorrhage. + +TREATMENT. The patient should avoid using his voice as much as possible. +At the same time, attention should be paid to the diet, the bathing, and +the clothing. Every thing should be done that is calculated to build up +and improve the general health. Dr. Pierce's Golden Medical Discovery is +well adapted to remove morbid states of the disease, in consequence of +its direct action on the mucous membranes of the air-passages, and its +efficacy in allaying irritation of the laryngeal, pharyngeal, and +pneumogastric nerves. It should be perseveringly employed. Iodine +inhalations, administered with the pocket inhaler, illustrated by Fig. +3, and the application of tincture of iodine to the forepart of the +neck, are efficacious in many cases. Inhalations of chloride of ammonia, +administered with a steam-atomizer, Fig. 11, in the form of spray, are +frequently of great benefit. _Perseverance_ is necessary, and the +afflicted are cautioned against discontinuing the treatment too soon, +for the disease is very liable to return. + + * * * * * + + + + +CONSUMPTION. + +PHTHISIS PULMONALIS. + + +By this we understand a constitutional affection, characterized by a +wasting away of the body, attended by the deposition of tubercular +matter into the lung tissue. Hence the appellations, _Phthisis +Pulmonalis; Pulmonary Tuberculosis; Tubercular Consumption_. Tubercles +may form in other organs and result in a breaking down of their tissues, +but the employment of the term _Consumption_ in this article is +restricted to the lungs. The general prevalence, the insidious attack, +and the distressing fatality of this disease, demand the special +attention and investigation of every thinking person. It preys upon all +classes of society. Rich and poor alike furnish its victims. + +Some idea of its prevalence may be formed when we consider that, of the +entire population of the globe, one in every three hundred and +twenty-three persons annually dies of consumption. It may not be +definitely known just what proportion of all the deaths in this country +and Europe occurs from this one disease. Those who have gathered +statistics differ somewhat, some claiming one-fourth, while others put +the ratio at one-sixth, one-seventh, and even as low as one-ninth. A +fair estimate, and one probably very near the truth, would be one-sixth +or one-seventh of the whole number. In New York City, for five +consecutive years, the proportion was three in twenty. In New England, +about twenty thousand annually succumb to this destroyer, and in the +State of New York as many more. These figures may appear to be +exaggerations, but investigations of the subject prove them to be the +simple truth. Epidemics of cholera, yellow fever, and other diseases of +similar character, so terrible in their results, occasion wide-spread +alarm, and receive the most careful considerations for their prevention +and cure, while consumption receives scarcely a thought. Yet the number +of their victims sinks into insignificance when compared with those of +consumption. Like the thief in the night, it steals upon its victim +unawares. In a large proportion of cases, its approach is so insidious +that the early symptoms are almost wholly disregarded; indeed, they +excite but little, if any, attention, and perhaps for a time disappear +altogether. Thus the patient's suspicions, if they have been aroused, +are allayed and appropriate measures for his relief are discontinued. +This may be the case until renewed attacks firmly establish the disease, +and before the patient is fully aware of the fatal tendency of his +malady, he is progressing rapidly towards that "bourne from which no +traveler returns." + +As has already been stated, consumption is a constitutional disease, +manifested by feeble vitality, loss of strength, emaciation--symptoms +which are too often classed under the name of _general debility_, until +local symptoms develop, as _cough, difficult breathing_, or +_hemorrhage_, when examination of the chest reveals the startling fact +that tubercular deposits have been formed in the lungs. Invalids are +seldom willing to believe that they have consumption, until it is so far +advanced that all medicine can do is to smooth the pathway to the grave. +Another characteristic of this disease is _hope_, which remains active +until the very last, flattering the patient into expectation of +recovery. To the influence of this emotion, the prolongation of the +patient's life may often be attributed. + +NATURE OF THE DISEASE. It is an error to suppose that the disease under +consideration is confined to the lungs. "Pulmonary Consumption," as has +been remarked, "is but a _fragment_ of a great constitutional malady." +The lungs are merely the stage where it plays its most conspicuous part. +Every part of the system is more or less involved, every vital operation +more or less deranged; especially is the _nutritive_ function vitiated +and imperfect. The circulation is also involved in the general morbid +condition. Tubercles, which constitute a marked feature of the disease, +are composed of unorganized matter, deposited from the blood in the +tissue of the lungs. They are small globules of a yellow, opaque, +friable substance, of about the consistency of cheese. After their +deposition, they are increased in size by the accretion of fresh matter +of the same kind. They are characteristic of all forms of scrofulous +disease. + +The most plausible theory in regard to them is, that they are the result +of imperfect nutrition. Such a substance cannot be produced in the blood +when this fluid is perfectly formed. It is an unorganized particle of +matter, resulting from the imperfect elaboration of the products of +digestion, which is not, therefore, properly fitted for assimilation +with the tissues. The system being unable to appropriate it, and +powerless to cast in off through the excretory channels, deposits it in +the lungs or other parts of the body. There it remains as a foreign +substance, like a splinter or thorn in the flesh, until ejected by +suppuration and sloughing of the surrounding parts. It might be supposed +by some that when the offending matter was thus eliminated from the +lungs, they would heal and the patient recover; but, unfortunately, the +deposition of tubercular matter does no cease. Owing to the morbid +action of the vital forces, it is formed and deposited as fast or +faster than it can be thrown off by expectoration. Hence arises the +remarkable fatality of pulmonary consumption. + +CAUSES. The causes of consumption are numerous and varied, but may all +be classed under two heads, viz: _Constitutional_, or _predisposing_, +and _local_, or _exciting_. Of just what tubercular matter consists, is +still a subject of controversy, but that its existence depends upon +certain conditions, either _congenital_ or _acquired_, is generally +conceded; and one of these conditions is impaired vitality. +Constitutional predisposition must first give rise to conditions which +will admit of the formation of tubercular matter, before any cause +whatever can occasion its local deposition. It must modify the vitality +of the whole system, when other causes may determine in the system thus +impaired, the peculiar morbid action of which tubercular matter is the +product. The general division of causes into predisposing and exciting, +must ever be more or less arbitrary. Individuals subject to predisposing +causes may live the natural term of life and finally die of other +disease. Indeed, when predisposing causes are known to exist, they +should constitute a warning for the avoidance of other causes. Again, +among the so-called exciting causes, some may operate in such a manner, +with some individuals, as to predispose them to consumption, and the +result will be the same as if the disposition had been congenital. The +causes which in one individual are _exciting_, under other circumstances +and in other individuals, would be _predisposing_, because they act so +as to depress the vitality and impair the nutritive processes. + +THE PREDISPOSING CAUSES, then, are hereditary predisposition, scrofula, +debility of the parents, climatic influences, sedentary habits, +depressing emotions, in fact, _anything_ which impairs the vital forces +and interferes with the perfect elaboration of nutritive material. + +THE EXCITING CAUSES are those which are capable of arousing the +predisposing ones into activity, and which, in some instances, may +themselves induce predisposition; as dyspepsia, nasal catarrh, colds, +suppressed menstruation, bronchitis, retrocession of cutaneous +affections, measles, scarlatina, malaria, whooping-cough, small-pox, +continued fevers, pleurisy, pneumonia, long-continued influence of cold, +sudden prolonged exposure to cold, sudden suspension of long-continued +discharges, masturbation, excessive venery, wastes from excessive mental +activity, insufficient diet, both as regards quantity and quality, +exposure to impure air, atmospheric vicissitudes, dark dwellings, +dampness, prolonged lactation, depressing mental emotions, insufficient +clothing, improper treatment of other diseases, exhaustive discharges, +tight lacing, fast life in fashionable society, and impurity and +impoverishment of blood from any cause. This list might be greatly +extended, but the other causes are generally in some manner allied to +those already named. + +SYMPTOMS. The symptoms of consumption vary with the progress of the +disease. Writers generally recognize three stages, which so gradually +change from one to the other that a dividing line cannot be drawn. As +the disease progresses, new conditions develop, which are manifested by +new symptoms. Prior to the advent of pulmonary symptoms, is the latent +period, which may extend over a variable length of time, from a few +months to several years; and, indeed, may never be developed any +farther. Until sufficient tubercular matter has been deposited in the +lungs to alter the sounds observed on auscultation and percussion, a +definite diagnosis of tubercular consumption cannot be made, even though +there may have been hemorrhage. Nevertheless, when we find _paleness, +emaciation, accelerated and difficult breathing, increased frequency of +the pulse, an increase of temperature_, and _general debility_ coming on +gradually without any apparent cause, we have sufficient grounds for +grave suspicions. These are increased if tenderness under the +collar-bone, with a slight, hacking cough is present. These symptoms +should be sufficient to warn any individual who has the slightest reason +to believe that he is disposed to consumption, to lose no time in +instituting the appropriate hygienic and medical treatment, for it is at +this stage that remedies will be found most effective. Unfortunately, +this period is too apt to pass unheeded, or receive but trifling +attention; the patient finds some trivial excuse for his present +condition, and believes that he will soon be well. But, alas for his +anticipations! The disease goes onward and onward, gradually gaining +ground, from which it will be with great difficulty dislodged. + +The cough now becomes sufficiently harassing to attract attention, and +is generally worse in the morning. The expectoration is slight and +frothy; the pulse varies from ninety to one hundred and twenty beats in +a minute, and sometimes even exceeds this. Flushes of heat and a burning +sensation on the soles of the feet and palms of the hands are +experienced. A circumscribed redness of one or both cheeks is apparent. +These symptoms increase in the afternoon, and in the evening are +followed by a sense of chilliness more or less severe. The appetite may +be good, even voracious; but the patient remarks that his food "does not +seem to do him any good," and, to use a popular expression, "he is going +into a decline." As the strength wanes the cough becomes more and more +severe, as if occasioned by a fresh cold, in which way the patient +vainly tries to account for it. Expectoration increases, becomes more +opaque, and, perhaps, yellow, with occasionally slight dots or streaks +of blood. The fever increases, and there is more pain and oppression of +the chest, particularly during deep respiration after exercise. +Palpitation is more severe. There may now be night-sweats, tire patient +waking in the morning to find himself drenched in perspiration, +exhausted, and haggard. Bleeding from the lungs occurs, and creates +alarm and astonishment, often coming on suddenly without warning. The +hemorrhage usually ceases spontaneously, or on the administration of +proper remedies, and in a few days the patient feels better than he has +felt for some time previously. The cough is less severe, and the +breathing less difficult. Indeed, a complete remission sometimes occurs, +and both patient and friends deceive themselves with the belief that the +afflicted one is getting well. + +After an indefinite length of time, the symptoms return with greater +severity. These remissions and aggravations may be repeated several +times, each successive remission being less perfect, each recurrence +more severe, carrying the patient further down the road toward the "dark +valley." Now the cough increases, the paroxysms become more severe, the +expectoration more copious and purulent, as the tubercular deposits +soften and break down. The voice is hollow and reverberating, the chest +is flattened, and loses its mobility; the collar-bones are prominent, +with marked depression above and below. Auscultation reveals a bubbling, +gurgling sound, as the air passes through the matter in the bronchi, +with the click, to the air cells beyond. Percussion gives a dull sound +or if there are large cavities, it is hollow, and auscultation elicits +the amphoric sound, as of blowing into a bottle. Hectic fever is now +fully established; the eye is unusually bright and pearly, with dilated +pupils, which gives a peculiar expression; the paroxysms of coughing +exhaust the patient, and he gasps and pants for breath. The tongue now +becomes furred, the patient thirsty, the bowels constipated, and all the +functions are irregularly performed. Another remission may now occur, +and the patient be able to resume light employment, for an indefinite +length of time, which we have known to extend over three or four years, +when the symptoms again return. + +If the patient is a female, and deranged or suppressed menstruation has +not marked the accession of pulmonary symptoms, the flow now becomes +profuse and clotted, or is scanty and colorless, sometimes ceasing +altogether. In the male, the sexual powers diminish, and copulation is +followed by excessive and long-continued prostration. From this time +onward, the progress of the disease is more rapid. The liver and kidneys +are implicated. In addition to the pallor, the complexion becomes +jaundiced, giving the patient, who is now wasting to a mere skeleton, a +ghastly look. The urine is generally copious and limpid, though +occasionally scanty and yellow. The pulse increases to one hundred and +thirty or one hundred and forty beats in the minute, and is feeble and +thread-like. The cough harasses the patient so that he does not sleep, +or his rest is fitful and unrefreshing; whenever sleep does occur, the +patient wakes to find himself drenched with a cold, clammy perspiration. +The throat, mouth, and tongue now become tender, and occasionally +ulcerate. Expectoration is profuse, purulent, and viscid, clinging +tenaciously to the throat and mouth, and the patient no longer has +strength to eject it. The hair now falls off, the nails become livid, +and the breathing difficult and gasping; the patient has no longer +strength to move himself in bed and has to be propped up with pillows, +and suffocates on assuming the recumbent position. Drinks are swallowed +with difficulty. Diarrhea takes the place of constipation. The +extremities are cold, swollen, and dropsical; the voice feeble, hollow, +grating, husky, the patient gasping between each word; the respiration +is short and quick. A slight remission of these symptoms occurs. The +patient is more comfortable, lively, cheerful, and perhaps forms plans +for the future. But it is the last effort of expiring vitality, the last +flicker of the lamp of life, the candle burns brilliantly for a moment, +and with one last effort goes out, and death closes the scene. + +The duration of the active stage of consumption varies from a few weeks +to several years, the average time being about eighteen months. + +_Cough_ is always a prominent symptom throughout the entire course of +the disease, varying with its progress. + +_Expectoration_, at first scanty, then slightly increased, colorless, +frothy, and mucous, is also a characteristic. After a time it becomes +opaque, yellow, and more or less watery; then muco-purulent and finally +purulent, copious, and viscid. When tubercular matter is freely +expectorated, with but little mucus, it sinks in water. This symptom +continues to the very last. + +_Haemoptysis_ (bleeding from the lungs) may occur at any stage of the +disease, often being the first pulmonary symptom noticed, again being +delayed until late; and there are cases in which it does not happen at +all. It seldom occurs in any other disease. + +_Night-sweats_ may occur at any stage, though they are rarely +experienced until the disease is pretty well established, and are very +exhausting. + +_Hectic Fever_ generally occurs soon after the pulmonary symptoms are +developed, and increases in intensity with the progress of the disease. +There are usually two paroxysms in twenty-four hours, one of which +occurs towards evening and is followed by night-sweats. + +_Dyspnoea_ (difficult breathing) is at first slight, except after +exertion, amounting to only a sense of oppression; but it becomes more +and more severe as the disease advances, until the very last, when it is +agonizing in the extreme. + +_Aphthæ_, sometimes extending to the pharynx and larynx, generally +occurs towards the last. The mouth and throat become so very sore and +tender that nourishment and medicine are taken with difficulty. + +_Emaciation and Debility_ are characteristic of the disease. They +fluctuate as the disease advances or is retarded, increasing to the very +last. + +_Auscultation and Percussion_ constitute valuable means of diagnosis +from the time tubercular matter begins to be deposited to the very last, +and, when correctly practiced, reveal the extent and progress of the +disease. As a knowledge of the sounds elicited can only be acquired by +practical experience with proper instruments, they will not be described +here. The only diseases with which consumption is likely to be +confounded are general debility in the early stage, bronchitis, chronic +pleurisy, chronic pneumonia, and abscess in the lungs, after the advent +of pulmonary symptoms. + +CURABILITY. Notwithstanding the prevailing opinion that consumption is +incurable, there exists ample, incontrovertible evidence to the +contrary. Its curability is established beyond the shadow of a doubt. +Individuals have recovered in whom there was extensive destruction of +pulmonary tissue, and, indeed, entire destruction of one lung. Numerous +instances are on record in which persons have suffered from all the +symptoms of confirmed consumption, and have regained their health and +subsequently died of other diseases. The case of the late Dr. Joseph +Parish, of Philadelphia, affords a striking example of this kind. In +early life, he manifested all the symptoms of confirmed consumption, +including frequent hemorrhages, yet he fully regained his health, and, +after a very useful life, died at an advanced age of another disease. +Post-mortem examination revealed the existence of cicatrices, or scars, +in his lungs where tubercular matter had been deposited. Dr. Wood, in +his Practice of Medicine, mentions another instance of a medical +gentleman in Philadelphia, who in early life suffered from consumption +with hæmoptysis, from which he recovered, and afterwards died, at an +advanced age, of typhoid fever, when the knife revealed the presence of +cicatrices. Post-mortem examinations of individuals who have died of +other diseases, have revealed, in numerous instances, the presence of +consumption at some period of their existence. In these cases the lungs +were perfectly healed by cicatrization, or by the deposit of a chalky +material. A French physician made post-mortem examinations of one +hundred women, all of whom were over sixty years of age, and who had +died of other diseases, and in fifty of them he found evidences of the +previous existence of consumption. + +Professor Flint says that consumption sometimes terminates in recovery, +and that his observations lead him to the conclusion that the prospect +of recovery is more favorable in cases characterized by frequent +hemorrhages. Drs. Ware and Walshe are also led to the same conclusion. + +Professor J. Hughes Bennett, of Edinburgh, has thoroughly investigated +the subject, and adds his testimony to that of others, citing numerous +cases that have resulted in perfect recovery. If such testimony is not +sufficient, we may mention the following, whose names are well known and +respected in professional circles, and all of whom declare that +consumption is a curable disease. The list includes Laennec, Andral, +Cruveilhier, Kingston, Presat, Rogée, Boudet, and a host of others. + +No farther back than 1866, on page 145, of the proceedings of the +Connecticut Medical Society, we find "Observations, Ante-mortem and +Post-mortem, upon the case of the late President Day by Prof. S.G. +Hubbard, M.D., New Haven," from which we learn that Jeremiah Day, LL. +D., who was for twenty-nine years President of Yale College, was, while +a mere youth, a victim of pulmonary consumption. During his infancy and +boyhood his vitality was feeble. He entered Yale College as a student in +1789, "but was soon obliged to leave the institution on account of +pulmonary difficulty, which was doubtless the incipient stage of the +organic disease of the lungs which subsequently developed itself." He +remained in feeble health for two years, but returned to college, and +graduated in 1797. For the next six years his lung difficulties were +quite severe, and he repeatedly bled in large quantities, but he had so +far recovered in 1803, as to accept a Professorship. He was afterwards +chosen President of the college, which office he held for many years, in +the enjoyment of good health. He died from "old age," as we are told, in +1867, aged 94 years. + +Statistics show that under the improved methods of treating this +disease, the mortality, as compared with previous years, has been +greatly reduced. Clinical observation proves that injuries to the lungs +are not so fatal as was once supposed. + +TREATMENT. The earlier the treatment of this disease is undertaken, the +greater is the probability of success. The reason of this is obvious; at +first the disease is general or constitutional, but as it advances, by +the deposit of _tubercular matter_, it becomes both constitutional and +local. Hence the treatment must be both _general_ and _local_. The +occurrence of certain prominent and distressing symptoms, either from +the natural progress of the disease, or from complications with other +affections, often renders it difficult, even for physicians, to +determine how far their treatment should be general and how far local. + +Treating the symptoms instead of the general disease, or treating the +constitutional disease without regard to the symptoms which arise from +it, is an error into which many physicians have fallen. The +constitutional affection, the local manifestations and complications, +and the circumstances and individual peculiarities of the patient, must +all be carefully considered; bearing in mind all the while, that +tubercular matter is the product of a morbid action, which, in every +case, must exist before its deposition in the lungs, or any other +tissue, can take place. + +In every case in which curative treatment is to be instituted, the +hearty and persistent co-operation of both patient and friends is +absolutely necessary; and the treatment, which is both hygienic and +medical in character, should have in view the following aims: + +(1.) The avoidance of the causes concerned in the production and +perpetuation of the disease. + +(2.) The restoration of healthy nutrition, in order to stop the +formation of tuberculous matter. + +(3.) The arrest of the abnormal breaking down of the tissues, and the +prevention of emaciation. + +(4.) The relief of local symptoms, and the complications arising from +other diseases. + +The fulfillment of the first indication, the avoidance of causes, is of +the utmost importance, for if they have been sufficient to _produce_ the +disease, their continued operation must certainly be sufficient to +_perpetuate_ it. A single individual is very often subjected to the +operation of several of the causes already enumerated, some of which, in +consequence of circumstances and surroundings, are unavoidable. Of +these, the one most difficult to overcome is climate; _i.e._ the +frequent variations of temperature. + +Upon the subject of climate much has been written. But that which is +best adapted to the cure of consumption, is that which will enable the +patient to pass a certain number of hours every day in the pure open +air, without exposure to sudden alterations of temperature. There are +very few persons who change their place of residence, except as a last +resort, when the disease is in the last stage. It is then productive of +little or no good. This is one reason why so many people having +consumption die in Florida, and other warm countries. If a change of +climate is to be effected at all, it should be made early. + +The most powerful stimulant to health is well-regulated exercise. It +assists the performance of every function, and is of paramount +importance to promote good digestion and proper assimilation, conditions +essential for recovery. It should not, however, be carried beyond the +powers of endurance of the individual, so as to exhaust or fatigue. +Everything that can invigorate should be adopted; everything that +exhausts should be shunned. + +To fulfill the second indication, to restore healthy nutrition, requires +not only a proper diet, both as regards quantity and quality, but +demands that the integrity of the organs concerned in the process of +digestion and assimilation, shall be maintained at the highest standard +of perfection possible. + +That the diet be sufficient in quantity should be obvious to all. It is +also necessary that it be nutritious, and that it should contain +carbonaceous elements. Food of a starchy or saccharine character is apt +to increase acidity, and interfere with the assimilation of other +elements, therefore, articles, rich in fatty matters, should enter +largely into the diet. The articles of food best adapted to the +consumptive invalid are milk, rich cream, eggs, bread made from unbolted +wheat-flour, and raised with yeast, cracked wheat, oatmeal, good butter, +beef, game, and fowls. These contain the necessary elements for +assimilation. Oily food is of great importance, and the beef eaten +should contain a good proportion of fat. Plenty of salt should always be +eaten with the food, and a desire for it is often experienced. +Over-eating should be avoided, lest the stomach be induced to rebel +against articles of diet rich in important elements. + +Derangement of the process of nutrition requires careful attention, and, +if necessary, correction. For this purpose, nothing can excel Dr. +Pierce's Golden Medical Discovery. It increases the appetite, favors the +nutritive transformation of the food, enriches the blood, and thus +retards the deposition of tubercular matter. It is so combined that, +while it meets all these indications, it relieves or prevents the +development of those distressing symptoms so common in this disease. + +The "Golden Medical Discovery" is adapted to fulfill the third +indication in the management of this disease, which is to check the +abnormal breaking down and waste of tissues, which constitute such a +prominent feature in this malady. The antiseptic properties of the +"Discovery" are unmistakably manifested in preventing such abnormal +decomposition. The emaciation, excessive expectoration, profuse +perspiration, diarrhea, and hectic fever, common to consumption, are all +due to a too rapid disintegration and waste of the tissues. It is in +this condition of the system that this medicine, by its powerful +antiseptic properties, manifests its most wonderful curative ability. +When, as in this disease, the vital forces of the system have, in a +degree, lost their restraining influence over the processes of +disintegration, waste, and decay, which goes on so rapidly that +nutrition cannot compensate for the loss to the system, then it is that +the "Golden Medical Discovery," by its antiseptic influence, checks this +rapid waste of the tissues, and thus arrests the disease. To the lack of +employment of such a remedy in the treatment of consumption, the +unparalleled fatality of the disease is largely due. In their anxiety to +improve digestion and nutrition, and thus build up the tissues, +physicians often lose sight of the no less important indication of +restraining the destructive waste going on in the system, which +overbalances the supplies furnished by absorption. The gradually +increasing emaciation and loss of strength render perpetuity of the +organism impossible. + +The fulfillment of the fourth indication, to relieve local symptoms, and +the complications with other diseases, is often attended with no little +difficulty. + +_The Cough_ is a secondary symptom, arising from the irritation caused +by the tubercular deposits. Medicated inhalations may give temporary +relief, but cannot cure it. They strike at the branches of the disease, +while the root is left to flourish and develop new branches. + +Expectorants have been employed to a great extent, and the theories, +which have been advanced in favor of their use, are sometimes very +ingenious. That they modify the cough, we do not attempt to deny; but it +is usually at a great expense, for they derange the stomach and +interfere with digestion and assimilation. + +Improvement of the general health is always attended with amelioration +of the cough. If the patient did not cough at all, the lungs would soon +fill up with broken-down tissue, and death from suffocation would +result. Irritation of the nerves supplying the lungs sometimes occurs, +and causes the patient to cough immoderately, when it is not necessary +for the purpose of expectoration. This condition is readily controlled +by Dr. Pierce's Golden Medical Discovery, which exerts a decidedly +quieting and tonic influence upon the pneumogastric nerve, which, with +its ramifications, is the one involved. An infusion of the common red +clover, in tablespoonful doses, will also be found a valuable adjunct in +overcoming this condition. + +_Hoemoptysis_. Hemorrhage from the lungs is generally sudden and +unexpected in its attack, though sometimes preceded by difficulty of +breathing, and a salty taste in the mouth. Although it _very rarely_ +destroys life, it often occasions alarm. Common table salt, given in +one-fourth to one-half teaspoonful doses, repeated every ten or fifteen +minutes, is generally sufficient to control it. Ligatures applied to the +thighs and arms, sufficiently tight to arrest the circulation of blood +in the veins, but not tight enough to impede it in the arteries, is a +useful proceeding. Ergot, in teaspoonful doses of the fluid extract, +hamamelis, and gallic acid, all are valuable for this purpose. + +_Night-sweats_ can only be regarded as a symptom of weakness, and are to +be remedied by an improvement of the general health. Bathing in salt +water is sometimes attended with good results. The practice of giving +acids for this symptom can only be regarded as irrational. It may arrest +the sweating, but it will do harm in other ways. Belladonna, given at +bed-time, is an effectual remedy. + +_Frequency of the pulse_ is generally a prominent symptom in this +disease. It sometimes points to a condition of sufficient importance to +require a remedy. Although the "Golden Medical Discovery" is combined to +meet this condition, its value may be greatly enhanced by adding +one-half to one teaspoonful, according to the urgency of the case and +the frequency of the pulse, of the fluid extract of _Veratrum Viride_ to +each bottle. The benefit of this, when persisted in, will be apparent in +the amelioration of all the symptoms, and in the general improvement. +This fluid extract can be had at any drug store. + +_Diarrhea_ is sometimes a troublesome symptom, and particularly so in +the latter stages of the disease. It is generally due to acidity of the +alimentary canal, to which the treatment must be directed. Great care +should be taken in the selection of the diet to improve the quality and +avoid everything which disagrees with the patient. Improve digestion by +every possible means. Carbonate of soda and rhubarb, in the form of a +syrup, are sometimes excellent. The Compound Extract of Smart-weed, in +small doses, will generally diminish the frequency of the discharges. + +_Derangement of the Liver_ is often a complication requiring attention, +and the timely relief of which goes very far in ameliorating the general +condition of the patient. The "Golden Medical Discovery" is generally +sufficient to relieve this complication. Its influence, however, may be +considerably increased in this direction by the use of Dr. Pierce's +Pleasant Pellets, according to the directions which accompany them. They +should only be taken in the smallest doses, one or two "Pellets "every +day, just enough to produce a natural movement of the bowels each day. + +_Uterine Derangements_. In the female, derangement of the menstrual +function is generally an early complication of consumption, if indeed it +does not occur at the outset. It deserves early attention, and, in +addition to the remedies already advised, Dr. Pierce's Favorite +Prescription is so compounded as to meet the requirements of this +condition, and at the same time exert a favorable influence upon the +constitutional disease. + +The numerous reports of cures of well-developed cases of Consumption to +be found in the back portion of this little treatise must be sufficient, +it seems to us, to convince the most skeptical of the wonderful power +which Dr. Pierce's Golden Medical Discovery exercises over this terribly +fatal malady. As will be noted, many of the cases there reported had +long been unsuccessfully treated with cod liver oil emulsion and all the +other usual remedies employed by the profession and were fast running +down. "Golden Medical Discovery" aroused the stomach and liver, and +started all the nutritive functions into action, whereby digestion and +nutrition were promoted and both the strength and flesh steadily built +up. The reader will bear in mind, that most of the cases hereinafter +reported, were pronounced Consumption by their attending physicians as +well as by us. It cannot be said, therefore, that we exaggerate the +malady and that the cases were merely bad, lingering coughs. Thousands, +whose maladies have been pronounced genuine Tubercular Pulmonary +Consumption, (Phthisis Pulmonalis) by eminent physicians have been +_perfectly_ and _permanently_ cured by the use of Dr. Pierce's Golden +Medical Discovery. It can, therefore, no longer be doubted that this +wonderful compound is far superior as a remedy for Consumption to cod +liver oil, compound Hypophosphites, and the many other agents so highly +extolled, and so generally prescribed for this fatal malady by even the +more progressive and advanced of the medical profession of our day. Read +the letters received from grateful patients who have been cured and note +how many commend the use of "Golden Medical Discovery," as a "last +resort," after their home physicians had exhausted all their skill and +resources in vain. + + * * * * * + + + + +CHRONIC BRONCHITIS. + + +This is a subacute or chronic form of inflammation of the mucous +membrane of the bronchial tubes, of a very persistent character and +variable intensity. There are few diseases which manifest a greater +variety of modifications than this. + +SYMPTOMS. The symptoms of this disease vary greatly with its violence +and progress. Cough is always present, and is very often the first +symptom to attract the patient's attention. It is usually increased by +every slight cold, and with each fresh accession becomes more and more +severe, and is arrested with greater difficulty. The cough is always +persistent, sometimes short and hacking, at other times deep, prolonged, +and harsh. Sometimes it is spasmodic and irritating and particularly so +when it is associated with affections of the larynx, or with asthma, +involving irritation of the branches or the filaments of the +pneumogastric nerve. + +When the chronic follows the acute form of the disease, or follows +inflammation of the lungs, the expectoration may be profuse from the +first, and of a yellowish color and tenacious character. When the +disease arises from other causes, the expectoration is generally slight +at first, and the cough dry or hacking. This may continue some time +before much expectoration occurs. The expectorated matter is at first +whitish, opaque, and tenacious, mixed sometimes with a frothy mucus, +requiring considerable coughing to loosen it and throw it off. As the +disease progresses, it becomes thicker, more sticky, of a yellowish or +greenish color, mixed with pus, and sometimes streaked with blood. In +the latter stages, it becomes profuse and fetid, and severe hemorrhage +may occur. Sometimes the cough and expectoration disappear when the +weather becomes warm, to appear again with the return of winter, which +has gained for it the appellation of _winter cough_. The sufferers feel +as if something was bound tightly round them, rendering inhalation +difficult. Soreness throughout the chest is often a persistent symptom, +especially when the cough is dry and hard. Behind the breast-bone there +is experienced a sense of uneasiness, in some cases amounting to pain, +more or less severe. + +As the disease progresses, the loss of strength is more and more marked, +the patient can no longer follow his usual employment, his spirits are +depressed, and he gradually sinks, or tubercular matter is deposited in +the lungs, and consumption is developed. + +TREATMENT. Thorough attention to hygiene, with the avoidance of the +causes concerned in the production and perpetuation of the disease, is +necessary. The patient must be protected from the vicissitudes of the +weather by plenty of clothing; flannel should be worn next to the skin, +with a pad of flannel or buckskin over the chest, and the feet should be +kept warm and dry. Exercise in the open air is essential. When the +weather is so cold as to excite coughing, something should be worn over +the mouth, as a thin cloth, handkerchief, muffler, or anything which +will modify the temperature of the atmosphere before it comes into +contact with the mucous lining of the lungs. Good ventilation of +sleeping-rooms is all-important; not that the air should be cold, but +that it should be as pure as possible. + +The diet must be nutritious, cabonaceous, and of sufficient quantity. +Beef, milk, rich cream, plenty of good butter, eggs, fish, wheat bread +from unbolted flour, supply the appropriate alimentary substances for +perfect nutrition and the maintenance of animal heat. + +To overcome the modified form of inflammation in the bronchial tubes, +all sources of irritation should be avoided, as the inhalation of dust, +or excessively cold air. It is in the cure of severe and obstinate cases +of this disease that Dr. Pierce's Golden Medical Discovery has achieved +unparalleled success, and won the highest praise from those who have +used it. Its value will generally be enhanced in treating this complaint +by adding one-half a teaspoonful of the fluid extract of _Veratrum +Viride_ to each bottle. This can be added by any respectable druggist. +Especially should it be thus modified if the pulse be accelerated so as +to beat ninety or a hundred times in a minute. The "Golden Medical +Discovery" should be taken in teaspoonful doses, repeated every two +hours. When the cough is dry and hard, with no expectoration, it arises +from irritation of some of the branches of the pneumogastric nerve, +which this remedy will relieve. It may, however, be aided by inhaling +the hot vapor of vinegar and water, or vapor from a decoction of hops, +to which vinegar has been added. + +The use of Dr. Pierce's Golden Medical Discovery should be _persisted_ +in, taking it in frequent doses, every two or three hours, and keeping +up its use until the disease yields and is perfectly stamped out. Do not +expect a formidable disease of perhaps weeks' or months' duration to be +_speedily_ cured. Chronic diseases are generally slow in their inception +and development and can only be cured by gradual stages. Perseverance in +treatment is required. Many invalids do not possess the strength of +purpose--the will power--to continue the use of the "Golden Medical +Discovery" long enough to receive its full benefits. It is worse than +useless for such to commence its use, for without persistency it cannot +be expected to cure such obstinate maladies as chronic bronchitis. + + * * * * * + + + + +ASTHMA. + +PHTHISIC. + + +One of the most distressing ailments with which the human family is +afflicted is asthma. Its symptoms are not to be mistaken. Suddenly and +without apparent provocation the patient experiences the greatest +difficulty in breathing. When warning is given, there is usually a sense +of fullness in the stomach, flatulence, languor, and general nervous +irritability. The countenance is a picture of anxiety and horror. The +difficulty of breathing increases and the struggle for air commences. +Windows and doors are thrown open, fans used, and, utterly regardless of +consequences, the sufferer passes the whole night in exposure and +torture, even though the temperature be below zero. Fearing suffocation, +the patient dare not lie down; he rushes to the window for air, rests +his head upon a table or chair, or upon his hands, with the elbows upon +the knees, jumps up suddenly and gasps and struggles for air. The eyes +are prominent and the veins of the forehead distended with blood; +sometimes the bowels are relaxed. The urine is colorless and is passed +in copious quantities. This symptom indicates great excitement of the +nervous system. The voice is hoarse, articulation difficult, breathing +limited, noisy and wheezy. The _wheezing_ is pathognomonic of the +disease. It can only be confounded with croup, and then only in the +young. In croup there is pain and difficulty in swallowing, fever and +cough, which are usually absent in asthma. A severe paroxysm of asthma +is very distressing to witness, and one unused to it might well suppose +the sufferer to be in his last agonies. No definite limit can be +assigned to the duration of the attack or of the disease. It may last +but a few minutes, may endure for hours, or with slight remission +continue for days. The condition of the patient may be for years as +changeable as the pointings of the weather-vane. In fact, the atmosphere +has much to do with the disease. With every approaching storm, with +every cloud of dust, even the dust from sweeping a room, with every foul +odor, and, in some more sensitive organizations, with even the perfume +of flowers, a paroxysm is provoked. Truly he is a "child of +circumstances," a veritable football upon the toes of every atmospheric +disturbance. + + +UNPARALLELED SUCCESS. + + +Persons affected with asthma or phthisic are numerous. With such an +amount of suffering in our midst is it not a marvel, if not a disgrace, +that the medical profession of to-day endorse the opinions of a half +century ago and pronounce it incurable, rather than make stupendous and +laudable efforts to discover plans of medication that will result in +certain and permanent cure? Almost single handed we undertook this field +of investigation, and we take pleasure in reporting that our labors have +been crowned with success. The large experience furnished us has led to +the discovery of remedies for this distressing malady of more than +ordinary efficacy. Through the agency of these means we have been +enabled to cure hundreds, who had suffered untold tortures for twelve, +fifteen, or twenty-five years. Some whom we have been successful in +curing had suffered from childhood to middle and even old age. The +treatment of asthma, or phthisic, still continues to be a prominent +specialty at the Invalids' Hotel and Surgical Institute. + + +NATURE OF THE DISEASE. + + +As to the exact pathological condition in this malady, opinions differ. +Some physicians consider it a disease of the nervous system, others, of +the blood, others, of the bronchial tubes, while not a few believe it to +be dependent upon some disease of the stomach, heart, liver, kidneys, or +due to urinary affections, or "female weakness." Respecting all these +diseases of special organs, it is evident that any complication, and +particularly one that is debilitating or causes irritation of the +nervous system will increase its severity. This important fact we keep +constantly in view in our treatment, and prescribe remedies to remove +all complications. + +In heart disease there is often dyspnoea, or difficult breathing, but +this is not of the nature of asthma, or phthisic. The condition of the +lungs is readily understood. There being an obstruction to the free +passage of the blood through the heart, any excessive muscular exertion, +or anything, in fact, which increases the action of the heart, is very +apt to produce congestion of the lungs, and then the blood becomes +surcharged with carbonic acid, which causes increased efforts to take +more air into the lungs. + +A NERVOUS DISEASE. A sudden fright, unfavorable news, grief, loss of +property, etc., circumstances which affect the mind and nervous system, +almost invariably throw the phthisical into a paroxysm. Nervines are +demanded, particularly if the case be a chronic one, and we see that +they are carefully and properly prepared and supplied, and in such a +form as to be exactly fitted to the temperament and constitution. + + +POPULAR REMEDIES USED FOR SELF-TREATMENT OF ASTHMA. + + +There are numerous remedies that may be used to _relieve paroxysms_ of +asthma. Among them we will notice a few that are most frequently +employed by the profession. They can be easily and inexpensively +prepared by any patient or druggist: + +1. Equal parts of the tinctures of lobalis capsicum and skunk cabbage +root. _Dose_.--Take a half teaspoonful in a little water every ten or +fifteen minutes until relieved. + +NOTE.--This is an antispasmodic and relaxant. In considerable quantities +it will produce sickness at the stomach and perhaps vomiting. It should +not be used when there is disease of the heart. + +2. Chloroform. _Dose_.--A small quantity (say thirty drops), may be +poured upon a handkerchief or napkin, held about one inch from the +nostrils and the vapor inhaled. It is quite unnecessary to use this +until insensibility follows; in fact, such an effect would be hazardous +to life in the hands of the inexperienced. + +3. Sulphuric ether. _Dose_.--The same as No. 2, and with the same +precaution. Either of them should be used promptly upon the beginning of +the paroxysm. + +4. Take four ounces of stramonium leaves and strip from the stems, +rubbing between the hands to partly pulverize. To this add one ounce of +saltpetre, finely powdered. _Dose_.--Place a half teaspoonful upon a +very hot shovel. Inhale the rising smoke. If the first few inspirations +cause coughing, the smoke should not be evaded as the coughing incites +deeper inspiration. + +5. Stramonium and saltpetre as in No. 4. Dampen with water and make into +balls or cones. These are more easily handled and are fired in the same +way as the powder and used in the same way. + +6. Take of sunflower leaves, stramonium leaves, mullein leaves, one +ounce each; of lobelia leaves, half an ounce; of powdered nitre, one +ounce; and benzoic acid, two drams. Mix thoroughly. _Dose_.--A pipeful, +to be smoked the same as tobacco. + +7. A cup of hot coffee or several of hot water. This is especially +effective in cases arising from checked perspiration, from rheumatism, +etc. + +These recipes are given to the public as being the principal agents +employed by the medical profession throughout the world. It must be +distinctly understood that they are not _curative_ but merely +_palliative_, and used to relieve paroxysms. We object to them wholly +and unqualifiedly because they contain NARCOTICS. It is a fundamental +principle in our treatment not to use this class of remedies. They +stupefy the brain, debilitate the nervous system, and have, in not a few +instances, formed an unfortunate appetite and habit, most difficult to +overcome. We are of the opinion that one of the chief reasons why this +malady has been considered incurable is the fact that physicians have +almost universally relied upon narcotic drugs. With such medication a +cure is the exception. A cure can only be effected under such +circumstances when the _powers of nature are sufficient to overcome both +the_ NARCOTIC _and the_ DISEASE. That they will _relieve_ we do not +deny, but _they will never cure_. It reminds us of an old country doctor +who advised a lady to smoke tobacco to cure acid dyspepsia. She followed +the prescription for over thirty years and at last accounts was not +cured yet. In all seriousness we ask would any other remedy except a +narcotic or stimulant be used with such persistency for anything like +this length of time? Is it not apparent that such agents form a habit +which is often worse than the disease, and yet fail to effect a cure? We +appreciate the necessity for relief, and do not blame sufferers for +availing themselves of any means for this purpose. But they should not +be satisfied with relief only, but should look about for such a system +of medication as will rid them of the disease completely and +permanently. If a week's or a month's exemption is a "foretaste of +heaven," how incomparable are the comforts and happiness to be derived +from a life-time immunity? + + +MILLIONS OF DOLLARS + +are annually spent upon the advice of physicians, in traveling expenses, +and hotel bills, by sufferers from asthma, or phthisic, in seeking a +change of climate that will be advantageous. It is the last expedient of +the doctor who is annoyed by the continued complaint of his unrelieved +patient, and can only be made available by the wealthy. In some +instances the change is beneficial, but to be effectually so a permanent +change of residence is required. Most patients are unable or unwilling +to do this. In some cases change only affords temporary relief, the +attacks returning after a few months. Even the wealthy dislike to take +such chances. The less opulent cannot think of such methods, and hence +are compelled to bear their sufferings as best they can. In the majority +of instances the "change of climate" is only an illusion, or only +temporarily beneficial at best. We can tell them a better way, and if +they are wise they will follow it. + + * * * * * + + + + +HAY ASTHMA, OR HAY FEVER. + + +This affection, known also as Hay Catarrh, Hay Fever, or Rose Cold +differs but little in its manifestations, from coryza, or cold in the +head, save in its _inciting cause_, and in its element of periodicity. +In this latitude there are persons who, during summer or early fall, are +invariably attacked with acute congestion or inflammation of the upper +air-passages, giving rise to sneezing, watery discharges from the nose +and eyes, difficult respiration, fever, and general prostration. These +symptoms are supposed to be induced by the inhalation of pollen or odors +from grasses or flowers, which at that time are supposed to give off +certain exhalations of an Irritating character. Unless arrested by +medical treatment, the disease lasts until cool weather, or the +occurrence of a hard frost rids the atmosphere of the exciting +influence. + +Some feather beds give off an odor which excites all the aggravated +symptoms of this disease. Thus it appears that certain emanations have +the power of inciting these inflammatory conditions in certain sensitive +constitutions. In all individuals suffering from this disease there is +an over sensitiveness of the nervous system which admits of the +appearance of such sudden and severe manifestations. Many cases +suffering only mild symptoms for the first few seasons, annually become +aggravated until severe spasmodic asthma is a regular, and sometimes +continuous complication. A case or two are on record in which the odor +from the body of a horse so induced these symptoms that the individual +could never ride or drive him. + +TREATMENT. In mild cases, or when the attack first appears, the daily +use of Dr. Sage's Catarrh Remedy fluid will neutralize and wash away the +poisonous particles which have found lodgment in the nasal passages. The +Remedy is best applied with Dr. Pierce's Nasal Douche. When the disease +has existed the previous season it is necessary that the patient begin +both constitutional and local treatment four or six weeks prior to an +expected return of the disease. The nervous system should be +strengthened, and the resistance of the patient to the irritating +influence of these pollens and odors so increased, that even though he +may be exposed, no severe symptoms will follow. + +Dr. Pierce's Golden Medical Discovery will be found invaluable as an +alterative, blood purifier, and nerve tonic, and should be taken +regularly while Dr. Sage's Catarrh Remedy is being used locally for its +antiseptic and curative properties. The action of the "Discovery" is +especially desired in cases that are so far advanced as to be attended +with asthmatic symptoms, such as difficult breathing, headache, and a +feeling of lassitude and prostration. + +In very obstinate or distressing cases our specialists have been able to +prescribe and send, by mail or express, special courses of treatment +which have proven so effective as to cure the disease _permanently_, so +that it has not reappeared the following season. The treatment seems to +have produced such an impression upon the system as to have fortified +the individual against a return of the disease. + +In rare cases morbid growths in the upper air-passages are of such a +nature as in themselves to be a source of sufficient excitement to +unbalance the nervous equilibrium so that the individual is thus +rendered more susceptible to this disease. In such, or exceedingly +obstinate cases a personal examination by our specialist is desirable, +and often results in the use of such measures as give permanent relief. + + * * * * * + + +TESTIMONIALS. + + +If the following letters had been written by your best known and most +esteemed neighbors they could be no more worthy of your confidence than +they now are, coming, as they do, from well known, intelligent, and +trustworthy citizens, who, in their several neighborhoods, enjoy the +fullest confidence and respect of all who know them. + +Out of thousands of similar letters received from former patrons, we +have selected these few at random, and have to regret that we can find +room only for this comparatively small number in this volume. + + +BLEEDING FROM LUNGS, CONSUMPTION + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: (Before) +C.H. HARRIS, ESQ.] + +[Illustration: (After) +C.H. HARRIS, ESQ.] + +_Gentlemen_--I wish to say to you that Doctor Pierce's Golden Medical +Discovery saved my life and has made me a man; my home-physician says I +am good for forty years yet. You will remember that my case was a case +just between life and death, and all of my friends were sure it was a +case of death, until I commenced taking a second bottle of "Golden +Medical Discovery," when I was able to sit up and the cough was very +much better, and the bleeding from my lungs stopped, and before I had +taken six bottles of the "Golden Medical Discovery" my cough ceased and +I was a new man and ready for business. + +And now I feel that it is a duty that I owe to my fellow-men to +recommend to them the "Golden Medical Discovery" and Dr. Sage's Catarrh +Remedy, which saved my life when doctors and all kinds of medicines +failed to do me any good. + +I will send to you with this letter two of my photographs; one was taken +a few weeks before I was taken down sick in bed, and the other was taken +after I was well. + + Yours respectfully, + C.H. HARRIS, + No. 1622 Second Avenue, Rock Island, Ill. + + +SEVERE CHRONIC COUGH. + +Wilbar, Wilkes Co., N.C. + +DR. R.V. PIERCE, 663 Main Street, Buffalo, N.Y.: + +_Dear Sir_--I cannot recommend your "Golden Medical Discovery" too +highly. I had a severe chronic cough and I began to use that medicine +and took only one bottle, and I have not been sick a day since. When I +began to use your "Golden Medical Discovery" my weight was 104 pounds, +and now I weigh 125 pounds. + + Yours very truly, + Mrs. Anna Parsons + + +SPITTING OF BLOOD. LUNG DISEASE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: J.M. Hite, Esq.] + +_Gentlemen_--I can gladly recommend Dr. Pierce's Golden Medical +Discovery to all suffering from diseases for which you recommend it. In +the summer of 1888 I took a severe cold, which settled on my lungs and +chest, and I suffered intensely with it. I tried several of our best +physicians here and they gave up all hopes of my recovery, and my +friends thought I would have to die, and I thought so myself, as the +doctors did not know what was the matter with me. In the morning, on +rising, I would cough and spit blood for two hours, and I was pale and +weak and not able to work any. I then ran across Dr. Pierce's +advertisement and I came to the conclusion I would try the "Golden +Medical Discovery," as it was so highly recommended. I was greatly +discouraged when I began the use of the "Discovery," but after I had +taken four or five bottles I then noticed I was getting better, and I +could stand it to work some, and kept on taking it till I took about +twenty or twenty-five bottles. It has been five years since I took it +and have had no return of that trouble since. I gladly recommend your +medicine for I know it saved my life. + + Yours respectfully, + JOHN M. HITE, + Audubon, Audubon Co., Iowa. + + +LUNG DISEASE. + +[Illustration: Mrs. McGill.] + +Blue Rock, Muskingum Co., Ohio. + +DR. R.V. PIERCE, Buffalo, N.Y.: + +_Dear Sir_--I feel like taking you by the hand and saying, "thank God, +you have saved my wife," for we had given her up. We had sat by her, +when the doctor said she could not live till morning; so bad was her +lung disease. Dr. Pierce's Golden Medical Discovery cured her. + + MR. THOMAS McGILL. + +When her case was reported to the specialist of the Invalids' Hotel, +Mrs. McGill was suffering from pain in the chest, struggling for breath, +hard dry cough; jarring hurt the chest; short breath, backache; uterine +disease, leucorrhea, menstruation scanty and painful; feet and ankles +swollen; was confined to house most of the time; was given up by her +home physician. Her disease began six years before with "lung disease" +which was followed by bleeding from lungs. + + +CURES WHEN COD LIVER OIL FAILS. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +_Gentlemen_--My wife a few years ago had hemorrhages of the lungs, and +we summoned our home physician. He checked the hemorrhage but failed to +cure her. She had also a terrible cough and expectorated a great deal. +She wanted to see another doctor so I called one and he examined her. +She asked him whether she had consumption, and his answer was, "Madam, +it is very near consumption." He advised her to use cod liver oil, but +this gave but little relief. I happened to get hold of one of your +little books that comes with each bottle of Dr. Pierce's medicines and I +read some cases about like my wife's. I went to the drug store and +procured a bottle of Dr. Pierce's Golden Medical Discovery and my wife +commenced using it according to directions. She began to get better +right away and her cough has left her. She used about ten bottles. She +is in her fifty-fifth year and can walk ten or twelve miles without any +trouble. We are satisfied that her life and health have been saved by +the use of "Golden Medical Discovery." As soon as she takes any cold she +insists upon having a bottle of her medicine, as she calls it, and that +is the last we hear of her cold. + + Yours respectfully, + Joseph D. Wiles + West Point Street, Frederick, Md. + + +MALARIA, CHILLS, AND LUNG DISEASE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: R. Williams, Esq. ] + +_Gentlemen_--It has been about eight months since I quit using Dr. +Pierce's Golden Medical Discovery. When I commenced using it I only +weighed 130 pounds. I had been suffering with malarial fever, chills, +and lung disease for four years. I took treatment from many doctors, and +tried many different kinds of patent medicines and all seemed to do no +good. Since I have used four bottles of "Golden Medical Discovery" and +one bottle of Dr. Pierce's Pleasant Pellets I feel well in every respect +_and weigh 160 pounds instead of only 130_, my weight when I began its +use. + + Yours truly, + ROBERT WILLIAMS, + Hazelton, Barber Co., Kas. + + +CONSUMPTION. + +ALMOST RAISED FROM THE GRAVE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: MRS. VANSICKLIN.] + +_Gentlemen_--I have long felt it my duty to acknowledge to you what your +"Golden Medical Discovery "and "Pleasant Pellets" have done for me. They +almost raised me from the grave. I had three brothers and one sister die +of consumption, and I was speedily following after them. I had severe +cough, pain, copious expectoration, and other alarming symptoms, and my +friends all thought I had but a few months to live. At this time I was +persuaded to try your "Discovery," and the first bottle acted like +magic. Of course I continued on with the medicine, and as a result I +gained rapidly in strength. My friends were astonished. When I commenced +the use of your medicines, six years ago, I weighed but 120 and was +sinking rapidly. I now weigh 135, and my health continues perfect. I +have a copy of your "People's Common Sense Medical Adviser," and neither +money nor friends could ever induce me to part with it. + +Twelve years later, Mrs. Vansicklin writes: "My health still continues +_perfect_. I now weigh 148 pounds. Your book--the Common Sense Medical +Adviser is a treasure in our home." Yours truly, + + MRS. H.H. VANSICKLIN, + Brighton, Ont. + + +CONSUMPTION. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: J.A. Henson, Esq. ] + +_Gentlemen_--Two years ago I thought I had consumption, and was +continually coughing day and night, and not able to work. I bought six +bottles of Dr. Pierce's Golden Medical Discovery and it did me more good +than all the other medicine I ever took, and now I am feeling all O.K., +and I weigh 165 pounds. Two years ago I weighed 145 pounds. I can fully +recommend Dr. Pierce's Golden Medical Discovery to any person that has +consumption. I remain, Yours truly, + + JOHN A. HENSON, + South Bosque, + McLennan Co., Texas. + + +IT "FILLS THE BILL." LUNG DISEASE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: A.D. Simmons, Esq.] + +_Gentlemen_--In 1872, when living in New York State, my health was very +poor. I was clear "run down." Pain in my lungs, right side and in my +bowels; had been ailing for nearly two years; my feet swelled during the +day so I could hardly stand it till night, as I was on my feet the most +of the time. + +I wrote you and you sent me special medicines, which brought me around +all right. I have weak lungs, and when I get run down I usually take a +few bottles of Dr. Pierce's Golden Medical Discovery, which always +builds me up. We have used your "Discovery" in our family with the best +results. + +When living at Blue Mound I was very sick with inflammation of the lungs +from taking cold. When I took cold I was at Clinton, Missouri. Was +confined to my bed for a few days. I said to the doctor that I must go +home; he advised me to stay where I was, but I started for Blue Mound +with my pulse at 140. When I arrived home I was glad to get in bed, and +called in Dr. ----. He said my lungs were in a bad condition. Well, I +was very sick for three weeks or more, and when I got around I was not +well, and at that time Dr. ---- came to Blue Mound, stopped there two +weeks, gave free lectures and had lots of patients. He examined me and +said I needed treatment, and he could cure me. + +I was suffering all the time with pain in my right lung. He wanted +$50.00 for treatment, and would cure. So I let him pass along and wrote +to your Association for advice, which was to take the "Discovery," and I +took one-half dozen bottles which "filled the bill." Yours respectfully, + + A.D. SIMMONS, + Emporia, Lyon Co., Kansas. + + +CONSUMPTION. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Smith.] + +_Gentlemen_--It is my pleasant duty to you and to suffering humanity to +acknowledge the benefit I received from Dr. Pierce's Golden Medical +Discovery. About seven years ago I became troubled with my +lungs--consumption in its first stage. Some of my friends in Ontario had +been using your medicine before I knew anything of it; and after coming +to this country, I commenced taking it, and I think it has done wonders +for me. I am positive, that if any one will persist in taking it, it +will do all you say. It has done so much for me that I feel it my duty +to testify to its wonderful curative properties. Respectfully, + + MRS. JESSE K. SMITH, + Baldur, Selkirk Co., Manitoba. + + +DYSPEPSIA AND NASAL CATARRH. + +DR. PIERCE, Buffalo, N.Y.: + +[Illustration: J. Larson, Esq.] + +_Dear Sir_--I had been very badly troubled for many years with +dyspepsia, also nasal catarrh, and got so bad and weak that I could not +work. I could hardly eat anything without vomiting; had a pain in the +stomach and a burning sensation coming into the throat. I took Dr. +Pierce's Golden Medical Discovery and "Pleasant Pellets," and can truly +say these medicines have helped me wonderfully. I improved right along +from the very beginning. I stopped taking medicine in the latter part of +May and then felt as well as ever in my life. I am pretty well now, for +a man of sixty-three years. I can eat all kinds of food and it doesn't +cause me any pain in the stomach as it always did before I took Dr. +Pierce's medicines. I can cheerfully say to the public that they need +not hesitate in taking Dr. Pierce's Golden Medical Discovery for +dyspepsia; it will eradicate and cure the disease if anything will. + + Yours truly, + JOHN LARSON, Ashby, Grant Co., Minn. + + +LUNG DISEASE. + +Dr. R.V. PIERCE, Buffalo, N.Y.: + +[Illustration: J.J. Hume, Esq.] + +_Dear Sir_--I cheerfully make the following statement: In February, +1893, I was attacked with a severe illness. It came on very gradually, +and was attended with a severe cough and expectoration; also had pain in +the lungs; had chills and night-sweats; was much reduced in strength. +After trying for relief in different directions without success, I was +induced to apply to your eminent Staff of Physicians at 603 Main St., +Buffalo, N.Y., and I am happy to say that my improvement began as soon +as I began the use of the medicines which were prescribed for me at that +time. The improvement has been continuous, until I now feel my lungs are +entirely cured; have no cough, no expectoration in the last month, and +my usual weight of 183 pounds has been restored. Have been able to do a +fair day's work any time during the past two mouths without unusual +fatigue. I can cheerfully recommend your Institution to persons +similarly affected, and will authorize you to refer any one making +inquiry to me. + + Yours respectfully, + J.J. HUME, Corfu, Genesee Co., N.Y. + + +A BAD COUGH. + +Vanburen, Kalkaska Co., Mich. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +_Gentlemen_--Your medicine is the best I have ever taken, I was not able +to do hardly any work at all; had pain in my left side and back, and had +headache all the time. I tried your medicine and it helped me. Last +spring I had a bad cough; got so bad I had to be in bed all the time. My +husband thought I had consumption. He wanted me to get a doctor, but I +told him if it was consumption they could not help me. We thought we +would try Dr. Pierce's Golden Medical Discovery and before I had taken +one bottle the cough was stopped and I have had no more of it returning. + + Respectfully yours, + Jennie Dingman + + +SEVERE COUGH. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Jewell.] + +_Gentlemen_--I want to say a word in favor of your medicine. I can not +do it justice by mere words. + +I was taken sick the 5th of July; I called a doctor but did not receive +any benefit from him. I was going into quick consumption. Had a terrible +cough, raised a great deal of phlegm; had pain through chest, was very +weak and all run-down." I told my husband to get a bottle of "Golden +Medical Discovery;" he did so; I commenced taking it and I began to get +better. I was not outside of the door yard, from July 5th, until August +22d. I only took two bottles, and the first of September I was able to +do the work for boarders, and have had boarders ever since. It is the +grandest medicine ever invented. + + Respectfully, Mrs. CHARLES JEWELL, + (P.O. Box 89), Rockford, Kent Co., Mich. + + +SPITTING OF BLOOD. + +Olanta, Clearfield Co., Pa. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +_Gentlemen_--I can truly say that your "Golden Medical Discovery" and +"Pleasant Pellets" have been the means of saving my life. When I began +taking your medicines I thought my time was short. I have not spit up +blood now for about four months, and am feeling much better. Our home +doctor says my temperature and pulse are all right now; and that I do +not need further medicine, and that I will get all right again. I feel +that your medicine has done wonders for me. I would have written sooner, +but I was waiting to see if the improvement Would be permanent. + + Yours truly, + D.Y. Rowles + + +DESPONDENCY. + +NERVOUS PROSTRATION--THREATENED WITH CONSUMPTION. + +WORLD'S DISPENSARY MEDICAL, ASSOCIATION, Buffalo, N.Y.: + +[Illustration: H. Cummins, Esq.] + +_Gentlemen_--I have felt inclined to say to you, and your whole staff of +physicians, and now do convey to you, my heart-felt gratitude for your +able and skillful assistance rendered me in my afflictions. I had been +for years a sufferer, and at times nearly despondent. I had been treated +by the most able and skillful physicians that this north-western country +could provide. I had paid them large sums of money and was finally given +to understand that there was no hope for my cure. Your advertisements +fell into my hands, which treated upon my case. I read and compared my +case with the insight you so ably explained, so I was satisfied you +understood your profession well. I started full of hope and as I reached +Buffalo, after three days' travel by rail, some 1,500 miles, there was +something that cheered me on. I made my way to your Invalids' Hotel. I +was examined and pronounced curable. I was operated upon for a local +affection that caused much of my suffering, the same day I arrived, and +in ten days was discharged permanently cured. I have felt perfectly well +ever since. I was nicely treated by the able nurses and attendants who +were always gentle and kind. + +I can cheerfully say to the public, that they need not hesitate in +throwing themselves into your kind care in every case that is curable by +the hand of man, and you will treat them honestly. + +Hoping this may be of some benefit to some afflicted persons who may +feel some diffidence in trusting themselves in your hands. + + Yours respectfully, H. CUMMINS, + Eagle Lake, Blue Earth Co., Minn. + + +LUNG DISEASE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Fisher.] + +_Gentlemen_--I am much better, and believe it was through your medicine +and advice that I am as well as I am. I might have been entirely well if +I had been able to have kept the medicine to take as directed. I have +taken only four bottles, and it would be four or five months from the +time I would take one bottle till I could get another one. I can talk +better, and feel almost like a new person to what I did two years ago. I +weigh more and can do any kind of work. Dr. Pierce's Golden Medical +Discovery is the only medicine that did me any good. + + Your friend, + MRS. RACHEL D. FISHER, + Silver Point, + Putnam Co., Tenn. + + +CHILLS AND LINGERING COUGH + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: H. Dietzel, P.M.] + +_Gentlemen_--In 1879 I wrote you after suffering eighteen months. I had +tried three doctors--took over one dozen bottles of patent medicines, +without relief. + +I had chills with hacking cough; my friends said I had consumption; was +reduced in flesh and nerve till the least work or exercise would exhaust +me completely. + +Thanks for the day I wrote you, for I sent you ten dollars, and received +four bottles of medicine which I took, and have been able to do hard +work. I have never had any symptoms of those dreaded chills since. My +weight got as low as 135 pounds; now I weigh 175 pounds. I would advise +any one affected with chronic disease to consult you, as your treatment +is genuine. + + Yours truly, + HENRY DIETZEL, P.M. + Ernst, Clark Co., Ill. + + +HEREDITARY CONSUMPTION. + +HOME DOCTORS OPPOSED HIS COMING TO US (THEY OFTEN DO) ALTHOUGH UNABLE TO +HELP HIM THEMSELVES. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: J.F. Jones, Esq. ] + +_Gentlemen_--For the benefit of the afflicted, I wish to say, that I +visited your Institution in 1889, completely broken down in health and +suffering, as I thought, from heart disease and consumption. I had spent +money with many of our home physicians, but they only gave me partial +relief and I would soon be worse than ever. When I spoke of coming to +you, the doctors here cried "humbug," but I told them I had been +humbugged at home and if I staid I would surely die, and if I went could +do no worse. I spent thirty days at your Invalids' Hotel and Surgical +Institute, and came away like a new man, comparatively speaking. I found +the Institution all it had been represented, and I may truthfully say, +that the time spent there was to me as an oasis in a desert to a weary +and thirsty traveler; for those were among the happiest days of my life. +No pains were spared to make each patient comfortable and at home. I +cannot recommend your Institution too highly, for I feel that to your +treatment I owe my life. I have sold a great deal of your medicines, and +recommend them with the same faith I would water to the thirsty. They, +the "Pellets," "Golden Medical Discovery" and "Favorite Prescription," +give universal satisfaction. You are at liberty to use this as you +desire, for my only motive in writing is to benefit the afflicted, by +pointing out to them a place of cure; for, no matter what their disease, +I am confident that if medical skill can avail, they can be cured at the +Invalids' Hotel and Surgical Institute. + + Yours truly, + J.F. JONES, + Raleigh C.H., Raleigh Co., W. Va. + + +ABSCESS OF LUNG. REDUCED ALMOST TO A SKELETON. + +Bisbee, Cochise Co., Ariz. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +_Gentlemen_--I had been confined to my bed four months, had tried the +skill of four doctors and all the patent medicines that were recommended +for my case, which was an abscess on the lung. My physicians and friends +had given me up to die; I was reduced to a perfect skeleton; my strength +was gone; my eyesight was so dim I could scarcely see at all, and I had +no appetite--could not eat anything at all when I commenced using Doctor +Pierce's Family Medicines. I have taken sixteen bottles of the "Golden +Medical Discovery," twelve bottles of "Pellets" and three bottles of +"Favorite Prescription," and to-day I am well and strong and weigh 128 +pounds--two pounds more than I ever before weighed in my life. + + Your true friend, + Mrs. Sarah A. Kelly + + +LUNG DISEASE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Sickles.] + +_Gentlemen_--My daughter had pneumonia and it left her with a horrible +cough and one lung was almost gone; our doctor seemed to think there +could be nothing more done, and said to go South; but not having the +means at that time, I began giving her Dr. Pierce's Golden Medical +Discovery, which she took steadily for two years. During that time she +gained rapidly in strength; the lungs became normal, the cough leaving +her entirely. We are never without this medicine in the house, and have +recommended it to all our friends, and I am positively certain that if +Dr. Pierce's medicine is used in time, it will cure in other cases as +well as in this one. + + Yours respectfully, + MRS. RUTH A. SICKLES, + Ocean Port, Monmouth Co., N.J. (Box 33.) + + +REDUCED TO A SKELETON. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Mills.] + +_Gentlemen_--Having felt it a duty to write of the good I received by +taking your medicine, I now would say, that one year ago I was given up +by my family physician and friends; all said I must die. My lungs were +badly affected, and body reduced to a skeleton. My people commenced to +give me your "Medical Discovery" and I soon began to mend. It was not +long before I became well enough to take charge of my household duties +again. I owe my recovery to Dr. Pierce's Golden Medical Discovery. + + Respectfully yours, + MRS. MIRA MILLS, + Sardis, Big Stone Co., Minn. + + +COUGH AND NIGHT SWEATS. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: H.M. Detels and Wife.] + +_Gentlemen_--In regard to your medicines I will say that they are always +in the house. I shall never forget those nights when I was down with +pneumonia. Had it not been for Dr. Pierce's Golden Medical Discovery I +would not be a well man to-day. One bottle stopped the cough and night +sweats. + +My wife was troubled with leucorrhea so bad that we did not know what to +do until Dr. Pierce's Favorite Prescription was brought into the house +and gave her rest. + + Yours truly, + H.M. DETELS, + Traver, Tulare Co., Cal. + + +PULMONARY DISEASE. A WONDERFUL CURE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Chas. E. Lees, Esq. ] + +_Gentlemen_--I am 29 years old. During the winter of '84 I contracted a +severe cold, which settled on my lungs. Each succeeding winter my cough +grew worse, and in the winter of '85 I had chicken-pox, and taking cold, +drove them in causing me a severe spell of sickness. The following +summer I had congestion of the lungs and hemorrhage and a severe spell +of fever. My physician advised me to go West in search of health. My +friends thought I had consumption of the lungs, I coughed so much. In +September, 1889, I left Carthage, Mo. (where I then lived), for Phoenix, +Ariz. After I had been there about four months I had a severe attack of +"_La Grippe_" and with this I coughed myself almost (I thought), to +death; and to add to my distress I had an almost intolerable attack of +pleurisy. A doctor was summoned and after an examination said I had +Empyemia, and said he could do me but very little good until he removed +the pus. He and his partner came and by the use of an aspirator drew off +nine pints of pus; after about a week he drew off two pints. After a few +days I told my doctor I could hear the pus gurgle as I had before he +drew it off. Strange to say, but nevertheless true, my heart was crowded +over on the opposite side for three months. I knew it was there for I +could feel the pulsations there, and I was so short of breath for a long +time I could not stoop down to tie my shoes. + +The doctor told me it would be useless again to use the aspirator, but +that he would be obliged to make an incision in my side and treat it +till I got well. On the 28th day of March. 1890, my doctor and his +partner and three other doctors undertook the operation, and, after +removing about two inches of one of my ribs, withdrew 16 pints of pus. +This came near being too much for me though I slowly recovered and in +three months the doctors thought I was able to come home. I arrived home +in June and was very poorly all summer, and did not sit up but _very +little_, and had fever every day. In the latter part of the summer of +'90 I commenced to take "Golden Medical Discovery" and although my side +had been discharging for TWENTY-THREE MONTHS it healed up sound and +well. I am now able to do considerable hard work. I would advise all who +are afflicted as I was, to give your medicine a trial. I am glad I have +out-lived my friends' expectations. + + Yours truly, + CHARLES E. LEES, + P.O. Box 2, Winslow, Washington Co., Ark. + + +THROAT AND LUNG DISEASE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. White. ] + +_Gentlemen_--I was troubled with throat and lung disease for about two +years and lost strength so that I was unable to do much work. I took +four bottles of Dr. Pierce's Golden Medical Discovery, and can say that +it did more good than any other medicine that I ever took. I am now able +to do my work, and enjoy good health. + + Yours truly, + MRS. JULIA WHITE, + Willow Creek, + Blue Earth Co., Minn. + + +WEAK LUNGS, COUGH, PROFUSE EXPECTORATION AND CATARRH. + +[Illustration: A. Kratz, Esq. ] + +MR. ANTON KRATZ, of _Crawford, Dawes Co., Neb._, had weak lungs, cough +and catarrh, with profuse expectoration; difficult breathing, lasting +from one to eight hours. He writes: + +"I took sick and went to the doctors. They gave me medicine, but it did +not help me, so I got two or three bottles of 'Golden Medical Discovery' +and some 'Pellets.' After awhile I got better, until three winters ago I +got sick again so I could not do anything, and I wrote to you giving my +symptoms on one of your question blanks, and asked you about my case. +You told me to take your 'Golden Medical Discovery.' I took four bottles +and got well and have been well ever since." + + + +LUNG DISEASE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: Buffalo, N.Y.: + +[Illustration: Mrs. Lincoln. ] + +_Gentlemen_--Before taking the "Discovery" I would have four or five bad +coughing spells every day and would cough up mouthfuls of solid white +froth, and before I took one bottle it stopped it. I could not walk +across the room with the pain in my back and sides; but soon the pain +was all gone, and I could sleep well at night. My general health is much +better since I have taken the "Golden Medical Discovery" although I have +been obliged to work hard on a farm. + + Respectfully yours, + MRS. JOHN LINCOLN, + Glen Annan, Huron Co., Ont. + + +CONSUMPTION AND GENERAL DEBILITY. + +CURED BY SPECIAL HOME TREATMENT. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. F. Nienhuis. ] + +_Gentlemen_--I had pain in lungs and across the chest; had been spitting +blood for the past six years. Menstruation was scant and caused great +prostration. Suffered from constipation; cutting pains about the stomach +and rumbling in the bowels; exceedingly nervous; indigestion. She writes +as follows: "I wish to inform you that I am well. I never can praise you +or your ways of treatment enough. I shall bring you all the patients +that I can. I feel so rich to get my health back. I can eat well and +sleep well, and work all day. I suppose you will think it took a long +time to pull me up, but I was very low, much worse than I ever told you +of at the time. I was not able even to feed myself any more. My husband +had to undress me. I could not wash my own face, or stand alone. I did +not lie down to sleep for eleven months; I always had to sit up, because +I would choke if I laid my head down. _I have not raised a drop of blood +since your treatment_, and I did it always for five years before. Our +minister said this spring that he had never thought I could live, and +says that he advises every one that is sick to go to you. He was so +surprised to see how strong and well I was. My relatives all think that +you ought to write my case up for the papers in Chicago. I can never +repay you for what you have done for me. A thousand thanks is but empty +words. My husband was telling a man just last week, "do not spend all +your money in Chicago, as we did, and then write to Buffalo, but go and +write now, and your wife will soon be well." My father was saying that +he wished the doctors that gave me up could see me now. I think they +could not believe their own eyes. I am astonished when I think back how +I was six years ago; I could not walk across the room alone for three +years, and after taking your treatment for eighteen months, I am +_completely_ well. I can hardly believe it myself when I read over those +letters that I received from you. I work hard every day. There is never +a day that you are not remembered. I hope that you may live many years +to do for others what you have done for me. I had this taken so that you +might have my picture as I am now; I wish you could have seen me as I +was then, and I wish to thank you for those little notes of inquiry that +you used to send to find out how I was getting along, which showed that +I was remembered not only while the money lasted, but that you cared for +me after that." + + Respectfully yours, + MRS. F. NIENHUIS, Crawford, Cook Co., Ill. + + +"COMPLETELY WRECKED." + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Lindsey. ] + +_Gentlemen_--Last August I was taken sick of a fever and was confined to +bed for nearly six months. I had four doctors to see me, but it just +seemed to me that they could relieve me for only a short while. I had a +bad cough and all thought I was going into consumption. After being sick +for so long, my nerves were nearly exhausted and my stomach, liver and +bowels refused to act, in fact, my whole system was completely wrecked. +I could not rest nor sleep, unless influenced by some drug and at last, +mother concluded to try your medicines on me. She had taken them about a +year before and had been greatly benefited by their use, so she said I +will try the last resort--for I had been given up to die. + +I began taking your "Golden Medical Discovery" and "Pleasant Pellets." I +improved rapidly--was soon able to be up in my room, and to my surprise, +I could eat a little of nearly everything I desired. Before I began the +use of your medicines, I could eat nothing in peace; I would almost +cramp to death, even when I took a little cold water. + +But after the use of four and a half bottles of your "Golden Medical +Discovery," and two vials of "Pellets," with God's help, I have almost +risen from the dead. + +I will cheerfully recommend your remedies to my afflicted friends, for I +am to-day, well and strong as ever. You can use this among your +testimonials, if you choose, with my greatest approval. + + Very Respectfully yours, + Miss LOULA LINDSEY, Ringgold, Pittsylvania Co., Va. + + +BRONCHITIS OF TWENTY YEARS' STANDING. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: B.F. Wiley, Esq.] + +_Gentlemen_--I had bronchitis for twenty years and over, and I could not +work without coughing so hard as to take all my strength away. I took +five bottles of Dr. Pierce's Golden Medical Discovery, and give you my +word and honor that I can do any work that there is to do on my "ranch" +without coughing. Sometimes in the winter when exposed to the change in +the weather, I have a slight attack of coughing. Remember, I have not +taken any of the "Golden Medical Discovery" for a year. + + Yours, + B.F. WILEY, + Box Elder, Converse Co., Wyo. + + +BRONCHITIS. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: M.M. Alexander, Esq.] + +_Gentlemen_--I was troubled with bronchitis for over two years, had +severe cough and great difficulty in breathing; appetite was poor and +suffered from indigestion, became very weak and despondent. My age (I am +now 71) was against me. I was treated by two physicians but they did me +no good. I then used four bottles of your "Golden Medical Discovery" and +was entirely cured, for which I am very thankful. + + Yours truly, + M.M. ALEXANDER, + Hedrick, Alexander Co., N.C. + + +LUNG DISEASE. + +Schuylersville, Saratoga Co., N.Y. (P.O. Box 396). + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +_Gentlemen_--Something over a year ago I wrote to you about my lungs. I +used Dr. Pierce's Golden Medical Discovery besides using Iodine and +mustard paste. + +That pain in my lung entirely left me, and I have not felt it at all +since last August. The doctor who lives here and who has always treated +me thinks it is a great cure. Words cannot express my gratitude to you. +I am now able to do a good day's work. + + Yours gratefully, + Lulu E. Baugs + + +CHRONIC SORE THROAT, COUGH HOARSENESS. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Traphagen.] + +_Gentlemen_--I am feeling well at the present time; I took fourteen +bottles of Dr. Pierce's Golden Medical Discovery. I had chronic sore +throat, hoarseness, sore chest, rheumatism in my arms, and was very much +run down. The doctor here at home said one lung was affected and that I +had symptoms of consumption. I know that your "Golden Medical Discovery" +was the cause of regaining my health. I remain, + + Respectfully yours, + MRS. MARY TRAPHAGEN, + NO. 6 Front Street, Poughkeepsie, N.Y. + + +CONSUMPTION. BAD COUGH, SPIT UP BLOOD. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: K.C. McLin, Esq.] + +_Gentlemen_--When I commenced taking your "Discovery" I was very low +with a cough, and at times spit up much blood. I was not able to do the +least work, but most of the time was in bed. I was all run-down, very +weak, my head was dizzy, and I was extremely despondent. The first +bottle I took did not seem to do me much good, but I had faith in it and +continued using it until I had taken fifteen bottles, and now I do not +look nor feel like the same man I was one year ago. People are +astonished, and say, "well, last year this time I would not have thought +that you would be living now." I can thankfully say I am entirely cured +of a disease which, but for your wonderful "Discovery," would have +resulted in my death. + + Yours truly, + K.C. McLIN, + Kempsville, Princess Anne Co., Va. + + +LUNG DISEASE. + +COUGHED DAY AND NIGHT. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Steinmann.] + +_Gentlemen_--Three years ago I was so sick I could not eat, sleep or +walk, for I coughed all day and night. My weight was reduced from 150 to +127 pounds. The first night that I slept four hours at one time, was +after I had taken three doses of Dr. Pierce's Golden Medical Discovery. +The offensive matter expectorated grew less every day and when I had +taken the whole of one bottle I could sleep all night without coughing, +and have been well ever since and weigh 178 pounds. + + Respectfully yours, + MRS. LOUISA STEINMANN, + 67th St., near 15th Ave., Lefferts Park, Brooklyn, N.Y. + + +BILIOUSNESS, CONSTIPATION, BAD COUGH. + +[Illustration: G.I. Wilder, Esq.] + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +_Gentlemen_--Some twenty-five years since I was feeling very miserable +all summer; I was very bilious; sometimes my bowels would not move once +in sixty or seventy hours, and then almost impossible. I would take some +bitters, which would help to move the matter, but as soon as the bitters +were gone, I had to buy more or I would be as bad as before, and +sometimes worse; but none of them appeared to do me any good except to +move the bowels, until thirty years since a druggist called my attention +to Dr. Pierce's Golden Medical Discovery, and before I had taken half a +bottle of the "Golden Medical Discovery" I felt much better and by the +time I had taken all, I could eat three hearty meals per day and had not +felt so well for a long time. Soon after I was called to do a job some +miles from home, and one night the old lady there was speaking about her +daughter, (Mrs. Brooks) who had been under the doctor's care for five +months and did not get any better, and I learned by asking a few +questions that she had no appetite, and no ambition to do anything. Then +I told her what the "Golden Medical Discovery" had done for me. The next +day the old lady drove down to her daughter's, and got Mr. Brooks to +send to Rutland--ten miles away--for two bottles of the "Golden Medical +Discovery," and the next day the doctor came, and when about to take +leave, Mr. Brooks told the doctor he did not want him any more at +present and would send for him if necessary. I saw the old lady about +ten days later and her daughter was improving, and Mr. Brooks had great +faith in the "Golden Medical Discovery," and had not sent for the +doctor, but had gone to Rutland for more of the "G.M.D." + +When I commenced taking the "Golden Medical Discovery." I thought I was +going into consumption as had a cough for three years or more and my +weight decreasing. My weight before taking the "G.M.D." was 133 pounds; +last March it was 147 pounds, and I give the credit to the "Discovery." + + Yours respectfully, + GEORGE I. WILDER, + East Wallingford, Rutland Co., Vt. + + +THROAT AND LUNG DISEASE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Bringer. ] + +_Gentlemen_--I had complicated chronic disease for several years--throat +and lung and other affections, which almost resulted in consumption. Our +doctors could do me no good. I happened to get hold of some of Doctor +Pierce's books, and was induced to try his treatment. To the surprise of +myself and family, I was, in a short time, changed almost to a new +person--from pale sallow complexion to the bloom of health again. Many +thanks for restoring me from an untimely grave. I will say to the public +it is not always necessary to go to the Institute; I was treated at home +with success. I cannot speak in too high praise of Dr. Pierce's Golden +Medical Discovery, "Pellets" and "Favorite Prescription." I think they +will do all that is claimed for them. + + Respectfully, + MRS. ALMEDA BRIGNER, + Oxford, Furnas Co. Neb,. + + +SEVERE LUNG AND BRONCHIAL DISEASE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: E. Campbell, Esq. ] + +_Gentlemen_--For some time I have been troubled with a severe lung and +bronchial disease, following a severe attack of pneumonia. Was raising a +great amount of pus, had severe night-sweats and was very much +prostrated, when I was induced to visit Dr. Pierce's Invalid's Hotel and +Surgical Institute for examination. After having a full statement of my +case, I paid for one month's treatment in the Sanitarium and during that +time was fully restored to health. I can not speak too highly of the +physicians, and this famous Institution. + +I take great pleasure in making my cure public and in highly +recommending this Institution to all afflicted. The Staff of Physicians +and Surgeons is skillful and of large experience, and I feel confident +that all the benefit that can possibly be obtained from medical +treatment, can be obtained at the Invalids' Hotel and Surgical +Institute. + + Yours truly, + EUGENE CAMPBELL, + New Cumberland, Hancock Co., W. Va. + + +DYSPEPSIA AND CONSUMPTION. + +DR. R.V. PIERCE, Buffalo, N.Y.: + +[Illustration: Mrs. Ferguson.] + +_Dear Sir_--I was not able to do my work for nearly two years, and I +tried four different doctors and grew worse all the time. Then I began +on your medicine and took twelve bottles of "Golden Medical Discovery" +and one of "Favorite Prescription," and am able to do my work and feel +as well as I have felt in years. Physicians called my disease Dyspepsia +and Consumption. + + Respectfully yours, + MRS. R. FERGUSON, + Ink, Shannon Co., Mo. + + +LUNG DISEASE CURED. + +[Illustration: Miss M.H. Snead.] + +Will you please accept a few lines from me thanking you for your skill +in preparing your medicines and placing them within reach of the +suffering. I have a daughter, Miss M.H. Snead, who has been very low, +was almost given up by two physicians, who treated her with their best +skill, and did not receive much benefit. She was first attacked with +pneumonia and pleurisy in very bad form and was then taken with a very +bad cough, which kept growing worse and worse, until finally it seemed +as though she had consumption very bad. The physicians prescribed Cod +liver oil, but to no benefit. Mrs. Miller, a neighbor of ours, +recommended Dr. Pierce's Golden Medical Discovery to me with very strong +faith, as she had been in the same condition and was cured by its use. I +procured two bottles and she grew better. She hasn't felt any return of +lung disease in over twelve months. She was nothing but a skeleton when +she took the first dose, and to-day she weighs 135 pounds. I thought it +my duty to write to you in regard to her case, as so many other +medicines had failed, and it has acted like a charm. + + Respectfully yours, + MRS. SARAH E. SNEAD. + Clio, Iredell Co., N.C. + + +DISEASE OF LUNGS AND STOMACH. + +Locust Lane, Scott County, Va. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +_Gentlemen_--I am happy to inform you that after consulting you by +letter and two months' trial of Dr. Pierce's Golden Medical Discovery, I +am enjoying a better state of health than I have for some time. I have +had weak lungs for several years--at times spit up blood. In January, +1893, I took a severe cold, which settled on my lungs--had a very bad +cough, it seemed as if my lungs were swollen; could not expectorate much +at a time, very hard to get up; suffered much with pains in my chest; +was reduced in flesh and became very weak. + +Physicians prescribed for me but I found no relief until I consulted +you. It seemed I was going into consumption very fast. I have as good +health now as could be expected. I am fifty-seven years of age and able +to work on my farm, and feel under many obligations for your kind +advice. Also my stomach was out of order, suffered with burning in my +stomach and chest. I have no burning nor pains in my stomach and chest +now. + + Yours truly, + Milton Ramry + + +DOCTORS ENDORSE IT. + +AN EMINENT PHYSICIAN OF ARKANSAS TELLS OF SOME REMARKABLE CURES OF +CONSUMPTION. + +[Illustration: Mrs. Rogers.] + +Dr. PIERCE:--I will say this to you, that Consumption is hereditary in +my wife's family; some have already died with the disease. My wife has a +sister, Mrs. E.A. Cleary, that was taken with consumption. She used your +"Golden Medical Discovery," and, to the surprise of her many friends, +she got well. My wife has also had hemorrhages from the lungs, and her +sister insisted on her using the 'Golden Medical Discovery." I consented +to her using it, and it relieved her. She has had no symptoms of +consumption for the past six years. People having this disease can take +no better remedy. + + Yours truly. + W.C. Rogers, M.D. + Stamps, La Fayette Co., Ark. + + +CHRONIC BRONCHITIS AND DYSPEPSIA. + +WORLD'S DISPENSARY MEDICAL, ASSOCIATION, Buffalo, N.Y.: + +[Illustration: A. Rosenberger, Esq.] + +_Gentlemen_--Several years ago I spent many dollars for medicine, but in +vain, and expected to die with consumption. But hearing of your +Invalids' Hotel and Surgical Institute, I visited you. + +To your advice and treatment I owe my life and present good health. + +Hoping that you and your eminent faculty may be spared many years to +cure the afflicted, I send you my best wishes. + + Yours truly, + ALBERT ROSENBERGER, + Laotto, Noble Co., Ind. + + +"SORE THROAT." + +Palatka, Putnam Co., Florida. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +_Gentlemen_--About seven years ago I was taken with sore throat and +tried some home remedies, and it grew worse; and then I went to a doctor +here in town, and after trying his remedies for three or four months, +which did me no good, then I tried Dr. ---- remedies; and still I grew +worse for two years when I wrote you about it. You advised me to take +Dr. Pierce's Golden Medical Discovery and his "Pellets," according to +directions, and they would cure me, and so they did after taking eight +bottles of the "Discovery," and the "Pellets" to keep my bowels regular. +We now take the "Discovery" and "Pellets" for all our aches and pains, +and think there are no medicines half so good. We use no other. + + Yours Truly, + Mrs. Ellen Calvert + + +LUNG AND WOMB DISEASE, DROPSY, SICK HEADACHE, DYSPEPSIA AND BLOODY +PILES. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Knavel. ] + +_Gentlemen_--In the winter of 1881, I became irregular in my monthly +courses. Of course at first I paid but little attention to it, hoping it +would amount to nothing and probably wear away. But I slowly but surely +grew worse, and at last resolved to apply to the doctors for help. My +water came often, and in small quantities, and with great pain, and with +red brick-dust deposit. I was attacked with severe womb trouble, bloody +piles and dropsy of the ovary. I was treated by five different doctors. +I was compelled to wear an inside support for a year, but it still +seemed impossible for me to get well and I began to feel exceedingly +alarmed and very uneasy, not knowing what course to pursue, or what the +consequences might be. I had heard of Dr. Pierce, and concluded to make +one more trial, so I sat down and wrote a letter to him, stating matters +as near as I could, and in due time I received a favorable reply; then I +commenced with his medicine. I commenced somewhere in February 1891 with +the "Golden Medical Discovery" and "Favorite Prescription," in alternate +doses. A strange occurrence followed. My limbs felt like what we call +"asleep," and I felt as if I were in a strange land and wondered what +was going to take place. I kept on till I took nine bottles. The first +relief I felt was from sick headache, which I had been troubled with for +many years; I was also cured of a very bad cough which I had been +troubled with for many years, and of dyspepsia of long standing. I was +entirely cured of a very singular and severe itching on my back, between +my shoulders, which our doctor's called winter itch and which they +pronounced incurable. I had suffered with this for twenty years; it +would come in the winter and go away in the summer. I was also cured of +the worst form of bloody piles and of womb disease. At present I feel +like a new person. + +When I first commenced with Dr. Pierce's medicines, I could not walk +half a mile without a pain. The other day I walked to Mercersburgh +post-office, a distance of twelve miles, and the next day walked back +again, and felt no bad results from the Journey. I am now 51 years old. + +Mrs. Knavel further writes, that "To any person desiring to know more +concerning my case and its wonderful cure, and who will enclose to me a +return self-addressed and stamped envelope for reply, I will be pleased +to write further information." + + Yours respectfully, + SARAH A. KNAVEL, + Indian Springs, Washington Co. Md. + + +BRONCHITIS AND LUNG DISEASE. + +[Illustration: Mrs. Neal.] + +Mrs. Neal, of Crockett Mills, Tenn., had an attack of measles, followed +by _bronchitis_ and _pneumonia_. Her husband writes: "I feel gratified +with the effect of your wonderful medicine. I can recommend it to +anybody, and feel I am doing them justice. My wife was not able to +perform her household duties for six months. She has used two bottles of +'Golden Medical Discovery,' and is now able to do all her work. I think +it the finest medicine in the world, and I am, gratefully, + + Your life-long friend, + J.B. NEAL." + + +BLEEDING FROM LUNGS; CHRONIC CATARRH; VERY LOW. + +CURED BY SPECIAL HOME-TREATMENT + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: Buffalo, N.Y.: + +[Illustration: G.R. Sprinkle.] + +_Gentlemen_--I was very low--almost given up by two physicians who +treated me with their very best skill and did not receive much benefit. +I was attacked with "La Grippe" in December, 1891, and pleurisy, and was +taken with a very bad cough, which kept growing worse. The physicians +prescribed Emulsion of Cod Liver Oil, but no benefit. In June, 1892, I +bled from the lungs; everybody thought I would die. A friend told me to +try Dr. Pierce's medicines. I did so, and after taking six months' +home-treatment I was cured. When I commenced taking his treatment I only +weighed 130 pounds, now I weigh 175, and can do as good a day's work as +I ever could. I can cheerfully say that I believe I owe my life to his +valuable medicines. + + Yours truly, + G. RILEY SPRINKLE, + California Creek, Madison Co., N.C. + + +LUNG DISEASE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Van Baskirk.] + +_Gentlemen_--I was troubled with my lungs and stomach for five years. I +could do no work hardly until I used Dr. Pierce's Golden Medical +Discovery. After using five bottles of the "Golden Medical Discovery" +and three vials of the "Pleasant Pellets" I was cured, and now I am +doing the work for a family of nine. I tried other medicines and nothing +would do me any good, and if I had not gotten your medicine I would have +been in my grave. I could not recommend it too highly for the good it +did me; it is the best medicine I ever got hold of. + + MRS. E.C. VAN BOSKIRK, + Selin's Grove, Snyder Co.,Penn. + + +"COMPLETELY BROKEN DOWN" + +FROM DYSPEPSIA, CATARRH, SPINAL DISEASE--NERVOUS PROSTRATION. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: C.M. Niles, Esq.] + +_Gentlemen_--I wish to express my heartfelt thanks to you for the +wonderful cure that your special remedies performed in my case. In the +Spring of 1891, I had a severe attack of La Grippe, which left me in bad +shape. I consulted as good a physician as there was in the county, and +he told me that I was suffering from enlargement of the heart and that I +must be very careful about taking: any violent exercise, and I must not +allow myself to get excited, as excitement of any kind might prove +fatal. He gave me remedies for my trouble which made me feel some +better; but being a farmer I was obliged to work hard and soon began to +run down. I began to have spells of a terribly deathly sinking feeling +at my stomach and a terrible pressure at the heart--in the region of the +heart, and sometimes I would fall prostrate and although I was conscious +all the time I could not speak aloud. + +The last of October, 1891, while doing my chores in the morning, I had +one of those bad spells and upset my lantern, which resulted in my +losing my buildings by fire. + +My wife was out of health at that time--she, too, was suffering from the +effects of La Grippe. Having lost everything eatable for ourselves and +stock, I was forced to work very hard to get through the winter. The +next February, 1892, we had another attack of La Grippe, which resulted +in the death of my beloved wife. The next May, this terrible affliction +together with hard work completely broke me down and although I was +doctoring all the time I kept steadily growing worse. I got so bad that +I could not sleep more than two or three hours any night and very often +I would go all night without closing my eyes at all. + +The last of September, I had to give up work almost entirely. I got so +that I _could not walk one-fourth of a mile without being completely +exhausted_. One physician whom I consulted said I was suffering with +nervous prostration and gave me medicine for it, but I got no better. My +food distressed me terribly and after eating, it would sour and I would +have to vomit up the most that I had eaten. At last, I got so I had to +live on bread made of wheat middlings and for about three months I could +not eat anything else, although it seemed as though I should starve to +death. I thought I would give anything if I could eat a hearty meal of +anything that I wanted, but did not dare to because every kind of food +distressed me so. My bowels became badly constipated and for three +months I did not have a natural operation of the bowels; and I suffered +very much with catarrh, and there was such a pressure across my forehead +that it seemed sometimes as though it would burst. I became very +despondent. I did not want to go anywhere, neither did I want to see any +one, everything looked dark and gloomy to me. When well, I was naturally +or a lively disposition and a great hand to joke with my friends, but no +one could say anything funny enough to get a smile out of me then. I was +always very fond of music too, but I could not bear to hear a bit of +music, neither vocal nor instrumental. About the first of February, +1893, some of my friends prevailed upon me to consult a physician who +made a specialty of treating chronic nervous troubles; he said I had no +organic trouble of the heart and that it was caused by my stomach being +out of order; he said that I had a bad kidney trouble and that my spine +was affected, and that unless I got help it would end in "Locomotor +Ataxia." He said he could help me but it would probably take a year to +cure me. He let me have a month's treatment and gave me advice in regard +to diet, etc. I thought for awhile that it was helping me but soon I +began to go down hill again, and as a last resort I began to take some +of the cure-alls (patent) with which the country is flooded; but I soon +became disgusted with them and made up my mind there was no help for me. +I had to use about all the strength I had to walk; I could not lift my +left foot up to step over anything--had to draw it after me; I could +hardly sleep; neither could I transact any business, in fact I did not +take any interest in any of my affairs. It seemed to me as though I did +not have a friend on earth, and I longed for death to come to put me out +of my misery. + +My son, with whom I was living, had been trying for a long time to get +me to send to you for treatment, but I had paid out so much money and +received no benefit from it, that I did not believe there was any help +for me. + +At last I thought I would write you what I could of my symptoms, and get +your opinion of my case, but it took me about two days to write the +letter. My head felt so bad that I could not collect myself enough to +describe my feelings. You wrote me that my trouble was caused by +indigestion, dyspepsia, catarrh, and spinal affection, and that you +could cure me, and in fact, make a new man of me if I would send for +your special treatment and follow your advice. My son sent for the +medicine for me. I took it and followed your directions as near as I +could; the first week I could not see much of any change--the second +week I could see that I was improving some, the third week I could look +back and see that I had gained considerable. I could sleep better; the +bloating in my bowels did not trouble me so bad; my stomach did not +distress me so much and I could eat different kinds of food and my +digestion seemed to be improving fast; and by using your Special Catarrh +Remedy my nose began to run (it had been nearly six months that my nose +was perfectly dry) and one day it felt as though something gave way in +my head--it seemed to be back, in behind my eyes, and I blowed a large +amount of filth out of my head that looked like the yolk of an egg, and +it was nearly as thick as jelly; after that my head began to improve +rapidly and I began to gain in flesh and strength, and the best of all +is, I have kept right on gaining until at the present time _I feel as +well as I ever did in my life_. Sleep well, can eat three hearty meals +every day and digest them too, and eat anything I want, and seven days +in a week. + +To look back now I don't see why I did not apply to you when I was first +taken sick. For about ten years ago. I had treatment of you for catarrh, +liver and kidney trouble, and you helped me then; also, about eight +years ago my wife had two months' treatment from you which helped her of +the troubles from which she was suffering at that time. All the reasons +that I can give, is, that owing to financial troubles and having to pay +out so much for sickness, I could not seem to get the money (that I +could spare) to pay for the treatment. + +Gentlemen, I wish I could express my thanks to you for what you have +done for me, but I cannot do it. I am a poor hand to express myself, but +I consider my restoration to health almost a miracle, and I firmly +believe that I owe my life to you, for I do not believe that I should +have lived till the present time had it not been for your Special +Treatment. Now, if there is any part of this letter that you would wish +to publish, you are at liberty to do so: and if it would be the means of +directing any suffering fellow being to a place where they can get +relief, I shall be very thankful. + + Respectfully, + C.M. NILES, + East New Portland, Somerset Co., Maine. + + +CATARRH, INDIGESTION, AND NERVOUSNESS. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: E.A. Baldwin, Esq.] + +_Gentlemen_--For a long time I was suffering from indigestion, catarrh +and nervousness. I was so run down that I could not go to school, and, +as the various remedies I tried did me no good, I applied to you, and +was advised to try a course of special treatment. After taking only two +months' medicines from your noble institution, I feel perfectly restored +to health. I have, moreover, recovered my lost flesh, and I am pleased +to say need no further medicines. + + Yours truly, + E.A. BALDWIN, + Proctorsville, Windsor Co., Vermont. + + +NASAL CATARRH. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Miss Pollak.] + +_Gentlemen_--My daughter had for many months severe nasal catarrh with +sores forming on the inside of nose; if not attended promptly the sores +would come out on bridge of nose and also in the corner of nose and +upper lip. We had several physicians attending her, but they gave her +only temporary relief. We were advised by a friend who had used your +remedies to try them. After using thirteen bottles of Doctor Sage's +Catarrh Remedy, and at the same time two bottles of Doctor Pierce's +Golden Medical Discovery my daughter was completely cured of the dreaded +disease and in the past three years has had no symptoms of the disease +ever coming back. I am satisfied the above medicines will cure any kind +of catarrh. + + Yours truly, + JOSEPH POLLAK, + McPherson, McPherson Co., Kan. + + +CHRONIC NASAL CATARRH + +RESULTED IN LUNG DISEASE. DESPAIRED OF OBTAINING RELIEF. + +DR. R.V. PIERCE, 663 Main Street, Buffalo N.Y.: + +[Illustration: H.J. Converse, Esq.] + +_Dear Sir_--Without solicitation from you, I feel it my duty to +suffering humanity, to make known the virtues of your medicine in curing +catarrh. About ten years ago, I first began to realize that I was the +victim of nasal catarrh; I tried every known remedy, but gradually grew +worse. My ears would gather and break; nights of restlessness would +succeed days of agony. The disease finally attacked my left lung, and I +despaired of obtaining relief. About six years since I began the use of +Dr. Sage's Catarrh Remedy, in connection with the "Golden Medical +Discovery," and by the persistent use of the above remedies I feel that +I am completely cured of this loathsome disease. + +For attacks of biliousness, coughs and colds, I think there is nothing +equal to the "Discovery," and I bless the day that I first began the use +of your remedies. + + Very respectfully, + HOWARD J. CONVERSE, + Civil Engineer, + Plain City, Madison Co., Ohio. + + +A TERRIBLE CASE OF CATARRH. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Lansing.] + +_Gentlemen_--I suffered for two years with catarrh in the head, having +very severe pains in the top of my head. A hunch came on the side and +back of my head--my whole head and face were so sore and sensitive that +a pillow of down felt hard, and I was obliged to change my position +often. I could not breathe through my nose at all and was obliged to +keep my bed fully one half of the time, and could not collect my +thoughts to think steadily on any subject--I was really afraid of losing +my reason. I got all run-down and was "out of sorts" in general; then I +commenced using Dr. Sage's Catarrh Remedy and Dr. Pierce's Golden +Medical Discovery. To-day my health is good and I have no catarrh. + + Yours truly, + MRS. JAMES LANSING, + Fort Edward, Washington Co., N.Y. + + +CATARRH AND GENERAL DEBILITY. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Thos. Lewis, Esq.] + +_Gentlemen_--Being an invalid for many years and trying home physicians +without benefit, I went to the Invalids' Hotel and Surgical Institute, +and can most highly recommend this place to all sufferers. I had a +severe attack of catarrh and general debility, and after a short stay at +this Institute, my whole system was toned up and I was soon enjoying +perfect health. + +I can truthfully say that this institution fully merits all the praise +that could be given it. I never lose an opportunity to recommend all my +suffering friends to the Faculty of this Association, for I believe it +is in advance of its kind in the world. The physicians and surgeons are +skillful and of wide experience, the nurses kind and thoughtful, the +rooms large and pleasant, and everything is done to make the visit of +any one pleasant as well as beneficial in the highest degree. + +I do not hesitate to urge all invalids, no matter what their trouble, to +place themselves under the care of the eminent physicians of this +institution, being confident that they can give them all the relief that +possibly can be obtained from medical treatment and skill. + + Truly yours, + THOMAS LEWIS, + Kamas, Summit County, Utah. + + +CATARRH AND LIVER COMPLAINT. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Wm. King, Esq.] + +_Dear Sirs_--After suffering for several years with nasal catarrh and +liver complaint, and having become greatly reduced in health, as a last +resort I placed myself in your hands for treatment My improvement began +almost immediately after entering your institution. I was enabled to +leave at the end of one month, having experienced great benefit. The +treatment was continued at home for a few months, after which my cure +was complete. At the present time, I am able for office work, and feel +that I am completely cured of the catarrh and have but little if any +trouble with my liver. I shall lose no opportunity to recommend your +institution or your medicines to the afflicted. I do most unhesitatingly +recommend chronic sufferers to visit your institution or take your +remedies at home. + + Sincerely yours, + WILLIAM KING, + Rose Bud, + Pope Co., Ills. + + +CATARRH, BRONCHITIS, LIVER COMPLAINT AND DYSPEPSIA. + +Ely, White Pine Co., Nevada. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +_Gentlemen_--For ten years I was greatly afflicted with Catarrh, +Bronchitis, Liver Complaint, and Dyspepsia. I tried many doctors and +remedies to see if I could not obtain relief, but I grew constantly +worse instead of better. + +I heard much concerning the Invalids' Hotel and Surgical Institute at +Buffalo. I concluded to go there and try and obtain some benefit. I +staid a month in this famous Institution, and during that time made fine +improvement, and when I left felt like another man. + +I can truthfully recommend this world-renowned Institution to all the +afflicted. The Institution itself, in all its appointments, is far in +advance of the age. It is more like a home than a hospital; the rooms +are large and pleasant; the table the very best; the nurses kind and +considerate, and the doctors skillful and of wide experience. While +there I saw and talked with a great number of people who had come to +this Institution as a last resort, and they were all unanimous in their +praise. + +I cannot say too much in favor of the World's Dispensary Medical +Association and its Staff of skilled attendants, nor can I too strongly +urge all sufferers to go there, being confident that all within the +power of medical science and skill can be done for them there. Would +send you my photograph as requested, but there is not a photograph +gallery within a hundred miles of here. Yours truly, + +D.D. Phillips + + +BRONCHITIS; CATARRH. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.: + +[Illustration: Mrs. Osborne.] + +_Gentlemen_--I was troubled for several years with bronchial disease, +having a severe cough a good share of the time. Some of my friends +thought I had consumption; I got so weak I could scarcely walk across +the floor, and raised a good deal. I commenced taking Dr. Pierce's +Golden Medical Discovery and my cough soon got better, and I have not +been troubled with it since. That was four years ago; I took only three +bottles. I would recommend it to all having throat or lung trouble. I +have also used Dr. Sage's Catarrh Remedy with equally good results. I +believe that no one need suffer long with chronic catarrh who is within +reach of this remedy. + + Yours respectfully, + MRS. LENA OSBORNE, + Ripley, Chautauqua Co., N.Y. + + +NASAL CATARRH, LUNG DISEASE, INDIGESTION, ETC. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: H.A. Milne, Esq.] + +_Gentlemen_--Five years since my family physician pronounced my case +Pulmonary Consumption. Since that time I nave taken various treatments, +some of which have given relief. One treatment that was administered for +nasal catarrh, from which I continued to be affected, caused erosion of +the mucous membrane, and destruction of the bony septum which separates +the two nostrils. Took cold quite easily, suffered from considerable +nasal catarrh, with discharges passing posteriorly dropping into the +throat; occasional cough with some shortness of breath on exertion. A +deep inspiration caused a dizzy sensation in the head; eyesight was +impaired as well as the memory. After sitting for a time, and then +quickly rising I suffered from blindness as well as a dizzy feeling in +the head. I never felt that I was entirely cured of my lung trouble, +having many of the symptoms which are common to those in the incipient +stage of consumption. I also suffered from indigestion, torpidity of the +liver, and constipation of the bowels. + +Upon consulting at your Institution, was advised at once to begin the +course of specially prepared medicines as indicated in my case. In all, +I have only taken two months' special treatment, and it has now been six +months since I have required any medicine; all symptoms of disease have +entirely disappeared, and I desire to thank you for the interest you +have taken in my case, and the treatment prescribed. I have no objection +to your publishing my testimony, if by so doing others may be induced to +place themselves under your care for treatment at your Institution, or +have medicines sent to their homes. + + Respectfully yours, H.A. MILNE, + Mekinock, Grand Forks Co., North Dakota. + + +CONSUMPTION. + +Ashland, Middlesex Co., Mass., (Box 171). + +DR. E.V. PIERCE, Buffalo, N.Y.: + +_Dear Sir_--It is now eight years since I took Dr. Pierce's Golden +Medical Discovery. I had a very bad cough, also night-sweats, and was +almost in my grave, as we thought, with consumption, when a friend of +mine who died with consumption came to me in a dream and told me to take +Dr. Pierce's Golden Medical Discovery, and, thank the Lord, I did so. By +the time I had taken half of the first bottle I felt so much better, I +kept on till I had taken three bottles, that was all I needed. I got +well and strong again. + + Sincerely yours, + Clura McIntyre + + +CHRONIC NASAL CATARRH. + +DR. R.V. PIERCE, NO. 663 Main St., Buffalo, N.Y.: + +[Illustration: Mrs. Flemming.] + +_Dear Sir_--I had been troubled with chronic nasal catarrh for a year; +could not sleep at night or rest in the day, because I could not breathe +through my nose. I tried everything I was told of, and all failed to +cure. I read about Dr. Pierce's remedies and thought I would try them. I +used three bottles of Dr. Pierce's Golden Medical Discovery, four of Dr. +Sage's Catarrh Remedy, and I was relieved within two weeks. I continued +these medicines for four weeks, and am perfectly cured. I would advise +any one who is troubled with catarrh to use Dr. Pierce's medicines. I am +very thankful for the remedies." + + Yours respectfully, + MRS. M. FLEMMING, + 698 17th Ave., Milwaukee, Wis. + + +NASAL CATARRH AND DYSPEPSIA. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Nuckolls.] + +_Gentlemen_--Twenty years ago I was nearly dead with nasal catarrh. I +had it several years before I knew what it was, then I read Dr. Pierce's +description of catarrh. I felt as he described. No one else had ever +been able to tell me anything of the symptoms he described. I simply +concluded that if he could so minutely describe, he could also relieve, +and I immediately placed myself under his treatment--by correspondence. +In a few months I was entirely relieved and have not suffered from it +since. + +At the time I placed myself under his care I could not breathe with my +mouth closed. My friends thought I could live only a few months more. I +have had no return of catarrh and enjoy good health. I believe Dr. +Pierce's treatment will cure any case of catarrh. + +Nine years ago I was under Dr. Pierce's treatment (by correspondence) +for dyspepsia. After a few months' treatment I was entirely cured of +that terrible disease. + + Yours respectfully, + MRS. HENRY NUCKOLLS, + Rockville, Hanover County, Va. + + +CATARRH OF TWENTY YEARS' STANDING. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: J. Weaver, Esq.] + +_Gentlemen_--My catarrh was of about twenty years' standing; my left +nostril closed, I could not breathe through it; had a constant pain +above my left eye night and day. I commenced using Dr. Sage's Catarrh +Remedy, at the same time using the "Golden Medical Discovery"; I used +one package and one bottle of "Golden Medical Discovery" and I found +great relief; after using the second I thought all was right, but I +began to feel the effects of it again, so I got the third and fourth +packages, and I am satisfied I am rid of it. Since I commenced using +your medicines, I have taken six bottles of Dr. Pierce's Golden Medical +Discovery. + + Yours respectfully, JOHN WEAVER, + West Carrollton, + Montgomery Co., Ohio. + + +CHRONIC NASAL CATARRH CAUSES GREAT SUFFERING. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Crocker.] + +_Gentlemen_--I had been a great sufferer from nasal catarrh for a number +of years which greatly debilitated my system, and in consequence, have +been in poor health for the last five years. + +Slight exposure would cause bronchial trouble, but kept up under it +until a little more than two years ago when I was taken with "La +Grippe," which greatly aggravated my other troubles; and for more than +six months before consulting you was scarcely able to do anything; +_could not breathe through my nostrils_ only a little while at a time +either day or night; I suffered _dreadfully_, having at times _terrible +pains in my head_ being unable to sleep some nights more than two hours +and then not without dreaming, and when I awoke my head felt worse then +when I retired. Had indigestion, chronic constipation and stomach +trouble. + +A little more than a year ago, while reading in one of your Memorandum +Books I decided to try your Dr. Pierce's Golden Medical Discovery, +"Favorite Prescription" and "Pellets;" and after using several bottles, +I began to get better and to get some strength, but my catarrh remained +about the same until I consulted you by letter and the remedy prescribed +proved effectual; after three months' treatment, I am able to do most of +my house work. + + Yours respectfully, MRS. SARA M. CROCKER. + P.O. Box 332. Niantic, New London Co., Ct. + + +CHRONIC NASAL CATARRH. + +THOUGHT HIS CASE HOPELESS--TWO BOTTLES CURE. + +WORLD'S DISPENSARY-MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: A.G. Meise, Esq. ] + +It gives me great pleasure to testify to the merits of Dr. Sage's +Catarrh Remedy. I can say honestly and candidly that it is the grandest +medicine ever compounded for catarrh. I suffered terribly with that +dreadful disease and thought my case a hopeless one. I have expended on +my case about forty dollars for different remedies guaranteed to cure +catarrh in its worst form, but received no benefit therefrom. I also +received treatment from two physicians, but they did me no good. Having +read a great deal about Dr. Sage's Catarrh Remedy, I concluded to try +it. The first bottle gave the most pleasing results, and the second +bottle completely cured my case, which I considered hopeless. I most +heartily recommend Dr. Sage's Catarrh Remedy to all suffering from +catarrh, with the assurance that it will surely cure. It is a great boon +to suffering humanity. Hoping that this humble testimony may be the +means of leading many sufferers to try your most valuable medicine with +the same happy results as I experienced, and wishing you the best of +success, I am, + + Yours sincerely, AUGUST G. MEISE, + Vincennes, Ind. + + +NASAL CATARRH. + +Naples, Uinta Co., Utah. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +_Gentlemen_--I have been using Dr. Sage's Catarrh Remedy and have been +taking "Golden Medical Discovery" since I last wrote to you. I am well +pleased with the result. I feel better than I have for years. The +"Golden Medical Discovery" caused a very unpleasant sensation to pass +through my body at first but I do not feel it much now. I have +recommended it to others and the only complaint I hear now is that our +druggist cannot keep a supply on hand. + +I take pleasure in reporting my case to you, and I feel that the +interest you have taken in my case has been a blessing unto me. + +My mother has suffered with bad legs for over twenty years and last fall +they got so bad she was unable to walk. She has taken "Golden Medical +Discovery" all winter and is now able to walk a little. She says she +feels better in body than she has for years. She has spent the most of +her life among the sick and speaks very highly of your medicines. + + Yours truly, + Geo A. Slough + + +IMPURE BLOOD AND CATARRH. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.: + +[Illustration: Rev. J.H. Tate. ] + +_Gentlemen_--My health is better now than it has been in ten years. I +used six bottles of "Golden Medical Discovery," and three bottles Doctor +Sage's Catarrh Remedy, and since using your medicines I have been able +to do more work than before. I have been teaching school since my health +got better and last year I was able to travel and preach fifty-nine +sermons, besides my work of teaching. + +For four years I suffered with catarrh in my head, and impure blood, +until my health was very feeble. Dr. Pierce's Golden Medical Discovery I +found to be the best blood-purifier I ever used. Had I not used your +remedies I believe that I would have been dead to-day, or at least not +able to say anything. But instead of that I am able to walk one and +one-half miles and teach school every day. + + Yours truly, + REV. J.H. TATE, + Wahoo, Sullivan Co., Tenn. + + +CATARRH AND DYSPEPSIA + +CURED BY SPECIAL HOME-TREATMENT. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: B. Eberhardt, Esq.] + +_Gentlemen_--I am happy to inform you that my catarrh and dyspeptic +symptoms have all vanished. I am no longer troubled with headache and +stoppage of the nose, my stomach is in good order, and I enjoy three +hearty meals daily without any bad feelings. + +I have gained in almost every respect, particularly in weight and +strength, since beginning the use of your specially prepared medicines. +By continuing to follow your special hygienic rules, I believe no +relapse will occur. + + Yours respectfully, + BERTHOLD EBERHARDT, + N.E. Cor. 10th and Callowhill Streets, + Philadelphia, Pa. + + +NASAL CATARRH. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: M.D. Ingram, Esq. ] + +_Gentlemen_--I have used your Dr. Sage's Catarrh Remedy and Dr. R.V. +Pierce's Golden Medical Discovery and they cured me of a severe Catarrh +in the Head. I can honestly recommend them to all who may suffer from +that distressing disease. + + Yours truly. + M.D. INGRAM, + Ingram, Bell Co., Ky. + +Mr. Ingram had suffered for many years from the most distressing +symptoms, such as profuse offensive discharge from nose, stopping up of +nose, sneezing, weak eyes and frequent headache. + + +CHRONIC NASAL CATARRH AND LUNG DISEASE. + +Marlow, Baldwin Co., Ala. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +_Gentlemen_--I had catarrh in the head for years, and trouble with my +left lung at the same time. You put so much faith in your remedies that +I concluded to try one bottle or two, and I derived much benefit +therefrom. I used up three bottles of Dr. Sage's Catarrh Remedy, five +bottles of your "Golden Medical Discovery," and in four months I was +myself again. I could not sleep on my left side, and now I can sleep and +eat heartily. So long as I have your medicines on hand I have no need of +a doctor; I do not think my house in order without them. + + Yours truly, + A.H. Heard + + +A DEBT OF GRATITUDE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Prof. W. Hausner, Famous Mesmerist.] + +_Gentlemen_--Some ten years ago I suffered untold agony from chronic +nasal catarrh. My family physician gave me up as incurable, and said I +must die. At this time I weighed 110 pounds. My case was such a bad one, +that every day, towards sunset, my voice would become so hoarse I could +barely speak above a whisper. In the morning my coughing and clearing of +my throat would almost strangle me. By the use of Dr. Sage's Catarrh +Remedy in three months I was a well man; the cure has been permanent, +and I now weigh 148 pounds. + + Yours truly, PROF. W. HAUSNER, + Ithaca, Tompkins Co., N.Y. + + +CATARRH, DEAFNESS AND OTHER COMPLICATIONS. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: M.C. Weaver, Esq.] + +_Gentlemen_--I take pleasure in announcing to you that I have been +greatly benefited by your medicines; my trouble began with nasal catarrh +and extended to my throat and ears; my bowels were inactive and my +general health became impaired; my worst trouble, however, was dullness +of hearing. I had an uncomfortable, bad feeling in my ears--akin to +earache; I had a watery discharge from the nose; I had to hawk and spit +a great deal at times; my mind was greatly affected also and had a great +deal of pain in the head. Upon advice of friends to try your medicines I +resolved to do so. Have used six bottles of your "Golden Medical +Discovery" and two bottles of Sage's Catarrh Remedy. The pain in my head +is gone and my health is greatly improved and am working every day, +something I could not do before. My appetite is good. + + Yours truly, + MORRIS C. WEAVER, + No. 171 E. Genesee St., Buffalo, N.Y. + + +BRONCHIAL DISEASE. + +Clifford, Susquehanna Co., Penna. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +_Gentlemen_--The doctors said I had bronchitis, and I doctored with five +different physicians before taking your medicines. My throat would bleed +from three to five times a day--half a dozen mouthfuls perhaps--as fresh +as if you had cut your finger, and I was in a generally weakened state +although able to be about the house, but the least exertion would make +me tremble. Finally I purchased one of Dr. Pierce's Common Sense Medical +Advisers, and read it a good deal, and so was induced to take your +medicines. I took in all seven bottles of the "Golden Medical +Discovery," one of the "Favorite Prescription," and one bottle of Dr. +Sage's Catarrh Remedy, and some of the "Pellets," and they did +everything for me--more than anything else I ever tried. In about six +months' time I was well. Now, my throat does not trouble me unless I +take cold. It has been about six years since I took your medicines, and +I think they cured me. + +I think there are no medicines equal to your medicines, and would +recommend them to all suffering ones. + + Yours truly, + Mrs. Lewis Johnson + + +CATARRH. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: D. Miner, Esq.] + +_Gentlemen_--I had the catarrh in the head for about fifteen years; my +head was always stopped up and I had pains almost constantly. My nose +would run, and stuff would fall into my throat whenever I would lie +down, and at other times it seemed dry and crusty, and then my head +would become stopped up and I would suffer again. + +I used cubebs and glycerine for a long time; they only relieved me while +I was using them. I used several other kinds of stuff, but I received no +benefit from them. I had nearly given up in despair. At last I came +across one of your advertisements of Dr. Sage's Catarrh Remedy in one of +your Memorandum Books, and I thought I would try it. It is the grandest +thing on earth. I was thankful to God I found something at last to stop +my suffering. May God bless you, dear friends, for saving my life. + +I used your medicine about eight weeks: it only took two bottles to cure +me sound and well after all the rest had failed. + + Yours truly, + DAVID MINER, + Bridgeport, Marion Co., Ind. + + +CHRONIC NASAL CATARRH. + +HALF A DOZEN BOTTLES OF DR. SAGE'S CATARRH REMEDY WITH DR. PIERCE'S +GOLDEN MEDICAL DISCOVERY CURES PERMANENTLY A BAD CASE OF CHRONIC NASAL +CATARRH. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, NO. 663 Main St., Buffalo, N.Y.: + +[Illustration: N.M. Hodges.] + +_Gentlemen_--I was suffering from chronic catarrh, and bought a +half-dozen bottles of your Dr. Sage's Catarrh Remedy, also some of Dr. +Pierce's Golden Medical Discovery to purify my blood and I am happy to +say I am permanently cured of that disease. + +Years after this letter was written Mr. Hodges informs us that his cure +has remained permanent. + + Yours truly, + N.M. HODGES, + Laketown, Rich Co., Utah. + + +CHRONIC NASAL CATARRH. STARTED WITH LA GRIPPE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: E.W. Thomas, Esq.] + +_Gentlemen_--I think it is time I reported my case to you, as it is five +months since I began using your medicines. I have taken five bottles of +Dr. Sage's Catarrh Remedy, and used it with Dr. Pierce's Golden Medical +Discovery. I have no signs of catarrh now, and can say I never felt +better in my life, then while taking your medicine. Two years later Mr. +Thomas says: I nave not been troubled with catarrh since taking the +"Catarrh Remedy." I am a tenor singer and my voice almost left me when I +had the catarrh but now my voice has come back. Yours respectfully, + + E.W. THOMAS, + Box 18, Garden City, Miss. + + +CATARRH AND OTHER COMPLICATIONS. + +North Berne, Fairfield Co., Ohio. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +_Gentlemen_--My health is good. I am restored from weak eyes, weak +stomach, catarrh, also female trouble. I took two bottles of Dr. +Pierce's Golden Medical Discovery, one bottle of Dr. Sage's Catarrh +Remedy. It took wonderful effect. I have recommended your medicines a +great deal, and have done a great deal of work for you. I have been the +cause of selling quite a quantity of medicine in this county, and I will +do all I can for you. + + Yours truly, + Sarah Campfield + + +CATARRH OF EIGHT YEARS' STANDING. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: E.M. Baily, Esq.] + +_Gentlemen_--I write this to let you know that I am well of that disease +called catarrh of the head. Three years ago this fall I had catarrh in +its worst form, till from three gills to one and one-half pints of +corruption would be expectorated in twenty-four hours. + +Then I noticed your advertisement. Six months after taking your +medicines I thought it too soon to tell you, but I can now say that my +money was well spent in buying your medicine, for it resulted in a +permanent cure. The catarrh was of eight years' standing. + + Yours respectfully, + EDWARD M. BAILEY, + Taggart, Harrison Co., Mo. + + +DREADFUL COUGH. ABSCESS OF LUNG. + +Brookeland, Sabine Co., Texas. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: F. Berryman, Jr.] + +_Gentlemen_--Seven years ago I was on the verge of the grave, with what +the physician pronounced an abscess of the right lung. It lingered on +for three years. During that time my side discharged large quantities of +pus and I had a dreadful cough. I was so weak that I could not walk +fifty yards without being completely exhausted. I had taken every kind +of medicine that was recommended for similar maladies, such as cod liver +oil, sarsaparillas, iron tonic and syrup of hypophosphites, without any +relief. I was about discouraged when I commenced taking Dr. Pierce's +Golden Medical Discovery. I took six bottles and it completely restored +me to health. The discharge stopped from my side, and the cough has +ceased. I am now able to follow my profession, which is a teacher of +penmanship. I can walk ten miles any day without the least worry. If any +one doubts this statement they can write me and I will verify the above +statement. + +Trusting that this may be the means of assisting some one else who is +suffering untold miseries, as I did before using the "G.M.D." + + I am, fraternally thine, + F. Berryman, Jr. + + +CATARRHAL DEAFNESS. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: S.P. Gray, Esq.] + +_Gentlemen_--I was nearly deaf on the right side of my head. I used +three or four bottles of Dr. Pierce's Golden Medical Discovery and four +bottles of Dr. Sage's Catarrh Remedy with the Nasal Douche, in the first +trial. Cold weather coming on I had to stop, as I could not use the +Injector in freezing weather, but I was greatly benefited. Along towards +spring I found it was coming back, from taking cold, and, after several +trials of other remedies, I again began the use of your medicines, +taking two bottles of the "Golden Medical Discovery" and three bottles +of Dr. Sage's Catarrh Remedy, and I feel safe in believing I am cured as +I feel no signs of its return. My health is very good for a man of 74 +years of age and I am satisfied that Dr. Pierce's Medicines did it. I +recommend them whenever I have a chance. + + Yours respectfully, + S.P. GRAY, + Graham, Nodaway Co., Mo. + + +BRONCHITIS. LIVER COMPLAINT. + +318 E. 83rd St., New York City, N.Y. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +_Gentlemen_--I am extremely sorry not to have informed you sooner of the +magnificent result I obtained from your most valuable medicines. When, +sometime ago, I consulted you in regard to my affliction, bronchitis, I +was indeed fearing the worst. But I had so much confidence in your +medicines, which I had previously used for colds and liver complaint +with good results, that I strictly followed your kind advice and +continued taking it until I was assured of perfect health. I took five +bottles of your Dr. Pierce's Golden Medical Discovery, using the +"Pellets" combined as directed, and _the effect was magical_. I am now +healthy and hearty. Heartily thanking you for your kind advice and +assistance, I remain, gentlemen. + + Yours most respectfully, + Paolo Bedesing + + +LINGERING COUGH. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y. + +_Gentlemen_--I contracted a cough during the winter of 1889 and tried +many different kinds of cough medicines, but none did me any good. I at +last became alarmed, and wrote to Dr. R.V. Pierce to know if he could +prepare a medicine that would cure me, and I was advised to try his +"Golden Medical Discovery," which I did, and am glad to say that only +two bottles cured me after letting the cough run on from the winter of +1889 until the spring of 1893. + + Yours respectfully, + MORGAN. C. LILLY, + Holston, Washington Co., Va. + + +NERVOUS DEBILITY AND CATARRH. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Hoffman.] + +_Gentlemen_--I have enjoyed good health since I took your treatment. I +suffered intense agony for five months, and after taking one month's +medicine I found very much relief--so much I was surprised. + +Many thanks for the good your medicines have done me, and my prayers are +that God may help you in your good work, and that you may live long and +prosper. + + Yours respectfully, + MRS. ALICE HOFFMAN, + Box 183, Clarksville, Butler Co., Iowa. + + +NERVOUS DEBILITY AND CATARRH. + +Big Piney, Pulaski Co., Mo. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +_Gentlemen_--I was treated by you eleven years ago for nervous debility +and chronic catarrh of eight years' standing and of a very aggravated +nature. I was considered near my grave by many of my friends when I +commenced treatment. + +I used eight months' special treatment, after while I used some 12 or 15 +bottles of your Sage's Catarrh Remedy, and have had excellent health +ever since. + + Yours truly, + B.P. Dake. + + +CURE OF DEAFNESS DUE TO CATARRH. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: T.J. Williams, Esq.] + +_Gentlemen_--For several years I was troubled with catarrh and deafness +of the right ear--the hearing becoming more and more defective until I +could scarcely hear at all. There was a constant ringing, roaring noise +in my ear, and finally the disease assumed a very painful form. + +The ear became very sensitive to the touch, and the pain and +inflammation extended into the eustachian tube and down into the throat. +I could scarcely sleep at night, and during the day I suffered +constantly. + +I finally decided to consult Dr. Pierce, and acting under his advice, I +began the use of "Golden Medical Discovery" and Sage's Catarrh Remedy by +means of Dr. Pierce's Nasal Douche. + +I soon began to improve and after using three bottles each of the above +named remedies the pain and soreness left my ear, my hearing returned +and I considered myself completely cured, and indeed there has been no +recurrence of the trouble since. + + Sincerely yours, T.J. WILLIAMS, + Byrneville, Harrison Co., Ind. + + +ASTHMA AND CATARRH. + +[Illustration: G. Berner, Esq.] + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +_Gentlemen_--For some months I suffered from a shortness of breath and +dryness in the throat which usually came on at night, and these symptoms +gradually became aggravated until it was impossible for me to procure +enough sleep so that I could perform my daily duties about the farm. +Deriving no relief from such treatment as I was taking I came to your +Institution, was examined by your specialist, who pronounced my case +asthma, complicated with nasal catarrh. After using the special +medicines which he prepared for me for a few days I commenced to feel +better, the shortness of breath gradually disappearing; the paroxysms of +asthma were less frequent and not so severe. + +After taking only two months' treatment I was completely restored to my +previous good health, and for five months it has not been necessary for +me to use any medicine, and I feel that I am perfectly well. I give you +this testimonial in order that others who are similarly afflicted may +know of your skill in treating cases of this nature, and seek relief +from your Institution. + + Respectfully, + GOTTLIEB BERNER, + Cheektowaga, Erie Co., N.Y. + + +ASTHMA COMPLICATED WITH BRONCHITIS. + +[Illustration: T.E. Stanton, Esq.] + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +_Gentlemen_--It is five weeks to-day since I was at your place for +medical treatment for a bronchial and asthmatic difficulty; it had got +so bad that it was hard work for me to breathe if I moved around any; I +have sat up many a night for when I laid down I could not get my breath. +I had six different doctors to aid me--all the good they did me was to +get my money. Can say, of a truth, that you have done mo more good than +all other doctors. One doctor said I would not live two years; that is +four years ago and I am yet alive. I am sure I am now on the safe road +to recovery with your treatment. + + Yours, etc., + T.E. STANTON, + Manlius, Onondaga Co., N.Y. + + +ASTHMA, OR PHTHISIC. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: A.F. Buttles.] + +_Gentlemen_--In gratitude to yourselves as well as to give my fellow +sufferers the benefit of my experience I wish to say, that immediately +after receiving your courteous reply to my letter, describing the +difficulty in breathing after any extra exertion, I began taking Dr. +Pierce's Golden Medical Discovery, and before I had finished the first +bottle I was greatly relieved. + +I have taken less than one-half dozen bottles, and although the disease +was of about three years' standing, I can now do as big a day's work as +any of my neighbors and as many of them, for all of which I am indebted +to the "Golden Medical Discovery." + + Yours respectfully, + AVERY F. BUTTLES. + Norden, Keyapaha County, Nebr. + + +NASAL POLYPI. + +WORLD'S DISPENSARY MEDICAL, ASSOCIATION, Buffalo, N.Y.: + +[Illustration: G.H. Bailey, Esq.] + +_Gentlemen_--It is with pleasure that I can testify to your skillful +operation in removing a number of nasal tumors. + +I had been a great sufferer from acute headaches, caused by the tumors, +for years. + +I cannot speak too highly of the benefit I received at your Institution +the two months I stayed with you. I feel sure of a permanent cure as I +do not have the headaches as formerly. + + Yours respectfully, + GEORGE H. BAILEY, + Hinsdale, Cheshire Co., N.H. + + +ASTHMA CURED. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Kyker.] + +Gentlemen--My wife was afflicted with asthma for twenty years: as she +grew older she grew worse. Her case was treated by three eminent +doctors, but all failed; they told me there was no cure for it. +Discouraged as I was, I resolved to try Dr. Pierce's Golden Medical +Discovery; she used five bottles and two vials of your "Pleasant +Pellets," which has made a permanent cure. She has gained twenty pounds +in weight since the cure was effected. + + Yours truly, + D.R. KYKER, + English, Cocke Co., Tenn. + + +COMPLICATION OF DISEASES. + +A GRATEFUL PATIENT'S WORDS OF PRAISE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main Street, Buffalo, N.Y. + +[Illustration: W. Henkel, Esq. ] + +_Gentlemen_--Having been in your Institution as a sufferer from two +distinct chronic diseases of years' standing, and having been placed +under the charge of your specialists, I was speedily relieved of my +afflictions. The Invalids' Hotel is a place as much like home as it is +possible for such an institution to be. The physicians and surgeons are +all expert specialists and thoroughly efficient; the nurses are very +competent, attentive and kind; and, in fact, the whole _personnel_ of +the Invalids' Hotel endeavor to do their best to make the patients feel +like being at home. I always felt while there as if I was one of the +family. I gladly recommend your Institution to all persons who are +afflicted with any kind of chronic disease, for from my own experience I +_know_ the professional staff will do all which they promise to do. +Please accept my thanks for the speedy benefits and perfect cure of my +diseases, and I think your Institution is worthy of the highest +endorsement. + + Yours truly, + WILLIAM HENKEL, + No. 1917 Congress Street, + St. Louis, Mo. + + +LUNG TROUBLE. + +WORLD'S DISPENSARY MEDICAL ASS'N, Buffalo, N.Y.: + +[Illustration: Mrs. Sunderland.] + +_Gentlemen_--When I commenced taking your medicines, eighteen months +ago, my health was completely broken down. At times I could not even +walk across the room, without pains in my chest. The doctor who attended +me said I had lung-trouble and that I would never be well again. At last +I concluded to try Dr. Pierce's medicines. I bought a bottle of "Golden +Medical Discovery," took it and soon commenced to feel a little better, +then you directed me to take both the "Golden Medical Discovery" and the +"Favorite Prescription," which I did. Altogether I have taken eighteen +bottles of "Golden Medical Discovery," twelve of the "Favorite +Prescription" and five vials of "Pellets." I am now almost entirely well +and do all my work without any pain whatever, and can _run_ with more +ease than I could formerly _walk_. + + Yours truly, + MRS. CORA L. SUNDERLAND, + Chaneyville, Calvert Co., Md. + + +ASTHMA, OR PHTHISIC. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Owen.] + +_Gentlemen_--For six or seven years I have been a great sufferer from +asthma, being for weeks so I had to sit in my chair night and day; and +to all people suffering with the disease, I am glad to recommend your +medicines of which I have taken only a few bottles. I now call myself +cured, for I have not had asthma for a long time. + + Yours respectfully, + MRS. EMILY OWEN, + Hinsdale, Cheshire Co., N.H. + + +NERVOUS PROSTRATION FOLLOWING GRIP. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: W.S. Nicholson, Esq.] + +_Gentlemen_--In January of '90 took the "grippe," went to work before I +was well, was caught in a rain which gave me a very bad relapse, +resulting in lung fever and complete prostration; was on my bed two +months, and when I did get out, the strength to walk any more than just +a few rods did not come back. My family doctor and two prominent +physicians of Sioux City, did me no good. Late in the fall I got a +bottle of Dr. Pierce's Golden Medical Discovery, which quieted my +trembling nerves and gave me an appetite to eat. I then concluded to try +the Doctor, personally. Up to this time I was in a pitiable condition. +Sometimes I could not sleep until I felt almost wild, then sleep so much +I would be stupefied. I could not digest any food and my whole system +was wasting and failing fast. I doubt if any one who saw me expected me +to get well. I took the treatment sent me by the World's Dispensary +Medical Association for more than a year. The medicine never gave me any +distress as other medicines had done before. I began to improve from the +start, but the change from one extreme to the other was like the growth +of a child. + +To any one suffering from nervous prostration I would say, "don't be +impatient." It takes a long time for weakened nerves to grow strong. I +have at last become strong and well, thanks to the Giver of all good and +the grand Institution at Buffalo. I nave since married a noble-hearted +young woman, and when I am playing with our sweet, healthy, baby girl, I +give way to the thought that at last the long, Bad chapter of my life is +ended; at such times her merry laugh sounds like a song of triumph of +life over death. + + Gratefully yours, + W.S. NICHOLSON, + Willow Creek, Clay Co., Iowa. + + * * * * * + + + + + +DISEASES OF THE HEART. + + +Diseases of the heart are classified as either _functional_ or _organic_ +We shall dwell only briefly upon purely _functional_ derangements of the +heart; as _increased_, or excited action, _defective_, or enfeebled +action, and _irregular_ action. + +Increased action of the heart, indicated by palpitation, or increased +number of the beats, may be caused _mechanically_, as by distention of +the stomach, which, by preventing the descent of the diaphragm, excites +the action of this organ. Or it may be a _sympathetic_ disturbance +produced through the nervous system; thus the emotions and passions may +suddenly arouse the heart to excessive action; or the presence of worms +in the intestines, improper food, and masturbation, may be the cause. +The use of tea, tobacco, and alcoholic drinks excites the heart. We have +found that the excessive use of tobacco is very frequently the cause of +functional derangement of this organ. Deficiency of the blood, as in +anæmia, may be the cause of palpitation of the heart. + +Functional disturbance of the heart's action is manifested by +palpitation, irregularity, intermissions, a rolling or tumbling +movement, and a feeling as if the heart were in the throat. These +symptoms often give rise to great apprehension, anxiety, fear, and +depression of mind. + +TREATMENT. The curative treatment of functional derangement of the heart +must have reference to the causes producing it. If it is in consequence +of indigestion, the appetite and digestion should be improved by +observing regularity in the time of taking the meals, and eating very +easily-digested food. The use of strong tea, coffee, tobacco, and +spirits, should be interdicted, and regular exercise, rest, and sleep +should be enjoined. + +In all cases, the domestic management should include daily bathing, +exercise in the open air, regular habits, and the avoidance of all +causes which tend to excite the heart's irregularity. + +_The remedial treatment_ of these functional affections ought to be +confided to some experienced physician, as the remedies are not within +the ordinary reach of all families, nor if they were, would they have +sufficient experience and knowledge to select and properly administer +them. + + +ORGANIC DISEASE OF THE HEART. + + +By organic disease we mean disease pertaining to the structure of the +heart itself, in contradistinction to _functional_ disease, which has +reference merely to the _action_ of the heart. The heart is subject to +various organic diseases, but we have only space to consider, in the +briefest manner, those which are the most common. It is essential that +the reader should have some knowledge of the anatomy and functions of +the various parts of the heart in order that its diseases and their +effects may be comprehended; therefore the anatomy and physiology of +this organ, given in Part I, Chapter VII, of this work, should be +carefully studied. + +It is very evident that any disease which affects the structure and +function of any part of the heart must, necessarily, give rise to +certain modifications of the pulse, sounds, etc. It is through the +observation and study of these modifications and changes that we arrive +at a correct diagnosis as to the precise location and character of the +disease. + +[Illustration: Fig. 1. +Pond's Sphygmograph.] + +Until within comparatively recent years, physicians were very much in +the dark regarding diseases of the heart. Now, however, with a thorough +knowledge of the anatomy, physiology, and pathology of the heart and the +parts surrounding it, and with the aid of instruments which modern +ingenuity has given us, we are able to diagnosticate with precision the +slightest lesions of any part of this important organ, and, knowing +their nature, to map out an appropriate course of treatment. With the +aid of the stethoscope, invented by Laennec and improved upon by Camman, +we are able to distinguish the slightest deviation from the normal +sounds, and, by noting the character of the sound, the time when it +occurs, the area over which It is heard most distinctly, and the +direction in which it is transmitted, to locate the lesion which +produces it. By the aid of the sphygmograph, first invented by +Herrisson, and afterward improved upon by Ludwig, Vierordt, Marey, and +lastly by Pond, of our own country, the pulsations at the wrist are +registered, and thus made perceptible to the eye. + +We herewith give a cut, Fig. 1, of Pond's instrument, and two tracings +made by it. The first is a healthy tracing, and the second indicates +enlargement, technically called hypertrophy, of the heart + +PERICARDITIS, or inflammation of the membranous sac which surrounds the +heart, may be either acute or chronic. The symptoms in acute +pericarditis are made up from co-existing affections, and are frequently +associated with articular rheumatism, Bright's disease of the kidneys, +or pleuritis The intensity of the pain varies in different individuals. +The action of the heart is increased, the pulse is quick, and vomiting +sometimes takes place. When this disease is developed in the course of +rheumatism, it is known as rheumatic pericarditis, and is almost always +associated with endocarditis. In some cases acute pericarditis is very +distressing, in others it is mild. The fatality is not due so much to +the disease itself, as to co-existing affections. When it does not prove +fatal, it sometimes becomes chronic. + +In chronic pericarditis, pain is seldom present. The heart is generally +more or less enlarged, its sounds are feeble, the first being weaker +than the second. + +ENDOCARDITIS, or inflammation of the membrane lining the cavities of the +heart, is one of the most frequent forms of heart disease. It is almost +invariably associated with acute rheumatism, or some of the eruptive +fevers, as small-pox, scarlet fever, etc., and is due to the irritation +of the unhealthy blood passing through the heart. The disease is +generally attended with little or no pain, and, consequently, if the +attending physician be not on the alert, it will escape his observation. +When associated with acute rheumatism, the disease is only in rare +instances directly fatal, but in the great majority of cases it leaves +permanent organic changes, which sooner or later develop into valvular +affections, and these may eventually destroy life. When the disease +occurs, however, as the result of pyæmia (blood-poisoning produced by +the absorption of decomposing pus or "matter") or of diphtheria, or when +it is associated with any other septic conditions, it constitutes a very +grave element. Collections of matter formed on the membrane lining the +heart and covering its valves, are liable to be detached and carried by +the circulation to the brain, spleen, or liver, where they plug up some +artery, and thus cause death of the parts which it supplies with blood. + +Chronic endocarditis generally occurs in rheumatic subjects, +unassociated with any acute disease, It may exist without any marked +symptoms, except, perhaps, a sense of oppression and uneasiness in the +chest, with palpitation. It produces a thickening and hardening of the +membrane lining the heart, and generally causes a retraction, adhesion, +and degeneration of some of the valves of the heart, thus bringing on +valvular disease. + +VALVULAR LESIONS are, as we have seen, very frequently the result of +endocarditis. They are of two kinds. First, those which prevent the +valves from flapping back close to the walls of the ventricles, or +arteries, thus diminishing, to a greater or lesser extent, the size of +the valvular orifices, and offering an obstruction to the free flow of +blood through them; and which consist of a thickening and retraction, or +adhesion of the valves, chalky deposits, morbid growths, etc. Secondly, +those which prevent complete closure of the valves, and thus permit a +return of the blood into the cavity from which it has just been +expelled. These latter consist of retractions, perforations, and partial +detachments of the valves, chalky deposits around the base of the valves +and in them, and rupture of the chordæ tendineæ. + +These two forms of lesions are usually co-existent, one generally being +more extensive than the other. Thus, the regurgitation may be slight, +and the obstruction great, or _vice versa_. The symptoms and disturbance +of the circulation are altogether dependent upon the location and form +of the lesion, or lesions. Each valvular lesion has its characteristic +sound, or murmur, which is heard at a particular period in the cycle of +the heart's action, and it is, as before stated, from these sounds, from +tracings of the pulse, and from the many other indications, that we +arrive at a diagnosis. Thus, in obstruction of the orifice at the +junction of the aorta with the left ventricle, one of the most frequent +of valvular lesions, a murmur, generally harsh in character, is heard +with the first sound of the heart, with greatest intensity directly over +the normal position or the aortic semilunar valves. This is conveyed +along the large arteries, and may be heard, less distinctly, over the +carotids. In the sphygmographic tracing, the line of ascent is less +abrupt than in the normal tracing (Fig. 2), and not nearly so high, and +it is rounded at the top. In aortic regurgitation, the line of ascent is +similar to that of the healthy tracing, but the line of descent is very +sudden. The left side of the heart is almost invariably the primary seat +of these affections, but in the latter stages of their course, the right +side also is liable to become involved, and, as a consequence, there +then exists great disturbance of the venous circulation, with a damming +back of the blood in the veins, and passive congestion of the liver, +kidneys and brain, followed by dropsy, albumen in the urine, etc. + +[Illustration: Fig. 2. +The above is a representation of a tracing of a healthy +pulse as made with the Sphygmograph.] + +HYPERTROPHY OF THE HEART consists of a thickening of the muscular walls +of this organ. It may be confined to one portion of the heart, or it may +affect the entire organ. The affection has been divided into the +following three forms: _Simple hypertrophy_, in which there is an +increase in the thickness of the walls of the heart, without any +augmentation in the capacity of the cavities, and which is usually the +result of chronic Bright's disease, or great intemperance; _eccentric +hypertrophy_, in which there is an increase in the thickness of the +walls of the heart, together with increase in the capacity of the +cavities, and which is generally the result of some valvular lesion; and +_concentric hypertrophy_, in which there is an increase in the thickness +of the walls of the heart, with a decrease in the capacity of the +cavities. Valvular lesions, obstructions in the large arteries, or, in +fact, any thing which calls upon the heart to constantly perform an +undue amount of labor must, necessarily, produce hypertrophy of its +muscular walls, just as the undue amount of labor which the blacksmith's +arm is called upon to perform produces hypertrophy of its muscles. With +this condition, the pulse is hard and incompressible, and the line of +ascent in the sphygmographic tracing (Fig. 3) is higher than in health. + +[Illustration: Fig. 3.] + +DILATATION OF THE HEART is a condition which is closely allied to +hypertrophy of the heart, and which consists of an increase in the +capacity of the cavities of the heart, with diminished contractile +power. In simple dilatation, there is an increase in the capacities of +the cavities, without any marked change in the walls of the organ. It is +usually the result of some disease which has produced great muscular +prostration, and which has interfered materially with nutrition. More +frequently, however, dilatation is the result of valvular lesions, and +is associated with hypertrophy, there being an increase in the thickness +of the walls with a diminution of the contractile power. The hypertrophy +from valvular lesions goes on increasing until it reaches a certain +stage, when dilatation commences, the two conditions then being +associated. + +ATROPHY of the heart is the opposite to hypertrophy, and signifies a +wasting away of the muscular substance, and a diminution in the +thickness of the walls of the heart. Its power is diminished in +proportion to the degree of atrophy. + +FATTY DEGENERATION of the heart consists in the deposition of particles +of fat within the _sarcolemma_ (the sheath which invests the fibrils), +which are substituted for the proper muscular tissue. If the fatty +degeneration exists to any extent the muscular walls present a yellowish +color, and the heart is soft and flabby. This may be confined to one +ventricle, or it may affect the inner layer of fibres, the outer layer +remaining unchanged. Degeneration of the left ventricle occasions +feebleness of the pulse. Difficulty in breathing is one symptom of this +disease, especially when the right ventricle is affected. There is +pallor, feeble circulation, cold extremities, and frequently dropsy. +Fatty degeneration is more liable to occur in corpulent persons, and +between the ages of forty and fifty years. + +ANGINA PECTORIS, also termed _neuralgia of the heart_, might be included +among the diseases of the nervous system, but as it is usually +associated with a derangement in the action of the heart, it may be +properly considered in this connection. The pain varies in intensity, +sometimes being very acute, at others assuming a milder form. The action +of the heart is more or less disturbed. The beats are irregular, at +times being strong, while again they are feeble. A feeling of numbness +is experienced in those parts to which the pain penetrates. These +paroxysms _usually_ continue but a few minutes, although they sometimes +last several hours. Persons suffering from angina pectoris are liable to +sudden death. It is connected with ossification, or other organic +changes of the heart. Usually these paroxysms, if the life of the +patient continues, become more and more frequent. The danger is not to +be measured by the intensity of the pain, but by the co-existing organic +disease. Although it is not absolutely certain that organic disease is +present in all cases of angina pectoris, yet the exceptions are so rare +that when the signs of organic disease cannot be detected, it may be +inferred that angina is not the real affection, or that the existing +lesions escape observation. Those who suffer from this disease are, in +the great majority of cases, of the male sex, and rarely under the age +of forty. + +TREATMENT. In the foregoing consideration of organic diseases of the +heart, we have omitted to speak of their remedial management, for the +obvious reason that unprofessional readers are unable to correctly +distinguish between the various diseases of this vital organ; and it +would, therefore, be useless for us to attempt to instruct them as to +the medicinal treatment of the different cardiac affections. + +In the vast majority of instances, diseases of the heart are not +necessarily speedily fatal. Persons have been known to live twenty years +or more with very extensive organic disease of this organ. + +It is _very important_, however, that a correct diagnosis be made in the +early stages of these diseases, in order that an appropriate course of +hygiene and treatment may be adopted, which will check their progress. +While we cannot cure extensive organic diseases of the heart, we _can_ +check their progress, and prolong life, and render the condition of the +subject comparatively comfortable. Since we are able to diagnosticate +with the utmost precision the various affections of the heart, and since +the discovery of certain specific medicines which exert most beneficial +effects, we are enabled to treat this class of maladies with the most +gratifying results. Thus we have seen a case in a very advanced stage of +the disease, with the breathing so difficult that the subject had been +compelled to remain almost constantly in the sitting posture, in the +greatest agony, for so long a time that immense bed sores had formed on +the seat; in which the dropsy had become so extensive that the skin of +the legs had burst open; and yet this patient, through the influence of +a specific course of treatment, was speedily relieved, and enabled to +live in a comparatively comfortable condition for many months. + +One afflicted with heart disease should abstain from the use of all +kinds of stimulants, tobacco, and whatever tends to lower vitality. His +life should be an even one, free from all excitement of any kind +whatsoever. He should avoid severe physical exertion, and everything +which causes the heart to beat with undue frequency. + +There are certain symptoms, the result of _chlorosis_ (the green +sickness), a deficiency of blood, dyspepsia, uterine disease, and +certain nervous affections, which may simulate those of real organic +disease, but the physician of education and experience, with a trained +ear, is able to detect the difference speedily. + + +SORE MOUTH. (STOMATITIS.) + + +Stomatitis, or inflammation of the mucous membrane of the mouth, may +include the entire surface of the gums, tongue, and cheeks, or appear +only in spots. Vesicles are formed, having swollen edges and a white or +yellow center, which finally ulcerate. When mild, the affection is +confined to these parts. + +If the inflammation is acute, the mouth is dry and parched, or as is +more frequently the case, the flow of saliva is abundant and acrid, and, +when swallowed, irritates the stomach and bowels, producing fever, +diarrhea, griping pains, and flatulency. The tongue is either coated +white or red, and is glossy, and the sense of taste is considerably +impaired. Digestion and nutrition are then disturbed, and the patient +becomes rapidly emaciated. + +THRUSH, OR CANKER, is that form of stomatitis in which white ulcers +locate on the inner side of the upper lip, the tongue, or roof of the +mouth; the irritation which they cause not only interferes with eating, +but produces fever, together with the symptoms previously mentioned. + +APTHÆ, or follicular inflammation, is distinguished by very painful +little ulcers, single or in clusters, scattered over the surface of the +tongue and lining of the mouth. Sometimes it is complicated with little +lumps in the tongue. These form ulcers and denote scrofulous +inflammation. Fissures and cracks in the tongue indicate derangement of +the stomach. + +THE CAUSES of stomatitis, in nursing infants, are unhealthy milk, or +effete matter, which, for lack of proper care and cleanliness, +accumulates upon the nipple. In older children, improper diet, +irritants, debility of the digestive functions, or hereditary syphilitic +taint, disorder the blood and induce local inflammation. + +TREATMENT. Locally, use a wash of golden seal or gold thread sweetened +with maple-sugar, and rendered slightly alkaline with borax or +saleratus. Also use a very weak, alkaline tea, or one of slippery-elm +flour, to obviate the acridity of the secretions. If the sores do not +heal, constitutional treatment may be required, as the use of the Golden +Medical Discovery. The family physician should be consulted if the sore +mouth resists all these remedial measures. + + +NURSING SORE MOUTH. (STOMATITIS MATERNA.) + + +During the period of nursing, and sometimes in the latter months of +pregnancy, women are liable to a peculiar variety of sore mouth. The +soreness is sometimes so great that, although the appetite may be +ravenous, the patient cannot eat. When this condition extends to the +stomach and bowels, symptoms of a very grave character appear, and the +disease, by interfering with the process of nutrition, causes emaciation +and debility, and in extreme cases, death. It is a strange affection, +nearly always disappearing upon weaning the child, though this course is +not absolutely necessary. It appears to depend upon a hepatic, or +gastric derangement, in connection with a vitiated condition of the +blood, but how this is brought about is unknown. + +SYMPTOMS. The disease sometimes comes on suddenly, at others more +slowly. The fact that the woman is either pregnant or nursing, is of +importance in forming a diagnosis. At first there is a severe, scalding +sensation of the tongue, mouth, and fauces, with pain, which is +sometimes intense. The color of the tongue is often pink, or a light +red, while the mouth is generally of a deeper hue. This stinging, biting +sensation is accompanied by a profuse, watery discharge from the mouth, +which seems extremely hot and acrid, causing excoriation whenever it +comes in contract with the face or chin. The appetite is good, sometimes +ravenous, but food or drinks, except of the blandest character, occasion +such intense pain that the patient avoids their use. Ulceration occurs +after a little time. The bowels are generally constipated, but when the +disease extends to the stomach or intestines, diarrhea occurs. There is +generally anæmia, debility, and impairment of the vital powers. + +TREATMENT. The indications for treatment in this affection are to +overcome the vitiated condition of the blood, and to sustain the vital +powers. The remedies for this purpose are alteratives, antiseptics, and +tonics. Give the Golden Medical Discovery, the value of which may be +greatly enhanced by adding one-half ounce of the fluid extract of +baptisia to each bottle, in doses of a teaspoonful four times a day. +Chlorate of potash, half an ounce in a pint of water, used as a wash and +gargle, is of great value. A teaspoonful of the same may be swallowed +several times a day. This will not interfere with other medicines. As a +tonic, the tincture of the muriate of iron, in five to ten-drop doses, +diluted with water, may be taken three or four times daily. Quinine, in +one or two-gram doses, should be given with the iron if the debility be +extreme. When there is great acidity of the stomach, which may be known +by heart burn, saleratus may be taken in water, to neutralize it, but +should not be drunk within an hour of the time for taking other +medicines. If constipation exists, use the Pleasant Pellets. This course +of treatment, thoroughly carried out, will seldom fail to effect a +perfect cure, without weaning the child, yet this latter course may +sometimes become advisable to promote the recovery of the patient. +Should the treatment advised not produce the desired result, a skillful +physician's services should be secured, as he may, in individual cases, +distinguish other important indications which may enable him to modify +the treatment to advantage. + + +DIARRHEA, CHOLERA INFANTUM, OR SUMMER COMPLAINT, AND DYSENTERY. + + +These diseases are usually considered separately by medical writers but, +as they are closely related, a simple diarrhea not unfrequently running +into a _cholera infantum_ or a dysentery, we shall consider them +together. + +DIARRHEA is an affection characterized by unnaturally frequent +evacuations from the bowels of a liquid of morbidly soft consistency. It +may be simple or inflammatory, and acute or chronic. + +A diarrhea is said to be bilious when the discharges are composed +principally of serum, highly colored with yellow or green bile; +catarrhal, when they are of a semi-transparent, mucous character; +serous, when the dejections are thin and watery, sometimes mixed with +blood, bile, or ingesta. + +The symptoms of the affection are usually at first those of indigestion, +a fullness of the stomach, flatulency, and colicky pains. The pains, +which precede each evacuation, are intermittent in character. There may +be an unpleasant sinking sensation in the abdomen, and, with the +discharge, exhaustion, a feeble pulse, and a cool skin. In the +inflammatory variety, there is more or less fever. + +CHOLERA INFANTUM, or summer complaint, is a disease peculiar to the warm +season, and more prevalent in cities, and among those children who do +not nurse at the breast. It is characterized by great irritability of +the stomach, and persistent vomiting and purging, the discharges from +the bowels being copious and watery, and sometimes containing specks of +curd, yellowish-green matter, and mucus. The limbs of the little +sufferer are usually drawn up, indicating pain in the bowels, and there +is great prostration with cold extremities. The invasion may be so +sudden, and the disease so violent as to destroy life in a few hours. + +DYSENTERY, also known as _bloody-flux,_ consists of an inflammation of +the mucous membrane of the large intestine, with ulceration of the +affected surfaces. The disease is accompanied with much nervous +prostration, and is distinguished by severe pains in the abdomen of a +griping nature, followed by frequent scanty and bloody stools, and much +straining. Occasionally the attack is ushered in with a chill and aching +pains in various parts of the body, with copious fecal dejections. In +other cases the attack is preceded by loss of appetite, a sense of +uneasiness with dull pains in the abdomen, and weariness. The disease, +like diarrhea, may be either acute or chronic. + +THE CAUSES of these affections of the bowels are many and varied. They +may be brought on by exposure to cold and wet, or by improper and +indigestible articles of food, such as unripe fruits, salads, pastries, +and, in fact, anything which interferes with the normal operations of +the digestive apparatus. One of the most fertile sources of diarrhea in +infants, and of _cholera infantum_, is the administration of unsuitable +food, the ill effects of which are greatly increased by exposure to heat +or cold. Uncleanliness, and the inhalation of impure air, are prolific +causes Of these diseases. Epidemics have been supposed to be due to some +peculiarity in the condition of the atmosphere, or to some impalpable +germ of a vegetable or animal nature. + +TREATMENT. In the treatment of these diseases, one should first endeavor +to ascertain the cause of the trouble, and then, if possible, effect its +removal. Attention should be given to the hygienic surroundings of the +individual afflicted; if he reside in a miasmatic district, or in a +location in which the atmosphere is contaminated by the decomposition of +animal or vegetable matter, or filled with noxious gases, his abode +should be changed. A pure, dry air is most beneficial in these cases. + +Only the least irritating and most easily digestible articles of food +should be taken. Healthy cow's milk is slightly alkaline, but that of +cows fed on slops is usually acid, and unfit for infants. It is, +therefore, well to test all milk with blue litmus paper before feeding +it to young children. If found to be strongly acid, that is if it turns +the paper red, it should be rejected, but if only slightly so, +sufficient lime water may be added to render it slightly alkaline. For +adults and older children, the diet should consist of such starchy foods +as arrow-root, sago, corn starch, and rice, and of ripe grapes, freed +from the skins and seeds, peaches, and boiled milk, or milk and lime +water. In some cases the animal broths are beneficial, especially mutton +broth. To quench the thirst, crust coffee, rice coffee, and lemonade, in +small quantities, may be taken. + +Rest is important in these diseases. In severe cases, the patient should +be kept in bed. + +At the onset of an attack of diarrhea or dysentery, if there be reason +to believe that the intestinal tract contains irritating matter, a dose +of castor oil, with a few drops of anise oil added to render it +palatable, should be administered. After all irritating ingesta have +been removed, Dr. Pierce's Compound Extract of Smart-weed should be +given in doses proportionate to the age of the patient, and the severity +of the case. Being composed of the extract of smart-weed, or water +pepper, Jamaica ginger, camphor, and genuine French grape brandy, it +exerts a most wonderful effect not only in those diseases but in cholera +morbus and intestinal colic. It allays the irritation and inflammation +of the affected mucous surfaces, and soothes the nervous system. In the +great majority of cases, the above course of treatment will be found +sufficient, but in the more severe forms of these diseases additional +remedies may be required. + +In dysentery, accompanied with severe pain and straining, injections of +starch water and laudanum, from two to four ounces of the former to from +twenty to fifty drops of the latter should be used. + +Hot fomentations applied to the abdomen are beneficial. If the +discharges contain much blood, a flannel cloth moistened with the +spirits of turpentine should be laid over the lower part of the abdomen, +and kept there until slight irritation is produced. + +Lime water, bicarbonate of soda, bicarbonate of potash (saleratus), +chalk, and the subnitrate of bismuth are valuable agents to correct the +secretions, and allay irritation of the diseased mucous surface. The +above-named preparations of soda, potash, and bismuth may be taken in +doses of from five to twenty grains every few hours. + +Blackberry root and cranesbill (_Geranium Maculatum_), in the form of +fluid extract or infusion, are beneficial in acute cases in which the +discharges are profuse and watery, and in the chronic forms of these +affections. + +In _cholera infantum_ subnitrate of bismuth should be given in doses of +from five to ten grains at intervals of from two to four hours. If the +discharges are very profuse, the fluid extract of cranesbill may be +administered in from two to ten-drop doses alternately with the bismuth. +The camphorated tincture of opium (paregoric) is required in doses of +from two to twenty drops, depending upon the age of the child and the +severity of the case, if there is much pain, but great caution should be +exercised in administering the preparations of opium to children. A +single drop of laudanum given to a young infant has caused convulsions, +coma, and death in more than one instance. To check the vomiting of +_cholera infantum_, mild irritation over the stomach is sometimes +effectual. For this purpose a weak mustard plaster, or a cloth moistened +with turpentine, may be laid over the stomach for a few minutes at a +time. If the child is old enough to suck pellets of ice, these are +beneficial, or a piece can be wrapped in a cloth and sucked. + + +COLIC. + + +_Colic_ is a term applied to griping pains in the abdomen, which are +sometimes accompanied with nausea and vomiting. The derangement is +recognized in several forms, some of which we shall briefly describe. + +BILIOUS COLIC. This may be the result of a morbid condition of the +liver. + +SYMPTOMS. It is characterized by severe pain occurring in paroxysms, +which may be relieved by pressure upon the bowels. The pulse is quick, +the tongue coated, and the skin harsh and dry; there is headache, +impaired appetite, acrid taste in the mouth, thirst, nausea, attended +with vomiting and general chilliness, followed by febrile symptoms. + +CAUSE. It may be induced by exposure to cold, in consequence of which +the circulation is impeded, the pores of the skin obstructed, and all of +the vitiated matters having to be expelled through the liver, stomach, +and intestines. It may also be due to malaria in the atmosphere. It most +commonly occurs during the autumn, after a season of hot weather. + +FLATULENT COLIC. Flatulent or "wind" colic is one of the results of +indigestion. + +SYMPTOMS. A sense of fullness in the pit of the stomach, attended with +pain, which is transferred from one part of the bowels to another. There +is fever, a quick pulse, nausea, and the presence of gas; by the latter +feature it may be detected from the other forms. + +CAUSES. Cold or atmospheric changes, the eating of unripe fruits, +uncooked vegetables and those articles of diet which ferment easily, are +the principle causes. + +PAINTER'S COLIC. This form is also known by various names, such as +_colica pictonum, saturnine_, or _lead colic_. Those persons who are +engaged in the manufacture of lead, and painters, are the most frequent +victims of this affection. + +SYMPTOMS. Impaired appetite, fetid breath, thickly coated tongue, +obstinate constipation, a dry skin, scanty urine, languor, severe pain +in the umbilical region, and general derangement of the functions of the +system. + +CAUSES. From the term applied to this form, the cause may be inferred. +It is induced by the absorption of lead through the lungs, stomach, and +skin. + +TREATMENT. The indication to be fulfilled in _bilious_ colic is to +relieve the intestinal spasm. This may be done by drinking freely of a +decoction of yam-root, or _dioscorea villosa_, which is an effectual +remedy in this affection. If this be not at hand, the spasm may be +relieved by administering freely of Dr. Pierce's Extract of Smart-Weed. +If the stomach be irritable, a tablespoonful of laudanum and one of +tincture of lobelia, in four ounces of starch water, administered as an +injection, is effectual. If simple means do not promptly arrest the +attack, no time should be lost in summoning the family physician. + +In _flatulent_ colic, the treatment should depend upon the cause. If it +be occasioned by cold, a teaspoonful or two of the Extract of +Smart-weed, in warm water or catnip tea, repeated a few times, will be +sufficient. If it result from overloading the stomach, a dose of the +Pleasant Pellets will answer the purpose. If the pain in the abdomen is +severe, apply hot fomentations. Assist the action of physic, by giving +an injection of senna and catnip tea, or if the stomach is very sour, +take internally some mild alkali, such as common saleratus. + +In _painters'_ colic, the following cathartic mixture is an effectual +remedy: sulphate of magnesia (epsom salts), twelve ounces; nitrate of +potassa (saltpeter), half an ounce; sulphuric acid, one drachm; boiling +water, one quart. Of this remedy give a teaspoonful every thirty minutes +or every hour, until the bowels move. An injection of some diaphoretic +tea, or of alum water, is a good remedy. Castor oil and molasses, +containing a teaspoonful of spirits of turpentine, will add to the +efficiency of an injection. If the colic be not promptly relieved, a +physician should be employed. To eliminate the lead from the system, and +thus prevent a return of the colic, or other injurious effects, two +drachms of iodide of potassium should be added to a bottle of the Golden +Medical Discovery, and a teaspoonful of this taken four times a day. + + +JAUNDICE. (ICTERUS.) + + +This affection is generally regarded as a symptom of disordered liver, +since it frequently occurs during the progress of diseases of that +organ. When the disease imparts a greenish tinge to the skin, it is +termed _green jaundice,_ and, when it imparts a blackish color, it is +known as _black jaundice._ Jaundice is undoubtedly due to the presence +of biliary elements in the blood. + +CAUSES. In consequence of the varied conditions from which it arises, +Professor Da Costa has aptly remarked: "With the _recognition_ of +jaundice, the difficulty in diagnosis may be said to begin." He +considers the causes of jaundice to be (1) diseases of the liver; (2) +disease or the bile ducts; (3) diseases remote from the liver, or +general disease leading to a disorder of that viscus; (4) certain causes +acting upon the blood. + +SYMPTOMS. It is characterized by a yellowish color of the skin and of +the white of the eyes. The skin is usually dry and harsh; if it be +moist, the linen will be tinged yellow from the perspiration. The tongue +is coated yellow, the mouth is dry, and the appetite impaired; there is +headache, nausea, and sometimes vomiting; there is pain in the abdomen +after eating, and in the region of the liver, and it is also felt in the +right shoulder, and between the shoulder-blades. In severe cases, there +is fever, accompanied with chills, despondency and loss of flesh. The +stools are generally of a light clay color, and very offensive; the +urine is thick and yellow. When the disease terminates fatally, there is +delirium followed by stupor. + +TREATMENT. The first step should be to eliminate from the system, as +speedily as possible, all noxious materials. For this purpose, the +spirit-vapor bath should be used. If the urine is scanty or voided with +difficulty, take acetate of potash or queen of the meadow. These may be +taken in connection with the Golden Medical Discovery and Purgative +Pellets, the efficacy of which has already been described in the +treatment of chronic inflammation of the liver. They are indeed valuable +agents in this disease, since they increase the action of all the +excretory glands, and rapidly remove those matters, which, if retained, +would poison the system. + +In some cases, acids are of great value; good hard cider or hydrochloric +acid and the acid bath are frequently valuable agents. + +In other cases the employment, both internally and externally, of +alkalies in addition to the Golden Medical Discovery answers the purpose +much better. + +Again, there are persons who, in addition to alteratives and baths, +require tonics. In the treatment or this affection, whatever may be the +nature of the case, the use of _alteratives_ must not be forgotten, for +_without_ them, the auxiliary treatment with acids, alkalies, and +tonics, will not produce the desired effect. + +The employment of drastic remedies is sometimes resorted to; but, +although they may give temporary relief, the patient soon relapses into +his former condition, while if the treatment above given be adopted, the +recovery will be permanent. + + +GALL-STONES. (BILIARY CALCULI.) + + +These are concretions found in the gall-bladder or bile duct, and vary +from the size of a pea to that of a hen's egg. There may be no +indication of their existence in the gall-bladder until they begin to +pass through the duct. + +CAUSES. The formation of gall-stones is undoubtedly due to an unhealthy +condition of the bile. Corpulent persons, and those indulging in +over-stimulating diet, or in the habitual use of fermented drinks, are +most liable to be troubled by them. + +SYMPTOMS. The patient is suddenly seized with excruciating pain in the +right side. After a time it subsides, but is again renewed with as great +severity as before. There is nausea, with vomiting, which is often +excessive and severe. The pulse is sometimes slower than is natural, the +extremities are cold, there is great exhaustion, together with +perspiration and spasmodic contraction of the abdominal muscles. As soon +as one stone has passed through the duct into the intestine, immediate +relief is experienced until another commences to pass, and the larger +the concretion, the greater is the pain. If the stools be washed, the +gall-stones may be seen floating on top of the water. + +TREATMENT. This consists chiefly in relieving the patient of pain and +vomiting during the passage of the gall-stones. Hot fomentations made +with stramonium leaves and lobelia, and applied over the painful parts, +are beneficial. Small doses of lobelia may be taken, but not in +sufficient quantities to produce vomiting. Doses of opium should also be +taken; this anodyne must, however, be used with care. Gelseminum is +often useful. Chloroform, ether, or the spirit vapor-bath generally +allays the pain. Carbonate of soda, dissolved in water, often relieves +the vomiting. + +These distressing symptoms are apt to recur until the removal of all the +gall-stones is effected. To aid in removing them, take the Golden +Medical Discovery rather freely for a day or two, and continue its use +with lobelia, in doses sufficiently large to produce nausea, but not +vomiting. From four to eight ounces of sweet oil may be given, and, if +the bowels do not respond within three hours, repeat the dose, and the +gall-stones will generally be evacuated. To prevent the formation of +these concretions take the Golden Medical Discovery, together with +alkaline drinks made with carbonate of soda. Tone and energy will +thereby be imparted to the liver, the free flow of bile will be insured +and the subsequent formation of gall-stones prevented. + + +INTESTINAL WORMS. + + +We have not the space to discuss the numerous theories which have been +offered to account for the presence of these parasites in the human +body. We shall enumerate the principal species, describe the symptoms +indicating their presence, and indicate the proper remedies. + +There are five species of intestinal worms, sufficiently common to merit +a description. + +(1.) The round worm, termed by naturalists, _ascaris lumbricoides_, +varies from six inches to a foot in length, and resembles the common +earth-worm. It infests the small intestines, and seldom migrates into +the stomach or large bowel. Instances are recorded, however, in which it +has crept upward in the esophagus, larynx, nostrils, and eustachian +tube; but their presence in these parts is of comparatively rare +occurrence, and is generally caused by some local irritation which +compels their migration. The fact that they have been found in the +peritoneal sac, gave rise to the opinion that they perforate the +intestine; but careful observations have proved that they can only +escape through openings made by ulcers. + +This species has been found in adults, but is more common in children +from three to twelve years of age. The number of this species existing +in a human body is variable. Sometimes only two or three are found. At +other times a hundred, and even twice that number, are voided in a few +days. + +(2.) The _ascaris vermicularis_, thread, pin, or seat-worm, is round, +very slender, and about half an inch in length. The habitation of this +species is the rectum, and they are often found matted together in the +excrement. They are very active, even after ejection, and have been +known to cause great local irritation by entering the vagina and +urethra. Their presence is an occasional cause of masturbation. It is +impossible to estimate the number of these parasites that may exist in +the human rectum. Great numbers, sometimes, are voided at a single +evacuation. + +(3.) The _tricocephalus dispar_ is a third variety of the round worm, +and is said to infest the bodies of almost every species of mammalia. As +its name indicates, the upper portion of its body is slender, hair-like, +and terminates at the lower extremity in a thick, spiral portion. It is +from one to two inches in length, and is found attached by its head to +the mucous membrane of the cæcum, and, in rare instances, in the colon +and small intestine. They are rarely numerous. + +_Tæceniæ_ or _tape-worms,_ are hermaphrodites, of a flat, ribbon-like +form, and are composed of numerous segments, each of which is provided +with a complete set of generative organs, and contains ova for the +production of thousands of individuals. Some authors have supposed that +each segment, or joint, is a distinct individual, but the existence of +one head for the whole precludes this theory. There are two species of +_tæniæ_ developed in the human intestine; the _tænia solium_ and the +_tænia lata_. + +(4.) The _tænia solium_ is the species commonly found in America and all +the countries of Europe, except France, Russia, and Switzerland. In +France, both species are found, but the tænia lata seems to be +indigenous to Russia and Switzerland. + +The _tænia solium_ varies in length from four or five to thirty, +thirty-five, or even forty feet. The head is hemispherical and armed +with a double row of twenty or thirty hooklets. The genital organs are +alternate and placed upon the outer edges of each segment. It inhabits +the small intestine, and is usually solitary. + +(5.) The _tænia lata_, or broad tape-worm, is distinguished by the +greater breadth of its segments, and the location of the genital organs, +which are found in the centre of each segment. Its small elongated head +is unarmed, and has a longitudinal fissure on each side. It usually +attains a greater length than the _tænia solium_. + +SYMPTOMS. The symptoms which the long worms occasion, are frequently +somewhat obscure. Thirst, irregular appetite, colicky pains, excessive +flow of saliva, enlargement of the abdomen, itching of the nose, pallor +of the face, offensive breath, disturbed sleep, and grinding of the +teeth, all are common symptoms. Occasionally, convulsions and other +nervous affections are produced by the presence of the _ascaris +lumbricoides,_ but generally they produce less constitutional +disturbance than the other varieties. The passage of this species of +worms from the bowels, or their ejection from the stomach, is the only +positive evidence of their presence. The _ascaris vermicularis_, thread, +pin, or seat-worm, gives rise to most of the symptoms produced by the +long worms, but in addition produces intense itching at the anus, and, +not unfrequently, an eruption upon that part. The itching is +particularly distressing at night. When the little sufferer is well +covered, the warmth occasioned by the bed-clothes causes these little +parasites to crawl out upon the anus, and produces such paroxysms of +itching and pain as to cause the child to kick the covering oft and lie +naked. The persistent manifestations of a disposition to lie naked, +should excite the parents' suspicions of seat-worms, and lead them to +investigate all the symptoms. By examining the child's stools the worms +may he found adhering to the feces, and they may also be seen on the +anus. Thousands of children suffer untold agony from these little +seat-worms, which are left unmolested to torment them, because the +parents are unfamiliar with the meaning of the symptoms manifested, and +therefore pay no heed to them. We have been thus particular in +describing the symptoms indicating the presence of these pestiferous +parasites, in order that they may be readily detected. + +_The Symptoms_ produced by the tape-worm are dizziness, ringing in the +ears, increased secretion of saliva, indigestion, ravenous appetite, +sharp abdominal pains, and emaciation. The only positive sign of the +presence of these parasites, is the passage of pieces of them in the +feces. The nervous and other symptoms produced by the ordinary long +worms are also caused by the tape-worm. + +CAUSES. Careful observations have proved that there are certain causes +which favor the generation or development of intestinal worms. Among +others, we may mention fatty or farinaceous articles of food, +gormandizing, constant exposure to a moist atmosphere, and sedentary +habits. + +It is now generally conceded that the development of tape-worms is due +to the swallowing of an egg or germ-cell, which is contained in many +kinds of animal food, and which the process of cooking has failed to +destroy. People living near low marshes, lakes, or the seacoast, are +liable to _tæniæ_. + +TREATMENT. The expulsion of the _ascaris lumbricoides_ may be very +easily and pleasantly effected. Santonin is an effectual remedy for this +variety of worms. For a child three years old, take santonin, six +grains; podophyllin, one grain; white sugar, thirty grains; mix, +triturate, and divide into twelve powders, and give one every three or +four hours, until they act upon the bowels; or take santonin, ten +grains; white sugar, twenty grains; mix, triturate, and divide into ten +powders, and give one every night at bed-time, and after giving two or +three in this way, administer a mild cathartic. As santonin is almost +entirely tasteless, if not combined with other medicines which are +unpalatable, no difficulty will be experienced in administering it to +children. By reference to the article on anthelmintics in this volume, +other valuable vermifuges may be selected, and directions found for +their employment. + +In the removal of thread or pin-worms, anthelmintic medicines taken into +the stomach are of little or no value. An injection of a strong solution +of salt, is a very efficient remedy. A teaspoonful of turpentine in half +a pint of milk makes a good injection. Strong coffee has been +recommended as an injection. The anus should be well anointed with +vaseline, lard, oil, or fresh butter, after each movement of the bowels. +Whatever injection or remedy is used, it should be followed by the +application of some ointment to the anus, otherwise they will continue +to deposit their eggs about that orifice and multiply there. + +Various remedies have been used to destroy tape-worms. Among others we +may mention the old and time-honored remedy, which consists of two or +three ounces of the oil of turpentine, taken in castor oil or some +aromatic tincture. + +A decoction made by boiling two or three ounces of freshly powdered +pomegranate bark in a pint of water was used by the ancients, and is now +highly recommended as a remedy. + +Some American physicians have used an emulsion of pumpkin seeds with +marked success. + +Twenty or thirty grains of the extract of male fern, followed by a +cathartic is highly recommended for the destruction and removal of +tæniæ. + + +TRICHINA SPIRALIS. + + +In 1835, Owen discovered a peculiar parasite, which sometimes infests +the human body, and is termed the _trichina spiralis_. The presence of +these parasites has given rise to morbid conditions of the system, +followed by the most serious results. They are developed in the +alimentary canal, and then perforate its tissues and enter the muscles. +Twelve trichinæ have been found in a section of human muscle only +one-twelfth of an inch square and one-fifth of an inch in thickness. + +The early symptoms of trichinæ are very uncertain, being the same as +those of some other disease. The patient complains of severe pain in the +abdomen and is troubled with diarrhea. When the trichinæ pass into the +muscles, they occasion great suffering. There are sharp pains in the +muscles, the perspiration is profuse, and the patient becomes exhausted. + +CAUSE. Nearly every case of trichinæ, which has been brought to the +notice of the profession, has been attributed to the eating of raw or +improperly cooked pork. The parasites can only be detected with a +microscope. + +TREATMENT. The impossibility of removing the trichinæ after they have +passed into the muscles is apparent; and, as yet, no special remedy has +been recommended to remove them from the alimentary canal. The only +safety lies in prevention. Hence raw or imperfectly cooked pork should +never be eaten. + + * * * * * + + + + +DYSPEPSIA. + + +It is generally conceded that a multitude of human ailments arise from +_indigestion_, and in its various forms it taxes the skill of the +physician to prescribe the proper remedies. It is undeniable that the +closest intimacy exists between happiness and good digestion. A healthy +digestion aids materially in making a cheerful disposition, and the +"feast of reason and flow of soul" is due as much to the functional +integrity of the stomach as to a strong and generous mental +organization. Dr. Johnson severely said: "_Every man is a rascal as soon +as he is sick._" We all know that a morbid condition irritates the +individual and excites sarcastic and disagreeable remarks. And, +likewise, an irritable temper and, suddenly aroused passions may not +only turn and disturb the stomach, but even poison the secretions. +Anxiety, excitability, fear, and irritability frequently cause the +perversion of physiological processes. + +The slightest functional disturbance of the stomach deranges, more or +less, all the succeeding operations of digestion and tends to the +vitiation and impairment of the delicate processes of nutrition. +Dyspepsia may commence and proceed so insidiously as not to excite the +suspicion of friends, although the patient generally desires active +treatment, such as cathartics, emetics, and medicines to act upon the +liver. When the disease becomes confirmed, it presents some of the +following symptoms: Weight, uneasiness, and fullness in the region of +the stomach, attended by impatience, irritability, sluggishness, +anxiety, and melancholy; there is impairment of the appetite and taste, +also sourness, flatulency, and, perhaps, frequent attacks of colic, loss +of hope, courage, and energy; apathy, drowsiness, and frightful dreams +are also symptoms common in the different stages of this disease. There +are, furthermore, the accompanying symptoms of a coated tongue, bitter +taste in the mouth, unpleasant eructations, scalding of the throat from +regurgitation, offensive breath, sick headache, giddiness, disturbed +sleep, sallow countenance, heart-burn, morbid craving after food, +constant anxiety and apprehension, fancied impotency, and fickleness. +The subjects of dyspepsia frequently imagine that they require medicines +to act upon the liver, desire active treatment, are endlessly +experimenting in diet, daily rehearse their symptoms, and are morbidly +sensitive. + +CAUSES. Overtasking the body or mind, overloading the stomach, the use +of improper food, such as stale vegetables and meat, unripe fruits, +indigestible articles, improperly prepared food, irregular meals, +disorderly habits, the use of alcoholic stimulants, loss of sleep, +masturbation irritability of temper, anxiety, or grief may all give rise +to indigestion. If the functions performed by the skin are embarrassed +by cold, tight clothing, or lack of cleanliness, the nutritive changes +cannot properly take place throughout the body, and consequently the +digestive functions are embarrassed, as the revolutions of a water-wheel +are impeded by the backset of the water. When food is not thoroughly +masticated, it is not properly mixed with saliva of the glands of the +mouth, and is not prepared for digestion by the acids of the stomach. + +Whatever diminishes the general strength, impairs the health, or +encroaches upon the functions of life, also hinders the perfect solution +of food and disturbs in a measure the function of digestion. Whatever +diminishes the normal amount of the digestive secretions or perverts +their quality, deteriorating their solvent properties, is a cause of +dyspepsia. This should be borne in mind in selecting remedies. + +TREATMENT. The hygienic treatment consists in the regulation of the +daily habits, proper selection and preparation of the food, cultivation +of cheerfulness, diversion of the mind, and cleanliness of person. We +cannot give particular directions as to the kind of diet, as there are +no established rules for guidance. Generally, a dyspeptic knows best, +from experience, what articles of diet can be taken with the least +injury. The directions applicable to the condition of one patient, are +not suited to those of another. In dyspepsia, animal food is, as a rule, +preferable. Foods rich in starchy matter often ferment and produce +distress. Sometimes alkalies may be given with beneficial effect, when +there seems to be an excess of acid in the gastric secretions. + +In some cases, the digestive fluids are weak and fermentation results, +giving rise to flatulency and belching. An antiseptic, which may be +prepared by mixing a teaspoonful of hydrochloric acid with four ounces +of water, of which a teaspoonful may be taken after each meal, will +prove beneficial to check the fermentation and aid digestion. The +addition of one or two drops of a mixture of one part of carbolic acid +and six of glycerine, to the above solution of hydrochloric acid +improves its antiseptic properties. Or, Dr. Pierce's Golden Medical +Discovery will stop undue fermentation, and from its tonic and +invigorating effect upon the lining membranes of the stomach will +generally overcome the indigestion. Some people are afraid to take it, +when suffering from indigestion, because it has a sweet taste. But the +sweet is not saccharine, or sugar sweet, but an entirely different sweet +principle which prevents fermentation instead of promoting it. + +Acidity of the stomach and the attendant irritation may be allayed by +the following mixture: Calcined magnesia, one drachm; refined sugar, one +drachm; subnitrate of bismuth, one-half drachm; oil of cajeput, ten +drops. The dose is half a teaspoonful an hour after every meal. Any +dispensing druggist can put it up. + +It is frequently difficult to prevent the patient from over-distending +the stomach, and thus impairing the tone of the muscular coats and +prolonging the process of digestion. + +In consequence of debility, over-exertion, anxiety, or chronic +inflammation of the stomach, there is not a proper secretion, in +quantity or quality, of digestive solvents, and it matters not whether +it be a deficiency of the fluids of the stomach, or of the intestines, +or of the pancreas and liver, the result is indigestion. The question of +what important agent is lacking, naturally presents itself to the +physician. Is it _pepsin_, the active principle of the gastric juice, +which converts proteids into peptone, that is wanting, or is there a +deficiency of _pancreatin_? Of course the principle which is lacking +should be supplied; but has the physician the remedial agents properly +prepared, and ready for prescribing? The specialist, having more cases +of dyspepsia to treat than the general practitioner, is more likely to +have the latest and most approved remedies applicable to loss of +appetite, indigestion, impoverished blood, imperfect assimilation, and +all diseases arising from faulty nutrition. In ordinary practice, the +physician's time is divided in his consideration of acute, chronic, +surgical, and obstetrical cases; in fact, much of it is occupied in +riding to reach his patients. His attention is continually diverted from +one class of cases to another, effectually preventing investigation in +any particular direction. His patronage does not warrant him in the +outlay of time required for the investigation of particular diseases, +and the expense necessary to obtain the latest and best remedial agents +for their treatment. In the multiplicity of his cares and arduous duties +by night and by day, obstinate chronic cases become an annoyance to him, +and whenever he can be otherwise professionally employed, he avoids +them, disliking to undertake their treatment. + +With plenty of time for scientific investigation, ample facilities to +meet the demands upon his skill, and each succeeding case presenting +some new phase, the treatment becomes a matter of absorbing interest to +the specialist, and each success inspires greater confidence. We not +only use in the treatment of indigestion, solvent remedies, like pepsin, +which act only upon proteids, but also other remedies of recent +discovery, which exert a remarkable curative influence in diseases of +the digestive organs. + +The chemistry of digestion and of life is becoming better understood. +Any of the free acids may serve to dissolve a precipitated phosphate; +but it is only the investigating therapeutist and experienced +practitioner who understands which of them is the _most_ and which is +the _least_ efficacious. Alkalies may dissolve lithic deposits, but who, +unless he be an experienced physician, can detect the fault of nutrition +which leads to their formation, or rightly interpret the symptoms +indicating it? These simple illustrations of the complications which +attend dyspepsia, are mentioned merely to show that they must be +anticipated and taken into account in the treatment. + +The number of cases of dyspeptic invalids treated by the staff of the +Invalids' Hotel and Surgical Institute within file past few years, is so +large as scarcely to be credited by those unacquainted with the +prevalence of this disease. For this reason we have taken unusual pains +to investigate the causes of the disease, and have spared no expense to +provide the most approved digestive solvents, and stomachic tonics, +which invigorate the mucous membrane of the stomach, and materially +assist in reducing the food to a liquid condition. Some of these, +without being purgative, increase the activity of the liver, and +stimulate the intestinal secretions, two very important indications +which should be fulfilled by remedies which cause no real depression. +The recent important discoveries made in obtaining the active principles +from indigenous plants, has opened the way to the use of a few of the +most important of these remedial agents, hitherto almost wholly unknown +to the medical profession, and the encouraging results attending our +practice have amply repaid us for the investigation and originality in +our treatment of this affection. + +A careful chemical and microscopical examination of the urine often +discloses the actual morbid conditions which perpetuate this functional +disease. + + +CHRONIC DIARRHEA. + + +On account of the frequency and importance of chronic diarrhea, we deem +it worthy of special consideration. It is frequently the sequel of the +acute form of the affection. The urgent and severe symptoms of acute +diarrhea are often abated, but the disease is not completely cured. The +bowels are left in an irritable condition, perhaps in a state of chronic +ulceration, which perpetuates morbid discharges. + +The most noticeable symptom is the tendency to frequent and unhealthy +discharges from the intestines. The evacuated matter varies much in +appearance and character in different cases. The precise location of the +morbid conditions which give rise to the discharges, as well as to their +extent, modifies the color, consistency, and ingredients of the stools. +Most frequently they are dark colored and of very offensive odor. They +are of a more liquid character than is natural, except when, as is +sometimes the case, periods of constipation alternate with periods of +unnatural looseness. Tormina, or griping, is usually present, but not so +severe as in the acute affection. Tenesmus, or straining, often +accompanies it. The appetite is impaired, there is general debility, and +the patient is nervous and irritable. The complexion becomes sallow, the +skin dry and rough, the tongue dark colored, and the body emaciated. + +The affection may be the sequel of neglected or badly treated acute +diarrhea, may arise from the injudicious use of powerful purgative +medicines, may result from dissipation, unwholesome food, bad air, +absence of light, long continued exposure to dampness and cold, +overwork, and extreme mental anxiety. Sometimes it is associated with +other diseases, such as Bright's disease of the kidneys, scurvy, or some +of the various forms of scrofulous disease. + +The more prominent symptoms are so apparent and so characteristic that +the most unskilled may be able to decide whether the patient has chronic +diarrhea; but to determine in what portion of the intestinal canal the +affection is chiefly seated, to decide upon the extent of its ravages, +to ascertain what peculiar shade or type the affection has taken on, to +investigate its complications and modifications, to ferret out its +producing or aggravating causes, and above all, to nicely and skillfully +adjust remedies to meet the depraved conditions, is by no means an easy +task, even for the educated and experienced physician. It should be +borne in mind that this is a dangerous malady, and one which should not +be trifled with or neglected. Its tendency is to corrode and destroy the +bowels, a process which if unchecked, must sooner or latter result in +death. There is little tendency to spontaneous recovery, nor is a +removal of the exciting cause often followed by recovery. The disease +becomes so firmly seated, and the powers of life so debilitated, that +nature cannot rally. + +TREATMENT. A warm, salt bath, several times a week, taken at bed-time, +is beneficial. Flannel should be worn next to the skin, and the +sleeping-room should be warm and well ventilated. + +As will be seen from testimonials hereinafter inserted, Dr. Pierce's +Golden Medical Discovery has achieved great success in curing chronic +diarrhea. Its use should be persisted in for a considerable time to +strengthen and tone up the bowels. To relieve the discharges, take Dr. +Pierce's Compound Extract of Smart Weed, as needed from time to time. + + +CHRONIC INFLAMMATION OF THE LIVER. + +(CHRONIC HEPATITIS.) + + +This is what is ordinarily termed _liver complaint, torpid liver, and +bilious disorder_. + +Under this head may be considered all those chronic affections known as +congestion, induration, and enlargement of the liver, and which result +in deficient action, functional derangement, morbid secretion of bile, +and various chronic affections. + +SYMPTOMS. Owing to the liability of other organs to become diseased +during the progress of chronic affections of the liver, great precision +in diagnosis is required to determine, by the symptoms, the organ which +is _primarily_ diseased and those secondarily affected. This requires +not only familiarity with the signs of a complicated disease, but also +thorough anatomical knowledge of the diseased organ, of the morbid +changes which occur in its structure, and their influence on its own +functions, as well as on those of other organs. + +The symptoms may differ according to the circumstances, temperament, +sex, age, or constitution of the individual, and the complications of +the disease. The local indications are fullness of the right side, thus +denoting congestion of the liver; a dull, heavy pain, which is increased +by pressure or by lying on the left side; a sense of fullness, weight, +and oppression about the stomach; an aching in the right shoulder-blade; +a dull, disagreeable pain in the shoulder-joint, which may extend down +the arm, and which is sometimes felt in the wrist and joints of the hand +Not unfrequently the complexion becomes pale and sallow, and there is +puffiness under the eye, headache, a bitter taste in the mouth, tongue +coated white or covered with a brown fur, and hardness of the gums; +there is frequent sighing, a hacking cough, fever, restlessness, and +loss of sleep; sometimes an unnatural, greasy appearance of the skin, at +others, it is dry and harsh, has scaly or branny eruptions, pimples, +dark blotches, and troublesome itching. The urine is frequently scanty +and high-colored, but variable as to quantity and appearance; it often +produces a scalding sensation when voided, and, if allowed to stand, +deposits a sediment which sometimes contains albumen. The pulse is very +slow, particularly when the elements of the bile are not eliminated from +the blood. The pulsations of the heart are easily quickened, and +palpitation is excited if the subject be low and anæmic. There is +depression of spirits, and a decided tendency to be discouraged and +despondent. The functional powers of the stomach are impaired; there is +loss of appetite, or it becomes capricious; uneasiness is felt in the +region of the stomach, oppression, sometimes nausea and water-brash, or +there is indigestion, flatulency, and acid eructations; the bowels +become irregular, usually constipated, and occasionally subject to +obstinate diarrhea attended with colicky pains; the stools are of a +light clay color, sometimes hard and dark, again thin and very +offensive, and occasionally green or black. As the disease progresses, +during the day the circulation is sluggish, the feet and hands are cold, +but at night the pulse is accelerated, and a burning sensation is felt +in the palms of the hands and the soles of the feet. + +The foregoing symptoms are not all present in one case, nor are any two +cases alike in every respect. They vary according to the organs most +implicated in the hepatic derangement. Thus, when chronic inflammation +of the liver is associated with _heart_ disease, the subject may have +palpitation, excessive or defective action of the heart, attended with +more or less pain and shortness of breath. If the _lungs_ be specially +influenced, then, in addition to the ordinary hepatic symptoms, there +may be a dry cough, asthma, hurried respiration, bronchitis, hoarseness, +and pain in the chest. If the _stomach_ be the sympathizing organ, the +tongue is coated white or brown, there is nausea, loss of appetite, +flatulency, acidity, dyspepsia, fullness, and oppression, amounting, +sometimes, to pain in the stomach after taking food; the food ferments +and gives rise to eructations and various other manifestations of +disorder. If the _bowels_ are morbidly influenced by this affection, +there is constipation or diarrhea, griping pain, distension of the +abdomen, piles, and pain just within the points of the hips, thus +indicating irritation of The colon. If the _brain_ or _nervous system_ +sensitively responds, there is headache, dizziness, disturbed sleep, +depression of spirits, peevishness, capriciousness, lack of energy, +irritability, and congestive symptoms. When the _skin_ is involved the +surface is dry, harsh, and scaly, displaying dark "moth-spots," +blotches, or numerous little sores, and the countenance has a dull, +tawny look. If the _kidneys_ be disturbed by it, there may be pain and a +sensation of weight in the back, while the urine may be scanty and +high-colored, or abundant, pale, and limpid, frequently charged with +sedimentary products of disease, and voided with difficulty. If the +_womb_ be implicated in this chronic affection, the menstrual function +may be deranged, and result in an excessive or a deficient monthly flow, +and be followed by profuse leucorrhea. + +The preceding allusion to the complications of chronic inflammation of +the liver shows the necessity of clearly distinguishing between the +symptoms of this disorder and those reflected by the organs which +sympathetically respond. To discriminate more effectually, and place the +correctness of the diagnosis beyond doubt, we make a chemical and +microscopical examination of the urine, and thereby detect the morbid +products which it contains, and direct our attention to the diseased +organs furnishing them. These examinations together with a complete +history of the case, enable us to make a correct and definite diagnosis +of the disease, and the extent to which it has affected the other +organs. + +Before entering upon the consideration of treatment, let us briefly +enumerate the functions of the liver: _First_, it removes matter, which, +if allowed to remain in the blood, would become noxious and unfit it for +the further support of the body. _Secondly_, by secreting bile, it +furnishes to the digestive organs a fluid which assists in converting +the food into chyle, stimulates the intestine to action, and then is +itself transformed and absorbed with the chylous products, after which +it circulates with the blood and assists in nutrition until, becoming +injurious and pernicious, it is re-secreted and re-elaborated to serve +again, as described. + +For its growth and nourishment, the liver is furnished with blood by the +hepatic artery; but for the purpose of secretion and depuration, it is +abundantly supplied with venous blood by the portal system, which is +made up of veins from the spleen, stomach, pancreas, and intestines. +This impure, venous blood, surcharged with biliary elements, which must +be withdrawn from it, is freely poured into the minute network of this +glandular organ. In a healthy condition of the liver, the carbonaceous +elements of the blood are converted into sugar, and the constituents of +the bile are liberated by the liver, and set apart for further duties. +When it fails to eliminate these noxious elements from the blood, it is +itself thoroughly vitiated by them. + +TREATMENT. Food must be rich in carbon in order that it may build up the +tissues and keep the body warm, but carbonic acid, the result of the +combustion, must be removed from the blood, or death will ensue. So bile +is necessary to digestion, nutrition, and life; yet, if it be not +separated from the blood by the secreting action of the liver, it will +as surely poison the system and destroy life as carbonic acid. Although +the constituents of the bile exist in the blood, they must be removed in +order that the blood may be rendered more fit to support the body, while +the secreted bile is destined to assist in digestion, and the mysterious +process of nutrition. Therefore, we should induce a secretion of bile, +and restore the normal activity of the liver. This should be done, not +by administering stimulants, but by relieving it of all contingent +embarrassments as far as possible. Would any one think of giving to a +weak, debilitated man large portions of brandy to enable him to work? +Does not every one know that, when the unnatural stimulus is removed, he +fails? Apply this principle in the treatment of the liver. When harsh, +unnatural stimulants and "bile-driving" medicines are administered for a +time and then withheld, the liver relapses into a more torpid and +debilitated condition than before treatment was begun. Is not this true +of nine-tenths of all who suffer from this malady, and have recourse to +this class of remedies? + +Then how can we remedially fulfill the preceding indications? We answer +in the language of a distinguished author and standard medical writer, +"by using a class of agents which should never be overlooked in the +treatment of long-standing liver diseases, chiefly addressed to the +blood and denominated '_alteratives._'" + +_Alteratives, tonics_, and _restorative catalytics_ are required not +only in diseases of the liver, but in a large number of ailments in +which the blood becomes charged with morbid materials. The active +remedial properties of the most efficient agents of the above classes of +medicine now known, are scientifically combined in the "Golden Medical +Discovery," which acts _especially_ upon the blood, and hence influences +the system generally. It is also powerful in eliminating those morbid +humors which are afterwards subjected to excretion through various +organs. + +Its action is radically different from most medicines employed in +chronic diseases, for the reason, that what is usually prescribed, is +something corrosive. Unless the disease be temporary, it may return with +increased violence. + +We have been very minute in the description of the remedial properties +of the "Golden Medical Discovery," and have relied upon the reason and +intelligence of our patrons, believing that they can, in a degree, +understand why we deem it so applicable to the system. It does not +debilitate the liver by over-stimulation, nor irritate the stomach and +bowels by disturbing the delicate processes of digestion, neither does +it act with severity upon the blood, but it operates so gently, +insensibly, and yet with so much certainty, that it excites the surprise +and admiration of the patient. + +From the careful detail of its various properties, there is abundant +reason for its favorable action upon all of the excretory organs, which +co-operate in the removal of morbid materials from the system. If, +however, the bowels are unusually sluggish or obstinately constipated, +it is advisable, in conjunction with the "Golden Medical Discovery," to +use the "Pleasant Pellets," which are also powerfully alterative, +besides being mild and unirritating in their operation. They are the +natural assistants of the "Discovery," working harmoniously together. +They should be taken in small doses, and their use perseveringly +followed, until the bowels are properly regulated by the use of the +"Discovery" alone. + +It has been customary to resort to powerful drastic cathartics, followed +by bitters prepared in dilute alcohol. The habit is unscientific, for it +is well known that alcohol deranges the functions of the digestive +organs and depraves the blood, besides creating a morbid appetite. It +has been repeatedly demonstrated that the use of such bitters has led to +a life of drunkenness, with all the woe and untold misery which attend +it. + +Medicines to be strictly remedial, should exert a tonic influence upon +all the vital processes. Those organs which are contiguous to the liver, +or connected by sympathy with it, should be assisted in the performance +of their functions. Persons who are habitually subject to "bilious" +attacks are pleased to find that the use of the "Discovery" and +"Pellets" furnishes immunity from such onsets, and prevents their usual +recurrence. Thus these remedies are _preventive_ as well as _curative_. + +What we have thus far recommended for the treatment of this chronic +affection is within the reach of every family. Patients laboring under +this disease, when complicated with other affections, require special +consideration and treatment, and all such are counseled to employ only +those physicians whose experience and success entitle them to +confidence. Health is one of the greatest of blessings, and how to +restore it when lost, is a question of vital importance. + +Having successfully treated thousands of invalids who have suffered from +this chronic affection, we possess abundant evidence of the curability +of the disease, but we have only space to publish a few letters from +persons who have been under our care, or who have used our medicines, +purchased from druggists. + + +CONSTIPATION. (COSTIVENESS.) + + +Health depends very largely upon the regularity of the bowels. There +should be proper alvine evacuations every day. There are few persons who +have not suffered at some period of their lives from constipation of the +bowels. Inattentive to the calls of nature, or a neglect to regularly +attend to this important duty, sooner or later, produces disastrous +results. Furthermore, it is essential to the comfort of every +individual, for, when this function is not performed, there is +derangement of the mental as well as of the bodily organs. + +Constipation, or _costiveness_, as it is sometimes termed, is a +functional derangement of the large intestine. This intestine is about +five feet in length, and consists of the cæcum, colon, and rectum. It +serves as a temporary reservoir for the excrementitial residue of +alimentary matter, and for the effete materials excreted by the glands +contained in its mucous coats. It is distinguished as the _large_ +intestine, because of its great size. + +Habitual constipation produces many derangements, resulting from +_sympathy, irritation_, or _mechanical obstruction_. By referring to +Figs. 4 and 9, the reader may observe the anatomical relations which the +large intestine sustains to the other abdominal organs. The ascending +colon arises in the cæcum (Fig. 4), at the lower part of the abdomen, +and passes over the kidney on the right side, where it begins a +circuitous route around the abdominal cavity, comes in contact with the +inferior surface of the liver, proceeds behind and below the large +curvature of the stomach, emerges on the left side, and passes downward +in front of the left kidney, where it dips into the pelvic cavity, and +ends in the rectum. + +If fecal matters are retained until they are decomposed, great injury +follows, since the fluid portions are absorbed, conveyed into the blood, +and, of necessity, corrupt it with their impurities. In this way, +constipation may be the source of general derangement, but _such_ +disorder is seldom attributed to the torpid state of this intestine. +There is little doubt but that it thereby imposes a great tax upon the +functions of the liver, and, frequently, the fault is attributed to that +organ instead of the large intestine. Sometimes the blood becomes so +charged with fecal matter that its odor can be detected in the breath of +the subject. + +An overloaded condition of the large intestine may cause inflammation of +the liver or dropsy of the abdomen. When the colon is distended, it +becomes a mechanical impediment to the free circulation of the blood in +other organs, and causes congestion of the portal system, predisposing +to chronic inflammation or cirrhosis of the liver. This latter is a +structural affection, and may, in turn, give rise to abdominal dropsy. +In a word, the accumulation of feces in the colon irritates both the +large and small intestines, thus causing congestion of the bowels, +liver, or stomach. + +The protracted presence of feculent matter deadens the sensibility of +the intestine, so that great stimulation is required to provoke it to +action. The contents become dry, solid, knotty, and hard, and very +difficult to evacuate. If drastic, irritating physic be taken, only +_temporary_ relief is afforded, and it must be repeatedly resorted to, +and the dose increased, to obtain the desired effect. + +SYMPTOMS. One diagnostic symptom of a loaded state of the colon, is an +abundant secretion of urine, as limpid as water. The direct symptoms +relate to the hardness of the feces and the great difficulty of voiding +them. The influence of constipation upon the functions of the liver, is +indicated by the sympathy displayed between that organ and the mind. The +patient manifests apprehension, mental depression, taciturnity, and +melancholy, all indicative of hypochondriac dejection, induced by +constipation. + +We have treated patients, who, from this cause, had renounced their +bright hopes, lost their buoyant spirits, and, becoming subject to +superstitious fears, had given themselves up, night and day, to +devotions and penance. It often happens that the victims of this deep +dejection and morbid feeling of self-abasement, are persons not only of +good moral character, but of high religious attainments, and their +painful exhibitions of fear, distrust, and gloom, originate in +_physical_ rather than in spiritual causes. It is interesting to witness +this strange perversion of the imagination, this morbid debasement of +the religious faculties, and dejection of mind, due to causes disturbing +the functions of the liver and other vital organs. + +Young girls, as they approach the age of puberty, seem possessed with +the idea that the unfrequent action of the bowels is a desirable habit. +They do not associate with the duty a proper regard for health, but +consider it as an inelegant and repugnant practice. The consequence is, +that at this susceptible period, constipation, induced by neglect, +arouses a latent hepatic or pulmonary disease which has been lurking in +the system. + +How many girls illustrate the truth of this statement by their +complaints of dizziness, throbbing pain in the forehead and temples, +flushing of the face, transient flushes of heat over the body, while at +the same time the extremities are cold. At other times, they manifest +the evils of such a course by their stupor, drowsiness, and deep sleep, +although upon arising in the morning, they are still tired and +unrefreshed. + +The constipated condition of the bowels, often leads to congestion of +the uterus and leucorrhea, followed by uterine debility, prolapsus, +excessive menstruation, anteversion or retroversion of that organ. The +infrequency of the habit, incorrectly supposed to be desirable by a +young woman, becomes nearly, if not quite disastrous to all her desires +and bright prospects. Complications arise, and neither the inexperienced +girl nor her solicitous and afflicted parents know where to look for +remedial aid. If they seek an asylum from these sufferings, they find +many private institutions, where flattering expectations of speedy +recovery are aroused. At such institutions, these uterine disorders are +generally treated merely as local diseases, while the causes are +overlooked, and, consequently, a permanent cure is not effected. Having +spent nearly all the money at her command, the patient returns home +utterly disheartened. After such failures, many of these unfortunate +individuals have applied to us and received treatment, and by +persistently following our directions, have in due time been restored to +health, amid all the comforts of home, and among friends, who rejoiced +with them in the unexpectedly favorable turn of affairs, accomplished at +a comparatively trifling expense. + +We have seen infants, and also young children, in whom constipation was +obstinate. It therefore seems that it is often hereditary. In some +persons, this affection continues from childhood, with but little +variation, until bleeding pile tumors are developed. Habitual +constipation of the bowels for a long period of years will generate a +class of diseases, which are often very serious in their results. + +CAUSES. We have already alluded to a sense of false modesty which +prevents a response to the calls of nature, and we may mention other +reasons, equally trifling, which deter many from fulfilling its demands. +Some are in the habit of temporarily postponing their visits to the +water closet, until, when they do go, they find themselves unable to +evacuate the bowels. Sometimes the closet is a damp, uncomfortable +out-house, situated at a distance from the dwelling, or the access is +too public, and, hence, there is an unwillingness to visit it at the +proper time. Some appear to be too indolent to attend to this duty. +Others are too energetic, and think they cannot take the time, until +they have finished some self-imposed task or attended to a pressing +engagement. + +Inactive life and sedentary occupations are also causes of constipation. +Active exercise promotes all the bodily functions, and helps to regulate +the bowels. Those who are engaged in literary pursuits, find that mental +occupation determines the blood to the brain, thus drawing it from the +extremities; the temperature falls below the natural standard, and there +is almost invariably congestion of the bowels. The inmates of +boarding-schools, factory girls, seamstresses, milliners, employés in +manufacturing establishments, and all who sit and toil almost +unremittingly twelve hours in the day, do not get sufficient exercise of +all the muscles of the body, and are often troubled with obstinate +constipation. + +Food prepared according to the modern modes of cookery, is one of the +causes which favors the developement of this derangement. People live +too exclusively upon bolted wheat flour. The branny portion of a kernel +of wheat consists of various nutritive elements, with more than five +times the amount of phosphate of lime contained in fine bolted flour. +Those who daily use boiled cracked wheat are not troubled by +constipation. There is no dryness or hardness of the feces, and the +bowels are evacuated without discomfort. + +TREATMENT. Prevention is always better than cure; hence, a few hygienic +directions may not be amiss. Do not disregard the intimations of nature, +but promptly respond to her calls. If there is constipation, overcome it +by establishing the habit of making daily efforts to effect a movement +of the bowels. Taking regular exercise by walking, and lightly +percussing or kneading the bowels for five minutes daily, help to +increase their activity. The habit of early rising favors the natural +action of the bowels. Drinking a glass of water on rising exerts a +beneficial influence. The food should be such as will excite the mucous +secretion of the large intestines, and arouse its muscles to action. For +this purpose, there is no one article that excels coarsely-cracked +boiled wheat. Graham bread, mush, cakes, gems, and all articles of diet +made from unbolted wheat flour are valuable auxiliaries, and may be +prepared to suit the taste. Take the meals at stated hours; be punctual +in attendance, regular in eating, and thoroughly masticate your food. +Irregularity in the intervals between eating, disturbs the functions of +the intestine. The use of ripe fruits, such as apples, pears, grapes, +figs, and prunes, in proper quantities, is sometimes very beneficial. +Trivial or unimportant as these hygienic suggestions may appear, yet +were they observed, constipation, as well as most of the diseases +incident to it, would be obviated. A large proportion of the cases will +yield to the foregoing hygienic treatment without the employment of +medicines. Should it be necessary, however, to employ an aperient to +relieve the constipation, Dr. Pierce's Golden Medical Discovery will act +most congenially, and will be followed by no constipating reaction, +which invariably occurs when drastic cathartics are employed. Its +operation is mild, bringing about a healthy action by promoting the +biliary and other secretions, thus aiding nature in establishing normal +functional activity in the bowels. Recourse should be had to it before +employing any thing more strongly cathartic. However, should it prove +too mild in its aperient effects, small doses of Dr. Pierce's Pleasant +Pellets may be employed daily to assist it. Unlike other cathartics, +they produce a secondary tonic effect upon the bowels, which renders +their influence more lasting than that of other purgatives. We cannot +too strongly discourage the injurious custom which many people have of +frequently _scouring_ out their bowels with strong cathartics. It is a +bad practice, and cannot fail to do injury. The greatest benefit is +derived, not from cathartic doses, but from taking only one or two of +the "Pellets" per day, or enough to keep the bowels regular, and +continuing their use for several weeks, in connection with Dr. Pierce's +Golden Medical Discovery, strictly carrying out the hygienic treatment +heretofore advised. + +The medical treatment of individual cases sometimes involves many +considerations relative to the particular circumstances and +complications presented. The peculiar susceptibility of the +constitution, as well as the diseases incident to constipation, must be +taken into account. Symptomatic derangement should not be treated as +primary, although it is by inexperienced physicians. If the patient be +afflicted with uterine disease, piles, nervous affections, falling of +the lower bowel, or fistula, they should be treated in connection with +this disease. For these reasons, we would advise our readers to submit +all complicated cases, or those that do not yield to the course +heretofore advised, to a physician of large experience in the management +of chronic diseases, and not assume the great responsibility and the +dire consequences which are very liable to arise from the improper +treatment of such cases. We have been called upon to treat thousands of +cases of this troublesome affection, and as a result of our vast +experience, and in consequence of our original and improved methods of +diagnosis, it is not generally necessary that we should see and examine +the patient in person. We can almost always determine the exact nature +of the patient's malady, and its stage of advancement, without seeing +the subject in person. + + +PILES. (HEMORRHOIDS.) + + +There are few maladies more common than this, and few which are more +annoying. Piles consist of tumors formed within the rectum and about the +anus, by dilatation of the hemorrhoidal veins and thickening of their +walls. Sometimes, when attended by considerable inflammation, or when +the attacks are very frequent, there is thickening of the adjacent +cellular and mucous tissues. + +There are two general forms of this disease, the external or blind +piles, in which the tumors are outside the anus, and the internal or +bleeding piles, in which the tumors are formed within the sphincters, +although after their formation they may protrude. The external piles are +commonly made up of thick tissues; upon one side, the skin forms the +covering, while on the inner surface is the mucous membrane of the +bowel. It is this surface which is most tender and irritable and liable +to inflammation. The internal form of the disease is situated from a +half an inch to two and a half inches above the sphincter muscle of the +anus. The tumors are usually round, oval or cylindrical in form. They +may be scattered over the surface of the bowel, or clustered together. +The illustrations (Figs. 1 and 2) show the two forms of the disease. The +two protruding tumors in Fig. 2, illustrate the usual form of prolapsing +internal piles, whilst the one highest up in the bowel shows the form +most commonly met with. It is seldom that one pile tumor is found alone, +there usually being two or three, and sometimes as many as five or six, +in a cluster. Fig. 3 shows the manner of distribution of the veins in +the rectal region. The small venous loops, or bulb-like terminations of +the veins H. _i_., are the points at which the piles most frequently +occur. + +[Illustration: Fig. 1. +Swollen External +Piles.] + +CAUSES. Whatever tends to favor an undue accumulation of blood in the +hemorrhoidal veins predisposes to piles. For this reason the affection +is frequently a result of diseases of the heart and liver, which cause +an obstruction in the circulation of the blood through the portal vein. +Mechanical pressure from tumors in the abdomen, pregnancy, or an +enlarged or misplaced uterus, is not infrequently a cause of the +disease, by keeping the hemorrhoidal veins over-distended. Those +diseases which provoke much straining, as stricture, inflammation or +enlargement of the prostate gland, and stone in the bladder are also +active causative agents. The most common cause of all, however, is +constipation; and persons of indolent, sedentary and luxurious habits of +life are the ones most frequently affected with this derangement. The +following are also prolific causes of piles, viz.: pelvic tumors, +violent horseback exercise, indigestion, pregnancy, habitual use of +drastic cathartics, diarrhea, dysentery, sitting on heated cushions, +long-continued standing posture, diseases of the liver, worms, the +wearing of tight corsets, eating highly seasoned or indigestible food, +and the use of alcoholic stimulants. No age is exempt from piles, nor is +the disease peculiar to either sex. Aside from the serious inconvenience +and pain which are experienced with most forms of piles, there is a +tendency to fistula, and to cancer in the rectal region. It is +important, therefore, that the disease should not be allowed to run on +unchecked. + +[Illustration: Fig. 2. +Piles: internal and protruding. ] + +SYMPTOMS. The most common symptoms at first are slight uneasiness, such +as a little soreness or itching at the verge of the anus, and at times +lancinating pains. These sensations are more severe as a rule if the +bowels are constipated. If the piles are external they frequently become +inflamed, swollen and painful, and in some instances they suppurate, +which usually results in relief. When internal piles have increased to +any considerable extent, or have become inflamed, they produce not only +itching at the extremity of the bowel, pain in the back, etc., but also +a sensation of fullness in the rectum, as though some foreign body were +present, and, on action of the bowels, there is a sensation as though a +portion of the fæces had not been expelled. When the internal piles +become large, they frequently come down with fæcal matter from the +bowel, as illustrated in Fig. 2, and this prolapsus becomes more and +more marked with the progress of the disease, until, in many cases, the +tumors are forced down at each action of the bowels, causing +excruciating pain until they are properly replaced. Usually, in the +early stages, they recede spontaneously; however, after a time it +becomes necessary for the sufferer to press them back, but in some +instances this is impossible. Frequently during the protrusion one of +the hemorrhoidal veins gives away, and this is followed by a free escape +of blood, and ulceration may ensue. Not infrequently with this disease +the patient loses strength and flesh, and the face becomes pale and +puffy, assuming a waxy appearance. Many times there is nausea, with +vertigo. Is consequence of the relaxation, the bowel may descend when on +the feet, or with some extra muscular effort, especially when stooping. +These symptoms may not all be present in one person, and, indeed, +sometimes are somewhat obscure; when such is the case, an examination by +a competent physician will always determine the true character of the +complaint at once. + +[Illustration: Fig. 3. +H. _i._ Internal hemorrhoidal veins. H. _m._ Middle +hemorrhoidal veins. H. _e._ External hemorrhoidal +veins. S. _i._ Internal sphincter muscle, S. _e._ External +sphincter muscle. ] + +TREATMENT. Notwithstanding the well established fact that piles are +readily cured by the appropriate treatment, hundreds of thousands of +people suffer untold tortures from them because of the popular +impression that they cannot be cured. All cases are not, however, +amenable to the same form of treatment, for various unhealthy conditions +of the system are often concerned in their production and perpetuation, +and must, of necessity, be remedied by appropriate treatment, before a +cure of the piles can be expected. It will, therefore, become apparent +that the avoidance of causes is of paramount importance. Some of these +causes are external, and wholly under the control of the patient, while +others depend upon diseases that are curable; it frequently happens that +while other diseases are being remedied, the piles disappear Without any +special attention. + +Diseases of the urinary apparatus, as stricture of the urethra, +enlargement of the prostate gland, and stone in the bladder, dysentery, +diarrhea, and constipation,--all cause piles, by the irritation, and +determination of blood, which they induce; these difficulties must be +removed by appropriate treatment. + +Some years since, we ascertained that we were using in our practice +remedies which, in addition to other virtues, possessed a direct +specific influence upon the vessels concerned in the formation of piles. +These agents enter into the composition of Dr. Pierce's Golden Medical +Discovery, which, consequently, will be found exceedingly efficacious in +the treatment of this disease. This remedy, therefore, in removing the +disease upon which the piles depend, as a congested or torpid liver, +constipation, etc., and in exciting a direct curative control over the +piles themselves, exerts a double influence. It may be aided, when the +bowels are badly constipated, by the use of Dr. Pierce's Pleasant +Pellets, taken in the morning, to secure a regular and easy evacuation +of the bowels each day. All stimulating food and alcoholic drinks should +be abstained from. The cold bath is beneficial in these cases, provided +there is not great debility. The affected parts should be bathed +frequently with cold water, and, if prolapsus exists, it is well to +inject a little cool water into the rectum, and allow it to remain a few +minutes. As a soothing, astringing and healing application to the +affected parts we prepare an Ointment that has acquired great fame for +the prompt relief which it affords in all ordinary cases. This we do not +sell through druggists but can send by mail, on receipt of price, $1.00 +per large box, postage prepaid. The persistent use of this Ointment, at +the same time keeping the bowels regular by the use of "Golden Medical +Discovery," with an occasional laxative dose of "Pellets," will +generally cure all ordinary cases of piles. + +THE RADICAL CURE OF LARGE PILE TUMORS. In cases in which the tumors have +become indurated and very large it is impossible to effect cures by the +foregoing or any other medical treatment. Various methods have been in +use by the profession for the relief of the most severe cases. The most +common is excision with the knife or scissors. Reference to the large +vessels, shown in Fig. 3, which are affected in this disease, will at +once show the sufferer the dangers of this method. The sudden removal of +a tumor, which is connected with one or more of the large hemorrhoidal +veins, is sure to be followed by severe hemorrhage, and many times +painful ulceration, and a fatal result. To avoid this it has been the +practice of many physicians to apply caustics or to burn off the base of +the tumors with a red-hot iron. A more barbarous and painful method +could not be devised. When it is considered that in many cases, this +severe and painful treatment is followed by ulceration, and occasionally +by the developement of cancer, the matter should be carefully weighed +before any such dangerous procedure is attempted. Another common method +of treatment is to crush the base of the pile with a clamp, and then cut +off the tumors with scissors. After this it is also necessary to apply +the hot iron to prevent hemorrhage. Formerly, applications of nitric +acid were in common use by physicians as a means of cure, but it was +found that while this treatment would give temporary relief, yet in no +severe case would it effect a cure. By what we term palliative treatment +alone more cures are effected than by the old process of treatment with +nitric acid. Still another form of treatment is strangulation of the +pile by means of a ligature, and this is often more painful than the +application of hot irons, inasmuch as in cutting off the return flow of +blood from the piles, a large tumor is left for days fully distended and +extremely painful. It does not slough off for a considerable time, and +we have seen the strongest men suffer intensely, to whom the use of +scissors in removing the tumors was a positive relief in comparison with +the torture of the ligature. A treatment that has been highly +recommended by some physicians and condemned by others, is the process +of injection with carbolic acid. This method of treatment is not very +painful but, unfortunately, it is dangerous. The injection of the tumors +with a fluid which causes coagulation of the blood, and which does not +completely shut off the return current of the circulation through the +tumors, has proved fatal in a small percentage of cases. The clots which +are formed by this treatment become detached and are carried into the +general circulation and conveyed to the liver, lungs and even to the +brain, where, by plugging up the vessels of those organs, they cause +abscesses which terminate life. Serious inflammation of the veins is +another accident which often follows the injection of carbolic acid. +This treatment is, therefore, now seldom resorted to except by +physicians who do not appreciate its dangers. + +A MORE SUCCESSFUL METHOD. Fortunately for suffering humanity, a method +of treatment has been perfected and thoroughly tested in our +institution, in which all such trouble and danger as above described are +avoided. This consists in bringing down the tumors, cleansing them and +making application, of certain chemical preparations, that cause the +tumors to speedily shrivel up, and in a very short time, say ten to +fourteen days, disappear entirely. These treatments and applications +cause _no pain whatever_, for by first applying a weak solution of +cocaine to the parts they are speedily rendered entirely insensible, so +that the most sensitive, nervous lady experiences not the slightest +suffering from the application of our remedies. + +Having now at our command means so positively certain in their action +upon pile tumors, we do not hesitate to say that the very worst cases, +no matter of how long standing, can be promptly cured, if we can only +have the patient for a few days under our personal care. Considering the +very distressing character of pile tumors, it is a great boon that we +have at last found safe, painless, and positively certain means for +their cure. The news will be hailed with joy by a large class of +sufferers. + +Probably no other discovery in modern science is destined to be the +means of conferring greater blessings on a large class of sufferers than +that of a painless and positive method of curing the largest pile tumors +in the brief time required by our system of treating them. + +It seems to us that there is no longer an excuse for any one to endure +the tortures inflicted by pile tumors, provided the afflicted one can +command the little time and moderate amount of means necessary to secure +the treatment indicated. Piles are not only in and of themselves very +painful and annoying, but often greatly aggravate and even cause other +grave and painful affections, and should, therefore, not be neglected. +When large, they never get well without proper treatment. We have seen +many cases in which the long train of diverse and distressing symptoms +caused by piles led the sufferer, and even the family physician, to +suppose that other diseases existed, but all of which annoying symptoms +were speedily dispelled by the cure of the piles. We have no doubt that +neglected piles, fistulæ, and other morbid conditions of the lower +bowels, frequently degenerate into cancerous disease. We have the +eminent authority of J. Hughes Bennett, of Edinburg, and many other +close observers, for saying that benign or ordinary tumors often +degenerate into real cancerous disease, and our own extensive +observation convinces us that this is not infrequently a result of +neglected rectal disease, as piles, fistulæ and fissures. How important, +then, to give prompt attention and skillful treatment to disease of +these parts. When the ordinary palliative treatment, with ointments and +with laxative agents to keep the bowels soluble, does not _completely +and perfectly_ subdue the malady, lose no time in securing the most +skillful appliances, that every vestige of the affection may be promptly +removed. We have treated many thousands of cases with uniform success, +and our patients write to us expressing the greatest degree of +satisfaction, and recommending our method most highly. + +Reports of a few cases, selected at random from the large number which +we have cured, are given below to illustrate our success in curing them. + + +ANAL FISTULA. (FISTULA IN ANO.) + + +This disease is _more dangerous_ than piles, though, after once formed, +not so painful. It sometimes commences with intense itching about the +anus, accompanied with a little discharge; or the first symptom may be a +painful abscess, like a boil, which finally breaks. The soreness then in +a measure subsides, leaving a fistulous opening, with a continuous +discharge of matter. This unnatural opening, with its constant drain +upon the system, sooner or later is certain to ruin the health or +develop consumption or other maladies, and destroy life. + +Fistula in Ano may exist in three conditions: First, complete +fistula--when the opening is continuous from the cavity of the rectum or +bowel to the surface of the skin, so that liquids, gases, etc., escape; +secondly, internal incomplete fistula, when the opening extends from the +inside of the rectum into the tissues surrounding it, but not through +the skin. A few cases of this kind exist, while the sufferers are +unconscious of the nature of the difficulty, supposing it to be piles or +some trouble--they know not what. Thirdly, external, incomplete fistula, +when the opening extends through the skin into the tissues around the +rectum, but does not enter the bowel. + +Other complications, such as pendulous tits or projections, from +one-fourth to one and a half inches in length, are attendant upon +fistula. Two or more openings may appear in the skin, all communicating +with the same sinus, or opening into the rectum. Sometimes only a small +external opening is seen, while a large abscess exists internally. In +any case, the discharge is not only reducing to the system, but it is +disgusting and offensive. + +CAUSES The causes are a constitutional predisposition, constipation, +piles, or the presence of foreign bodies in the rectum, causing an +abscess or ulcer. Some authors have contended that fistula always +originates from an ulcer in the rectum, which gradually makes its way +through the cellular tissue to the surface. Others contend that the +cause of this disease consists in an abscess, which burrows in the +tissues and makes its exit into the rectum, or through the skin, or +both. No doubt it may originate in both ways. It can readily be seen +that when an internal opening is once established, the _foeces_ which +enter into it must sooner or later work their way to the surface, +burrowing through those parts which offer the least resistance, until a +place of exit is reached. + +DIAGNOSIS. The disease may be suspected, if there has been an abscess in +the parts involved, or if the patient has been subject to pain in the +rectum, and the parts are tender, tumid, or indurated. When the fistula +opens externally, the linen will be moistened and soiled with pus, or a +bloody fluid, and when the tract is large, the _foeces_ may pass through +it. A careful exploration with a probe, passed into the external opening +while the finger is in the rectum, generally reveals the direction of +the tract; but, sometimes, in consequence of the tortuous course of the +canal, the probe cannot he made to follow it. When the fistula is +incomplete, and opens internally, the probe is passed into the rectum +and directed outwards, when it may be felt externally. In such cases, a +tumor, caused by the contents of the fistula, may generally be seen +protruding near the anus, and the pain will be considerably increased +during defecation, by the _foeces_ passing into it and disturbing its +walls. The examination should be made with the greatest possible care, +for it is attended with more or less pain. + +TREATMENT. When constitutional derangement exists, it must be rectified, +or any treatment will be liable to result in failure. The comfort of the +patient may be greatly promoted by attention to the bowels, keeping +their contents in a soluble condition, and the liver active, so as to +prevent congestion of the rectum and adjacent structures. This can best +be done by careful attention to hygiene, and the use of "Golden Medical +Discovery" and "Pellets," in sufficient quantities to produce the above +named effects. + +A _radical cure_, however, cannot be accomplished except by surgical +means, for which we have the _knife, ligature, caustic, stimulating +injections, etc.,_ which may be varied to suit the emergency, but which +should never be employed except by a competent surgeon. Constitutional +conditions materially influence the cure, no matter what procedure is +adopted; the greater the constitutional derangement and the poorer the +general health, the longer is the cure delayed. The great secret of our +success in treating this disease consists in applying appropriate +constitutional treatment at the same time. + +The use of the knife is becoming obsolete, and has, to a great extent, +given way to other measures which are equally successful. Indeed, other +means will succeed in cases in which the knife fails or is for any +reason inapplicable. One great objection to the knife is not only the +dread which patients entertain of it, but the great liability of its use +to result in paralysis of the sphincters of the anus, the consequence of +which is loss of control over the bowels; and another is that it +sometimes entirely fails to result in cure. By the means which we +employ, these objections are entirely overcome, and, while the general +system is being renovated, the fistula is healed, without any +complications. + +Fistula is much more common than has generally been supposed. It is apt +to be associated with pulmonary diseases. Heretofore, it has been +supposed that to heal the fistula, during the progress of the lung +affection, would result in fatal consequences, and the patient has been +left to suffer and die under the combined influence, of the _two_ +diseases. Observation, based upon an extensive experience in the +management of such diseases, has proved that supposition to be +fallacious in every respect, and we would urge all persons afflicted +with fistula to have the affliction cured, no matter what complications +may exist. The fact underlying this erroneous opinion is, that when +grave constitutional troubles have co-existed the use of the knife has +resulted in failure, and the fistula has refused to heal. + +Having had ample facilities for observing the relative merits of the +various methods of treating this complaint, in hundreds of eases, in our +own practice and that of others, we feel justified in saying that the +plan which we have adopted is far superior to that in general use. The +local treatment which we employ depends upon the nature of the fistula; +in some instances the ligature is best, in others caustics, and again +injection, etc., while still others require a combination of two or more +methods, or a modification of them. + +In cases in which it is impossible for the patient to come to our hotel +for a radical and speedy cure of the fistula, we employ constitutional +treatment, with, the use of a medicated crayon, which is similar in +shape to a small slate pencil. This crayon is made of gelatine with the +remedial agents thoroughly incorporated through it, and in an easily +soluble form. They are very flexible and readily used, and where the +fistulous track is sufficiently large to admit of their insertion, the +most decided improvement invariable follows their application. One is +oiled and gently introduced into the track every two or three days, and +by its solution the unhealthy tissues which line the track are removed. +They are thrown off, and a healthy action is induced. With careful +constitutional treatment, decided improvement soon follows, and the +discharge is gradually lessened. The most satisfactory improvement +occurs in the general health and strength of the patient, and gradually +the fistula closes. Sometimes it is necessary to pursue this course of +treatment for many months, but the result obtained is sufficient reward +for the trouble. A large percentage of cures follow this treatment, and +we recommend it when it is impossible for the patient to leave home, or +when the general health is greatly reduced by severe constitutional +disease. + + * * * * * + + +TESTIMONIALS. + + +While we have a great cloud of witnesses testifying to the efficacy of +our treatment of the diseases described in this volume, yet for lack of +space we can here introduce only the few following: + + +"LIVER COMPLAINT." + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: J.H. May, Esq. ] + +_Gentlemen_--In the year 1889 I was taken with disease which the doctors +called "liver complaint." I tried three different doctors. They did me +no good. They tried about one year; I was not able to work for two +years. At last I thought I would try Dr. Pierce's medicines, and I wrote +to Dr. Pierce, and he wrote to me to take his "Golden Medical +Discovery," and I bought two bottles, and when I took it, I saw it was +improving me, and I got five more, and before I had taken all I was +well, and I haven't felt the symptoms since. I had a continued hurting +in my bowels for about two years. I feel as if the cure is worth +thousands of dollars to me. + + Yours truly, + J.H. MAY, + Potts' Station, Pope Co., Ark. + + +DYSPEPSIA AND WOMB DISEASE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Ransom. ] + +_Dear Sirs_--When first taking Dr. Pierce's Favorite Prescription I was +nervous and would have sour stomach and distress after eating, and when +I would rise after stooping over everything would turn dark before me +and I would feel dizzy. I suffered a great deal of pain at each monthly +period. I took one bottle and a half of the "Favorite Prescription," one +teaspoonful three times a day, and the "Pellets" as directions called +for. I gained in health and strength so rapidly that I have been able to +work very hard the past summer, and my back never troubles me; and when +I have my monthly periods I never feel the least bit of pain. In fact I +consider myself in excellent health. + + Very truly yours, + MRS. INEZ V. CARR RANSOM, + Panama, Chaut. Co., N.Y. + + +INFLAMMATION OF LIVER. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: T.J. Bentley, Esq. ] + +_Gentlemen_--I was taken sick with inflammation of the liver and could +get no relief from the doctors of this place--Randolph, N.Y. I was +induced to use Dr. Pierce's Golden Medical Discovery, and "Pleasant +Pellets," and after using five bottles of the medicine, I regained my +health, and now I am a well man. I weighed 185 pounds before taken sick, +and I was reduced to 135 pounds in sixty days' time. I suffered greatly +from headache, pain in my right shoulder, poor appetite, constipation +and a sleepy feeling all the time. My health is now very good, and I +weigh 170 pounds, and I am able to do a good day's work without any +trouble at all. Thanks to these valuable medicines. + + Yours truly, + THOMAS J. BENTLEY, + Randolph, Catt. Co., N.Y. + + +LIVER DISEASE AND DYSPEPSIA. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Hart. ] + +_Dear Sirs_--I am enjoying excellent health. After taking a bottle of +Dr. Pierce's Golden Medical Discovery and several bottles of "Pellets," +I am a different person. Only weighed 119 pounds when I began taking +your medicine, now weigh 160. My symptoms were pain under the left +shoulder, distress after eating, headache, dizziness, constipation, and, +in fact, my system was "out of sorts generally." I tell every one your +medicine has done more for me than any other. + + I remain, yours truly, + MRS. CHARLES H. HART, + San Ardo, Monterey Co., + California. + + +LIVER COMPLAINT AND CATARRH. + +[Illustration: Wm. King, Esq. ] + +_Dear Sirs_--After suffering for several years with nasal catarrh and +liver complaint, and having become greatly reduced in health, as a last +resort I placed myself in your hands for treatment. My improvement began +almost immediately after entering your institution. I was enabled to +leave at the end of one month, having experienced great benefit. The +treatment was continued at home for a few months, after which my cure +was complete. At the present time, I am able for office work, and feel +that I am completely cured of the catarrh and have but little if any +trouble with my liver. I shall lose no opportunity to recommend your +institution or your medicines to the afflicted. I do most unhesitatingly +recommend chronic sufferers to visit your institution or take your +remedies at home. + + Sincerely yours, + WILLIAM KING, + Rose Bud, + Pope Co., Ills. + + +A COMPLICATED CASE OF STOMACH, LUNG, AND UTERINE DISEASE. + +[Illustration: Mrs. Rademaker. ] + +_Dear Sirs_--Some six years ago I was taken sick with chills; I would +have a very bad chill and then I would begin to sweat and vomit; I had +no appetite; I had the catarrh very bad; I had inward troubles of +different kinds; my back ached all the time; I had sores gather and +break inside; I had a lung trouble; I was very bad off; I could sit up +only long enough to have my bed made; my husband sent for our family +doctor; he came three times a week for three months; I was not so well +at the end of three months as when he first came, but kept growing +worse; he gave me up to die, and said I had consumption. I had heard of +Dr. Pierce's medicines doing a good deal of good, so I made up my mind +to try them. I sent and got one bottle of "Favorite Prescription" and +one bottle of "Golden Medical Discovery"; also one bottle of "Pellets," +and commenced taking them. In a few days I commenced to gain, and In two +weeks' time I could sit up most all day, and in five weeks' time I could +do my work with the help of two small girls. After taking four bottles +of "Favorite Prescription," six bottles of "Discovery," and three of +"Pellets," I was well enough to get along without any medicine. I can do +a good day's work, and I owe my life to Dr. Pierce. With God's will and +the use of Dr. Pierce's medicine I am still alive and well. + + Yours respectfully, + Mrs. CLARA A. RADEMAKER, + Addison Point, Washington Co., Me. + + +LIVER COMPLAINT AND DROPSY. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION. Buffalo, N.Y.: + +[Illustration: Mrs. Dennis. ] + +_Gentlemen_--About two years ago I was confined to my bed for several +weeks with liver complaint. I became dropsical, my limbs swelled to +twice their usual size and I could scarcely move them. I commenced using +Dr. Pierce's Golden Medical Discovery; one bottle helped me so I could +sit up; two bottles gave me strength enough to be able to do part of my +household work; six bottles cured me, and to-day I am enjoying good +health. The "Medical Discovery" should be in every household, and in +gratitude for what it has done for me I have recommended it to many +friends. For nine years I have suffered from deafness, and while taking +the "Discovery" my hearing became much improved. + + Very truly yours, + MRS. I.C. DENNIS, + Burson. Calaveras Co., Cal. + + +INDIGESTION, CONSTIPATION, VARICOCELE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mr. Hodges.] + +_Dear Sirs_--In regard to my condition of health, will say, although I +am not entirely well, yet I have received much and lasting good from +your treatment. My digestion was improved greatly, so that little +trouble is experienced after eating; my liver seems to act reasonable +well, and my bowels are much better. My varicocele I consider entirely +cured, as I have not used the bandage for one half day for more than six +months, and do not experience any inconvenience from that source. + + Yours truly, + HARLAN HODGES, + Keota, Keokuk Co., Is. + + +CASE OF CHRONIC DIARRHEA CURED BY HOME TREATMENT. + +[Illustration: Mrs. Gwin. ] + +At the time the case was first submitted to us the bowels were moving +six or eight times a day. In addition to the diarrhea, the patient had +suffered from indigestion and womb trouble for eight years. There was +almost continual pain from the top of the head to the hips and through +the shoulders. There was weakness, soreness and numbness in the arms, +hands, back and hips; the bladder was irritable, urine being passed +frequently, or occasionally scanty, dark, thick, with a brick-dust +deposit. There was a dragging sensation in the region of the womb. +Menstruation was irregular, and she had frequent trembling spells +lasting for hours. There was difficulty in fixing the attention, even +for a sufficient length of time to write a brief letter. In fact, she +was so weak and nervous she could scarcely write at all. Sleeplessness +was a prominent feature of the case. The principal diet consisted of +light bread and hot milk; could not use Graham bread. A course of +special treatment was supplied to her about the first of January, 1890, +but soon after commencing the treatment she had an attack of pneumonia. +In due time the treatment was resumed, and then followed an attack of +the epidemic influenza, or grip, so that, although the treatment was +carried on at intervals during a year, there were but few occasions when +our specialist had what he considered full control of the case. A year +after the case was discharged the following communication was received: + + +February 15, 1893. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +_Gentlemen_--I should have written sooner, but I waited to see if there +would be any return of my old disease. After suffering over eight years +with severe chronic diarrhea, you have cured me; I have had no return of +it for over a year. It is with gratitude I write to you to tell you the +great good you have done me, for I am sure I would have been in my grave +before this had it not been for your treatment; My stomach troubles me +very little any more. Occasionally I use a bottle of "Golden Medical +Discovery" and a bottle of "Pellets." Hoping that the kind Father may +spare your lives for many years to do good to suffering humanity, + + I am, Very gratefully yours, + MRS. R.S. GWIN, + Peck's Run, Upshur Co., W. Va. + + +LIVER COMPLAINT, DYSPEPSIA, AND CONSTIPATION. + +CURED BY HOME TREATMENT. + +[Illustration: J. Fleener.] + +Received his first disability in the war; complains of getting very +weak; bowels move only in three or tour days; stomach so painful that +nothing passes through it digested; back so weak cannot sit up; had the +first attack of dyspepsia fifteen years ago, and has spent hundreds of +dollars trying to get well; kidneys badly affected, urine highly +colored, and burns in passing; has pains around the heart and fluttering +sensations at times, says: "I am not able to travel; all the doctors +have given me up as beyond medical aid. + +Reports after two months' treatment: "I am happy to say that I am almost +well; suffer with no pain in my stomach after eating; my appetite is +good; my bowels move once a day and very often twice a day, and the +urine is natural; do not have that dizziness in the head any more: rest +well at night and feel rested in the morning Have gained flesh all the +time; weigh 178 pounds, and work every day on the farm. Have taken no +medicine from any other physician, and give you and your medicine all +the credit for the health I now enjoy. My wife has taken your "Golden +Medical Discovery" for goitre (thick neck). She has taken it for about +six weeks and she is getting better." + + JOHN FLEENER, Brooklyn, Indiana. + + +DYSPEPSIA. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: G.R. Kenyon, Esq. ] + +_Gentlemen_--Your letter was received, and I am glad to say that I am +perfectly well, and have been since I took your last medicine. I think I +am better than I ever was, if such a thing could be. I am twenty pounds +heavier than I ever was before, weighing 155 pounds. I have not had a +pain or an ache since, for which fact I am thankful to you for looking +after my case as promptly as you did, as, in looking over your catalogue +of diseases, I thought that I had every thing ailing me that was in the +book. I have told dozens if they were sick to call on you. With my best +wishes, and hoping that all of your patients will receive as much +benefit as I did, I remain, + + Very truly yours, + GEORGE R. KENYON + Batavia, Ill. + + +DYSPEPSIA. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: J.P. McAdams, Esq. ] + +_Gentlemen_--"A few of my symptoms were: Heartburn and fullness after +eating, sometimes pain in my bowels, headache, poor appetite and bad +taste in my mouth. At night I was feverish, with hot flushes over skin. +After taking Dr. Pierce's Golden Medical Discovery I was relieved of all +these symptoms, and I feel perfectly well to-day." + + Very truly yours, + J.P. MCADAMS, + Elon College, + North Carolina. + + +OBSTINATE AND COMPLICATED DISEASE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: John H. Smith, Esq. ] + +_Gentlemen_--Yours of July 12th to hand. I am only too glad to comply +with your request. Having suffered for many years with a complication of +diseases and feeling conscious that they were rapidly making serious +inroads upon my constitution, and that I was speedily becoming unable +and incapacitated to attend to my ordinary business. I resolved, after +reading a number of testimonials from your patients, to place myself +under your treatment at the Invalids' Hotel and Surgical Institute. With +heart-felt gratitude I can truthfully say I am relieved of my trouble. I +most cheerfully and earnestly recommend this Institution to all who are +afflicted with chronic and painful diseases, no matter of what nature. +During my stay there I saw some wonderful cures and surgical operations. + + Yours truly, + JOHN H. SMITH, + Deckertown, Sussex Co., N.J. + + +COMPLICATION OF DISEASES. + +[Illustration: Andrew Holes, Esq.] + +Without solicitude or hope of pecuniary reward, with heart-felt +gratitude and a desire to aid my fellow-man to health and happiness, +allow me to state, that as an inmate for more than a month of the +Invalids' Hotel and Surgical Institute at No. 663 Main Street, Buffalo, +N.Y., I feel warranted in its highest recommendation. While there I saw +and talked with a great number of people who came there as a last +resort, to be cured of almost every chronic disease to which flesh is +heir, and they were unanimous in their praise of the Institution and the +skilled specialists who constitute its professional staff. + + ANDREW HOLES, + Moorhead, Minn. + + +NERVOUS DEBILITY, DYSPEPSIA, KIDNEY AND LIVER DISEASE--CURED. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: B.V. Wright, Esq. ] + +Gentlemen--I take pleasure in informing you that the treatment you gave +me for the relief of an affection of the spine and nervous system, +disease of the digestive organs, kidneys and liver, has been entirely +successful. I had feared that my health was gradually being undermined, +prior to entering your institution, and I can testify to the perfect +appointment that you have, the excellent apparatus for the +administration of electrical and other massage treatment and baths. My +relief was most satisfactory, and the cure has remained permanent. + +I take pleasure in recommending your institution to the afflicted, +believing that you have the very best treatment for chronic diseases +known, and I have had an opportunity to satisfy myself, from +conversation with other invalids in your Institution, of the care and +skillful treatment that you administer, and its excellent effects. I +believe that it is fully abreast of the times, and equal to any +institution in the world. With many good wishes and thanks for my cure, +I remain, + + Yours truly, + B.V. WRIGHT, + Graniteville, Middlesex Co., Mass. + + +PROLAPSING PILES (HEMORRHOIDS), ASTHMA, TORPID LIVER AND CONSTIPATION. + +CURED AT THE AGE OF 62--NOW 73 YEARS OF AGE--AND CONTINUES IN GOOD +HEALTH. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Plummer. ] + +_Dear Doctors_--It is with the greatest pleasure that I add my own +experience to that of the many that you have cured. I am now +seventy-three years of age, and enjoy very good health for my years, and +as you can see by the photograph I send you, time has dealt very +considerately with me so far as my activity and enjoyment of life are +concerned. To this I feel that in large measure my thanks are due to +you, for eleven years ago when I was sixty-two years of age you treated +the pile tumors so successfully. They had been the source of greatest +discomfort. I think that they were caused first by chronic diarrhea, +which had troubled me many years prior to their appearance. I was also +afflicted with asthma, torpid liver and constipation. These conditions +produced in time some pile tumors that were the source of much +suffering, and seemed to continually annoy me. As is usual with such +difficulties, I believe, I would be free from discomfort for a time, and +then the piles would get sensitive and irritable, come down at stool, +and gave rise to severe pain that seemed to affect my general health. +The nervous symptoms that resulted from their presence were such as to +lead me to fear that I would break down in health unless they were +relieved. From information obtained from others who had been relieved at +your hands, I applied to your institution, and can thankfully assert +that the tumors were permanently cured, as it has been eleven years +since your specialist treated me, and I have had no trouble of the kind, +and for an old lady I am pretty well. I had such good treatment and nice +care at your institution that I cannot express in my testimony the +thanks that I owe you. Wishing you every success in the treatment of +others, and that you may be able to relieve the sufferings of many +hundreds as you have mine, + + I remain. Very respectfully and thankfully yours, + MRS. MOSES PLUMMER, Groton, Caledonia Co., Vt. + + +BILIOUSNESS, CONSTIPATION, BAD COUGH. + +WORLD'S DISPENSARY MEDICAL, ASSOCIATION, Buffalo, N.Y.: + +[Illustration: George Wilder, Esq. ] + +_Gentlemen_--Some twenty-five years since I was feeling very miserable +all summer; I was very bilious; sometimes my bowels would not move once +in sixty to seventy hours, and then almost impossible. I would take some +bitters, which would help to move the matter, but as soon as the bitters +were gone, I had to buy more or I would be as bad as before, and +sometimes worse; but none of them appeared to do me any good except to +move the bowels, until thirty years since a druggist called my attention +to your "Golden Medical Discovery," and before I had taken half a bottle +of the "Golden Medical Discovery," I felt much better, and by the time I +had taken all, I could eat three hearty meals per day and had not felt +so well for a long time. Soon after I was called to do a job some miles +from home, and one night the old lady there was speaking about her +daughter (Mrs. Brooks) who had been under the doctor's care for about +five months and did not get any better, and I learned by asking a few +questions that she had no appetite and no ambition to do anything. Then +I told her what the "Golden Medical Discovery" had done for me. The next +day the old lady drove down to her daughter's and got Mr. Brooks to send +to Rutland, ten miles away, for two bottles of the "Golden Medical +Discovery," and the next day when the doctor came and was about to take +his leave, Mr. Brooks told the doctor he did not want him any more at +present, and would send for him, if necessary. I saw the old lady about +ten days later and her daughter was improving, and Mr. Brooks had great +faith in the "Golden Medical Discovery," and had not sent for the +doctor, but had gone to Rutland for more of the "Golden Medical +Discovery." When I commenced taking the "Golden Medical Discovery" I +thought I was going into consumption, as I had a cough for three years +or more and my weight decreasing. My weight before taking the "Golden +Medical Discovery" was 133 pounds; last March it was 147 pounds, and I +give the credit to the "Discovery," + + GEORGE I. WILDER, + East Wallingford, Rutland Co., Vt. + + +LIVER DISEASE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Bosworth. ] + +_Gentlemen_--I suffered greatly for thirteen years. Not one moment +during that time had I rest from pain or weakness. I consulted six of +our best physicians, taking medicines from each for a good long time. I +became completely discouraged, as I had been many times before. A letter +from the World's Dispensary Medical Association with questions to be +answered, fell into my hands; these I carefully answered. As soon as a +letter could go and come I received another saying I had the Liver +Disease. I could hardly believe it, for it had never entered my mind +that that was my trouble. I read the pamphlet sent me in the next mail, +describing my feelings much better than I could myself. I accepted their +advice, strictly followed it. I found complete relief in taking the +"Golden Medical Discovery." For years I could not ride a mile nor walk +to my nearest neighbor's without feeling worse for it, and most of the +time could not go at all. The day this picture was taken I rode eighteen +miles, walking up and down two long hills. To the afflicted and +discouraged I would say consult the World's Dispensary Medical +Association; accept their advice, strictly follow it, and if there be +help for you I believe you will find it in so doing. + + Respectfully yours, + MRS. HELEN C. BOSWORTH, + Money Creek, + Houston Co., Minn. + + +DYSPEPSIA, + +AND OTHER COMPLICATIONS. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Stephen Ogden, Esq.] + +_Gentlemen_--In reply to yours of the 7th instant, I would say that I +can cheerfully recommend your medicines, as I have tried them and found +them just as represented. I am enjoying splendid health at the present +time. + + Yours truly, + STEPHEN OGDEN, + Twin Mound, + Douglas Co., + Kansas. + + +DYSPEPSIA AND CONSTIPATION. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Miss. Helfer. ] + +_Gentlemen_--I have been troubled with dyspepsia and constipation for +the last six years, and have tried all medicines that I could think of; +and I got so low in health that I thought I would once more try the +"Golden Medical Discovery" and Dr. Pierce's Pleasant Pellets. After +taking it for three months I began to feel better, especially the gas +and sour rising off my stomach at night. Formerly it was a terrible +distressed feeling, could not rest nor sleep. I am very thankful to the +World's Dispensary Medical Association, and thankful to God who put the +great _power_ in your medicine that cured me. I will say a good word for +your medicines to all friends I meet. With many thanks, I remain, + + Respectfully. + Miss M.A. ELIZABETH HELFER, + Moreton Farm, Monroe Co., N.Y. + + +COMPLICATION OF DISEASES. + +A GRATEFUL PATIENT'S WORDS OF PRAISE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: William Henkel, Esq. ] + +_Gentlemen_--Having been in your Institution as a sufferer from two +distinct chronic diseases of years' standing, and having been placed +under the charge of your specialists, I was speedily relieved of my +afflictions. The Invalids' Hotel is a place as much like home as it is +possible for such an institution to be. The physicians and surgeons are +all expert specialists and thoroughly efficient; the nurses are very +competent, attentive and kind; and, in fact, the whole _personnel_ of +the Invalids' Hotel endeavor to do their best to make the patients feel +like being at home. I always felt while there as if I was one of the +family. I gladly recommend your Institution to all persons who are +afflicted with any kind of chronic disease, for from my own experience I +_know_ the professional staff will do all which they promise to do. +Please accept my thanks for the speedy benefits and perfect cure of my +diseases, and I think your Institution is worthy of the highest +endorsement. + + Yours truly, + WILLIAM HENKEL, + No. 1917 Congress Street, + St. Louis, Mo. + + +DYSPEPSIA AND GENERAL DEBILITY. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Rev. A.H. Mevs. ] + +_Gentlemen_--Having suffered for a number of years with dyspepsia, +torpid liver and general debility, and having tried several physicians +with little or no benefit, I resolved, as a last resort, to consult your +specialists at the World's Dispensary. Being advised by them to use Dr. +Pierce's Golden Medical Discovery, I did so, and after using several +bottles, I feel entirely restored to health. Now, I take great pleasure +in recommending your medicines to suffering humanity everywhere. + + Yours very gratefully, + REV. A.H. MEVS, + Friar's Point, + Coahoma Co., + Mississippi. + + +"LIVER COMPLAINT." + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: J. Gaughan, Esq. ] + +_Gentlemen_--When I commenced taking "Golden Medical Discovery," I was +suffering badly from "Liver Complaint." I had been out of health for +three years. I suffered terribly from "heart-burn," had bad coat on +tongue, and was often troubled with diarrhea. Three bottles of the +"Discovery" cured me. Had I not commenced taking it when I did, I should +have been dead long ago. You have my heartfelt gratitude for my cure. + + Yours truly, JAMES GAUGHAN, + Braidwood, Will Co., Ill. + +P.S.--There are lots of people here whom I have recommended to use your +Golden Medical Discovery," and each and every one says it is a good +medicine. One woman in particular, told me she was getting better every +day by the use of your medicines. + + J.G. + + +NERVOUS DYSPEPSIA. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Taylor.] + +_Gentlemen_--I had a dead aching in my head and down the back of my neck +and in my left ear, and my tongue was so stiff at night and dry, and I +had no taste, or appetite to eat anything. I also had such a dead aching +in the small of my back; it just felt as if I would break, and such +aching between my hips. I had been having the "change of life," and if I +worked hard I got a pain between my shoulders and a kind of aching in +the abdomen. I doctored a good deal and never got any relief. I was very +nervous. I took two bottles of Dr. Pierce's Golden Medical Discovery and +two of his "Favorite Prescription," and I am perfectly cured. + + MRS. ELLEN TAYLOR, + Clarion, Clarion Co., + Pennsylvania. + + +DYSPEPSIA. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Rev. Prosser.] + +_Dear Sirs_--I was a great sufferer from dyspepsia, and I had suffered +so long that I was a wreck; life was rendered undesirable and it seemed +death was near! but I came in contact with Dr. Pierce's Golden Medical +Discovery and "Pellets." I took twelve bottles of the "Discovery," and +several bottles of the "Pellets," and followed the hygienic advice of +Dr. Pierce, and I am happy to say it was indeed a cure, for life is +worth living now. A thousand thanks for your treatment. I enclose my +photo. + + Yours respectfully, + REV. CHAS. PROSSER, + Mount Carmel, + Northumberland Co. Pa. + + +LIVER DISEASE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Winter.] + +_Dear Sirs_--It is with pleasure that I tell you what your "Discovery" +has done for my mother. She was in poor health for a long time, coughing +and weak, and thought she had consumption; she had such palpitation of +the heart and could not rest at night because of the palpitation +sometimes, and then the right arm pained her so at times that she hardly +knew what to do; If we would put on hot applications, it would drive it +to the heart, and the doctor did her no good; so finally, as a last +resort, we happened to get hold of some of Dr. Pierce's pamphlets and +were constrained to write to him and send a small bottle of urine for +examination. He immediately wrote back, saying it was liver trouble, and +to take the "Golden Medical Discovery" according to directions. She took +it for two months, when the pain in her arm gradually left her and she +could comb her own hair, and began to be more cheerful, for she was +melancholy before. The palpitation grew less and less, and she rested at +night, and is now doing her own work for a family of five, and is +sixty-one years old. + +I have taken delight in recommending to others this wonderful medicine +for heart and liver trouble; she took a dozen bottles to effect the +desired end. + + Respectfully yours, + Miss LU WINTER, + Dakota, Winona Co., Minn. + + +TORPID LIVER, SUPPRESSED MENSTRUATION. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Fitzgerald. ] + +_Gentlemen_--I had suffered so much for years from "Liver Complaint" +that I did not care whether I got well or not, but my husband urged me +to take your "Golden Medical Discovery." I had not had my courses for +six months; after I had taken your medicine about two months, I was +well. + +When one of my daughters with a baby two weeks old was in so much pain +that she could not rest day or night, I went to her as quickly as I +could, and commenced giving her your "Favorite Prescription." The next +morning the pains were all gone. She said, "oh, mother, I would have +died if you had not come. I do feel so good." Your medicine makes people +feel like they wanted to live. There is a woman at Verdi who had several +children who died with consumption of the bowels and _chronic diarrhea_. +She had another one who was going the same way. The doctor said it was +bound to die. I went there and gave it five drops of Dr. Pierce's +Extract of Smart-Weed, and increased the dose every time its bowels +moved, until I got to a half teaspoonful. The next morning the child was +almost well. That woman says I saved her baby's life. + +I could write a week and not tell half the good your medicines have done +through my hands. Two weeks ago, a young man at my house was taken with +_cholera morbus_. He thought he was surely going to die, but as quickly +as I could get some hot water, I put hot applications on his stomach and +bowels, and gave him a few doses of your Extract of Smart-Weed. He got +well immediately. MRS. MARY ISABELL FITZGERALD. Reno, Washoe Co., Nev. + + +LIVER DISEASE AND NERVOUS DYSPEPSIA. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: I. Rhue, Esq. ] + +_Gentlemen_--I was weak, nervous, dizzy, with a fainting sensation when +walking; could not walk any distance, always feeling hungry but always +felt bad; after eating felt as though my victuals were sticking in my +throat; could not rest well at night; I was not well all winter. In 1891 +took sick and quit work; in March doctored with three different doctors +with very little benefit for a good deal over a year, then began taking +your "Golden Medical Discovery." Took ten bottles of that, and one +bottle of your "Pleasant Pellets," and steadily improved all the time I +was taking your medicine and have worked all this summer; did not work +for two years. + +My case was liver disease and nervous dyspepsia of which your medicine +has cured me, for which receive my sincere thanks. + + Respectfully yours, + ISRAEL RHUE, + Morrisdale Mines, Clearfleld Co., Pa. + + +TORPID LIVER. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +_Gentlemen_--From early childhood I have suffered from a sluggish liver +with all the disorders accompanying such a condition. Doctors' +prescriptions and patent medicines I have used in abundance; they only +afforded temporary relief. I was recommended to try Dr. Pierce's +Pleasant Pellets. I did so, taking three at night and two after dinner +every day for two weeks. I then reduced the dose to one 'Pellet' every +day and continued this practice for two months. I have in six months +increased in solid flesh, twenty-six pounds. I am in better health than +I have been since childhood. Drowsiness and unpleasant feelings after +meals have completely disappeared. + + Respectfully yours, + U.S. Inspector of Immigration, Buffalo, N.Y. + John H.M. Berry + + +LIVER DISEASE, CONSTIPATION. + +DR. R.V. PIERCE, Buffalo, N.Y.: + +[Illustration: Mrs. McDaniel.] + +_Dear Sir_--I enclose you my photograph as you requested; also, state +that I have taken your "Pellets" and "Golden Medical Discovery" for +chronic "liver complaint" attended with constipation of the bowels, and +after using six bottles of "Discovery" and same of "Pellets," I am +greatly benefited. You can use my name in advertising your medicines and +I can warrant them to do all you claim for them. + + Respectfully yours, + Mrs. M.F. McDANIEL, + Bee Branch, + Van Buren Co., Ark. + + +TORPID LIVER, DYSPEPSIA, NERVOUS AND GENERAL DEBILITY. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: J.F. Hudson, Esq.] + +_Dear Sirs_--Having suffered severely, for a long time, from a torpid +liver, indigestion, constipation, nervousness and general debility, and +finding no relief in my efforts to regain my health, I was induced to +try your "Golden Medical Discovery" and "Pleasant Pellets." + +Under this treatment I improved very much, and in a few months was able +to attend to my professional duties. + +I now feel very grateful for the benefits I have received from the use +of your valuable medicines, and recommended them to many of my friends +and neighbors. + + Respectfully yours, + J.F. HUDSON, + Witcherville, Sebastian Co., Ark. + + +"TROUBLESOME COMPLAINTS." + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, NO. 683 Main Street, Buffalo, +N.Y.: + +[Illustration: Miss Cheney.] + +_Gentlemen_--After using five bottles of Dr. Pierce's Golden Medical +Discovery, four bottles of Dr. Pierce's Favorite Prescription, and about +half-a-dozen packages of his "Pellets," I am convinced that I am +thoroughly cured of that dread disease, known as dyspepsia, and other +troublesome complaints. + + Very sincerely yours, + MISS HATTIE L. CHENEY, + Sac City, + Sac County, Iowa. + + +LIVER AND KIDNEY DISEASE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Ray.] + +_Gentlemen_--Your kindness to me I can never forget, I cannot express +half my feelings of gratefulness to you. I had despaired of ever getting +well. + +I had been in bad health twenty years--liver and kidneys, all out of +order and aches all through me; numb hands and cold feet. Everything I +ate distressed me, bowels constipated, was very nervous, depressed and +despondent; in fact I can't express half my bad feelings to you. When I +first wrote to you, I thought I would not live to get an answer from +you. + +I have taken twenty bottles of "Golden Medical Discovery" and "Pellets." +My health is now very good. You have my honest recommendations to all +sufferers. + + Thankfully yours, + MRS. REBECCA RAY, + DeAnn, Hempstead Co., Ark. + + +LIVER AND KIDNEY DISEASE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: G.W. Sweeney, Esq.] + +_Gentlemen_--I was for years hardly able to go about. I suffered from +liver and kidney trouble, six different Doctors treated me during that +time but could do me no good. I give your "Medical Discovery" the praise +for my cure. + +Then, too, my wife had a bad case of Asthma which was cured by the use +of that wonderful blood-purifier. + + Yours truly, + GEO. W. SWEENEY, + Haydentown, Pa. + + +TORPID LIVER. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Bransford.] + +_Gentlemen_--I can truthfully say that I believe your "Golden Medical +Discovery" saved my life. When I began your treatment two years ago, I +had been given up by the Doctor, and my friends had lost all hope of my +recovery. I had suffered for years with torpid liver; I had chronic +pleurisy and catarrh in a very bad form, attended with hemorrhages--was +confined to my bed two months. In a few days after beginning your +medicine I could perceive a slight change for the better; in three +months I felt almost like a new person. + + Yours very gratefully, + MRS. MAGGIE E. BRANSFORD, + Williamsburg, W. Va. + + +DYSPEPSIA, UTERINE DISEASE. + +[Illustration: Mrs. Martin. ] + +MRS. J.A. MARTIN, of _Cleburne, Texas_, had not had good health since +the birth of her child, eight years before; had a headache with burning +and throbbing sensations; and a hurting in her stomach; there was a dead +aching and gnawing or drawing of the stomach as she described it; sharp +pain in the stomach extending to her right breast and shoulder. Weighed +in health 125 pounds, but was reduced to 95 pounds; was weak; could +scarcely walk at all, was sick at stomach a great deal; when her monthly +sickness came on had much pain and the sickness of the stomach remained +until menstruation stopped. She writes: + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +_Gentlemen_--"I have taken about six bottles of your 'Golden Medical +Discovery' and 'Favorite Prescription,' and am glad to say that I feel +better and stouter than I have felt in a long time. I can work all day +now and not be tired at night. My head don't trouble me now. When I +commenced the use of the medicine I weighed 89 pounds, and to-day I +weigh 98 pounds. I feel better than I have for months." + + +DYSPEPSIA AND CONSUMPTION. + +DR. R.V. PIERCE, Buffalo, N.Y.: + +[Illustration: Mrs. Ferguson. ] + +_Dear Sir_--I was not able to do my work for nearly two years, and I +tried four different doctors and grew worse all the time. Then I began +on your medicine and took twelve bottles of "Golden Medical Discovery" +and one of "Favorite Prescription," and am able to do my work and feel +as well as I have felt in years. Physicians called my disease Dyspepsia +and Consumption. + + Respectfully yours, + MRS. R. FERGUSON, + Ink. Shannon Co., Mo. + + +DYSPEPSIA, COSTIVENESS. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Wickline. ] + +_Gentlemen_--I suffered a great deal with headache and dizziness in my +head and costiveness. My food would sour on my stomach and I would spit +it up. I also suffered with my back a great deal; in fact, I was +entirely broken down. Had different doctors but none seemed to do me any +good and I began to take your medicine--the "Golden Medical Discovery." + +I have been enjoying better health since I have taken your medicine than +I had for years before. I have recommended it to my friends; I believe +it to be the best medicine in the world. My sister has taken more of +your medicine than I have; her husband has also taken it; she thinks +there is no medicine in the world so good as Dr. Pierce's. + + Yours truly, + MRS. MAGGIE WICKLINE, + Box 95, Pulaski City, Pulaski Co., Va. + + +DYSPEPSIA OF FIFTEEN YEARS. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Strawderman. ] + +_Gentlemen_--Dr. Pierce's Golden Medical Discovery and "Favorite +Prescription" cured me of dyspepsia after fifteen years' suffering. I +doctored a great deal without receiving any benefit. About four years +ago my attention was called to Dr. Pierce's Favorite Prescription, which +was highly recommended for dyspepsia and I used three bottles of +"Prescription" and eight bottles of "Golden Medical Discovery," and they +have done me more good than all other medicines I ever used. + + Yours truly, + MRS. ANGELINE STRAWDERMAN, + Philippi, Barbour Co., W. Va. + + +DYSPEPSIA, SHORTNESS OF BREATH. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: W. Goodwin, Esq. ] + +_Gentlemen_--I was in bad health when I commenced your treatment; I was +troubled with my stomach, and with shortness of breath. Everything I ate +distressed me. I lost flesh and strength and became very nervous and +despondent. I took eight bottles of "Golden Medical Discovery," and six +bottles of "Pellets," and they cured me. + +I would advise all suffering people to go under your treatment. + + Respectfully yours, + WRIGHT GOODWIN, + Gaylord, Beaufort Co., N.C. + + +DYSPEPSIA IN ITS WORST FORM. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: E. Dieterly, Esq.] + +_Gentlemen_--Only those who have had dyspepsia in its worst forms know +what it really can be. What such a case needs I have found in your +kindly encouragement, and your "Golden Medical Discovery." + +Although I can now claim, if any one can, that I have a cast iron +stomach, I always keep your "Golden Medical Discovery" and the "Pellets" +on hand when settling down from an active summer's vacation, to quiet +student life. + +I heartily recommend these medicines to every one whose suffering is of +the nature that mine was. + + Yours truly, + ERVIN DIETERLY, + Gettysburgh, Pa. + + +DYSPEPSIA AND "FEMALE WEAKNESS." + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Hutchinson.] + +_Gentlemen_--Words fail to describe my sufferings before I took your +"Golden Medical Discovery" and "Favorite Prescription." I could not walk +across the room without great suffering, but now I am able to do my own +work, thanks to your wonderful medicines, I am a well woman. I suffered +all the time with a weight in the bottom of my stomach, and the most +severe bearing-down pains, low down, across me, with every step I +attempted to take. I also suffered intense pain in my back and right +hip. At times I could not turn myself in bed. My complexion was yellow, +my eyes blood-shot, and my whole system was a complete wreck. I suffered +greatly from headaches, and the thought of food would sicken me. Now I +can eat anything, and at anytime. My friends are all surprised at the +great change in me. Every one thought I would not live through the month +of August. Two of my neighbors are using your medicines, and say they +feel like new beings. + + Truly yours, + MRS. ANNIE HUTCHINSON, + Cambridge, Dorchester Co, Md. + + +INDIGESTION AND NERVOUSNESS. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Livingston.] + +_Gentlemen_--I am a woman of fifty-six years of age. Had been troubled +with Indigestion for three years, which, I think, resulted from "change +of life" and overwork. An eminent physician informed me I had no organic +disease. But I had distress after eating and was troubled with gas in +parts affected, an unpleasant taste in my mouth in the morning. I was +weak and nervous and had to live on a very light diet. After taking your +"Golden Medical Discovery" I was relieved of these symptoms. I believe +the results warrant me in recommending it to others. + + Yours respectfully, + MRS. CHARLES LIVINGSTON, + Livingston, + Grant Co., Wis. + + +INDIGESTION AND TORPID LIVER. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: E.M. Seavolt, Esq. ] + +_Gentlemen_--I can heartily recommend your "Golden Medical Discovery" to +any one who is troubled with indigestion and torpid liver; I was that +bad it was about chronic with me. All the other medicines could give me +no relief; but at last, what came to my relief was that wonderful +medicine, the "Golden Medical Discovery." I could scarcely eat +anything--it would put me in terrible distress in my stomach; I had a +dull aching and grinding pain in my stomach with pain in my right side +and back, and headache, bad taste in my mouth; at night I was feverish +and the soles of my feet burned. + +I took four bottles of the "Discovery" and two vials of the "Pellets." I +am well and hearty and can eat as well as any body can,--thanks to your +"Discovery." + + Yours truly, + E.M. SEAVOLT, + No. 427 Sandusky St., + Mount Vernon, Knox Co., Ohio. + + +DISEASE OF STOMACH. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: A. Lewis, Esq.] + +_Gentlemen_--Yours of the 4th instant was duly received. I take great +pleasure in recommending to the public your system of home-treatment for +chronic diseases. I am thankful to say I am in perfect health and have +worked every day since I last wrote to you and have not taken a particle +of medicine of any kind and am weighing about one hundred and eighty +pounds. I have taken your "Golden Medical Discovery" with very +satisfactory results, and "Pleasant Pellets" also. + + Yours respectfully, + ARTHUR LEWIS, + Schoharie, Schoharie Co., N.Y. + + +RHEUMATISM. + +WHAT A MINISTER SAYS. CURED FOR $4. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Rev. W. Williams.] + +_Gentlemen_--In the fall of last year I suffered from rheumatism in my +left shoulder and elbow. I tried a great many remedies, recommended to +me by friends, but they all failed to afford relief. From that time I +began Dr. Pierce's Golden Medical Discovery, until I felt that I was +cured, was a period covering four or five months. While the attack +lasted, I suffered a great deal, and could not dress or undress myself. +Although I am 73 years old, I now regard my health as splendid. I had +spent a great deal of money previously, in various kinds of medicine, +but the "Discovery," from the day I commenced until I was well, cost +only FOUR DOLLARS. + +Accept my gratitude, and I beg to subscribe myself, + + Sincerely yours, + Rev. WILSON WILLIAMS, + Trinity Station, Morgan Co., Ala. + + +HEADACHE AND CONSTIPATION. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Miss Wolfe.] + +_Gentlemen_--I suffered from loss of appetite, constipation, neuralgia, +and great weakness, and had terrible attacks of sick headache very +frequently; also nose bleed. My health was so poor that I was not able +to go to school for two years. I took Doctor Pierce's Pleasant Pellets +and "Golden Medical Discovery," and in a short time I was strong and +well. Many friends are taking your medicines seeing what they have done +for me. + + Respectfully yours, + Miss BERTHA WOLFE, + Markham, Cattaraugus Co., N.Y. + + +AS LIVER PILLS, + +NOTHING CAN COMPARE WITH DR. PIERCE'S PLEASANT PELLETS. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mr. S. Baker, Sr.] + +There is nothing that can compare with Dr. Pierce's Pleasant Pellets, as +Liver Pills, They have done me more good than any other medicine I have +ever taken. + + Respectfully yours, + SAMUEL BAKER, + No. 161 Summit Ave., + Phillipsburg. N.J. + + +ULCERATION OF BOWELS. + +SEVERE BLEEDING. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Aurelia Vanzile. ] + +_Gentlemen_--My friends said I would never be any better, for I had +ulceration of the bowels. By the time I had taken a bottle and a half of +Dr. Pierce's Golden Medical Discovery, the bleeding had almost stopped. +My appetite was good, nothing seemed to hurt me that I ate. My +improvement was wonderful. Several years have passed and my cure is +permanent. + + Yours respectfully, + Mrs. AURELIA VANZILE, + Hamilton, Ind. + + +BILIOUS ATTACKS. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: I.C. Seely, Esq.] + +_Gentlemen_--Nine years ago I was taken with severe pains in my stomach +and bowels which the usual home remedies failed to relieve; after +several days it passed off, leaving me very sore and weak but in the +course of a few weeks it came on again. I called in a doctor--he treated +me for biliousness; I occasionally went several months without any +attack and then it would come more severe than ever; I could scarcely +bear the weight of my clothes on my stomach and bowels. I grew thin, +weak and despondent,--could do no work without bringing on terrible +pain. Doctors treated me for catarrh of the head and stomach, +indigestion, dyspepsia, but all was of no avail; the suffering gradually +increased in severity and I despaired of any relief. + +In 1892 I had a spell that was so severe I cramped from feet to neck. +The Doctor said I must die--he couldn't do any thing for me. After about +five weeks in bed I could again sit up, but the pain had settled in my +right groin and limb. Relatives persuaded me to try "Golden Medical +Discovery." Two thirds of the bottle was gone when I felt a change for +the better; I had one very light attack after the first bottle; that has +been seventeen months ago and I have had no more trouble. I have taken +ten bottles of Dr. Pierce's Golden Medical Discovery and I am now well +and able to support my family. + +To any one with stomach and bowel trouble I will recommend Dr. Pierce's +Medicine. I am never without it in the house. + + I remain, yours, + I.C. SEELY, Lindsborg, + McPherson Co., Kans. + + +DYSPEPSIA--CONSTIPATION. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, 653 Main St., Buffalo, N.Y.: + +[Illustration: Mrs. A.L. Pierce.] + +_Gentlemen_--Three years ago I was suffering from constipation, distress +in the stomach, bowels, feet and ankles bloated, kidney and heart +trouble, loss of appetite, bad taste in the mouth, sour risings in the +stomach, and indigestion. I was under the treatment of three physicians +seven months. One gave me up to die. This was my condition when I was +prevailed upon to take Dr. Pierce's Golden Medical Discovery and +"Pleasant Pellets." I am well, your medicines have cured me permanently. +Had I the power and language to herald to the whole world the good +qualities of your medicines, I would most gladly do so, as they have +saved my life and brought health and happiness to me. + + Yours most sincerely, + MRS. A.L. PIERCE, + Stillwater, Penobscot Co., Me. + + +SORES IN MOUTH DUE TO INDIGESTION. + +[Illustration: C.K. Turney, Esq.] + +CHAS. KELLOGG TURNEY, ESQ., a prominent contractor and builder, also +well known as one of the accomplished singers at the Chautauqua +Assembly, and who does business at _Room 6, Bernard Block, Collinwood, +Cuyahoga County, Ohio_, writes: + +"I was troubled with little watery blisters which would form on the +under side of my tongue, and which proved very sore and troublesome. +Becoming alarmed at the frequency of their appearance, and having much +faith in Dr. Pierce and his associates, I wrote to them for advice. They +recommended me to take Dr. Pierce's Golden Medical Discovery, which I +did, and after using two bottles my trouble entirely disappeared." + + +GAINED THIRTEEN POUNDS; CATARRH OF STOMACH. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Powell. ] + +_Gentlemen_--Two years ago I was pale and emaciated, food fermented in +my stomach. A physician pronounced my case "Catarrh of the Stomach," but +he could not help me. I lived a month without solid food and when I +tried to eat I would vomit. At this time I began taking Dr. Pierce's +Pleasant Pellets, and in two weeks I was decidedly better. I am now in +good health, and never felt better in my life. I have a better color, +eat more, and have no distress after eating--having gained thirteen +pounds since I began taking them. + + Yours respectfully, + MRS. MARY POWELL, + Glen Eaton, Marshall Co., W. Va. + + +CHRONIC DIARRHEA--DYSPEPSIA. + +[Illustration: T.L. HALL, ESQ.] + +THOMAS L. HALL, of _Creek, Westmoreland County, Pa.,_ had chronic +diarrhea, which his physician called dysentery. He had been troubled +more or less for five years; had very severe attack fifteen months +before writing us; had not been able to work steadily for twelve months. +Food sometimes passed undigested; some days had three to six passages; +had watery and sour risings from the stomach; backache; was drowsy upon +rising in the morning; pain about the heart; itching all over body and +limbs. He had three months' treatment at home--the special medicines +being sent him by express. He writes that he "was greatly benefited by +first week's treatment," but continued and "in three months was entirely +well." + + +DYSPEPSIA--LOSS OF FLESH. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, NO. 663 Main Street, Buffalo, +N.Y.: + +[Illustration: B. MAKSON, ESQ.] + +_Gentlemen_--Three years ago I commenced taking Dr. Pierce's Golden +Medical Discovery; I weighed 140 pounds, and now I weigh 175 pounds, so +you see how I have gained in health and weight. Dr. Pierce's Pellets are +the best pills I ever took for the liver. All my friends say they do +them the most good. + + Respectfully yours, ROBERT MANSON, + West Rye, Rockingham Co., N.H. + + +TERRIBLE DYSPEPSIA CURED. + +[Illustration: MRS. LUKE COOK.] + +Mrs. LUKE COOK, of _Grove, Newaygo Co., Michigan_, writes: + +"I had been ill for five years. My symptoms were pain in the stomach and +bowels; could eat nothing but stale bread and tea or coffee. Meat and +vegetables passed through the bowels undigested in about two hours, +causing great pain. I was all "run-down." Tongue looked like a piece of +raw meat. One doctor pronounced my case cancer of the stomach. I took +treatment from five different physicians with but very little +benefit--only temporary relief. I got so weak I could scarcely walk +around, and suffered terrible agony. After taking fifteen bottles of Dr. +Pierce's Golden Medical Discovery, I am well and able to do my own work, +and frequently walk two miles and back the same day. I am now +sixty-eight years old." + + +INDIGESTION, CATARRH, AND NERVOUSNESS. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, NO. 663 Main St., Buffalo, N.Y.: + +[Illustration: E.A. BALDWIN, ESQ.] + +_Gentlemen_--For a long time I was suffering from indigestion, catarrh +and nervousness. I was so run down that I could not go to school, and, +as the various remedies I tried did me no good, I applied to you, and +was advised to try a course of special treatment. After taking only two +months' medicines from your noble institution, I feel perfectly restored +to health. I have, moreover, recovered my lost flesh, and I am pleased +to say need no further medicines. + + Yours truly, + E.A. BALDWIN, + Proctorsville, Windsor Co., Vermont. + + +GENERAL DEBILITY, MALARIA, SICK HEADACHE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: T.L. Hall, Esq. ] + +_Gentlemen_--I am happy to say that your valuable medicine has been a +great benefit to me. I was suffering from general debility, malaria and +nervous sick headaches, and after my third child was born (a beautiful +baby boy of ten pounds) I only recovered after a long illness; I barely +gained strength enough in two years' time so that I was able to crawl +about to accomplish the little housework that I had, by lying down to +read many times each day; had sick headaches very often; and many pains +and aches, all the time complaining of getting no better. I finally +asked my husband to get a bottle of Dr. Pierce's Favorite Prescription, +which he promptly did. After I had taken one bottle I could see a great +change in my strength, and fewer sick headaches. + +I continued taking the medicine until I had taken eight bottles--seven +of the "Favorite Prescription" and one of the "Golden Medical +Discovery." For some time past I have not used it, but I am now able to +do the housework for myself, husband and two children (aged nine and +five years). I also take in dressmaking, and enjoy walking a mile at a +time, and I think it is all due to the medicine, for I know I was only +failing fast before I commenced to take it. I take great pleasure in +recommending the "Favorite Prescription" to all women who suffer from +debility and sick headache. + + Respectfully yours, MRS. J.H. LANSING, + Fort Edward, Washington Co., N.Y. + + +MALARIAL FEVER. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Miss McConell.] + +_Gentlemen_--My little girl, eleven years old, took malarial fever and +lay 22 days in fever. Our family doctor was tending her twice a day; she +got no better; I sent unbeknown to the doctor and got one bottle of Dr. +Pierce's Pellets, and one bottle of his "Golden Medical Discovery," and +commenced to give them to her as directed; after taking the medicine +three days, the fever began to go down, and the doctor came in and said: +"what's the matter?" "Ida, you have no fever this morning," and laughed. +Then I told him I had been giving Dr. Pierce's medicines. He didn't say +a word--he was beaten. My oldest daughter is improving by taking Dr. +Pierce's Favorite Prescription. + + Yours respectfully, + MRS. ELIZABETH McCONELL, + Payne, Paulding Co., O. + + +GENERAL DROPSY. + +TAPPING AND MEDICATION CONQUERS THE DISEASE AFTER IT HAD RUN 22 YEARS. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: E.L. Waters, Esq.] + +_Gentlemen_--I wish to acknowledge that you have cured me of the worst +dropsy that ever came within my knowledge, it having afflicted me +twenty-two years. After I had suffered much from other surgeons without +any cure being effected, and with only relief for a short time, you +performed a not only painless but very scientific operation, and with +medicine completed the cure. It is now five years since you treated me +and no symptoms of the disease have shown themselves. I will also add +that while with you at the Invalids' Hotel I received the best of care +and attention from the well trained nurses in your employ, for all of +which I feel grateful. + + With respect and best wishes, + EDWIN L. WATERS, ATHOL CENTRE, MASS. + + +REDUCED TO A SKELETON. + +CHRONIC DIARRHEA--DYSPEPSIA CURED BY TWO MONTHS' SPECIAL HOME-TREATMENT. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: J.T. Yerby, Esq.] + +_Gentlemen_--To all sufferers from chronic diseases I want to say that I +suffered for six years, and was under fourteen different doctors in city +and country. They could not reach my case; I was given up to die; my +sufferings were _indescribable_; I could not retain food on my stomach; +could not control my bowels at times; suffered great pain; could not +sleep at night; I was reduced to a _skeleton_; in health I weighed 180; +then only 111; I now weigh as much as I did before I was sick. I am +sixty years old, but feel young and active; I owe it to the medicines +you sent to me. After taking it two months I was out of bed attending to +my work; my friends could hardly believe it was I when they would meet +me out away from home. I consider my cure as almost miraculous. + + Respectfully, + JOS. T. YERBY, + White Stone, + Lancaster Co., Va. + + +CHRONIC DIARRHEA. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: I.G. Hamilton, Esq.] + +_Gentlemen_--It is now nine years since I was afflicted with the above +disease, which reduced me to a mere skeleton, and my friends had very +little hope of my recovery. After trying different doctors, and many +other remedies for a year, from which I received little or no benefit, I +was advised to try Dr. Pierce's special treatment, which I did, and +after two months I was a well, strong, healthy man, and have been ever +since. + + Yours, etc., + ISAAC G. HAMILTON, + Baie Verte, + Westmoreland Co., N.H. + + +DYSPEPSIA OR INDIGESTION. + +KIDNEY DISEASE AND RUPTURE. + +[Illustration: A.N. Kingsley, Esq.] + +The following is from the widely-known and popular proprietor of the +Kingsley House at Ashuelot, N.H.: "It may seem useless to add testimony +to the overwhelming mass already given of the many remarkable cures +performed at your Institution, but I deem it a pleasure and a duty to +add mine to your long list as _very remarkable_. I had a rupture of +twenty-seven years' standing, with hemorrhage of the kidney for six +months, preceding my visit to your Institute, and was also troubled +badly with indigestion, all of which ailments had reduced me in strength +and flesh to a mere skeleton. Had been treated by many local physicians, +who failed to do me any good. I could walk but a very short distance +when I left my home on the 8th of July, 1892, for treatment at your +Institution, with but little faith or hope of ever being any better. But +through your skillful treatment I was able to return to my home on the +9th of August, 1892, and consider myself permanently cured, having had +to take no medicine since. Considering my case _almost a miracle_, I +cannot speak too highly of your Institute and skillful treatment, to +which I feel that I am indebted for my continued existence. You are at +liberty to refer to me, and to use this as you see fit. + + Very respectfully, A.N. KINGSLEY, + Ashuelot, Cheshire Co., N.H." + + +DYSPEPSIA, RHEUMATISM, NERVOUS PROSTRATION, SLEEPLESSNESS. + +[Illustration: J.T. Townsend, Esq. ] + +Mr. J.T. TOWNSEND, of _Noah, Coffee County, Tenn_., consulted us by +letter. He was suffering from great nervous prostration; could not walk +without tottering; was troubled greatly with inability to sleep; poor +appetite; did not relish food; suffered much pain and stiffness in the +joints; was overcome with neat working on a thresher, followed by +persistent nausea, confusion of ideas, his memory being very defective. + +After taking a single course of treatment, the medicines being sent by +express, he writes as follows: "The medicine you sent me lasted me five +weeks, and proved very beneficial indeed. I believe it, under God, was +the means of saving me from a premature grave. When I received the +medicine, I had just gotten rid of an attack of bilious fever, which +left me in a deplorable condition. I was very week and nervous, but my +improvement commenced with the first dose of your medicine, so by the +time my medicine was out I felt better than I had for years, and now +have no indication of a return of my trouble." A month later he writes: +"I continue to enjoy the most perfect health. Every organ of my body, +and every faculty of my mind, is in splendid condition, which makes life +worth living. I have gained twenty-one pounds since I have been able to +attend to business. Please accept my profound thanks for your promptness +in sending me my medicines." + + +NERVOUS DEBILITY. + +PILES, CATARRH, HEART SYMPTOMS. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: J. Talbott, Esq. ] + +_Gentlemen_--The effect of your remedies is little short of a miracle. +My general make-up and appearance are astonishing; my cheeks rosy, eyes +bright, circles nearly all gone from under eyes; am fleshier, stronger, +more active, and an entirely different man. No piles, catarrh, heart +trouble; no chills and fever; no despondency, no anything. + + Yours truly, + JOHN TALBOTT, + Pennsylvania Agricultural Works, + York, York Co., Penn. + + +DYSPEPSIA AND CATARRH + +CURED BY SPECIAL HOME-TREATMENT. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: B. Eberhardt, Esq. ] + +_Gentlemen_--I am happy to inform you that my catarrh and dyspeptic +symptoms have all vanished. I am no longer troubled with headache and +stoppage of the nose, my stomach is in good order, and I enjoy three +hearty meals daily without any bad feelings. + +I have gained in almost every respect, particularly in weight and +strength, since beginning the use of your specially prepared medicines. +By continuing to follow your special hygienic rules, I believe no +relapse will occur. + + Yours respectfully, + BERTHOLD EBERHARDT, + N.E. Cor. 10th, and Callowhill Streets, + Philadelphia, Pa. + + +INDIGESTION, CONSTIPATION, AND UTERINE DISEASE. + +WORLD'S DISPENSARY MEDICAL, ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Miss Joslyn.] + +_Gentlemen_--Some months ago I consulted your specialist concerning my +health, which had at that time become very much impaired from the +effects of uterine disease, indigestion and chronic constipation. I was +also troubled with frequent attacks of nervous headache which rendered +me very miserable. + +A line of treatment was outlined by your specialist, which I followed +closely, and I immediately began to improve under the use of the +medicine advised. The benefits wore so marked that within two or three +months I was able to discontinue the use of the medicine, and have since +that time been enjoying good health. I attribute my cure to the use of +your medicines, and I heartily thank you for the benefits received, as +well as for the kind attention given me by your specialist. + + Respectfully yours, + IDA M. JOSLYN, Groton, Conn. + + +CHRONIC BRONCHITIS AND DYSPEPSIA. + +WORLD'S DISPENSARY MEDICAL, ASSOCIATION, Buffalo, N.Y.: + +[Illustration: A. Rosenberger, Esq.] + +_Gentlemen_--Several years ago I spent many dollars for medicine, but in +vain, and expected to die with consumption. But hearing of your +Invalids' Hotel and Surgical Institute, I visited you. + +To your advice and treatment I owe my life and present good health. + +Hoping-that you and your eminent faculty may be spared many years to +cure the afflicted, I send you my best wishes. + + Yours truly, + ALBERT ROSENBERGER, + La Otto, Noble Co., Ind. + + +A COMPLETE COLLAPSE. + +STOMACH TROUBLES + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.: + +[Illustration: J.L. Warner, Esq.] + +_Gentlemen_--Fifteen years ago I felt the first effect of a diseased +stomach. It was very light at first, but as time went on it gradually +grew worse. I did not suffer much at first--say for the first five +years; but after that it was continual suffering all the time (and +growing worse all the time), until just two years ago, when I completely +collapsed, and had to give up all thoughts of work. I have not done a +day's work since, but am now ready to go to work again. During the last +five years I have been doctoring with as many as six different doctors +here and in San Francisco. I was with one specialist here in my city +five months, but none of the doctors gave me even temporary relief. The +main symptoms of my disease were that my food would sour on my stomach +and give me an awful heart-burn. I would bloat and have sour risings, +and an awful burning sensation in my chest which would bring the tears. +I have felt many times that I would like to leave this world. In looking +over the ads. in the San Francisco Examiner, I ran across yours--stating +that any one who would send twenty-one one-cent stamps to the address +given would receive The People's Common Sense Medical Adviser I did as +requested, and read a copy, and I now owe my life and present good +health to Dr. Pierce and his noble staff of physicians. I have now taken +fourteen bottles of the "Golden Medical Discovery" and four bottles of +the "Pleasant Pellets," and will say that I am entirely well of all my +stomach troubles. Can sleep nine hours every night. + +A word to those who are taking or contemplating taking this grand +remedy. Do not give up with one or two bottles, but continue on, and it +will cure you as sure as the sun shines above. + + Gratefully yours, J.L. WARNER, + 1005 Fourth Street, Sacramento, Cal. + + +NERVOUS DYSPEPSIA. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: J. Smith, Esq.] + +_Gentlemen_--For over twelve years I was a great sufferer from nervous +indigestion and acidity of the stomach. I tried some of the best +doctors, both in England and this country, but did not find permanent +relief until I went to the Invalids' Hotel and Surgical Institute. The +medicine prepared for me by the specialist at this famous institution +was so effectual that I feel that I am perfectly cured. + +I cannot speak in too high praise of the Invalids' Hotel and Surgical +Institute. The Staff of Physicians is skillful and of large experience, +and the institution itself, in all its appointments, excellent and in +advance of the age. I highly recommend it to all the afflicted, feeling +confident that all the benefit to be derived from medical or surgical +treatment can be had at that institution. + + JOSEPH SMITH, + No. 200 Eighth Street, Olean, N.Y. + + +BAD CASE OF DYSPEPSIA, + +CURED BY SPECIAL HOME-TREATMENT. + +[Illustration: Mrs. Johnson. ] + +Mrs. JOHANNA JOHNSON, of _Big Springs, Union Co., South Dak_., forty-six +years old. A pain began in the stomach, a sort of cramp; extended to the +chest, shoulders and arms, also affecting the spinal column opposite the +location of pain; had a hard lump that felt like lead in the pit of her +stomach. Pain was brought on sometimes by eating something that at other +times she could eat with impunity. Attacks of pain lasted usually about +three days. After the pain would leave, she was weak and sore. Sometimes +attacks would come on every day. + +Had two months' special treatment. + +Reports five months afterwards as follows: "Since taking your medicine, +I am a new person; at least I feel so. I have used only one-half of the +last set of medicines, and think I will not need to continue. A lady +similarly afflicted is trying some of my medicine, and will order from +you direct. I am glad to know where to direct the sick, and where the +most good can be had for one's money. I am feeling well, and can work as +formerly." + + +INDIGESTION AND CONSTIPATION. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: O.F. Sinigar, Esq.] + +_Gentlemen_--I was troubled with chronic indigestion and constipation. +Had to be constantly taking physic, and finally was compelled to resort +to hot water injections regularly to move my bowels. This got to be a +great drudge to me. I took treatment from the leading physicians of this +part of the country for my stomach and bowel troubles, and spent over +one hundred dollars in this way, but they did me no good whatever. I got +so bad that I began to think my time on earth was short, and did not +care if I lived or died. I had to stop work; everything was a burden to +me, until at last I tried your Institution. I went there, and you said +you could help me, and those words sounded so good to me, as I thought I +never could get well again. After taking your special home-treatment for +five months, I was in the enjoyment of perfect health. This was two +years ago, and ever since my bowels have moved regularly, and I have not +taken any medicine to make them move. I cannot find words in which to +express my sincere thanks for the almost immediate relief. I received +from your specialists, and will say I am now enjoying the very best of +health. + + Yours with respect, + ORWIG F. SINIGAR, No. 71 Feather St., Canton, Ohio. + + +FISTULA IN ANO, PILES, PROLAPSE OF RECTUM. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: N.T. Roberts, Esq.] + +_Gentlemen_--For more than twelve years I have been a sufferer with a +complication of rectal troubles; pile tumors, prolapsus and fistula in +Ano. I have been under the treatment of our most skilled practitioners, +by ligature, carbolic acid, constitutional treatment, change of climate +and the celebrated Brinkerhoff treatment, and also tried all of the +local guaranteed nostrums, from all of which I have been only +temporarily relieved. The old troubles would in a short time return, and +with seemingly renewed vigor. With fast failing health and terrible +nerve prostration, I left home the 1st day of October last, to take a +two weeks' trip, hoping for some temporary relief. On the trip I stopped +over at Buffalo, and having several years before been in correspondence +with the Infirmary, concluded to consult you. I did so with little hope +of a beneficial result. From the manner in which I was received and the +satisfactory diagnosis of my case, I placed myself under your treatment. +On the 16th day of October you operated upon me with such complete and +satisfactory success, that I am now a sound and happy man, and am +confident that had I been treated by you ten years ago that I would now +be twenty years younger in feeling and thousands of dollars better off. +It affords me pleasure, doctors, to recommend the Invalids' Hotel and +Surgical Institute to all of the afflicted, and to assure them of the +most skillful treatment, honest and polite attention, and with the +assurance of my kindest and most grateful remembrance, + + I am, Yours truly, + N.T. ROBERTS, Pine Bluff, Ark. + + +RECTAL FISTULA. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Lothrop. ] + +_Gentlemen_--Having been a great sufferer for years and receiving little +or no benefit from other physicians, I determined to try your +Institution, and with grateful results. + +Having a successful operation for a fistula (of five years' standing) +without the knife, while other home-physicians advised me there were no +other means. And my troubles are yielding slowly but surely; my general +health is better than for twelve years--all of which I owe to Dr. +Pierce, and his skillful physicians and surgeons. + +Please accept my sincere thanks for the kindness shown me while an +inmate by all connected with the Invalids' Hotel. I shall heartily +recommend your Institution to all sufferers. + + Yours gratefully, + MRS. M.B. LOTHROP, + Villa Park, + Orange Co., Cal. + + +UTERINE AND RECTAL DISEASE. + +HOME PHYSICIANS FAILED. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Clawson.] + +_To whom it may concern_--I was greatly afflicted with Uterine and +Rectal disease. My disease was of very long standing and had baffled the +skill of our home physicians. I went to the Invalids' Hotel and Surgical +Institute, and received treatment of their specialist. Under his +skillful care and kind attention I soon regained my strength and felt +that my former life and ambition were again restored to me. I cannot +speak in too high praise of this famous Institution; the rooms are large +and cheerful, the food of the very best, the nurses kind and attentive, +and the staff of physicians and surgeons skillful and of large +experience. + + Yours respectfully, + MRS. CHAS. CLAWSON, + Middlesex, Yates Co, N.Y. + +RECTAL FISTULA + +WITH BLOOD-POISONING, CURED BY A SAFE AND PAINLESS METHOD. A PROMINENT +MERCHANT TESTIFIES TO THE SUPERIOR METHODS EMPLOYED AT THE INVALIDS' +HOTEL AND SURGICAL INSTITUTE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: J.F. Saton, Esq. ] + +It is with pleasure that I testify to the cure of the Fistula, for which +you treated me. I had suffered from it for a long time, and felt that it +was likely to seriously undermine my health and poison my system. I had +deterred having it treated from the fears of the cutting operation in +common use by physicians in the large hospitals and by surgeons in +general practice. My fears were grounded on the fatal results that had +followed in cases in my knowledge. I am thankful that I placed my case +in the hands of your experienced specialists for treatment. The result +has been a perfect cure. The treatment of the blood-poison that you gave +me was successful in eliminating it all from my system, and I have since +enjoyed perfect health, and no recurrence whatever of the fistula. It +has been now many years since I was cured, and I thank you most +sincerely for the good results that were brought about in my case. + +I can recommend your institution as one in which all the requirements of +an invalid are fully met. + + Yours truly, + J.F. EATON, + Auburn, Mo., Box 806. + + +RECTAL FISTULA AND NERVOUS PROSTRATION-RUPTURE. + +[Illustration: M.L. Stigers, Esq.] + +_To the afflicted public_: + +It becomes my pleasant duty to recommend the Invalids' Hotel, Buffalo, +N.Y., as an Institution for the successful treatment of surgical cases +and chronic ailments of every description. It is with especial pleasure +that I recommend the surgeon-in-chief of the Hotel, who is a skilled +surgeon, one who stands at the head of the profession. The appointments +of the Hotel are excellent. I was afflicted with an Anal Fistula (a very +bad one it proved to be). I went to the Invalids' Hotel for treatment. +Was placed under the care of your surgeon, who treated my case with such +skill, that the parts are healed soundly. I recommended a friend of +mine, who had a rupture, to go to you for treatment. He did so and was +soundly healed of his trouble. I will cheerfully answer all +communications relative to my stay at the Invalids' Hotel, provided a +stamp is enclosed for return postage. + + Yours truly, + M.L. STIGERS, + Menlo, Iowa. + + +ANAL FISTULA. + +COMPLICATED CASE OF HEART DISEASE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.: + +[Illustration: N.S. Johnson, Esq. ] + +_Gentlemen_--I feel that it is my duty to suffering humanity to let them +know of your great success with me. I had a chronic disease that I had +suffered with for sixteen years, and last November, owing to a fall, the +disease doubled on me. I was confined to my bed for months, and the best +surgeons of our city attended me daily. I continually grew worse. After +consultation they decided that the knife must be used, which is attended +with great pain and danger. I wrote you and stated my case; you said you +could entirely cure me without pain, also without the use of the knife. +I determined to go to Buffalo. Arrived there the 18th of March, and on +the 20th of April I was at home entirely cured, and have enjoyed better +health than for years. You also treated my wife for heart trouble, and +greatly benefited her. The thoroughness of your methods, preparing the +system, etc., greatly adds to your success, as well as your skillful +treatment. I shall ever hold the surgeons at the Invalids' Hotel and +Surgical Institute as a green spot in my memory. + + Yours respectfully, + N.S. JOHNSON, Bloomfield, Iowa. + + +HERNIA AND PILES CURED WITHOUT PAIN. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: J.J. App, Esq.] + +_Gentlemen_--I have been successfully treated at your institution for +piles and also rupture of the left side. + +Your institution is all it claims to be, and the treatment of my case +was accomplished without pain and apparently any risk. Your method of +using locally cocaine as an anæsthetic is such a decided improvement. I +did not have to take any dangerous ether or chloroform, but had a small +quantity of medicine injected that made the operation as painless as +though it was being done on some one else. At the same time I knew +everything and could see what was being done. + +You have my kindest thanks for the good care and many attentions given +me. Your nurses and physicians all give kind and skillful care. + + Yours very truly, + J.J. APP, + Bolivar, Tuscarawas Co., Ohio. + + +LARGE PILE TUMORS. + +[Illustration: J.C. Bagley, Esq. ] + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +_Gentlemen_--I was afflicted with piles for many years, brought on by +heavy lifting during the war. My suffering was extreme, and the pile +tumors gradually increased in size, notwithstanding the fact that I +tried many different kinds of treatment. After becoming physically +incapacitated and unable to do any work at all, and after much +hesitation, I visited your institution as the last resort. I am happy to +state that my visit there has resulted in a complete and permanent cure. +A year or more has now elapsed since I placed myself under the care of +your specialist, and I wish to thank you most heartily, for the +attention which I received while there, and for the cure which has been +accomplished in my case. I cannot say enough in favor of you and your +staff of physicians who gave every attention, and whose treatment has +been so successful. All suffering has entirely vanished, and I have +gained about 35 pounds in flesh. + + Respectfully yours, + J.C. BAGLEY, Watts Flats, Chaut. Co., N.Y. + + +LARGE PILE TUMORS; CHRONIC INFLAMMATION OF BLADDER. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: P. Crump, Esq. ] + +I was troubled with piles for thirty years. These were very mild at +first but gradually increased in severity, and I was unable to get +anything which would relieve them. They gradually increased in size, and +for a good many years past have caused me a great amount of pain. The +tumors became of large size and protruded whenever I lifted anything +heavy or strained in the least; also bled copiously at times. This, +together with chronic inflammation of the bladder, with which I have +also suffered for some years, rendered my life miserable. Physicians at +home gave up my case as hopeless, and said that they did not think I +could be benefited, and certainly not cured. I visited your Institution, +hoping to obtain relief, but with very little faith, and am happy to say +that the treatment which I obtained there has resulted in a permanent +cure of the piles, and the inflammation of the bladder has been so +greatly relieved that at present I have no suffering of any kind. The +cure is complete and I feel like a new person. In fact I have not +experienced such comfort in many years. I shall always appreciate the +kindness and attention shown me by your staff of physicians, and also by +the nurses in your Institution, and shall advise my afflicted friends to +make you a visit. + + Very respectfully, + PETER CRUMP, Dennison, Goodhue Co., Minn. + + +PILE TUMORS. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: S.H. Crosby, Esq. ] + +Since the spring of 1872, I have been troubled with pains in head, the +result of sun-stroke while in the U.S. army, and pile tumor growth. For +the last named disease I was treated at the Invalids' Hotel and Surgical +Institute, in June of 1887, and the growth, as I believe, is killed, and +the result has been a great benefit to my general health. I am quite +comfortable and with strength to look after my little work and +superintend the same, much better than before treatment, for which +benefit please accept my thanks. + + Yours respectfully, + S.H. CROSBY, + Manito, Mason Co., Ill. + + +BAD CASE OF PILES CURED BY HOME-TREATMENT. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +_Gentlemen_--I received a few days ago a communication from you +requesting a photo, of myself. I will say that I am sorry, but I have +had no photograph of myself taken since I was a child, but will gladly +give you a testimonial and I will answer by letter any skeptical ones +that you refer to me, provided they send a return addressed and stamped +envelope for reply. + +Just one year ago, I was suffering untold agonies from internal piles +and prolapsus of the rectum: my bodily pain was so great that the mental +strain was almost more than I could stand. I was useless to myself and +family and had about persuaded myself it would be better to take my +life, and I think I should have done so had not a copy of the Common +Sense Medical Adviser happened to fall into my hands. I was not certain +just what my trouble was, at least what to call it. I began the Chapter +treating on Pile Tumors, and then I realized just what my trouble was. I +wrote you and received encouragement. I sent for a month's treatment and +it was certainly the best investment I ever made. I received the +medicines at noon--read the directions carefully and commenced at once +to carry them out. I seemed better the next day. I suffered less, and in +a few days there was a decided change for the better. I continued the +medicine until I had taken all of it; I have not taken any since, except +occasionally a few of Dr. Pierce's Pellets, just enough to act as a mild +laxative. I am perfectly well. I was always more or less constipated all +my life. I now understand that by keeping the bowels open and in good +order, I could have avoided all of the suffering that I have gone +through; my friends all think my recovery almost a miracle. I feel, Oh, +so grateful to you, I shall never fail to speak a word in your favor to +suffering humanity. + + Respectfully, + Mrs. J.W. Heist + Fayette, Howard Co., Mo. + + +PILES AND CHRONIC DIARRHEA. + +DR. R.V. PIERCE, Buffalo, N.Y.: + +[Illustration: J.J. Bradford, Esq. ] + +_Dear Sir_--I was a great sufferer for thirty years from piles, and take +great pleasure in bearing testimony to the fact, that since you treated +me, seven years since, I _have not had a symptom of piles_. + +At the above stated period I had also been a sufferer from diarrhea, in +its most aggravating form, for three and a half years, and I was +completely and radically cured of that, also. + +I beg to assure you, and your noble associates, of my lasting gratitude, +and feel no hesitancy in expressing the opinion that but for your great +skill in treating me, I should have been in my grave. I state for the +benefit of all those who may be similarly afflicted that if they will +place themselves in your hands, you will goon effect radical cures. + + JOHN J. BRADFORD, + Augusta, Perry Co., Miss. + + +LARGE PILE TUMORS. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: L.H. Esety, Esq.] + +_Gentlemen_--Allow me to thank you for the kind attention and skillful +treatment I received while at your Institution for five weeks' +treatment. I cannot speak too favorably of your Institution. + +You have my best wishes for your continued success. + + Respectfully yours, + L.H. ESTEY, + Hinsdale, + Cheshire Co., N.H. + + +HEADACHE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: E. Vargason, Esq. ] + +_Gentlemen_--I have used your medicines for a number of years, and know +that they do for me all that is claimed for them. I am employed mostly +at my desk, and not infrequently have an attack of the headache. It +usually comes on in the forenoon. At my dinner I eat my regular meal, +and take one or two of Doctor Pierce's Pleasant Pellets immediately +after, and in the course of an hour my headache is cured and no bad +effects. I feel better every way for having taken them--not worse, as is +usual after taking other kinds of pills. Your "Pleasant Pellets" are +worth more than their weight in gold, if for nothing else than to cure +headache. + + Very respectfully, + E. VARGASON, + Otter Lake, Lapeer Co., Mich. + + +DYSPEPSIA, NEURALGIA. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Miss Gwin.] + +_Gentlemen_--Before using your medicines, my food would not digest; then +neuralgia set in, and I suffered severe pain through my sides, +shoulders, breast and stomach. Bilious attacks were frequent; then my +flesh began stinging and my heart began beating badly and making me so +that I could not lift a chair, and all together threw me into a cramp +and a numbness, and the family thought I was dying, and sent for another +doctor who said it was hard to do anything for me; he visited me almost +six years and did not help me; the pain was so great I had to scream; I +said to my doctor, "can you give me something" and he said, "yes, but it +will not do you any good." I told him he had not done me any good in six +years, and I would quit him. I saw I was almost gone, very pale and weak +and did not eat anything. + +I began your "Golden Medical Discovery," and one-half bottle helped me +so much I began work and improved fast; it helped me so I got 10 +bottles. While using them my friends said when I quit I would be just as +bad as ever. It has been five years and no need of a doctor yet, and I +will say that I think it cannot be beat, and I will still believe in it, +for if it had not been for the "Golden Medical Discovery" I would have +been in my grave. Your medicines have helped my brother, and father is +using it now and it is helping him. + + I remain. Your true friend, + Miss C.B. GWIN, Cowardin, Bath Co., Va. + + +BLOATING OF BOWELS, CAUSED BY LIVER DISEASE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: MR. G.S. WATRING] + +_Gentlemen_--My son, aged fourteen years, was taken with bloating of the +abdomen; this would go down leaving the parts so sore he could scarcely +stand. We had three different doctors to treat him, but he grew steadily +worse. We then commenced giving him Dr. Pierre's Golden Medical +Discovery, and after using it three days he commenced to improve. Last +summer he had so fully recovered his health as to make a full hand in +the harvest field. He took, in all, only six bottles of the "Golden +Medical Discovery," and it saved his life. + + Respectfully yours, + J.B. WATRING, + Lead Mine, Tucker Co., W. Va. + + +NERVOUS DYSPEPSIA; UTERINE AND SPINAL WEAKNESS. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo. N.Y.: + +[Illustration: MRS. NAY.] + +_Gentlemen_--I had nervous dyspepsia for twenty years, followed by +uterine and spinal weakness with irritation of the same. In the Spring +of 1890 I became so exhausted that I was compelled to keep to my bed +with symptoms of paralysis in the lower limbs, and many other +distressing symptoms. I accidentally obtained one of Dr. Pierce's +Medical Advisers from a friend, and finding my ailments so well +described therein, I wrote to Dr. Pierce for his advice, which he sent +by return mail. For my recovery he requested me to use his "Golden +Medical Discovery," his "Favorite Prescription," and his "Pleasant +Pellets." He also gave me some directions for every-day living. These +means accomplished my complete cure. I am thankful that we can have such +reliable medicines brought into our homes without great expense. + + Yours truly, + MRS. AMERICA NAY, + Volga, Jefferson Co., Ind. + + +DYSPEPSIA, TORPID LIVER--TERRIBLE SUFFERING. + +[Illustration: MRS. O'BANNON] + +DR. R.V. PIERCE: _Dear Sir_--When I commenced your medicines, had +headache all the time, indigestion, pain in my back and loins, soreness +and stiffness in my joints, my limbs ached so I could not sleep at +night: I could not lie in bed more than two or three hours any night; +when I would lie my head on the pillow I would have to rise immediately +to get breath, sit up and walk the floor very near all night. I could +not eat anything that would digest; I would do the cooking for the +family, but I was in so much pain the tears were in my eyes all the time +I would get a meal ready. I would take one mouthful of bread and then go +off and sit down and cry with hunger, but dare not eat any more, and +then would have to vomit from that one mouthful of bread--I would have +such weak spells I could not stand on my feet. + +I had tried five doctors, they had done me no good; I had given +up--never to take anything more, only to lull the pain. I had given up +to die when I received a pamphlet and some papers from you. I decided to +try once more and I have been improving ever since I commenced your +treatment; my health is better than it has been for fifteen years; I +weighed one hundred pounds when I began taking your medicines; now I +weigh one hundred and thirty, as much as I ever weighed. I have taken +ten bottles of "Favorite Prescription" and still more of "Golden Medical +Discovery," and several vials of the "Pellets." + + Your sincere friend, MRS. M.H. O'BANNON, + Lameta, Leake Co., Miss. + + + * * * * * + + +[Illustration: Fig. 1. +Nervous System.] + + * * * * * + + + + +THE NERVOUS SYSTEM. + + + +The nerves of the human body are not unlike the vast telegraph system of +this continent. + +The millions of nerve filaments are similar to the network of wires that +keep all the cities in close sympathy and communion. The nerves have to +deal with organs instead of villages, and with cells in place of +individuals. + +Commerce is regulated and train loads of food supplies dispatched here +and there by telegraph, while in the body the nerves send their +analogue, increased blood and nourishment, where it is required. + +[Illustration: +View on roof of Western Union Telegraph Company's Central Station, +Buffalo, +N.Y., showing net-work of wires leading to all parts of the country.] + +The various organs of sense receive manifold impressions of conditions +to be met, food required and dangers to be avoided and the nerves +transmit these impressions telegraphically to the brain. + +The structure of the brain, spinal cord and sympathetic nerves, is not +unlike a gigantic and complicated galvanic battery. The number of cells +in the brain and spine are more numerous, by many millions, than those +supplying any telegraph system. + +As the blood supplies each cell with its necessary nourishment and +removes its used up or waste materials, so does the workman give each +cell of his battery fresh chemicals from time to time, and removes the +used up waste. + +The wires that lead from this battery to every part of the country are +like the nerve filaments that go to each part of the human body and make +them all--no matter how minute--perform their functions in a proper +manner, and, when done, permit them to retire to rest. + +With the complicated human structure, when disease takes hold, we have +the same troubles that would be presented were the telegraph operators +suddenly to become ill. What confusion and discord would prevail! If the +sickness is severe enough to cause delirium, it would be as though +madmen were at the telegraph keys dispatching trains of passenger cars +which could hardly fail to bring injury and destruction to unwary +travelers. + +In health, we are unaware of the work of the nerves. The wheels of life +move without noise. Few realize that the cavities of the heart (auricles +and ventricles) are contracting steadily and alternately under the +guidance of nerve cells. By this means the stream of blood, laden with +nourishment, is sent to every part of the body. + +Silently the stomach pours out, under nerve influence, its juices that +dissolve and change parts of the food, that it may pass into the blood +in condition to nourish. In a similar way, the pancreas pours out a +fluid that digests the fats. + +The muscular fibres of the intestines are caused to contract +rhythmically and force along the bolus of digested food, so that its +soluble parts may be taken up by the minute absorbent vessels to enrich +the blood. + +All these things of most vital importance we know least about. They go +on, from day to day, without our being aware of the work done. + +Let something interfere with the process, and how quickly is the +sensation changed. Few there are who have not felt the agony of colic +pain, due to stoppage of digestion. What suffering is greater than the +sense of awful suffocation from a heart that is not acting well? + +These are only familiar illustrations of a thousand and one distressing +derangements and symptoms that come from exhaustion and prostration of +the nervous system. + + * * * * * + + + + +NERVOUS DEBILITY OR EXHAUSTION. + + +This affection, also popularly known as Nervous Prostration, or Nervous +Weakness, and, to the medical profession, as Neurasthenia, or Nervous +Asthenia, is becoming alarmingly prevalent. + +The wear, tear and strain of modern life are concentrated upon the +nervous system. The care and consequent fret, worry and labor of this +age are greater than ever before known. + +The result of this extreme activity, is exhaustion and weakness. +Physical bankruptcy is the result of drawing incessantly upon the +reserve capital of nerve force. + +We extract the following from an article which recently appeared In the +New York _Tribune_: + + AN AGE OF NERVOUSNESS. + + The stone age, the bronze age and the iron age, we have heard + of; likewise of the Dark Ages, and other self-marking eras in + human history. As for the present, it might with fitness be + known as the age of engineering, or of electricity, both of + which proud titles it has won by its achievements. Yet there + is also a less roseate view to be taken of it, and another + title to be given to it, based upon its too-evident frailties; + namely, that it is an age of nervousness. + + Such is the view taken by the famous psychologist, Dr. William + Erb, of the University of Heidelberg. Nervousness, he says, + meaning nervous excitement, nervous weakness, is the growing + malady of the day, the physiological feature of the age. + Hysteria, hypochondria and neurasthenia are increasing with + fearful rapidity among both sexes. They begin in childhood, if + not indeed inherited. Minds are overburdened in school, with + too much teaching or misdirected teaching. The pleasures of + social life follow, overexerting the already enfeebled nervous + system. Business life is made up of hurry and worry and shocks + and excitements. Society, science, business, art, literature, + even religion, are all pervaded by a spirit of unrest, and by + a competitive zeal which urges its victims on remorselessly. + No man knows repose. The result is, wreckage. The + pharmacopoeia is overcrowded with nerve tonics, nerve + stimulants, nerve sedatives. The medical profession devotes + its best energies to the treatment of neuropaths. And as a + people we are, or are becoming, excitable, irritable, morbid, + prone to sudden collapse through snapping of the overtense + chord of the nervous vitality. + + Nowhere are the rush and hurry and overstrain of life more + marked than in this much-achieving Nation. The comparative + youth and freshness and vigor of the American people enable + them to do and to endure what would be beyond the power of an + older and more worn-out community. Yet there is no disguising + the fact that the pace tells even here, and often tells to + kill. True, all the tendencies of the age are in that + direction. Inventions, discoveries, achievements of science, + all add to the sum of that which is to be learned, and widen + the field in which there is work to be done. What we need to + learn is, however, that all these things are for man, not man + for them. If knowledge has increased, we should take more time + for acquiring it, knowing that, with the consequent increase + of power, we shall be able to achieve as much afterward in the + shorter time as our predecessors did in the longer time their + briefer study afforded. Greater ability should mean not only + greater results wrought, but fuller repose as well. For it + would be a sorry ending of this splendid age of learning and + of labor to be known as an age of unsettled brains and + shattered nerves. + +A distinguished medical authority says: + + "It is proved beyond any dispute that nervousness is the + characteristic malady of the American Nation, growing upon + them in a frightfully accelerated ratio every year, and + threatening them with disasters at no distant date which the + mind shrinks from contemplating." + + He continues as follows: "The number of deaths from this cause + is already appalling and is steadily and rapidly increasing. + In some of the busy centres the tables of mortality show that + the proportion of nerve deaths has multiplied more than twenty + times in the last forty years, and that now the nerve deaths + number more than one-fourth of all the deaths recorded. What + is most shocking in these returns, this fearful loss of life + occurs mainly among young people of both sexes." + + "This means that the Americans are fast becoming a very + short-lived people; and that if they were shut in on + themselves for only a few years, without any influx of + vitality by immigration, the publication of the census would + send a pang of horror and alarm throughout the land." + +The annual report of the State Board of Charities of the State of New +York for 1894, shows that while the increase in the State's population +from 1880 to 1892 was 28 per cent., the increase of the insane in State +institutions for the same period was 83 per cent.! + +The enjoyment of the fruits of fortune, earned at the expense of the +nerve cells, is an impossibility. The quiet and harmony of the nerve +centres and nervous system are gone. Rest is impossible, continuance of +work only causes increased jarring and discord of that many stringed and +wonderful mechanism. + +SYMPTOMS. It is well nigh impossible to give the symptoms of this +disease in an orderly manner, as the affection gives rise to a thousand +and one varying and ofttimes vague symptoms. The particular part of the +nervous system affected, and also the cause and character of the attacks +modify the symptoms. The eminent Dr. Wood says: "Nervous exhaustion may, +in the beginning, affect the whole of the nervous system, or it may be +at first purely local, and co-exist with lack of general nervous +strength." + +SPERMATORRHEA furnishes many examples of the local form of neurasthenia, +or exhaustion, the sexual centres being primarily affected. In these +cases, however, sooner or later, the whole nervous system becomes +Involved. So in other forms of the disorder, the exhaustion at first +local, finally, if neglected, implicates the whole organism. Often, in +brain exhaustion, the symptoms are at first purely local. Almost always +the cause of a local neurasthenia, or exhaustion, is excessive use of +the part. Thus, cerebral or brain exhaustion, or debility, is usually +the result of mental overwork, while sexual asthenia, or weakness is +generally due to abuse of the sexual organs or to sexual excesses. When +to the brain fatigue, or exhaustion, are added the depressing effects of +excessive anxiety, or allied emotions, the symptoms from the first are +more general, and the exhaustion may effect chiefly a single function of +the brain. In pure brain exhaustion, the loss of a disposition to work, +is usually the first symptom, the sufferer finding that it constantly +requires a more and more painful effort of the will to perform the +allotted task. At first, there is loss of the power of fixing the +attention, and this, by and by, is accompanied by a weakness of the +memory; disturbances of sleep are frequent; various abnormal sensations +in the head are complained of. In most cases there is not absolute +headache, but a feeling of weight or fullness, or an indescribable +distress, usually aggravated by mental effort. It is true that in some +cases of very dangerous brain tire, mental labor is performed with +extraordinary vigor and ease; the power of work, is, for the time, +markedly increased, and even the quality of the product may be raised. +The patient may glory in a wild intellectual exaltation, a sense of +mental power, with an almost uncontrollable brain activity. It is +probable, however, that these cases are not instances of pure +neurasthenia, or brain exhaustion, but that there is active congestion +of the gray matter of the brain. In these cases the disease is very +prone to end in serious organic affection of the brain. + +[Illustration: Melancholy. ] + +Severe brain exhaustion may be associated with good spirits, but usually +there is marked depression, and this perversion of function generally +goes on, if the disease be not checked, to decided melancholy. The will +power, like all the other functional activities of the brain, is prone +to be weakened, morbid fears may finally develop, and at last, that +which was at the beginning a single brain exhaustion, may end in +persistent hypochondria, followed by insanity. + +Peculiar sensations are common in neurasthenia, such as chilliness, +unnatural itching, a feeling as though ants or other insects were +crawling on the skin. Eruptions are common. Attacks of neuralgia are +often frequent and sometimes severe, being usually worse in those +persons of nervous ancestry. In some cases there is a lack of proper +sensation, in others an unnatural sensitiveness. There is also in many +cases a peculiar tenderness over some portion of the spinal column, +especially in women. + +IN WOMEN, with nervous disturbance of the sexual organs, there is +frequently great pain felt during menstruation; in others, ovarian +irritation and a so-called "irritable," or sensitive uterus, giving rise +to manifold nervous and hysterical symptoms, sometimes culminating in +convulsions or "fits." In not a small proportion of the uterine diseases +which are generally only locally treated by physicians, the local +disease is largely and sometimes solely the expression of a general +weakness of nervous origin. + + +SELF-ABUSE AND EXCESSES. + + +It is well known that Onanism, or masturbation, as well as sexual +excesses, produce an exhaustion of the nerve centres presiding over the +sexual functions. This is the common history of spermatorrhea or loss of +the virile fluid by nightly emissions, accompanied by lascivious dreams. + +GENERAL NEURASTHENIA, or nervous exhaustion, may also produce a local +weakness of the sexual centres of the brain and spinal cord, with +symptoms at least resembling those of partial impotency and great +irritability of the sexual organs, or a complete impotence, with +premature seminal discharge whenever coition is attempted. Many times +this condition results from excessive intellectual labor, even with no +sexual excesses or abuses. Nocturnal, or nightly emissions, are not +always experienced in these cases. When they do occur, the debilitating +losses of vital fluid react upon the brain, robbing the victim of +courage and manliness and exciting various phases of morbid fear and +sensitiveness. + +Many cases of nervous debility, or exhaustion, are the result of long +continued malarial poisoning, diarrhea, Bright's disease, exhausting +fevers or other debilitating affections. Numerous are the cases in which +the patient is able to trace the origin of the malady back to an attack +of influenza, or grip. An epidemic of the latter disease is sure to be +followed by numerous cases of nervous prostration, or exhaustion. + + +CARE SHOULD BE EXERCISED. + +In all cases, it is necessary to make careful examinations in order to +detect any obscure chronic disease which may exist. In women, nervous +prostration often develops without perceptible cause at the age of +puberty or at the "change of life." Overwork, especially overwork +combined with worry, are fruitful causes of nervous exhaustion in both +sexes. + + +AN OVERWORKED NERVOUS SYSTEM + +is always an exhausted nervous system. The nerve cells have been robbed +of their vital forces. All the nutritive organs of the body suffer from +the lack of nerve control, and the blood-vessels that supply the nerve +centres are not in proper tone. Hence the supply of blood and the action +of the heart are greatly interfered with. Many times, the most +troublesome symptom, early in the disease, is an excessive perspiration +of the hands and feet. + + +IMPOVERISHED OR POOR BLOOD. + +A badly nourished nervous system is irritable. Many of the symptoms of +weakness and lack of nutrition resemble those found in congestion, or +stimulation from excess of blood. Then, too, we find sometimes that +poor, thin, watery blood, not suitable for nourishment although sent in +large amount to the brain, does not properly nourish that organ. There +will still be brain exhaustion, as the nervous structures have lost +their power of absorbing the nutrient materials from the blood which, +being poor in quality, does not vitalize and strengthen the nerve +centres as it should. In such cases thought is an effort and sustained +mental exertion is impossible; the memory is uncertain, and the patient +drowsy. Occasionally, after rest, there may be flashes of brilliancy, +but generally they are brief. + + +DANGER OF CONTRACTING INTEMPERANCE. + +The patient often learns that a small amount of wine or spirits is a +temporary aid, and sometimes its habitual use is begun in this way. +Stimulants only make a bad matter worse when their use is continued for +any considerable length of time. The sufferer becomes more and more +dependent upon them and the nervous exhaustion is much aggravated as +large quantities are taken to satisfy the morbid craving that has been +acquired. + +WAKEFULNESS, OR INSOMNIA, is present in many cases; in others, there is +unusual drowsiness but sleep gives neither rest nor strength; often it +is disturbed by dreams that exhaust the vitality and leave the patient +more tired than when rest was sought. + +HEADACHE is one of the most annoying symptoms and sometimes is very +persistent. It may incapacitate the patient for the ordinary duties of +life. After laying down awhile and being quiet, the headache may be +relieved, but recurs on attempting to go about. + +FRETFULNESS. Sometimes, owing to the discomfort experienced, there is +likely to be a change of disposition, irritability of temper, +fretfulness and peevishness; a tendency to an irascibility all out of +proportion to the real provocation. In many cases there is dizziness, +and frequently noises in the head, ringing in the ears, spots before the +eyes, twitching of the muscles, eyelids or eye muscles, and at times +dimness of vision, or sudden spells when the sight is not satisfactory. +At times there is a feeling of discomfort, as if the quantity of good +air were not sufficient to aerate the blood, and there is sighing or a +desire to sit in an open window, or a strong desire to be fanned. The +pulse and temperature are usually normal, or a little below, but may +rise if any local irritation exists. At times the face is flushed and at +others pale. The skin may be dry, or in other cases bathed in +perspiration on slight exertion or mental worry. When there is weakness +of the nervous system, the disease manifests itself through various +organs. Hence, the palpitation of the heart, dyspepsia or acute attacks +of indigestion, with colicky pains and heaviness after meals, with +eructations or belchings of gas, or local discomfort and unnatural +action affecting, at different times, almost every organ of the body. It +is well known that insanity may result from the loss of sleep and +constant brooding over the symptoms that the patient fails to properly +understand. + + +TREATMENT. + +In no class of diseases is greater care, scientific knowledge and skill +more necessary than in the treatment of nervous affections. Almost every +case is a law unto itself, and must receive careful consideration, +pains-taking advice and specially prescribed treatment suited to the +peculiarities of the individual. Hereditary influences, causes of the +disease and constitutional peculiarities of the patient must all be +taken into account. + + +VALUE OF EXPERIENCE. + +Only through extensive experience can the medical practitioner become +expert at detecting and successfully meeting, by rational scientific and +carefully adapted treatment, the many phases and complications incident +to the different forms and stages of this very prevalent malady. + +For more than a quarter of a century, the Specialists of the Invalids +Hotel and Surgical Institute having charge of this department of +practice, have been actively engaged battling with diseases of the +nervous system. As a result of this long time and vast experience, they +have naturally developed and thoroughly tested many valuable remedial +agencies for the relief and cure of this class of sufferers. Many of +these can be successfully prescribed and used at the patients' homes +without a personal consultation; while others can only be brought into +use at our Institution. + + +TREATMENT AT HOME. + +Many cases, especially when the exciting cause of the malady can be +easily ascertained, as in spermatorrhea from self-abuse, or sexual +excesses, or in women when arising from uterine affections, can be very +successfully managed and cured at home. This is also true when the +disease is due to the excessive use of tobacco, opium and other +narcotics. + + +CONSULTATION BY LETTER. + +The patient has thought over his symptoms hundreds of times. The +location of every discomfort has been carefully noted. These matters are +stated with accuracy, common sense and good judgment when writing to us. +The people are far more intelligent in these matters than physicians are +generally willing to admit. A patient is often confused while being +personally examined by a physician and gives imperfect or incorrect +answers. After he has left the presence of the physician, he finds that +he has failed to enumerate many of the most important symptoms. In +consulting by letter, the patient is not embarrassed, states the exact +symptoms and carefully reads over the letter, to see if it is a complete +and accurate description of his sufferings. In this way he often conveys +a much better idea of the case than if present in person, and subject to +the most thorough questioning and "cross-examination." The timid lady +and nervous young man write just as they feel and one reason why we have +had such success in treating intricate and delicate diseases, is because +we have obtained such true and natural statements of the cases from +these letters, many of which are perfect pen pictures of disease. As +bank tellers and cashiers, who daily handle large quantities of +currency, can unmistakably detect spurious money by a glance at the +engraving or touch of the paper, so the experienced physician, by his +great familiarity with disease, becomes equally skilled in detecting the +nature and extent of a chronic malady, from a written description of its +symptoms. To aid the patient in giving a clear and intelligible history +of his case we send, when requested, a very complete question blank. + + +EXAMINATION OF THE URINE. + +A careful, microscopical examination and chemical analysis of the urine +is a valuable aid in determining the nature of these diseases of the +nervous system. This important fact is not overlooked at the Invalids' +Hotel and Surgical Institute, where experienced chemists are employed to +make such examinations and report the result to the attending +physicians. Persons consulting us and desiring to avail themselves of +the advantages afforded by these examinations, can send a sample of +their urine by express. The bottle should be thoroughly cleansed and +should contain from two to four ounces of that first passed after +arising in the morning. It should be carefully packed in saw-dust or +paper and inclosed in a light wooden box. All express charges must be +prepaid through and a complete history of the case, including the age +and sex of the patient, should accompany every package, or it will +receive no attention. This saves valuable time by directing the +examination into the channels indicated and thus avoiding a lengthy +series of experiments. As we are daily receiving numerous bottles of +urine, every sample, to prevent confusion, should be labeled with the +patient's name. By the postal regulations, all liquids are excluded from +the mails, unless packed in accordance with our printed directions, +which will be sent free on request being received for them. + + +WE AIM TO CURE, + +not merely to palliate as is so often done by practitioners in dealing +with these distressing maladies. We do not prescribe coca mixtures, +whiskey, malt extracts, so-called celery compounds or other nerve +stimulants, which only spur the already weakened nervous system on as a +man would urge his jaded horse to renewed efforts when the animal should +be refreshed by proper food and rest. Neither have we any faith, in +lasting good resulting from prescribing such nerve sedatives as put the +nerves to sleep and so, by simply blunting sensibility, delude the +patient into the false belief that he is being benefited. + +To effect a radical cure of the weakness, the nerve centres must be +restored to a normal condition by improving the nutrition of the nerve +cells. To do this the causes of the difficulty must be understood and +any local weakness or disease of any organ, be it the liver, kidneys, +lungs, stomach, rectum, bladder, or generative organs, must be +understood, properly treated and overcome. The desire for alcoholic +stimulants is a most common and dangerous tendency of the disease. To +gratify the morbid appetite for stimulants is to do the patient lasting +injury. + + +IMPOVERISHED BLOOD. + +In some cases the nervous affection is the result of an impure, or +impoverished, condition of the blood. In such cases the use of Dr. +Pierce's Golden Medical Discovery has, in the great majority of cases, +resulted in an immediate benefit and gradually in a permanent +restoration of the nerve centres to a normal condition. This remedy, +particularly if assisted by the use of Dr. Pierce's Pleasant Pellets, +when constipation is present, unloads the liver, and their combined +action tends to remove from the blood the poisons which it is the +function of the liver to take from that fluid. The cells of the brain, +after performing their function, throw into the blood certain poisonous +materials which it is the function of the liver to remove. If this is +not done, the cells become clogged, and can only be restored to a +natural and healthful condition by increasing the activity of the liver. +This treatment gives rise to an immediate improvement, and a continuance +of the remedies results in a gradual toning up of the nervous system and +relief from the unpleasant symptoms. + + +"FEMALE WEAKNESS." + +Many women suffer from nervous prostration, or exhaustion, owing to +congestion of the uterus and ovaries, caused by over-indulgence; again +by overwork, the strain of too many household cares, or too frequent +childbirths. In these cases, the use of Dr. Pierce's Favorite +Prescription is of the greatest benefit, tending to restore the uterus +and ovaries to a normal condition. Its wonderful restorative effects, +tonic and nerve invigorating properties, especially adapt it to the cure +of these cases. Digestion and assimilation of food are promoted by its +use. When the liver or blood is not in healthful condition, as +previously referred to, the "Golden Medical Discovery" should be used in +conjunction with the "Prescription." If menstruation be scanty, Dr. +Pierce's Pellets will have a beneficial influence in increasing the +flow, and overcoming the headache and congestion of internal organs that +is the result of scanty menstruation, especially if their use be +accompanied with full doses of Dr. Pierce's Compound Extract of +Smart-Weed. + + +LOCAL CAUSES. + +In the great majority of cases, when nervous prostration has made its +appearance at intervals, with periods of prolonged good health +intervening, but in which, as a rule, slight excesses, over-exertion or +the attacks of some acute disease, produces a nervous exhaustion, we +have found that local derangement is the cause of the whole trouble. +This cause may often be readily removed and a perfect and permanent +restoration of the health will follow. + +IN MEN, we have often found a varicocele to be the cause of nervous +prostration. In others rupture, or urethral stricture, sometimes of a +character so mild as hardly to give serious inconvenience, has been the +cause. + +IN WOMEN,, ulceration of the uterus, stricture of the cervix, congestion +or other diseases of the ovaries, such as cysts, abscesses, etc., +inflammation of the Fallopian tubes, characterized with more or less +periodical discomfort and attacks of leucorrhea, or "whites," are common +causes. + +In all cases in which the nervous disease depends upon local causes, we +find that the relief of the local source of irritation, which tends to +reduce the general health and interfere with perfect nervous tone, is +all that is necessary to give the invalid a perfect restoration to +health, vigor and activity. It is like removing the burden from a tired +horse who has fallen prostrate under an excessive load. The removal of +the burden puts the individual under a favorable condition for the +immediate restoration to health and strength, and permanent relief is +only a matter of a few days' or weeks' time, with appropriate +nourishment and restorative nerve tonics. + + +ALCOHOL, OPIUM AND TOBACCO + +affect different individuals according to their several +susceptibilities. Some are able to withstand, with apparent impunity, an +amount of these that can not be tolerated by others without great +injury. No one, however, is wholly proof against these unwholesome +agents which are in such common use. The sad results of their excessive +use are seen in thousands of cases of shattered nerves and wasted vigor. +The excessive use of tea and coffee is also a prolific cause of nervous +affections. + +Happily, we have now at our command remedies which exercise a most +potent controlling influence over the acquired, morbid appetite for +these narcotics and stimulants. Of course we have to depend, to some +extent, upon the will power of the patient, but where this is not wholly +lost, we have in all our later experience, been able to realize a degree +of success which has been alike gratifying to both physician and +patient. + + +THE INVALIDS' HOTEL AND SURGICAL INSTITUTE SPECIALLY EQUIPPED FOR THE +CURE OF NERVOUS AFFECTIONS. + +Private institutions, well supplied with the numerous and costly aids to +the work of the specialist treating nervous diseases, are now a +recognized necessity. Physicians and sufferers alike appreciate this +fact. + +Public hospitals do not answer this purpose, owing to the fact that they +are more especially intended for the alleviation of the sufferings of +the poor, and the greater part of the work done is in affording relief +from acute diseases and emergencies requiring surgical aid. Attention is +thus detracted from delicate nervous affections and is almost wholly +engrossed in caring for sufferers from other diseases and injuries. +Besides, association with the charity cases that abound in such places +and the evidences of suffering present on every hand, are enough to +prevent all improvement in sensitive and sympathetic invalids. + +Perfect equipment is an important part of the battle in the cure of +nervous affections. + + +ELECTRICITY IN NERVOUS AFFECTIONS. + +[Illustration: Fig. 4. +Our large 40 cell Galvano-Faradic Battery with Switch-board.] + +Electrical applications, to be beneficial, require, on the part of the +attendant, a technical knowledge of the highest character with costly +apparatus and special appliances. There can be little doubt that +electricity is convertible into nerve force. + +[Illustration: Fig. 5. +Our Franklin, or Static Electricity, Machine.] + +In treating cases in the Invalids' Hotel, a large variety of batteries, +dynamos and other electrical appliances are brought into use. These +consist of cell batteries, such as is illustrated by Fig. 4, dynamos, +operated by power, Franklin, or static electrical machines illustrated +in Fig. 5, and other electrical apparatus, the choice of the particular +machine or battery being determined by the nature of the case. + + +CARE AND SKILL REQUIRED. + +Electricity, like other powerful agencies, in order to prove remedial +must be used of proper strength and in proper quantity. The potential, +or strength, as well as the volume, or amount, of current has to be +carefully measured for that purpose. To accomplish this, we employ an +instrument called a galvanometer, or amperemeter, illustrated in Fig. 6, +which indicates the exact amount of current being applied. For the want +of such instruments to measure the current, physicians often fail to get +beneficial results, as they are not able to administer either the proper +quantity or quality of current. Ofttimes, for like reasons, their +hap-hazard way of employing this powerful agent does positive injury to +the patient. + +[Illustration: Fig. 6. +The Galvanometer, or Amperemeter.] + +Of course, in treating cases at a distance, we cannot avail ourselves of +all the great variety of apparatus brought into use at our Invalids +Hotel, yet we have some forms of machines well adapted for home use, and +so simple that, by sending plain printed directions with the machines, +our patients are able to use them effectively without the aid of the +physician. Especially is this true in the milder forms of nervous +disease, and when great exactness and nicety of application is not so +important. We show in Fig. 7 and Fig. 8, two forms of such batteries +which are often furnished our patients for use at their homes. Many +times, after cases are under treatment here for a while, we are able to +educate them in the use of the battery so that by taking one of these +home with them they can continue the treatment with good results after +leaving the Institution. + + +ORGANIC, OR ANIMAL, EXTRACTS AS REMEDIES. + +The experience of Pasteur, Brown-Sequard, and our own specialists, in +the use of extracts of nerve substance and of certain glands and organs +by hypodermic or subcutaneous injection of these fluids, has, in a vast +number of cases, been most gratifying to both physicians and patients. +Many wonderful cures have thus been obtained. Injected subcutaneously +these animal extracts are immediately assimilated and we are often able +to stop, at once, the progress of disease and turn the tide towards +recovery. Thus the cells receive the special stimulants upon which their +life and activity depend. + +[Illustration: Fig. 7. +A small Battery for home use.] + +The animal extracts employed in our Institution are all scientifically +and carefully produced in our chemical laboratory under the direct +supervision of an experienced chemist, and are believed to be superior +in quality. They are turned out fresh, as wanted, which is important, as +all such preparations, no matter how carefully made and put up, +deteriorate with age. + +These extracts are made from the glands and organs of the lower animals, +as from the brain, spinal cord, heart, testicles, ovaries and some other +organs and parts of bullocks, rabbits, guinea pigs and other animals. +That they possess properties which exert most potent tonic, or +invigorating, influences upon those organs and parts of the human system +corresponding to the organs and parts of the lower animals from which +they have been extracted, no longer admits of doubt. In cases of partial +and even complete impotency, especially in elderly men, attended with +nervous exhaustion, most astonishingly favorable results are obtained by +our specialists through the administration of our extracts obtained from +the nerve tissue of the spinal cord, associated with the use of the +expressed juices from animal testes. We do not, however, prescribe these +extracts to the exclusion of other well tested remedial agents, but do +regard them, especially in the more confirmed and obstinate cases, as +among our most positive curative agents. + +[Illustration: Fig. 8. +A small Battery for home use.] + +We must confess that when first proclaimed by Brown-Sequard as Valuable +remedial agents, we regarded the use of these extracts with good deal of +skepticism, but experience is, after all, the best teacher and we were +forced, after numerous successful tests, to admit their great efficacy. +We have always endeavored to keep up with the vanguard of the army of +medical reform, and so took early occasion to introduce these agents +into our practice and made preparations to produce them in our +laboratory. + +From an article written by an eminent specialist in nervous diseases, +and recently published in the New York _Medical Journal_, we extract the +following: + + "Organic beings possess the power of assimilating from the + nutritious matters they absorb the peculiar pabulum which + each organ of the body demands for the development and + sustenance. The brain, for instance, selects that part which + it requires, the heart the material necessary for its growth + and preservation, and so on with the liver, the lungs, the + muscles, and the various other organs of the body. No mistake + is ever committed. The brain never takes liver nutriment, nor + the liver brain nutriment; but each selects that which it + requires. There are, however, diseased conditions of the + various organs in which this power is lost or impaired, and, + as a consequence, disturbance of function, or even death + itself, is the result." + + "Now, if we can obtain the peculiar matter that an organ of + the body requires and inject it directly into the blood, we + do away with the performance of many vital processes which + are accomplished only by the expenditure of a large amount of + vital force." + + "Let us suppose a person suffering from an exhausted brain, + the result of excessive brain-work. Three hearty meals are + eaten every day, but, no matter how judiciously the food may + be arranged, the condition continues. Now, if we inject into + that person's blood a concentrated extract of the brain of a + healthy animal, we supply at once the pabulum which the organ + requires. Then, if under this treatment the morbid symptoms + disappear, we are justified in concluding that we have + successfully aided Nature in doing that which, unassisted, + she could not accomplish." + + "That is the system. I believe it is applicable not only to + the brain, but to all the other organs of the body." + + +The writer of the above is, very probably, a little over sanguine in his +opinion that the plan of treatment will prove efficacious in all organic +diseases, but certainly, from our experience, we can endorse his belief +as to its great efficacy in many forms of organic weakness, especially +those of the generative organs, nervous system, heart and some other +parts of the body. We believe that we are placing a conservative +estimate upon the remedial value of these animal juices, or extracts, +when we say that they are destined to fill an important place in the +curative resources of the specialist in chronic diseases. + +Under the head of epilepsy, also in connection with our consideration of +locomotor ataxia, we shall have occasion to refer to the use of these +extracts as applicable to the cure of those maladies. + +Most cases of nervous diseases that come to us, for examination and +treatment, do so after having tried, without success, treatment by +baths, enforced seclusion, as well as unskillfully applied electrical +treatment and massage. Prolonged medication has frequently aroused +digestive disorders and made the patient hate the sight of the medicine +bottle. In such cases our improved methods, as applied in the +Institution and also prescribed for patients at a distance, enable our +specialists to give relief and effect cures with a minimum of medicine. +They also enable us to treat many cases of nervous diseases heretofore +regarded as almost hopeless, such as locomotor ataxia, paralysis, +epilepsy and spinal affections, with a degree of success which has been +very gratifying alike to physicians and patients. + + * * * * * + + + + +HEADACHE AND NEURALGIA. + + +There is no ill to which flesh is heir that is the source of a greater +degree of discomfort to the human race than headache. The farmer, +housewife, banker, merchant and laborer seem to be equally prone to the +affliction and all who suffer have a great number of days rendered +uncomfortable and unhappy by the presence of this most unpleasant +affection. Pain is the warning finger of disease--the threatening +indication of coming trouble. In headache, we have an indication that +the system is subjected to some strain or injurious impression. It may +be that the eyes have been overworked or the brain unnaturally taxed; or +that the nervous and physical systems have not been properly refreshed +by sufficient sleep, and have used up the residue of reserve power. Many +suffer from headache only after they have been subjected to sudden +changes of temperature and have taken cold; others only when the bowels +have become inactive, the liver torpid and the blood vitiated with +retained poisons. + +All appreciate the discomfort that results from this malady and +earnestly seek for permanent relief. + +Headaches may be divided in two classes: (1) those due to the presence +of poisons in the blood, and (2) those due to irritation of various +organs, as of the eyes, stomach, liver, and intestines. + +Of the first form, or variety, of headache, influenza, or grip, and +acute "cold in the head," are the most common causes. These give rise to +most excruciating pain. There is congestion, followed by inflammation in +the nasal passages and cavities communicating therewith. The membranes +of these passages throw out a thin, watery, irritating discharge, which +gradually thickens and becomes pus-like and offensive in character, if +the disease continues. + +Poisonous matters are absorbed from the affected surfaces into the +blood. These poisons, circulating in the blood, produce great irritation +of the nerve cells, so much so, that the severity of the attack is felt +in the nervous centres, the brain and spinal cord, with pain varying +from the most acute and sharp, to a dull, numb ache. The temples, eyes, +neck and small of the back, are in their order, the usual locations of +greatest pain. Such attacks vary in frequency and severity. One attack +is usually followed by an early recurrence, which may be more or less +severe, while the period of active pain varies from a few hours to +several days. Such attacks leave an exhausted state of the nerve centres +and general weakness of the system that often lasts for weeks and may +permanently impair the system, except such results be prevented by +appropriate treatment. Every recurrence of the attack leaves the system +in a worse condition, until profound nervous prostration; ensues. + +Malarial headache, sometimes termed "brow ague," is a common form of the +malady with those residing in malarial regions. The pain rapidly +develops, usually over one eye. It lasts from five to ten hours, and is +often of frightful intensity. + +Other forms are rheumatic and gouty headache; usually a heavy aching +pain appearing on the approach of storms, but at times almost +continuous, made worse by improper diet. + +Uræmic headache is due to kidney disease, and alcoholic to direct +irritation of the brain membranes from the use of alcoholic beverages. +The latter is accompanied with much irritation of the stomach and +intestines. + +Headaches of a similar character result from the presence in the blood +of an excess of the active principles of coffee and tea. + +Overindulgence in these agents, as with alcohol, affects the nerve cells +and membranes, often causing severe attacks of headache. + +Nervous headache is another common affliction. This seems to arise from +several causes, such as impoverished blood and exhaustion from overwork +of the brain. Hysterical headache is not uncommon. There is a severe +kind of headache, the attacks of which appear first at early puberty and +continue at intervals more or less frequent in women up to the change of +life and in men to about the fortieth year. + +The periodical headache is usually preceded by yawning, chilliness, +languid, exhausted feelings, in others by peculiar emotional or mental +activity. This is followed by unusual drowsiness, in which the night's +rest is broken by dreams, and from which the patient awakes tired. +Gradually, during the day, the headache develops, beginning in the eyes +or bones over them. It gets more and more severe, shooting into the jaws +and neck or extending to the back of the head and spine. As the pains +get most severe, nausea or vomiting, often repeated, follow, in which +the contents of the stomach, with mucus and bile, is ejected. The whole +paroxysm lasts from five hours to two or even three days. + +NEURALGIC HEADACHE is a common variety; often the pain is not confined +to the head, in fact neuralgia may affect almost any part of the system. + + +NEURALGIA. + + +Neuralgia is an affection of the nerves, of which the chief symptom is +pain. This is of variable intensity and character. It follows the course +of the affected nerve and its branches, and occurs in paroxysms, of +agonizing pain with periods of intermission during which the pain may be +very slight, and cause but little discomfort. + +The severe pain is described as lancinating, cutting, tearing, burning, +boring and pressing. Patients use different words in describing the +attacks, and there is probably a difference in the character of the +pain, though in a severe paroxysm one is scarcely able to make a very +nice distinction. We have known cases in which the pain occurred +suddenly and overwhelmed the patient's fortitude by its severity and +unexpected onset. Between the paroxysms there may be less severe pain, +which is then more frequently of an aching, burning or pricking +character. In some, paroxysm after paroxysm succeed each other with +almost lightening-like rapidity, and even in the intervals the pain is +very intense. At another time there is only one sharp sting of pain, +which attacks recur several times an hour or day, or may be absent for +days or months. An extended freedom from all pain is rare in a patient +very much affected. The first attacks in all forms of neuralgia are +often comparatively light, and the severity of the pain gradually +increases as the attacks multiply. We have frequently had patients +unacquainted with anatomy, map out the distribution of a nerve very +perfectly, simply describing the portion of the body in which the pain +was experienced. For convenience, the neuralgia has been named with +reference to the nerve most seriously attacked; lumbago to the spasms of +pain affecting the small of the back; tic-douloureux is a term applied +to neuralgia of the fifth nerve, that supplying the side of the face, +with branches to the eyes, jaw, and teeth. Neuralgia of the testicles, +ovaries, stomach, heart, are frequently met with. That affecting the +large nerve supplying the thigh and leg is termed sciatica. These nerve +affections often prove a most grave disorder, rendering the life of the +sufferer a burden. + +TREATMENT. Contrary to opinions frequently expressed by members of the +medical profession, we find that most cases present some removable, or +remediable, cause for attacks of headache and neuralgia. The temporary +relief that is obtained by the use of "headache powders," various +bromide combinations, caffeine and other anodyne and narcotic medicines, +is sometimes necessary in order that the excruciating sufferings may be +borne for the time, but as a rule such remedies only react unfavorably +by interfering still further with the natural restoration of the +affected organs, or protract the removal of the cause of the disease. +Hence, the next attack is usually earlier in its appearance and more +severe and lasting when such agents are employed. + +The great majority of headaches and neuralgias are due to the presence +of poisons in the blood. This may be due to affections of the +blood-making, or blood-purifying organs. + +For the correction of inactive blood-making glands, or a lack of +purification of the blood, due to such cause, the use of Dr. Pierce's +Golden Medical Discovery is particularly beneficial. It has no equal in +its direct effect upon the liver, the great purifying organ of the body. +Through this natural gateway, it removes from the system poisonous +materials which are the waste from the nerve cells. The accumulation of +these waste materials irritates the cells and causes them to cry out +with pain. The blood, being properly purified by the use of "Golden +Medical Discovery" supplies to the nerves, and to the nerve cells, what +they crave--a healthy and rich blood that furnishes proper nourishment. +Hence the headache disappears, and the neuralgic pains are overcome. + +When the liver is engorged and torpid, the intestines become overloaded +with fecal matters that putrefy and give rise to gases and consequent +distention. Deleterious poisons are formed and absorbed by the blood +from such hardened and irritating lumps in the intestines. When the +bowels are thus constipated, Dr. Pierce's Pleasant Pellets are necessary +as an adjunct to the "Golden Medical Discovery." The "Pellets" remove +from the intestinal canal all irritating materials and thus enhance the +alterative, or blood-cleansing, action of the "Golden Medical +Discovery." + +In women, when there is a nervous affection, dependent upon some +unnatural state of the ovaries or uterus, and complicated with an +imperfect or unnatural circulation in those parts, we have noted that +most satisfactory results invariably follow the use of Dr. Pierce's +Favorite Prescription. This agent improves the tone of the nervous +system, and by its direct restorative tonic effects, lessens, or +overcomes, any congestion of the womb or its appendages, regulates +menstruation and promotes a condition of health and vigor. + +In a vast experience, our specialists have thoroughly tested a great +many specific remedies which we prescribe for home-treatment, sending +the necessary remedies to our patients by express or mail, carefully +adapting them to each individual case. Many sufferers have been, by a +brief course of our home-treatment, relieved permanently from +excruciating sufferings that had been a source of annoyance and loss of +time for many years prior to the use of our remedies. + +Our treatment is intended to effect permanent cures. We do not use those +narcotics and compounds of antipyrine and other similar agents which are +very depressing in their effects, and, like morphine and other +preparations of opium, give only temporary relief, and interfere with +the action of the heart, but we use treatment that builds up the system, +removes the cause of the difficulty and restores the nervous system and +all the organs of the body to a normal and healthful condition. + +In some cases we advise treatment in our Institution, where we have +every facility in the way of electrical appliances and many other aids +that can only be employed by the personal attention of a skillful +physician. These aids are more fully described under the head of nervous +exhaustion and a reference is also suggested to what we have to say +under the heads of paralysis and locomotor ataxia. + +Headaches or neuralgic pains, due to local irritations, as uterine +disease, stricture, neurotic or nerve tumors, pressure of trusses, eye +strain from weakened eye muscles, or lenses that need the help of proper +spectacles, require for a permanent cure the removal of the cause. +Sciatic neuralgia, one of the most common and painful forms of nerve +irritation, is particularly amenable to treatment by the modern means of +cure used in our practice at the Invalids' Hotel. + +We find, as a rule, that severe headaches and neuralgias are but the +forerunners of more serious conditions, and are therefore deserving of +special attention. They should be corrected as early as possible, before +any organic changes have occurred. + + * * * * * + + + + +PARALYSIS OR PALSY; + +LOCOMOTOR ATAXIA AND KINDRED AFFECTIONS. + + +Paralysis is an affection characterized by loss of muscular power or by +the sense of touch, taste, sight or smell becoming impaired from injury +to a nerve by accident or disease. + +The disease is sometimes due to simple lack of nerve force or power. +This may come from interference with the blood supply of the nerve +centres, as in hysterical palsy and reflex paralysis. Frequently the +power of speech is affected in this way, ability to remember and +difficulty in pronunciation of certain words being the most common. +Certain affections of the womb and its appendages, in women, and, in +men, stricture of the urethra, adherent prepuce, or foreskin, with +wounds and injuries, many times of nerves and organs remote from the +paralyzed points, cause the loss of power. + +THE CAUSES OF PARALYSIS are very numerous. Whatever destroys, or impairs +the natural structure of nervous matter, or whatever interferes +materially with the conducting power of nerve-fibre, or the generating +power of the nerve-centres, will produce a paralysis, the extent of +which will depend upon the amount of nervous matter affected. Thus +paralysis may be due to disease of the brain arising from apoplexy; to +abscess, softening, syphilitic or other tumors, or epilepsy; to disease +of the spinal cord, or marrow; to disease of the structures which +surround the spinal cord, producing pressure upon it; to injury or +compression of a nerve, by which its conducting power it impaired; to +the effects of diphtheria, hysteria, or rheumatism. It may also be due +to poisoning of nervous matter with opium, lead, arsenic, or mercury; or +to the retention of poisonous substances which are generated in the +living body and which should pass off through the excretory organs, as +the elements of the urine and bile. + +Members of consumptive families are very prone to paralysis. + +We also find that the disease is often the result of some nervous +strain, or over excitement The over indulgence of the passions is +particularly a fruitful source of injury to the brain and spinal +centres. An angry man or woman uses up more nerve energy in a few +minutes than would be sufficient to serve the muscles with stimulus +through hours of toil. + +The young, in unnatural indulgence of the sexual passions, waste the +vigor and energy of maturity. Sexual excesses must be put down as among +the most prolific causes of this terrible malady. Ignorance shields no +one from the consequences of violations of the laws of health. + +The passion for wealth with its ceaseless toil, continuous strain, and +rapid exhaustion of the nerve forces, usually brings its devotee into +the same condition of discord as does the abuse of a stimulant. For a +time the system will repair and bolster up the weakness, but the longer +the day of reckoning is postponed, the more serious and terrible is the +collapse. + +Such individuals need only an exposure to cold, or an over indulgence of +some kind, to suddenly precipitate a paralysis. + +GENERAL PARALYSIS. This term is applied to paralysis affecting the arms +and legs. In this form of paralysis there is generally more loss of +motion than of sensation, and the mind is usually more or less affected. + +HEMIPLEGIA, or paralysis of one side of the body, is generally spoken of +as a "stroke of palsy." Sometimes only one extremity, the arm, is +affected. Only occasionally is the face involved. In the majority of +cases the mind is affected, the memory being poor, the sufferer becoming +melancholy, peevish, and fretful. + +In paralysis of the right side, there is sometimes a curious +forgetfulness or misplacement of language, the patient being unable to +think of words to express his thoughts. This condition is called +_aphasia_. It is usually the result of some injury or disease of the +brain, almost invariably the side of the brain opposite the affected +half of the body. In some cases it is due to a wasting, or softening, of +the brain substance, on account of insufficient nourishment, a deficient +supply of blood; whilst in others, it is due to just the opposite +condition, an excess of blood, producing rupture of some blood-vessel, +transudations, and pressure. + +PARAPLEGIA, or paralysis of the lower half of the body, is the result of +disease of the spinal marrow. The paralysis may occur suddenly, but, in +the majority of cases, it comes on slowly and insidiously, with weakness +and numbness of the feet and legs, or with tingling and a sensation +resembling that produced by ants creeping on the surface of the skin. By +degrees the weakness increases, until there is complete loss of both +motion and sensation in the feet and legs. The lower bowel and bladder +are generally involved, and as a result, the patient suffers from +constipation, and retention and dribbling of urine. Although completely +paralyzed, the patient is often tormented with involuntary movements and +cramps in the affected muscles. + +Paraplegia may be caused by various injuries of the spinal cord; by +congestion, degeneration, or hemorrhage; by pressure from thickening of +the sheath of the cord, or from tumors, or from disease of the bones and +cartilages of the spinal column. Paraplegia may also be produced through +reflex action, by an irritation, or injury to some organ or part of the +body distant from the spinal cord; thus, irritation of the skin, or of +the bowels from the presence of worms, or disease of the bladder or of +the womb, may produce paraplegia. + + +LOCOMOTOR ATAXIA. + + +Locomotor ataxia, or creeping palsy, is also called progressive +paralysis. This affection consists of a disease of the nervous matter in +the posterior columns of the spinal cord. It usually affects first the +lower part of the cord, and those portions of the nerve matter that +supply the muscles of the legs. In other cases it first affects the +portions of the spinal cord that supply the arms. In most cases of this +disease there is an early stage in which the patient suffers from +"lightning pains," as they are called. These are of a severe, stabbing, +boring character, very sudden in their onset, and at times so serious as +to have induced suicide. These paroxysms, in the milder form of the +disease, are not so severe, and are readily controlled by anodynes. They +may affect the stomach, and be mistaken for dyspepsia, or the rectum, +and be taken for fissure or piles. At times they affect the bladder, +when the symptoms are not unlike those of stone or cancer. In many cases +we find the patient has been treated for a long period of years for +rheumatism, sciatica, or neuralgia, when the real disease has been this +progressive paralysis in its earlier stage. Sometimes the disease takes +the form of spermatorrhea or impotency; in other cases it is manifested +in weak eyes, disturbances of vision, or cross-eyes. Sooner or later, +there appears the peculiar paralysis of the disease, which consists of +more or less numbness of the feet and legs, and, in the later stages, of +the hands and arms, sometimes of the face. As a rule, however, the +patient finds difficulty in properly maintaining his balance, and in +walking his movements are tottering, like a man partially intoxicated. +It is difficult for him to maintain his balance and walk with his eyes +closed. If the arms are affected, their movements are uncertain. In +guiding a needle or in buttoning or unbuttoning the clothing, there is +an inability to move the hand with rapidity and certainty, or to any +portion of the face or body if the eyes be closed. The eyes and +attention must be constantly directed to the motion that is about to be +performed, or it is imperfectly done. The brain centres in this case +supply the weakened action of the spinal cord, and the stimulus to the +muscles is directed by the intelligence instead of being automatic, as +in health, and due to spinal action. Still later, the voluntary +movements become spasmodic or jerking. The neuralgic pains often become +very distressing; there is often a sense of constriction around the +limbs or body, as if they were encircled with tight cords. In extreme +cases locomotion becomes impossible, the patient is unable to bring the +hand to the mouth, and the speech may become impaired, articulation +being difficult and imperfect. In all cases there is more or less loss +of sensation in the lower limbs, the patient generally being usable to +distinguish between two points and one, even when the two, are a +considerable distance apart. The inability to feel the contact of the +ground or floor with the feet occasions the difficulty in walking. THE +CAUSES of this disease are somewhat obscure, but unquestionably exposure +to cold and dampness, and over-mental work, are largely instrumental in +its production. Scrofula and syphilis favor its development, while abuse +of the nervous system, such as results from over-indulgence of the +animal and reproductive instincts, are frequent sources of the nervous +changes that lead to ataxia. + + +SHAKING PALSY. + + +_Shaking Palsy, or Paralysis Agitans_, is an affection dependent upon +degenerative changes in the nervous centres. It is characterized by a +tremulous agitation, or continual shaking, beginning in the hands, arms +or head, and gradually extending itself over the entire body. The +disease progresses slowly, but when far advanced the agitation is +violent, and the patient swallows and masticates his food with great +difficulty. In an advanced stage of the disease, the body becomes bent +forward, and the chin almost touches the breast-bone. The tremor, which +early in the disease only occurred during the time the patient was +awake, now continues during sleep, and not infrequently the agitation +becomes so violent as to waken the sufferer. + + +GENERAL TREATMENT OF PARALYSIS. + + +The indications of treatment for the various forms of paralysis are to +remove the causes, if these can be determined, and rouse the functions +of the paralyzed parts. Measures should be adopted to remedy the morbid +conditions upon which this affection depends. Keep the skin clean and +healthy, promote the circulation of the blood, especially in the +paralyzed limbs, and encourage healthy nutrition. These ends may be best +attained by the daily employment of stimulating baths and frictions upon +the surface. As much regular exercise as the patient can bear without +fatigue should be taken in order to favor the preservation of the +appetite and strength. Care should also be taken that the bowels are +evacuated regularly every day. The circulation through, and consequently +the nutrition of, the palsied muscles may be aided by having a strong +healthy person knead and manipulate them. These manual movements upon +the surface of the body will often excite muscular sensibility, similar +to that awakened by a weak Faradic current. The internal medicines +should be such as to regulate the general functions of the system. The +use of these remedies must be directed by the skill and experience of +those who are professionally qualified to administer hem. + +When the patient has been able to be under our personal care at the +Invalids' Hotel, we have found the employment of mechanical movements +and manipulations, applied by means of a variety of machinery, employed +in this Institution, together with the use of the equalizer, or large +dry cupping, or vacuum apparatus, to be of the greatest benefit. These +several machines and apparatus furnish a perfect system of physical +training, thus rendering valuable aid in the cure of many forms of +obstinate chronic diseases. A few of these machines are shown in Figs. +9, 10, 11, 12, 13, and 14; also see page 32 of Appendix. + +[Illustration: Fig. 9. +Manipulator Extended.] + +[Illustration: Fig. 10. +Manipulator Folded.] + +The general practitioner often endeavors to overcome the inertia of the +nerve-centers and nerves by means of specific irritants, with the view +of exciting the power-producing function, of compelling the weakened and +disabled centers to evolve more power. By such stimulation and forcing, +he places a burden on the weakest parts. The compulsory and ineffectual +endeavor of the weak parts to act in response to such stimulation is +very liable to make undue drafts upon the capacity to act, which only +end in exhaustion of the little remaining power instead of its +re-enforcement. Cases which were previously curable by direct and +appropriate means, are thus forever placed beyond the reach of remedies. +No powerful stimulating or depressing medicines are indicated in any of +the various forms of the affection. In paralysis it should be our aim to +improve local and general nutrition, to relieve local congestions and +inflammations, to produce absorption of deposited matters, and to force +an abundance of blood through palsied muscles, from which they may +derive a proper supply of nutriment, and to which they may give up the +products of waste. All this can be accomplished by massage, mechanical +movements, regulation of the atmospheric pressure on the body, baths, +and proper physical culture. + +In paralysis, there is a diminution or total loss of the contractile +property of the muscles to which the affected nerve fibers are +distributed; consequently the capillaries and small veins are not +compressed, as in health, and the blood is not forced on through them +towards the heart; hence there is a backing-up of the circulation, +passive congestion, and all the evils incident to that condition ensue. + +[Illustration: Fig. 11. +Oscillating the Arms and Chest.] + +_Mechanical movements_ properly applied to the affected limbs, or parts +of the body, accomplish the same results as contraction of the muscles. +They compress the capillaries and veins and thus force the blood on +through these vessels towards the heart. There is a constant pressure in +the arteries, hence the flow of blood in the capillaries is always +towards the veins, and, when it gets into the veins, it is prevented +from flowing back by the valves in those vessels. + +A proper circulation of the blood through the disordered parts is thus +effected, and, as the result, they receive an abundance of nutriment, +and their waste products are promptly carried away to the excretory +organs, by which they are separated from the body; the deposits of fatty +matter between the muscular fibers are absorbed, and the agglutinated +fibers are separated. + +[Illustration: Fig. 12. +Rubbing the Legs.] + +As proof of these statements, it has been found by experiment and +observation that there is an increase of temperature in the parts +subjected to this action, which _must_ be due mainly to an increase in +the chemico-vital changes that are superinduced by the nutritious +elements of the arterial blood, particularly that element which is +supplied to it by the inspired air, oxygen. All the products of waste +are increased. The skin becomes more soft and moist, showing that the +amount of matter eliminated by it is increased. The urine becomes more +abundant, and the relative amount of urea, its most important +constituent, becomes greatly increased. The amount of carbonic acid gas +exhaled is increased, and further evidence in the same direction is +furnished by the very marked increase in the inspiratory acts, +necessitated by the increased demands for oxygen. + +[Illustration: Fig. 13. +Oscillating the Legs.] + +The local increase of the circulation incident to properly applied +mechanical movements, must produce a corresponding diminution of blood +in other, even in remote, regions of the body. Thus this treatment, by +its revulsive effects, is capable of relieving various disorders of the +head, chest, digestive organs, and pelvis. Nowhere, however, is the +effect more satisfactory than in affections of the brain and spinal +cord, whether characterized by loss of power, of sensation, or by +neuralgic pain. Any portion of these nerve centres suffering from +congestion, will find prompt relief in mechanical vibratory movements. + +THE MOVEMENT CURE which we advocate is not a "Swedish Movement Cure," +nor anything akin to it. It is the application of remedial forces by +complex structures, which combine a variety of mechanical powers. The +inventions are solely American. + +[Illustration: Fig. 14. +Apparatus for Rubbing in a Recumbent Position.] + +By means of this machinery, which is driven by steam power with great +velocity, we are able to apply _soft, pleasant, rapid vibrating +movements_ over the surface of the body, and thereby increase the +circulation of blood through the parts, raise the temperature, and +excite pleasant sensations. The movements can be applied by our +ingeniously-devised machinery to any part of the body through the +clothing and _without the least exposure of the person._ They can be +administered in a great variety of ways, by light, quiet persuasions, by +gentle frictions, by rubbing, by oscillations, by kneadings, by circular +movements, in fact, by an almost _endless variety_ of reciprocating and +alternating motions, which, if described, would convey to the mind of +the reader but a faint conception of their remedial value. + +VIBRATORY MOTION not only establishes activity of the circulation +through the skin and muscles, but it also affects profoundly the +circulation in the important and vital organs of the body; it is thus +capable of overcoming torpidity or congestion of the liver, spleen, and +other deep-seated organs, without the depressing effects which sometimes +follow the administration of powerful medicines. + +It has not been our purpose to literally explain, in detail, the methods +of applying vibratory motion in the treatment of paralysis for popular +experiment, since to be successful one should become an expert, not only +in this mechanical treatment, but also in the diagnosis of the various +forms of paralysis, as well as familiar with their causes, pathology, +and remedial requirements. Thus, to be successful in the treatment of +paralysis and other nervous diseases, by the application of motor forces +with our ingeniously-contrived machinery, the cost of which is beyond +the means of most invalids, one must exercise great discretion. + +GRATIFYING SUCCESS. Not only is vibratory motion as a remedial agent +rational and philosophical, but our experience has fully demonstrated +its marvelous effects in the treatment of paralysis in its various +forms, and also in the cure of other chronic diseases. We have cured +cases of infantile paralysis which had resisted the skill of the most +renowned physicians in our country. We have treated those who could not +stand or bear the weight of the body, but who have been so far restored +as to be able to walk and run without assistance. Writer's and telegraph +operator's paralysis, or cramp, we have cured in a few weeks' time. +Club-feet, spinal curvature, and other deformities resulting from +paralysis, have been successfully treated in our Institution. In short, +our success has been most flattering in all curable cases of paralysis, +and it is such experience that induces us to hold out encouragement to +those who are afflicted with paralysis and other nervous affections. + +Vibratory motion is a desideratum of priceless value to those who are +afflicted with diseases of the nervous system, as well as to all others +who need a gentle stimulus to call forth their latent energies and +improve their physical condition. + + +RECAPITULATION. + + +Motion, properly transmitted to the human system by mechanical +apparatus, is transformed into other forms of force identical with vital +energy, by which the ordinary processes of the system are greatly +promoted. + +It increases animal heat and nervous and muscular power to the normal +standard. + +It removes engorgement or local impediments to the circulation. + +The electrical induction produced, renders it a most efficacious remedy +for paralysis of all kinds. + +It removes interstitial fluids and causes rapid absorption and +disappearance of solid and fluid accumulations. + +It is a powerful alterative, or blood-purifier, increasing oxidation and +stimulating excretion. + +It diminishes chronic nervous irritability and promotes sleep. + +It hardens the flesh by increasing muscular development and improves +digestion and nutrition. + + +ANIMAL JUICES, OR EXTRACTS. + + +The use of animal, nerve and gland extracts has proven of surprising +efficiency in the treatment of paralysis and locomotor ataxia. They +furnish a pabulum in concentrated form for the nourishment and +restoration of the weakened nerve cells and fibres. + +In the vast majority of cases, we have been able, by the use of these +recently discovered curative agents, when assisted by other means at our +command at the Invalids' Hotel and Surgical Institute, to arrest the +progress of these nervous affections, hitherto so generally considered +incurable, and bring about restoration of the paralysed functions and a +renewal of lost power. + +These comparatively new remedial agents have been very thoroughly tested +by us. Their merits are more fully considered in a preceding chapter of +this treatise, under the head of treatment for Nervous Exhaustion, or +Debility. + + * * * * * + + + + +EPILEPSY ("FITS"). + + +Epilepsy, or falling sickness, is a disease which is characterized by +attacks of sudden loss of consciousness, together with convulsive +movements of the muscles. The paroxysms occur at irregular intervals, +the periods between them, in some cases, being only a few minutes or +hours, while in others, several months elapse. + +There are two classes of Epilepsy: 1st. The general form, with a +convulsion that usually involves all the muscles of the body +simultaneously. It begins suddenly with little or no warning, commonly +with a cry or scream. The convulsion may last several minutes and is +followed by a deep sleep for some hours. + +2nd. The local or Jacksonian form in which the attack begins with a +peculiar sensation in some particular region of the body, either in one +extremity or one half of the face. This sensation is followed by a +twitching of the muscles of the part. The sensation and spasm extend or +advance gradually to other parts. Consciousness is not usually lost, +though it may be when the spasms culminate in a general convulsion. + +Great weakness generally follows in the parts convulsed, gradually +passing away. When the attack begins on the right side of the face it is +associated with an immediate inability to speak. + +SYMPTOMS. In the severe forms of the disease, the subject suddenly loses +consciousness and falls; there is rigidity of the muscles, which causes +a twitching of the face and limbs; the eyes are turned up, and there is +foaming at the mouth. In the severe form of the disease, the respiration +is arrested, while in the milder attacks, the breathing is difficult, +slow, deep, and snoring. With the commencement of the spasm, the tongue +is sometimes caught between the teeth and severely bitten. During the +paroxysm, the countenance changes from a livid hue to dark purple. The +convulsion continues from one to three minutes, and is followed by a +deep, sighing inspiration; the subject then sinks into a deep sleep, +which continues for half an hour or longer. When consciousness is first +regained, the subject appears confused, stupid, and usually complains of +headache. He has no recollection of what has occurred during the attack, +he pronounces words indistinctly, and if he attempts to walk, he +staggers like a drunken man. Sometimes, several attacks occur so closely +together that there is no interval of consciousness between them. + +In some cases, there are premonitory symptoms, such as giddiness, +drowsiness, headache, and irritability of temper, which warn the subject +of an approaching paroxysm. Occasionally, a wave of cold commencing at +the feet and proceeding to the head, is experienced. This is called an +_aura_. When it reaches the brain, the subject becomes unconscious, +falls, and the convulsion commences. If the disease be allowed to +proceed unchecked, it almost invariably leads to great impairment of +mind, insanity, or paralysis. + +CAUSES. The _predisposing causes_ are an hereditary tendency to the +disease, and everything which impairs the constitution and produces +nervous prostration and irritability. Syphilis, phimosis, sexual abuses, +uterine disease, and the use of alcoholic liquors are prominent +predisposing causes. Many of the causes treated by us have been brought +on by masturbation. Others are the results of injury to the head. Often +fracture of the skull is followed by epileptic attacks. + +_The exciting causes_ include everything which disturbs the equilibrium +of the nervous system. Indigestible articles of food, intestinal worms, +loss of sleep, great exhaustion, grief, anger, constipation of the +bowels, piles, and uterine irritation may be enumerated among such +causes. Convulsions of an epileptic character may also be induced by a +poisoned condition of the blood, from malaria and disease of the kidneys +or liver. + +TREATMENT. When the time of an expected paroxysm approaches, great care +should be exercised that the patient be not suddenly attacked while +carrying a lighted lamp, or that he does not fall in some dangerous +place, strike upon a heated stove, or in some similar way inflict great +injury. If there be warning symptoms before the attack, the subject +should carry a vial of the _nitrite of amyl_ in the pocket, and, when +the premonitory symptoms are felt, two or three drops should be poured +on a handkerchief and held about an inch from the nose and inhaled, +until flushing is produced, or a burning sensation is felt in the face. + +During the paroxysm, the subject should be laid on the back, with the +head slightly elevated, and the clothing about the neck and waist, if +tight, should be loosened. If there be sufficient warning, a folded +napkin, or a soft pine stick covered with a handkerchief or cloth, +should be placed between the double teeth, to prevent the tongue from +being bitten. During the fit, the head may be bathed with cold water. + +A person who suffers from this disease should avoid everything which +tends to excite the nervous system, or increase to any great extent the +action of the heart. The sufferer should go to bed at regular hours, and +take at least eight hours sleep. The sleeping-room should be large and +well ventilated, and the patient should lie with the head elevated. All +indigestible articles of food should be avoided and the diet should +consist principally of bread, vegetables, milk, and fruits. Meat should +be taken but once a day, and then in very small quantities. The use of +alcoholic liquors and coffee should be avoided, and tea only taken in +small quantities. The bowels should be regulated with Dr. Pierce's +Pleasant Pellets and injections, if necessary. A thorough bath should be +taken once or twice a week. If the attacks occur at night, the body +should be sponged before going to bed with tepid water, to which should +be added sufficient tincture or infusion of capsicum, or red-pepper, to +render it stimulating to the skin. + +The causes, if they can be determined, should be removed, and those +remedies administered which relieve nervous irritability and cerebral +congestion. If due to worms, the proper remedies should be given; if to +phimosis, the subject should be circumcised; if to pressure on the +brain, from fracture of the skull, trephining should be practiced, and +the depressed bone raised. There are no _specifics_ for this disease; +each individual case must be treated according to the condition +presented. The nostrums advertised extensively over the country as +specifics for this disease, while they may, in some instances, prevent +the attacks for a short time, irritate the stomach, impair digestion, +lower vitality, and permanently injure the system, often rendering the +disease incurable. They deceive the sufferer, leading him to think that +his disease is being cured, until it progresses so far that he is beyond +the reach of any treatment. As a rule, the longer the disease +progresses, the more difficult it is to cure. + +Epilepsy has by many physicians been regarded as incurable, but our +extensive experience has convinced us that by an appropriate course of +treatment, the _vast majority_ of cases can be cured. The animal +extracts, or juices, herein more fully described under the head of +treatment for Nervous Exhaustion, have proven curative in some cases +that have resisted other remedies. This treatment requires the personal +attention of a physician skilled in its employment. It is also of first +importance that the extracts be properly made. We have discovered +several new remedies, which undoubtedly exert a powerful curative +influence over this disease, but it is necessary to vary the treatment +so much in different cases, that it would be useless to enter further +into details in this treatise. + +SURGICAL TREATMENT. A considerable proportion of those cases of +epilepsy, termed Jacksonian, have been found to be caused by new growth +upon, or in, the substance of the brain. Sometimes cysts form as a +result of small hemorrhages, or of spots of softening from clots in the +cerebral arteries. Other cases are due to a small spot of hardened +tissue or an inflamed centre of irritation in the outer gray matter of +the brain. + +The majority of these forms of disease can be exactly localized in a +small area of the brain, and may usually be traced to a blow or fall on +the head, or to fracture of the skull without depression. The discovery +of the fact that such results of injury will produce localized spasm has +naturally lead to the conclusion that similar products anywhere in the +brain may give rise to epilepsy. In these cases trephining of the skull +and the removal of irritation from the brain has been followed by the +most successful results. It is seldom a serious or dangerous operation, +but very few deaths having resulted in the practice of good surgeons in +many hundreds of cases, and these were individuals who were not +favorable for operation, and in whom it was undertaken as a last resort + +In these cases of epilepsy, due to injury, the operation is fairly safe, +and in carefully selected cases that have not been allowed to run so +long as to bring upon the brain a general epileptic tendency, the +results of operation are good and the procedure warrantable. + +SEE TESTIMONIALS FROM A FEW OF THE MANY CURES EFFECTED BY OUR +SPECIALISTS. + + * * * * * + + + + +CHOREA (ST. VITUS'S DANCE). + + +This disease is an affection of the nervous system, which is +characterized by spasmodic contractions of certain muscles. It may +affect the entire body, although it is usually confined to the left +side, or to a special group of muscles. + +SYMPTOMS. Twitchings of the muscles of the face are the most conspicuous +symptoms. They are at first comparatively slight, but as the disease +progresses, these spasms become more decided, and the face is twisted +into various shapes and forms. The head, in some cases, is constantly +jerking. It is with great difficulty that the tongue is thrust out of +the mouth, and then, with a sudden jerk, it is quickly withdrawn. + +These spasms or contortions, may affect the extremities in a similar +manner, the hands and arms cannot be kept quiet, the gait may be +unsteady, and one foot is merely dragged after the other. If one limb be +forcibly held, to keep it quiet, some other limb will involuntarily +move. Strange as it may appear, these contractions, which cannot be +controlled by the will during wakefulness, are very much lessened or +arrested by sleep. + +Prior to the development of the spasmodic affection, there is usually a +period in which the sufferer notes a want of appetite, languidness, with +disinclination towards mental or bodily pursuits, headache, +restlessness, pains in the limbs and joints, with irritable temper and +weakness of memory. There are many other symptoms in special cases. As +the disease develops, the patient gradually begins to exhibit an +awkwardness of movement in the extremities, and objects frequently fall +from the grasp. Children thus afflicted, spill their food while eating, +and it becomes difficult for them to stand still. Attempts to write, +sew, or draw are imperfectly performed. Such children are very often +punished for supposed ill-behavior or careless habits. Later on the +symptoms become more unmistakable, and the presence of the disease is +readily recognized. The patient may become incapable of dressing, and +the limbs and face are no longer under the control of the will. +Uncontrollable movements of the fingers, hands, shrugging of the +shoulders, dancing of the legs, grimaces of the face, and distortions of +the body, become more or less constant. Speech and swallowing may be +seriously embarrassed. Any unusual excitement of the mind or body is apt +to intensify the muscular twitchings. Severe mental application, the +reading of exciting books, the witnessing of entertainments, and +excessive indulgence in sports, have to be discontinued. + +THE MOST COMMON CAUSES seem to be exhaustion of the nerve centres, due +to the appearance of the second teeth in children and the development +common to the age of puberty. Other causes may be briefly mentioned as +follows: rheumatic affections, constipation, a morbid state of the +blood, suppression of the menstrual function, uterine difficulties, +masturbation, or self-abuse, blows, injuries, or any cause which would +give rise to nervous debility. Sometimes it is caused by obstruction in +the alimentary canal, or by intestinal worms. + +TREATMENT. The disease is one in which there is a debility of the nerve +centres, complicated with a lack of assimilation and digestion. There is +no affection more amenable to treatment in its early stages than this. +We are daily in receipt of correspondence from sufferers, or their +parents, or friends, in which the most gratifying relief and a cure has +resulted from the use of Dr. Pierce's Favorite Prescription used in +conjunction with Dr. Pierce's Golden Medical Discovery. These two +remedies should be used alternately, the dose being suited to the age of +the patient. + +A large majority of the cases of chorea occur in females and at the +period of life when the nervous system is subjected to unusual +requirements. In these cases the "Favorite Prescription" effects a +gradual restoration of nervous energy, and improvement in the tone of +the nerve centres, and by its direct effect upon the circulation in the +ovarian region, eliminates the most potent causes of debility. In young +people, we usually advise a dose of three drops for each year of the +age. For instance, children of eight years of age should take +twenty-four drops; those of twelve, thirty-six drops; those of fifteen, +forty-five drops, which is about two-thirds of a teaspoonful. A similar +dose of Dr. Pierce's Golden Medical Discovery should be administered, +taking it before meals, and the "Prescription" after meals. Under their +administration the patient will rapidly improve in health and strength; +the circulation is materially bettered, the blood is purified, enriched, +vitalized. The remedies effect a complete removal, from the blood, of +the impurities that represent nerve waste, and as a consequence the +nerve cells are properly nourished. The disease is gradually controlled, +and when the favorable influences of quiet, nourishing food, with plenty +of outdoor air, and not too active exercise is added, the progress is +most gratifying. The patients, in a few weeks, are able to control much +of the spasmodic movements, and gradually their restoration to a normal +condition is accomplished. + +In occasional cases, where there is some complication, as rheumatism or +other severe affection, complicating and preventing their recovery, +special treatment is required. We are always ready to advise in regard +to such cases when consulted either by mail or in person. + + * * * * * + + +TESTIMONIALS. + + +If the following letters had been written by your best known and most +esteemed neighbors they could be no more worthy of your confidence than +they are now, coming, as they do, from well known, intelligent and +trustworthy citizens, who, in their several neighborhoods, enjoy the +fullest confidence and respect of all who know them. + +Out of thousands of similar letters received from former patrons, we +have selected these few at random, and have to regret that we can find +room only for this comparatively small number in this volume. + + +NERVOUS AND GENERAL DEBILITY. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.: + +[Illustration: T.M. Carson, Esq.] + +_Gentlemen_--I am thankful to-day that I can honestly say, that as a +result of your few weeks' treatment, I feel better now in both body and +mind than I have for fifteen years. Before I consulted you I felt more +like taking my own life to end my miserable feelings than I felt like +living; I had given up all hopes of ever being any good to myself or +anybody else, but, thank God, your encouragement, and kind words, and +skillful treatment have made a different man of me. + +Before I consulted you, I took no interest in business nor any thing +else in the world, which the wise Creator has placed in this world for +all mankind to enjoy; but now my mind is clear, and I take an interest +in business and enjoy life better than I ever did before. + +Now, may God bless you for your good and skillful treatment of me; and, +also, may this be the means of inducing others who are to-day suffering +from the same complaint to at once consult you, as I can assure them +that they will receive full benefit of your kind attention, for moderate +charges. + + Yours respectfully, T.M. CARSON, + P.O. Box 145, Swissvale, Allegheny Co., Pa. + + +NERVOUS DEBILITY. + +SPECIAL TREATMENT, FOLLOWED BY USE OF "GOLDEN MEDICAL DISCOVERY." + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Ltd., 3, New Oxford Street, +London, W.C.: + +[Illustration: F. Macey, Esq. ] + +_Gentlemen_--I now write to describe the benefit which I have received +from your treatment. For some time I had been suffering from nervous +debility, and before placing myself under your treatment my trouble was +very severe; and not understanding the nature of my disease, I did not +know what to do until I saw a few testimonials of your wonderful cures, +when I was led to at once communicate with you; and after two months' +special treatment from you, I was greatly relieved, and was advised to +then use Dr. Pierce's Golden Medical Discovery, which I did for a time, +and am happy to say that I now feel like another man, and am troubled no +longer with the old symptoms, and I thank God, and also the kind +gentlemen that have been conducting my case, for the treatment and +advice which I have received. I also think the "Golden Medical +Discovery" is a most wonderful medicine, and I shall feel it my duty to +speak well of your medicines and treatment to all fellow sufferers I may +meet. I am, + + Yours truly, F. MACEY, + Faversham, Kent, England. + + +NERVOUS DEBILITY. + +[Illustration: A.E. Norcross, Esq.] + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.: + +_Gentlemen_--Two and a half years ago, after seeking in vain for health +at the hands of local doctors, I began treatment with you for "Nervous +Debility of a complicated nature. Ag a result thereof I now give this +testimonial, having been changed from a person of rapidly declining +health--often despondent and with no inclination to work of any kind, to +one of sound constitution who enjoys life and is once more able to +battle his way to success in life; and it is now about two years since +the change occurred, showing it to be permanent. + +I cannot say too much in praise of your methods, and careful, courteous +attention which myself and others have enjoyed at your hands; and that +the good work may go on to an unlimited extent is my earnest wish. + + Yours sincerely. + A.E. NORCROSS, + (General Delivery), Detroit, Mich. + + +NERVOUS DEBILITY, DYSPEPSIA, HEART DISEASE. + +[Illustration: Miss Greenwell. ] + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +_Gentlemen_--I feel very grateful to you, and to our all-wise Creator +for restoring my health. When I first wrote to you I was a miserable +sufferer with nervous debility, dyspepsia, heart disease, also female +weakness. I was so nervous and low-spirited I could not sleep, in fact I +was just about as weak and low as I could be, and could scarcely drag +around; but, after persevering for about twelve months, occasionally +with the help of your kind treatment and advice, I once more begin to +feel like myself again. Words cannot tell how I do appreciate my health. + +Thank you, gentlemen! I shall never forget the kind business-like manner +in which you have treated me. May God bless you, inasmuch as your +heart's desire is to do good to suffering humanity. + + Very truly, Miss K. GREENWELL, + No. 253 Twenty-second St., Ogden, Utah. + + +NERVOUS DEBILITY--RESULT OF INDISCRETION. + +[Illustration: C.H. Goodsell, Esq. ] + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +_Gentlemen_--For the last year and a half I was troubled with Nervous +Debility. I tried some medicine that I bought from the druggist, which +did me little or no good; so, hearing of the World's Dispensary Medical +Association, of Buffalo, I wrote them about my case, and in reply, they +said they were sure they could cure me. At that time I was weak in my +arms and legs, had poor sight and, worst of all, I was very nervous and +bashful. I could not sleep at night and feel refreshed in the morning. I +could not look any one in the eye without feeling ashamed. + +I have now taken two months' treatment and I feel sound in mind and +body; but to be sure I am going to take another month's treatment from +these same doctors in Buffalo. + +I recommend all men who are afflicted with any disease similar to the +one of which I have just been cured to apply to the World's Dispensary +Medical Association, and if they take treatment from these doctors they +will surely be cured. I cannot praise them too much for what they have +done for me. + + Yours truly, C.H. GOODSELL, + No. 151 S.W. Temple St. + Salt Lake City, Utah. + + +NERVOUS AND GENERAL DEBILITY. + +WORLD'S DISPENSARY MEDICAL, ASSOCIATION, 663 Main St., Buffalo, N.Y.: + +[Illustration: T.W. Knapp, Esq. ] + +_Gentlemen_--I had been out of health for a period of about three years. +Suffered with pains in the head, catarrh, chills, fever, nervousness, +and general debility. Spent about all the money I had in order to obtain +relief, but received little, if any good. I was scarcely able to work, +when in July, 1887, I wrote to your Association, describing my case. You +replied, advising me, and prescribing a course of treatment, which you +sent to me. After taking but a part of these medicines I began to feel a +great deal better; could sleep very much better and was able to resume +work as usual, but still suffered some pain in head, and my buck was +lame and weak. I continued treatment for some three or four months, +until all remaining symptoms of distress and weakness had disappeared. +At the end of about eight months I found I felt as well as I ever did. +My weight had increased fully twenty pounds, and I could safely say that +you had effected a perfect cure in my case. + + Respectfully yours, + THOMAS WESLEY KNAPP, + Myhart, Allen Co., Ind. + + +NERVOUS AND UTERINE DISEASE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.: + +[Illustration: Mrs. Williams. ] + +_Gentlemen_--I was sick for over three years with nervous complaint, +with blind dizzy spells, palpitation of the heart, pain in the back and +head, and at times would have such a weak tired feeling when I first got +up in the morning, and at times nervous chills. At other times, I would +feel as if there were a tight bandage around my forehead. + +The first physician I went to said I had nervous dyspepsia; the next one +did not say what he thought ailed me; the third said I had dyspepsia, +but none of them did me any good. As soon as I commenced taking Dr. +Pierce's Favorite Prescription, I began to get better; could sleep well +nights, and that bad nervous feeling and the pain in my back soon left +me. I can walk several miles without getting tired. I took in all, three +bottles of the "Favorite Prescription" and two of Dr. Pierce's Golden +Medical Discovery. + + Yours truly, + MRS. JENNIE WILLIAMS, + Mohawk, Lane Co., Oregon. + + +NERVOUS AND GENERAL DEBILITY. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, NO. 663 Main St., Buffalo, N.Y.: + +[Illustration: W.C. Dillon, Esq.] + +_Gentlemen_--When I applied to you for medical treatment I was in a very +bad state. Your suggestion that I use Dr. Pierce's Golden Medical +Discovery was followed with good results, and I can say I felt the +effects of it before the first bottle was finished. The dull pains in my +back were leaving me very fast. I used three bottles of the "Golden +Medical Discovery." I had a dull pain in the back, restless sleep +followed by very trying dreams, appetite poor, weakness, consequently +very easily tired. Now I can go about my work, walk twelve or fifteen +miles a day and not feel tired. When I commenced to use your "Golden +Medical Discovery" I only weighed 125 pounds; now have increased to 150. + + Yours respectfully, + W.C. DILLON, + Box 63, Woburn, Middlesex Co., Mara. + + +NERVOUS DEBILITY. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.: + +[Illustration: M.H. Moore, Esq.] + +_Gentlemen_--I had been ailing for months and did not know what was the +matter. I had a heavy and languid feeling; dimness of sight, spots and +flashes before my eyes; an "all gone" feeling in my stomach as if the +bottom had fallen out; was nervous and irritable and felt like sinking +down when at work. I could hardly get up in the morning; it seemed as if +I were more tired then I was when I went to bed. My appetite at times +was ravenous, and at other times the smell of food made me sick; I would +often go from the dinner table and vomit. I would have spells when it +seemed that every man was my foe and would be melancholy, and think that +something was going to happen to me; was easily upset, could not get my +mind to stay on anything long at a time. When I read about your +remedies, I made up my mind to try them. After taking one month's +treatment I felt better, and kept on until I had taken three months' +treatment and was made a new man. I would advise any one who is in bad +health to do the same, and will assure them that Dr. Pierce is a +gentleman, and will do Just what he says, as he did in my case. + + Yours truly, + MARIS H. MOORE, + Ocean City, Cape May Co., N.J. + + +NERVOUS AND GENERAL DEBILITY. + +Dr. R.V. PIERCE, Buffalo, N.Y.: + +[Illustration: Mrs Linn.] + +_Dear Sir_--My case was a complication of diseases--a general +break-down, lasting three years. I placed myself under the treatment of +four different physicians. At last, giving up all hope of recovery at +home, I was making arrangements to go to a Sanitarium in Michigan for +special treatment. One of your small books with blank enclosed was +handed to me; I filled out the blank, and thought I would try rather +than leave home and little ones,--"Happy decision;" two months' special +treatment and I was well and happy, and to-day, I have the very best of +health. + + Yours respectfully, + MRS. LOMA LINN, + Ladoga, Montgomery Co., Ind. + + +NERVOUS AND GENERAL DEBILITY. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: J. Thomas, Esq. ] + +_Gentlemen_--Had vertigo, or dizziness. Pain over right eye. Vomiting +sometimes, severe pains in arms, from elbows to shoulders, pain in left +side. Numbness of the fingers. His home physician said "will run into +paralysis." Analysis of the urine shows phosphatic deposits. Began +treatment with specialists of Invalids' Hotel and Surgical Institute, in +August, '87; used the remedies interruptedly for about six months. +Writes May 11th, '89, "have not had a dizzy spell for a year." In +October,'90, writes, "the dizzy spells have gone for good, I hope." +November 9th, '93, reports, "I most willingly recommend your medicines +for they cured me of those dizzy spells of long standing, after four +doctors in this county had treated my case for three years, without +benefit." + + Respectfully yours, + JASPER THOMAS, + Alamosa, Conejos Co., Col. + + +IRRITABILITY AND EXHAUSTION OF THE NERVOUS SYSTEM, RHEUMATISM AND HEART +DISEASE. + +CURED BY SIX BOTTLES OF THE "GOLDEN MEDICAL DISCOVERY." + +[Illustration: C.A. Roberts, Esq. ] + +Mr. C. Allison Roberts, of Cassville, White Co., Tenn., suffered a great +deal from rheumatism, he says: "Legs ached more like toothache than +anything I can think of, the thigh bones throbbing and paining; had +pains in hips, back, arms and shoulders." His symptoms also showed that +the heart was affected. Had chills, headache often and sometimes sick +headache. Bowels were costive and irregular. Food distressed and could +not eat meat; urine milky; coughed in early part of night, and feet and +legs would become numb. Had difficulty in getting to sleep before +midnight, and was restless through the night and dreamed much. Had +sinking spells which lasted for thirty minutes. Turned pale, became +trembly and sometimes vomited his food. + +Almost immediately after beginning the use of the "Golden Medical +Discovery" the headache ceased. After using four bottles, reported that +he had been benefited by the remedy. Later he reported: "I have been in +reasonable health for some time. I took six bottles of the 'Golden +Medical Discovery' and it cured the rheumatism entirely. I had suffered +with it for several years and found no relief until I used your +medicine. Have no weak nor nervous symptoms now, and no spells of +turning sick at the stomach, or of bad action of the heart, palpitation, +etc." + + +NERVOUSNESS, "FEMALE WEAKNESS," NASAL CATARRH. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Sanderson. ] + +_Gentlemen_--My health was utterly gone. Was suffering from nervousness, +female troubles and nasal catarrh; life was almost a burden to me, but a +glorious change came, due solely to Dr. Pierce's Favorite Prescription +and Dr. Sage's Catarrh Remedy. I have suffered more than tongue can ever +tell. I have been treated by good physicians but they only help me +temporarily. I have taken a great many patent medicines with the same +result. In 1890, I began taking Dr. Pierce's Favorite Prescription and +Dr. Sage's Catarrh Remedy, which gave me immediate relief and a +permanent cure. + + Respectfully, + MRS. BELLE SANDERSON, + Sprout, Nicholas Co., Ky. + + +NERVOUS DEBILITY. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, 603 Main St., Buffalo, N.Y.: + +[Illustration: J.F. Ritter, Esq.] + +_Gentlemen_--It is now about six months since I discontinued your +treatment, and as I have had no return of the old symptoms, I consider +it unnecessary to take more medicine. When I visited your Institution +some two years ago, I had but faint hopes of ever being restored to +health, as I was suffering from a complication of diseases. My case was +an unusually obstinate one, yet I am satisfied that a cure could have +been accomplished in half the time, had I been able to follow your +directions in regard to diet more closely. I hereby tender you my +sincerest thanks for the kind treatment received while at your +Institution. Those days will always be the happiest in my memory. I will +close by giving your faculty my sincere thanks, and hope success will +crown your business. + + Yours very gratefully, + J.F. RITTER, + Medford, Jackson Co., Oreg. + + +NERVOUS DEBILITY. SPECIAL TREATMENT. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Ltd., 3, New Oxford Street, +London, W.C.: + +[Illustration: W. Trumbetta, Esq. ] + +_Dear Sirs_--In reply to your kind inquiries regarding my health, I am +only too glad to say that I am better than I ever was. Before taking +your medicines, I experienced great nervousness, loss of appetite, +restless nights, taking no interest in my work; had pale complexion, +with hollow checks, sunken eyes and loss of memory. I only took your +special treatment for about two months, and received great benefit from +taking it, but still go on taking your "Pellets" when required. I am +sorry to say that I have not got a photograph before taking your +medicines, or I should have been glad to send it to let you have seen +them both before taking your medicines and after. I remain + + Yours sincerely, + W. TRUMBETTA, + 84, Essex Street, South Heigham, Norwich, Eng. + + +NERVOUS PROSTRATION. + +WORLD'S DISPENSARY MEDICAL, ASSOCIATION, 663 Main St., Buffalo, N.Y.: + +[Illustration: Mrs. E.A. Northrop.] + +_Gentlemen_--It is now sixteen years since I suffered from that terrible +disease, nervous prostration. I suffered untold agony and thought I +would go insane. Had a terrible burning sensation across my shoulders, +and my head felt large as two, and as if there was a hole from one ear +to the other and all sounds passed right through. I could not see, nor +sleep, nor scarcely eat, and was that nervous the least thing made me +angry. I was treated by our home physician and given up as incurable. At +that time I saw your Memorandum Book and thought I would write you, and +the result of it was you took my case. + +After one month of your valuable remedies I felt like a new person, and +after six months was restored to good health again after suffering +nearly one year of untold agony. + +I would heartily recommend all and every one suffering from any chronic +disease to place their case in the hands of the World's Dispensary +Medical Association, of Buffalo, N.Y., as I cannot praise your treatment +too highly. Words are inadequate to express the gratitude I owe you in +so successfully treating my case. + + Respectfully yours, MRS. E.A. NORTHROP, + South Main Street, Newark, Wayne Co., N.Y. + + +GENERAL AND NERVOUS DEBILITY. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: J.W. Stocking, Esq.] + +_My Dear Sirs_--I believe that I am free from all the troubles that you +have been treating me for. The pain in my back is gone--my digestion is +good. In all truth I can say _I am a man again_! + +I can stoop without pain--can labor without that weak and tired feeling. +I am truly grateful to you for the good that you have done me, and may +you reap a rich reward for the good you have done for suffering +humanity, is my sincere wish. + + Truly yours, + J.W. STOCKING, + Panama. Lancaster County, Nebr. + + +NERVOUS DEBILITY AND VARICOCELE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: D.A. Walton, Esq.] + +_Gentlemen_--I commenced treatment, I think, in July or August, of 1888, +and continued four months. My case was nervous debility of fifteen +years' standing. + +I tried home doctors but found they were only aggravating my case. I +also tried the Remedy Company, then of St. Louis, who claimed to perform +wonderful cures with their "Pastiles," but they proved utterly +worthless. Having come in possession of Dr. Pierce's little book and +circulars, a perusal of the same convinced me that my health would not +be trifled with at his Institution. + +I was a poor man and could not afford much experimenting. I ordered one +month's treatment, and at the end of this first month, I found, to my +surprise, that I was feeling different. The second month, still more +surprised at my returning health. Third month thought I was cured, and +engaged myself to a young lady, and wrote you to that effect, and you +advised me with your congratulations to marry, and to order another +month's treatment; and at the end of the fourth month I was a _man_, +something I did not know what it would be like to be before. + +I have now been married five years, and have two healthy children--a boy +and a girl. I would never have dared to marry had it not been for your +medicines. I must add that during this treatment I was troubled with +varicocele on left side. I wrote you this at third month of treatment, +and you sent without extra charge, a Suspensory and Lotion, and two +months' treatment cured me sound and well of this distressing malady; I +have not felt the least symptoms of its return. + +I want the world to know what a competent and honorable firm the World's +Dispensary Medical Association is. I would love to shake you by the +hand. May God let you continue to be a help to mankind is my prayer. + + Yours truly, + D.A. WALTON, + Marion, Grant County, Ind. + + +NERVOUS DEBILITY AND VARICOCELE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: J.L. Ridings, Esq.] + +_Gentlemen_--I can bear testimony to the removal of varicocele, for +which you treated me. I had been in the habit of getting out with the +boys and trying to see which could kick the highest with one foot on the +ground, and it caused me to have varicocele. I went to my home doctor +and he treated me with no success. It was getting worse all the time and +I got out of shape all over. My health got bad and I thought my case +hopeless. I had tried two doctors and received no benefit. + +I had one of your little Memorandum Books in my pocket, and one day, +looking through it I saw you treated such cases, and wrote you and +received word in a few days that you would treat me, so I sent off for +one month's treatment; and in five months I had gained my weight back, +and that was eight years ago and I feel sound and well and my health has +been good ever since. + +You are at liberty to use my testimony in whatever way it may be of most +benefit to you. + +I also enclose a photograph of myself that was taken soon after your +treatment. + +With feelings of much gratefulness, I am. + + Very truly yours, + J.L. RIDINGS, + Clarence, Shelby County, Missouri. + + +NERVOUS DEBILITY. INDIGESTION. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION. Buffalo, N.Y.: + +[Illustration: R,M. Bascom, Esq.] + +_Gentlemen_--It is now about thirteen months since I discontinued your +treatment, and I have no return of the old symptoms, I consider it +unnecessary to continue treatment. When I commenced taking your medicine +I was suffering from nervous debility, indigestion, dyspepsia, etc. +After using your medicine one month I am perfectly healthy, and +cheerfully recommend your Institution to suffering humanity. + + Yours truly, R.M. BASCOM, + Sunfield, Eaton County, Mich. + + +NERVOUS DEBILITY. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION. Buffalo, N.Y.: + +[Illustration: F. Zerbe, Esq.] + +_Gentlemen_--It is now about five years since I received a two months' +treatment for my case and I have had no return of the symptoms, I +consider it unnecessary to take more medicines because I am gaining +strength every day. I am healthier than I have been in fifteen years, +and I thank you for the kind favor you have done me in my case, and I +wish that all sufferers would send to you for treatment. + + Yours respectfully, + FRANKLIN ZERBE, + De Turksville, Schuylkill Co., Penna. + + + +NERVOUS DEBILITY, DYSPEPSIA, CONSTIPATION. + +Blackstone, Nottoway Co., Va. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +_Gentlemen_--Dr. Pierce's Golden Medical Discovery and "Pleasant +Pellets" made a perfect cure of me. I increased in weight from 120 +pounds to 150 pounds and my strength increased in proportion. It +improved me so rapidly that my friends inquired what produced such a +change in my general appearance and health. Some accused me of +dissipation. When I told them it was your medicine, the drug stores +found a ready market for it, and continue to sell it with increased +sales. + + Yours truly, R.E. Jones + + +NERVOUS AND GENERAL DEBILITY. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: O.A. Conklin, Esq.] + +_Gentlemen_--I was a great sufferer from nervous and general debility. I +applied to you by letter for advice and received from you medical +treatment for three months, which completely restored me to health; the +course of treatment did not interfere with my usual vocation and was not +difficult to follow. I am a well man to-day and take pleasure in +advising all the afflicted to consult you at once, and feel sure they +will, like myself, be well pleased with your treatment. + + Yours truly, + O.A. CONKLIN, + Ravenna, Muskegon Co., Mich. + + +NERVOUS DEBILITY. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: H. Culver, Esq.] + +_Gentlemen_--After taking the two months' treatment which you sent me by +mail for that broken-down condition, usually styled "Nervous Debility," +attended by the usual symptoms such as headache, sleeplessness, +confusion of ideas, etc., the above symptoms have so entirely +disappeared that I do not consider it necessary to continue the +treatment longer. I would say further that I am satisfied that you +understand your business, and would advise anybody suffering from any +chronic disease to avail themselves of your skill in preference to +resorting to any other source known to me. + + Yours respectfully, + HERMAN CULVER, + Port Angeles, Clallam Co., Wash. + + +GENERAL AND NERVOUS DEBILITY. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Wm. H. Coon, Esq.] + +_Gentlemen_--I am very thankful for what you have done for me. The +treatment which you furnished me a year ago gave me great relief. I had +been suffering for many months with general and nervous debility, with +headache, languor, sleeplessness, indigestion, constipation, etc., which +were increasing upon me. One month's treatment gave me perfect relief, +and I am now like a new person. I can heartily recommend all young men +to consult your staff when in need of medical advice. + + Respectfully yours, + WM. H. COON, Medina, N.Y. + + +NERVOUS DEBILITY AND CATARRH. + +Big Piney, Pulaski Co., Mo. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +_Gentlemen_--I was treated by you eleven years ago for nervous debility +and chronic catarrh of eight years' standing and of a very aggravated +nature. I was considered near my grave by many of my friends when I +commenced treatment. + +I used eight months' special treatment, after which I used some 13 or 15 +bottles of your Sage's Catarrh Remedy, and have had excellent health +ever since. + + Yours truely + B.P. Dake. + + +NERVOUS DEBILITY. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: G. Rankin, Esq.] + +_Gentlemen_--For about five years I was troubled with Nervous Debility. +I was weak and nervous, and my appetite poor. I saw your advertisement +in a newspaper and concluded to write to you. I took your medicine for +nine months, and at the end of that time, I had gained thirteen pounds, +was much stronger, my nervousness had left me and I felt well and +strong. I am sincerely thankful for the great help I received from you. + + Yours very truly, + GEORGE RANKIN, + New Castle, Lawrence Co., Pa. + + + + +NERVOUS DEBILITY. + +Richville, St. Lawrence Co., N.Y. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +_Gentlemen_--After two years of perfect health I write to you thanking +you for your treatment. + +I had suffered several years from Nervous Debility, and had tried +various remedies, and been treated by different physicians, but received +no benefit from them. I ventured to write to you, and after taking a +month's treatment and following your Hygienic rules, I am now fully +recovered and never felt better in my life. + +May God spare you for many more years, for the sake of suffering +humanity. + + Yours respectfully, + Evan P. Jones. + + +NERVOUS DEBILITY. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Edw'd Uelbrick, Esq. ] + +_Gentlemen_--In 1887, I had occasion to visit your Invalids' Hotel and +Surgical Institute for a course of treatment. I am happy to state that +my case was cured to my entire satisfaction, and that I always think +with gratitude of the kind treatment received from the hands of doctors +and nurses. While there I became acquainted with many undergoing +treatment for various chronic and surgical diseases, and all were +unanimous in their praise of the Institution. + + Respectfully yours, + EDWARD UELBRICK, + White Oaks, N.M. + + +NERVOUS PROSTRATION; RHEUMATISM; CONSTIPATION. + +Colebrook, Litchneld Co., Ct. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +_Gentlemen_--I desire to express my heartfelt thanks for the great +benefit you have done me. About ten years ago I contracted rheumatism, +from which I suffered dreadfully at times. Was also troubled with +chronic constipation; had been from boyhood. Had doctored more or less +for years without any great benefit until I consulted you and commenced +taking your Special Remedies. After taking three courses of your +medicines I was so far improved in health and strength that I considered +it unnecessary to continue it longer. + +Wishing you much success in your great work. + + Yours truly, + W.H. LOVELAND + + +NERVOUS DEBILITY. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: L. Rakes, Esq.] + +_Gentlemen_--So much of my good health is due to the excellent treatment +I received from the Invalids' Hotel and Surgical Institute, that I take +the greatest pleasure in recommending all the afflicted to this famous +Institution. + +I was run down and a great sufferer from nervous debility. The remedies +put up by the specialist of this Institute so suited my case, and so +improved my health, that I soon felt like a new man. My gratitude is so +heartfelt that I cannot speak to my friends and to all the afflicted in +too high praise of the skill of the physicians of the World's Dispensary +Medical Association and of the great benefit to be derived from their +treatment. + + Yours, truly, + LEVI RAKES, + Plattemouth, Cans Co., Neb. + + +NERVOUS DEBILITY. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: T.J. Carder, Esq.] + +_Gentlemen_--I was suffering with a very severe nervous debility and +general weakness, and after using your splendid treatment for four +months, I find myself perfectly cured. + + Respectfully yours, + T.J. CARDER, + Pacific Grove, Monterey Co., Cal. + + +NERVOUS PROSTRATION. + +Severe Palpitation of the Heart. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Moore.] + +_Gentlemen_--I am feeling quite well. I have taken Dr. Pierce's Golden +Medical Discovery and "Pellets," and I can truly say they have done me +more good than anything I have ever taken. I keep the "Pellets" in the +house all the time. + + Respectfully, + MRS. LAURA E. MOORE, + Wolfborough, Carroll County, N.H. + + +NERVOUS DEBILITY. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: G. Posson. Esq.] + +_Gentlemen_--My health had been gradually failing for years. I could not +sleep nights and was very nervous, and I was depressed in spirits and +was entirely unfit for business. The principal cause was over-work. +Through the influence of friends I began your treatment and continued it +three months, and at the end of that time I felt so much better that I +did not continue it longer. + +And I can cheerfully recommend your mode of treatment to every sufferer. + + Sincerely yours, + GEORGE POSSON, + Middleburgh, Schobarie Co., N.Y. + + +NERVOUS DEBILITY AND CATARRH. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y,: + +[Illustration: Mrs. Hoffman.] + +_Gentlemen_--I have enjoyed good health since I took your treatment I +suffered intense agony for five months, and after taking one month's +medicine I found very much relief--so much I was surprised. + +Many thanks for the good your medicines have done me, and my prayers are +that God may help you in your good work, and that you may live long and +prosper. + + Yours respectfully, + MRS. ALICE HOFFMAN, + Box 183, Clarksville, Butler Co., Iowa. + + + "A NERVOUS WRECK." + +NERVOUS DEBILITY, EXHAUSTION, THREATENED INSANITY. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: F. Moffat, Esq.] + +_Gentlemen_--About six years ago, I had tried all the doctors in my part +of the country with no satisfactory benefit. They did not understand my +case. + +I was a nervous wreck--unable to sleep--could not eat, and underwent the +usual horrors that one endures where there is loss of control of the +nerves. A few months more would have made me insane. + +My cure has remained permanent. The relief was something that I cannot +describe. It has enabled me to pursue my work steadily ever since, and I +am more than happy to testify to the excellent skill and honorable +dealings of your faculty and the fine appointments of your Institution. + + Respectfully yours, + FAYETTE MOFFATT, + Hendrum, Norman Co., Minn. + + +NERVOUS DEBILITY, + +KIDNEY DISEASE, NIGHT-EMISSIONS, SEVERE HEADACHES, INDIGESTION, +RHEUMATISM, COULD NOT SLEEP NOR REST. FOUND RELIEF AFTER FIVE OR MORE +YEARS OF AGONY. + +Elstonville, Lancaster Co., Pa. + +WORLD'S DISPENSARY MEDICAL, ASSOCIATION, Buffalo, N.Y.: + +_Gentlemen_--I am not able to express my thanks to you for the benefit +of your special treatment. I had no hope of ever being restored to +health again, having tried several home physicians, and having found no +relief. I had little faith of ever being relieved of the dizzy spells +and black spots before my eyes. Some of my friends told me it was +nothing but a fake and a humbug. Thank God I did not listen to them. The +first month's special treatment gave me such relief that I continued +five months, and to-day can do heavy work without that troublesome pain +in my back, and can stoop down without dizziness in my head. I would +advise any one that is afflicted with any of these diseases to at once +consult the practical and skillful physicians at the World's Dispensary +Medical Association, at Buffalo, N.Y. I cannot think of words that will +half express my gratitude. Thanks to God that he has granted you such +skill. I am. + + Yours truly, + John M. Ellinger. + + +GENERAL DEBILITY + +OF FIFTEEN YEARS' STANDING. CURED BY SPECIAL HOME-TREATMENT. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Lt'd: + +[Illustration: G.W. Whitrod, Esq.] + +_Gentlemen_--After being a sufferer from debility and general weakness +for fifteen years, I found a radical cure in the treatment I received +from you at my own home. The first supply of medicine seemed to start me +on the road, and the wheel was kept turning till I reached the happy +condition of health. + +I hope this will meet the eyes of some of my old comrades, who have been +to the eastern countries, and there lost their health, as I did, and as +many others do. + +Gentlemen, I wish again to thank you most kindly for your good treatment +and thoughtful attention. I will enclose my photograph. I am, + + Yours truly, + G.W. WHITROD, + Rockland, St. Andrews, Attleboro, Norfolk, Eng. + + +NERVOUS DEBILITY. + +WORLDS DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: C.M. Gates, Esq.] + +_Gentlemen_--About a year ago I found myself a victim of Nervous +Debility. For some time I hardly knew what course to pursue, nearly +every paper I might pick up contained some advertisement that would cure +me. But believing in the old adage, "never expect to get something for +nothing," I decided to write to an Association that _I knew_ was +reliable. + +Acting accordingly, I took a course of four months' treatment, which I +am pleased to state has given me in return a perfect cure. Thanks to the +medical skill of your Faculty. + + Yours truly, + C.M. GATES, + Girard, Macoupin Co., Ill. + + +NERVOUS AND GENERAL DEBILITY. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: A. Crowl, Esq.] + +_Gentlemen_--After taking your second months' treatment I feel as though +I am entirely cured. The trouble with my back is entirely removed; have +gained in strength right along and have been working hard for the last +two months. I cannot fully express my appreciation of your kindness and +beneficial treatment. + + Yours truly, + A. CROWL, + Oneida Mills, Carroll Co., Ohio. + + +NERVOUS DEBILITY. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: T.M. Hutchison, Esq.] + +_Gentlemen_--Your letter inquiring about my health, came duly to hand a +few days ago. In answer permit me to say that the three months' course +of treatment effected a cure. Now my general health is good, body +strengthened, mind clear, memory revived, and energy to work restored; +cheerfulness and bright hopes, once lost, are now fully regained. My +case was a complicated one of Liver disease and general effects of bad +habits and usage, yet I was not too far gone to be restored by your +wonderful treatment. My prayer is that you will ever prove a blessing to +mankind. + + Yours respectfully, + T.M. HUTCHISON, + Forest Hill, Summers Co., W. Va. + + +NERVOUS DEBILITY. + +PILES, CATARRH, HEART SYMPTOMS. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: J. Talbott, Esq.] + +_Gentlemen_--The effect of your remedies is little short of a miracle. +My general make-up and appearance are astonishing; my cheeks rosy, eyes +bright, circles nearly all gone from under eyes; am fleshier, stronger, +more active, and an entirely different man. No piles, catarrh, heart +trouble; no chills and fever; no despondency, no anything. + + Yours truly, + JOHN TALBOTT, + Pennsylvania Agricultural Works, + York, York Co., Pens. + + +NERVOUS DEBILITY + +RESULTING FROM INJURY TO SPINE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Geo. W. Benham, Esq.] + +_Gentlemen_--I take pleasure in saying that the Invalids' Hotel is the +best institution in the world for the cure and treatment of all kinds of +chronic diseases. I was afflicted for a long time before I went to your +Institution for treatment, and I tried many doctors, but without avail. +After being in your Institution two months, I was restored to health, +and I am a well man to-day, and take pleasure in giving you many thanks. +My difficulty was the result of injury received early in life, and it +has been permanently and perfectly cured. With many good wishes and +highest recommendations. + + Respectfully yours, + GEORGE W. BENHAM, + P.O. Box 227, Seymour, Conn. + + +NERVOUS DEBILITY, DYSPEPSIA, AND OTHER COMPLICATIONS. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, No. 663 Main St., Buffalo, N.Y.: + +[Illustration: D.H. Poff, Esq.] + +_Gentlemen_--I am now through with your last month's treatment. I have +taken in all three months' treatment. When I first wrote to you I +thought I was gone beyond the reach of recovery, but, thanks to God, I +am to-day a sound man, heartier than I have been for years, and your +Institution deserves the credit of it. I will forever remember you, and +want you to publish this testimonial for the benefit of others, as there +are thousands in the same fix that I was in. + + Yours truly, + D.H. POFF, + Raleigh, Raleigh Co., W. Va. + + +NERVOUS PROSTRATION. + +Everson, Whatcom Co., Wash. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +_Gentlemen_--As regards your medicines I can truthfully say that I +consider them good. Three years ago, I was much run-down with +indigestion and nervous prostration. I purchased about four bottles of +"Golden Medical Discovery" and "Favorite Prescription," and after taking +them along with the "Pellets", I felt much improved. Indeed, my friends +told me I looked like another woman. + + Yours truly, + Mrs. Rob't Burns + + +NERVOUS DEBILITY. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: W. Slattery, Esq.] + +_Gentlemen_--I am pleased to send you a testimonial regarding the +perfect and permanent cure which you have effected in my case. + +I suffered from Nervous Debility. The symptoms were prostration, +sleeplessness, exhaustion, over-fatigue from mental trouble, overstudy +and anxiety, indigestion, dyspepsia, constipation, headache, inability +to concentrate the mind, general lassitude, melancholia, backache and +pains from the top of my head to the sole of my feet. You treated me +about twelve months and effected a _perfect cure_. + + Yours respectfully, + WILLIAM SLATTERY, + Garden City, Finney Co., Kan. + + +HERNIA--LEFT INGUINAL--PRESENT EIGHT YEARS WITH NERVOUS PROSTRATION. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.: + +[Illustration: A.J. Kidder, Esq.] + +_Gentlemen_--I take greatest pleasure in making public the most +wonderful cure I received at the Invalids' Hotel and Surgical Institute +of Buffalo. + +I had suffered severely for eight years with a left inguinal hernia; had +tried many physicians and medicines, but found only temporary relief. I +was greatly run-down, and my nervous system considerably shattered. My +friends persuaded me to go to the Invalids' Hotel and Surgical +Institute. While there I was operated on by their specialist, and in a +few weeks began to gain strength and energy so that I could return home, +and have since felt entirely well. + +Words could not do justice to my feeling in regard to this institution. +There is no place like it for medical aid, and I would urge all invalids +to go there, feeling confident that they could no where receive more +skillful treatment or more kind attention and care. + + Respectfully, + A.J. KIDDER, + North Yam Hill, Yamhill Co., Oreg. + + +THICK NECK (GOITRE), + +NERVOUS DEBILITY AND WEAKNESS CURED. + +[Illustration: Mrs. Houghton.] + +Miss ELLA A. HOUGHTON, of _Theresa, Jefferson Co., N.Y._, was cured of +Thick Neck, Nervous Prostration, Weakness and a complication of ailments +by Dr. Pierce's '"Discovery" and "Favorite Prescription." She says: "My +health is now as good as it was before I was sick. The swelling (goitre) +has all gone from my neck. I don't have any bad feelings. My gratitude +for the benefit I have received from your treatment has induced me to +recommend you to all whom I know to be sick." "I have known of two or +three middle aged ladies residing near here, who have been cured by your +'Favorite Prescription.'" + + +NERVOUS DEBILITY, + +CURED BY SPECIAL HOME-TREATMENT. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Lt'd, 3, New Oxford Street, +London, W.C.: + +[Illustration: G. Dancy, Esq.] + +_Dear Sirs_--It is now over two years since I first began to feel +something the matter with me. I gradually got worse, with a nervous and +despondent feeling. I went to a doctor, who said I was suffering from +debility and ordered me away. I got a little better and returned to +work, but only to get worse again. I then had very restless nights with +terrible dreams, and would wake up all in a perspiration. I often wished +I was dead. At last, I had to give up work again, and thought that I +should never return to it. I was then under several doctors, but they +did me no good. I then came across a little book from your Association, +and seeing cases like mine cured, I determined to come to London and see +you. I was then under your treatment for three months at my home, taking +your medicines and adhering to your rules. I felt a change the first +week, and after three months' treatment I was restored to health. It is +now four months since I took any of your medicine, and have not had any +symptoms return. I am now at work again, and enjoying life the same as +anyone else. I thank you very much for your kind attention. I remain, + + Yours truly, G. DANCY, + 25, Merton Road, Stanford Road, Kensington, W. London. + + + "LIFE MISERABLE AT TIMES." + +NERVOUS EXHAUSTION. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.: + +[Illustration: J.W. Durham, Esq.] + +_Gentlemen_--For several years I was a sufferer from some constitutional +disease, or combination of diseases, which rendered life miserable at +times. Dyspepsia, headache, dizziness, irritability and gloomy +forebodings were among the symptoms I suffered. By chance, one of the +pamphlets you publish fell into my hands, and I was induced to write +you, describing my condition as best I could, and consequently I was +treated by your Specialists. + +When I had been treated for two months I felt so well and the symptoms +were so far gone that I felt I was cured and quit taking medicine. As +this was more than two years ago time has proved that I was correct, for +I am a healthy, robust man to-day--thanks to you and to your associates +in the noble Institution which you have established for suffering +humanity. + + Yours respectfully, + J.W. DURHAM, + Parkland, Jefferson County, Ky. + + +NERVOUS AND GENERAL PROSTRATION. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Miss Morrison.] + +_Gentlemen_--It is with pleasure that I add my testimony to your list, +hoping it may contribute to your success and induce others to avail +themselves of the benefit of your invaluable medicines. In June, 1890, I +took typhoid fever of malignant type; for two months I hovered between +life and death; at length the fever left me in a prostrated condition. +Then I was taken with a severe pain in my back and general nervous +prostration; could not move myself in bed nor bear to be moved by the +most careful nurses without experiencing excruciating pain. I had the +best medical attention in the community, but they failed to give relief. +My friends wrote to Dr. Pierce, stating my condition and requesting +treatment for me. He treated me for two months; by that time I had so +much improved that I did not think it worth while to continue the +treatment longer, and my health has been such that I have not had +occasion to lie in bed two days together since. I feel under lasting +obligations to Dr. Pierce, and thank God for blessing the world with so +able a physician. + + Very respectfully, + MISS MAGNOLIA MORRISON, + Abernethy, Iredell Co., N.C. + + +NERVOUSNESS, CATARRH, AND INDIGESTION. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, NO. 683 Main St., Buffalo, N.Y.: + +[Illustration: R.A. Baldwin, Esq.] + +_Gentlemen_--For a long time I was suffering from indigestion, catarrh +and nervousness. I was so run down that I could not go to school, and, +as the various remedies I tried did me no good, I applied to you, and +was advised to try a course of special treatment. After taking only two +months' medicines from your noble institution, I feel perfectly restored +to health. I have, moreover, recovered my lost flesh, and I am pleased +to say need no further medicines. + + Yours truly, + E.A. BALDWIN, + Proctorsville, Windsor Co., Vermont. + + +LOSS OF FLESH AND STRENGTH. + +NERVOUS PROSTRATION. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: C. Holmstedt, Esq.] + +_Gentlemen_--I was run down entirely, losing my flesh and getting weak +and nervous, and had hard work to draw a long breath; could hardly +breathe at all, and came nearly dying once or twice. Had tried many +kinds of patent medicines--many doctors, all in vain. + +One day I saw an advertisement in a newspaper, about "If you are run +down and losing flesh, use 'Golden Medical Discovery.'" I, like a +drowning man, would grab at anything on sight. So I went to my druggist +and asked him for "Golden Medical Discovery," and he had it and I bought +one bottle and followed the directions and it did me good at first +start; so I bought two bottles every month until I had used about six +bottles, then I had my strength back and could draw my breath and felt +like a new man. + + Yours truly, + CHARLES HOLMSTEDT, + Newtonville, Baraga County, Mich. + + +NERVOUS EXHAUSTION. + +A PROMINENT NURSE AND STUDENT IN DISEASES OF FEMALES. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Sarah Barnhardt.] + +_Gentlemen_--One could scarcely discharge a more pleasant duty to a +suffering fellow being than to direct them to a place of relief. Hence, +I desire to state that a short time ago, life was almost a burden to mo +until I began taking treatment for nervous exhaustion from Dr. Pierce of +the Invalids' Hotel and Surgical Institute, at Buffalo, N.Y., and can +conscientiously say at the end of six weeks, I feel like another being. + +I have also consulted Dr. Pierce on numerous occasions during the past +eight years, and at no time whatever have I known his remedies to fail, +more especially, his "Favorite Prescription," (which I have used in my +practice), and the "Golden Medical Discovery," when taken according to +directions. + +These remedies will in no event disappoint. I am now In the enjoyment of +perfect health--a blessing which I attribute to the kind Providence +which directed me to the World's Dispensary Medical Association. + + Yours gratefully, + SARAH BARNHARDT, + Grand Rapids, Mich. + + +NERVOUS EXHAUSTION. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.: + +[Illustration: W.E. Dixon, Esq.] + +_Gentlemen_--It is over a year now since I applied to you for help and +it is more than six months since I reported myself as well. I have +worked very hard since then, and still have continued well all the time. + +When I called upon you for treatment I was in a terrible condition. I +was subject to severe headaches; was troubled with a tired, an almost +lifeless feeling, and although I slept, _I could not get rest_. I was +nervous and fretful, and could not do as much work as I wanted to do. To +tell it all in a few words _I was all run down_. I had never wholly +recovered from the grip, which left me in a very poor condition; and +that, together with over-work and insufficient physical exercise, had +put me in such a condition that I was almost unfit to teach my school. + +After five months' treatment (one month intervening in which I received +none) I considered myself well, and I think that I was right. I feel +very grateful to you for your treatment of me, and shall ever be willing +to speak a good word for you. + + Yours respectfully, + WILLIAM E. DIXON, + Harwich Port, Barnstable County, Mass. + + +NERVOUS EXHAUSTION. + +DR. R.V. PIERCE, Buffalo, N.Y.: + +[Illustration: Geo. S. Wilson, Esq.] + +_Dear Sir_--After being troubled with my head for two years and taking +treatment with ten different doctors and getting no help, I started for +your city, but allowed myself to be talked out of seeing you by a man on +the train; stopped off at Lancaster and saw Dr. ----, took one month's +treatment with no benefit--grew worse. + +After that, started once more, did not tell where I was going. I was a +complete wreck--had to be helped on board of the cars. You looked me +over carefully--you seemed to know just what the trouble was. Gave me +medicine for a month's treatment. I came back homo and took the +medicine. Well, I was surprised the first week and have been ever +since--gained right along. Have been well ever since and all for one +month's treatment, for which I thank you very much. + + Respectfully, GEO. S. WILSON, + Perry, Wyoming Co., N.Y. + + +NERVOUS EXHAUSTION. + +Cayuga, Vermilion Co., Ind. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +_Gentlemen_--It is now about eighteen months since I discontinued the +use of your medicines. I can truly say I feel like a new man. I have +none of that wakefulness at night, or the tired feeling when I get up of +a morning. Now, I can work hard all day, go to bed at night tired, wake +up the next morning rested and refreshed, though I took but two months' +treatment; its value to me I am not able to estimate; before and during +treatment I weighed about 160 pounds, and now I weigh 185 pounds. With +many thanks and good wishes, I am, + + Yours truly, + Geo. F. Howard + + +SEVERE NERVOUS PROSTRATION. + +"OUT OF DARKNESS INTO LIGHT." + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main Street, Buffalo, N.Y.: + +[Illustration: Mrs. Austin.] + +_Gentlemen_--About eighteen years ago, after the birth of one of my +children I was left in a weak, run-down condition; it seemed to me that +my nerves were unstrung very bad: I did not suffer much pain, but I +think I suffered everything any one could suffer with nervousness; my +life was a misery to me. I doctored with seven different doctors and got +no relief; then I took almost all kinds of patent medicines and got no +relief from them, but got worse all the time, when I chanced to get one +of your little pamphlets. + +I thought I would write to you, and waited as I thought to hear that +there was no help for me; when my answer came and you said you could +cure me great was my joy. I had taken your medicine about a month when I +began to improve and in a few months was entirely cured. + +My recovery was like coming out of the dark into the light, so great was +the change. I will advise all sufferers to go to you for relief--I don't +think they will be disappointed. When I commenced taking your medicine I +weighed 94 pounds, now I weigh 125 pounds. + +I do not know how to thank you for all the good your remedies did me, +With heart-felt thanks I am. + + Sincerely yours, + MRS. AMANDA C. AUSTIN, + Burden, Cowley Co., Kansas. + +P.S.--I have a lady friend who is taking Dr. Pierce's Favorite +Prescription now, and last summer every one thought she was going with +consumption; four of her father's family had died with it in five years: +she has taken one bottle of "Favorite Prescription," and now she is +better in health than she has been in three years. Her address is Mrs. +Laura Paugh, Burden, Cowley Co., Kas. A.C.A. + + +NERVOUS EXHAUSTION. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, NO. 663 Main St., Buffalo, N.Y.: + +[Illustration: C. Gaul, Esq.] + +_Gentlemen_--For the last five years I have tried many leading doctors +in this country but without avail. I gave up every hope. Your +advertisement fell into my hands; at the time I did not know what to do +because all my money had gone for medicine, but money was no object to +me. I could not rest till I was cured. + +Your treatment, which I received, cured me in a short time, and I am +just as good as ever. I come before the public to advise anyone in need +of treatment to give you the first chance, and he will find relief for I +believe that nowhere can one obtain more skillful care or more kindly +attention. Hoping that success will crown your business, I am, + + Very truly yours, + CHARLES GAUL, + Muskegon, Muskegon Co., Mich, + care of "Warwick House." + + +NERVOUS PROSTRATION, SLEEPLESSNESS, DYSPEPSIA, AND RHEUMATISM. + +[Illustration: T. TOWNSEND, ESQ.] + +Mr. J.T. TOWNSEND, of _Noah, Coffee County, Tenn_., consulted us by +letter. He was suffering from great nervous prostration; could not walk +without tottering: was troubled greatly with inability to sleep; poor +appetite; did not relish food; suffered much pain and stiffness in the +joints; was overcome with heat working on a thresher, followed by +persistent nausea, confusion of ideas, his memory being very defective. + +After taking a single course of treatment, the medicines being sent by +express, he writes as follows: "The medicine you sent me lasted me five +weeks, and proved very beneficial indeed. I believe it, under God, was +the means of saving me from a premature grave. When I received the +medicine, I had just gotten rid of an attack of bilious fever, which +left me in a deplorable condition. I was very week and nervous, but my +improvement commenced with the first dose of your medicine, so by the +time my medicine was out felt better than I had for years, and now have +no indication of a return of my trouble." A month later he writes: "I +continue to enjoy the most perfect health. Every organ of my body, and +every faculty of my mind, is in splendid condition, which makes life +worth living. I have gained twenty-one pounds since I have been able to +attend to business. Please accept my profound thanks for your promptness +in sending me my medicines." + + +NERVOUS PROSTRATION. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, NO. 663 Main St., Buffalo, N.Y.: + +[Illustration: G.W. Colquitt, Esq.] + +_Gentlemen_--It gives me pleasure to testify to your skill in the +treatment of my case. When I applied to you last June, I was suffering +all the horrors of nervous prostration, which was brought on by +over-work and constant anxiety. I had no energy and no interest in +business; rather an aversion to anything like work. My appetite was +poor, indeed food seemed to distress rather than nourish. I felt tired +and drowsy mornings; irritable and despondent; suspicious of every body +and everything. After two months' treatment these unpleasant symptoms +disappeared, and my health is better than it has been for twenty years. + +I can never express to you my gratitude for your kindness, and would +cheerfully recommend your Institution to all sufferers. + + Yours truly, + GEORGE W. COLQUITT, + Palmetto, Campbell Co., Ga. + + +BAD CASE OF UTERINE DISEASE AND NERVOUS PROSTRATION, + +CURED BY HOME TREATMENT. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Glass.] + +_Gentlemen_--It is with pleasure that I write to let you know the great +benefit I have received from your medicines and self-treatment at home, +which you kindly sent me, advising me to take your Dr. Pierce's Favorite +Prescription and "Pleasant Pellets" and "Golden Medical Discovery" for +my troubles. I did take your advice as near as I could; when I wrote my +first letter to you, I had been treated by different doctors for twelve +months and received but very little or no benefit, but had spent one +hundred dollars for treatment and medicines. + +My husband, and little boy twelve years old, did all the family sewing +and washing and work in general, and I could not walk across the room +without help or stand on my feet one minute at a time; at night I could +not sleep, nor day time either; nothing I ate tasted well--I had no +desire to eat anything; my bowels were costive all the time, and after +following your advice and using about fourteen dollars worth of your +medicines altogether, I now feel like a new person. I am not bothered +with that nervousness, where it used to be that I could not stand a +sudden rush of horses feet, or a quick halloo from one's boys, or a +sudden sound of anything would cause me to take sudden nervous spells of +some kind, as if I were smothering or dying, or something of the kind--I +can't tell just how I did feel. Now I do all my washing, sewing and +house work in general for a family of seven--five children, my husband +and self, and help my husband in the field some besides. I can +truthfully say, ii it had not been for Dr. Pierce's medicines and the +kind advice to me, with self-treatment at home, I would have been dead +long ago, and I never can feel that I can say enough for his skill and +medicine nor thank him enough for the good he has done me. + +I use no other medicines in my family but these and never will, for they +do all that is claimed for them and more too. I have one of the +"Advisers," and I would not be without it for fifty times its cost. May +God be with you throughout your life is my prayer. + + Respectfully yours, + MRS. ADDIE GLASS, + Bandera, Bandera Co., Texas. + + +NERVOUS PROSTRATION FOLLOWING GRIP. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: W.S. Nicholson, Esq.] + +_Gentlemen_--In January of '90 I took the "grippe," went to work before +I was well, was caught in a rain which gave me a very bad relapse, +resulting in lung fever and complete prostration; was on my bed two +months, and when I did get out, the strength to walk any more than just +a few rods did not come back. My family doctor and two prominent +physicians of Sioux City, did me no good. Late in the fall I got a +bottle of Dr. Pierce's Golden Medical Discovery, which quieted my +trembling nerves and gave me an appetite to eat. I then concluded to try +the Doctor, personally. Up to this time I was in a pitiable condition. +Sometimes I could not sleep until I felt almost wild, then sleep so much +I would be stupefied. I could not digest any food and my whole system +was wasting and failing fast. I doubt if any one who saw me expected me +to get well. I took the treatment sent me by the World's Dispensary +Medical Association for more than a year. The medicine never gave me any +distress as other medicines had done before. I began to improve from the +start, but the change from one extreme to the other was like the growth +of a child. + +To any one suffering from nervous prostration I would say, "don't be +impatient." It takes a long time for weakened nerves to grow strong. I +have at last become strong and well, thanks to the Giver of all good and +the grand Institution at Buffalo. I have since married a noble-hearted +young woman, and when I am playing with our sweet, healthy, baby girl, I +give way to the thought that at last the long, sad chapter of my life is +ended; at such times her merry laugh sounds like a song of triumph of +life over death. + + Gratefully yours, + W.S. NICHOLSON, + Willow Creek, Clay Co., Iowa. + + +NERVOUS PROSTRATION COMPLICATED WITH KIDNEY AND BLADDER DISEASE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: M. Manheim, Esq.] + +_Gentlemen_--Having been a patient in your Invalids' Hotel for several +weeks, I take great pleasure in telling other sufferers of my treatment +which I received under your efficient staff of physicians, surgeons and +nurses, and I will say with clear conscience that every care and comfort +was given me that I wished for. I am sure that your Institution is far +in advance of the age, and would wish that every invalid could avail +himself of the treatment that I received in your most, excellently kept +Invalids' Hotel. I cheerfully give this as my testimonial to +individuals, friends and sufferers. My health is so fully restored that +I look upon life with pleasure and comfort, whereas before I was a +suffering nervous invalid, unable to sleep and much of the time in +torment. Wishing you success I am your friend and well wisher, + + M. MANHEIM, + Georgetown, S.C. + + +NERVOUS EXHAUSTION. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, NO. 663 Main St., Buffalo, N.Y.: + +[Illustration: A.D. Christie, Esq.] + +_Gentlemen_--I was troubled with nervous exhaustion; my legs and back +ached, and I could not sleep hardly any, and could not rest at night for +about three months, and, reading in one of your Memorandum Books a case +that suited mine and having taken medicines without any good results, I +concluded to try your medicines. I explained my case carefully and got +one month's medicines, of which I did not take all as I thought I did +not need it, as I felt like another man--could sleep well and work +without having that "all-gone feeling." + + Yours respectfully, + A.D. CHRISTIE, + Maple Creek, Forest Co., Penn. + + +NERVOUS AND GENERAL PROSTRATION. + +"LIFE IS NOW SWEET." + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Miss Moyers.] + +_Gentlemen_--Six years ago I had an attack of measles, which left my +health in a precarious condition. I was placed under the treatment of a +good physician who did all in his power to restore my health, but all in +vain. I had dyspepsia and could not eat meat, vegetables nor fruit of +any kind. I suffered alternately from cold and heat. At times my feet +and knees would feel like ice to the touch, and at other times I would +suffer the most excruciating torture, seeming as though every nerve in +my body was being seared with a hot iron. My left hip and knee would +become so affected that I could scarcely walk across the room. I slept +very little. On one occasion I remained awake four days and four nights, +and then was put to sleep by repeated doses of morphine. My nervous +system became so shattered that words spoken by any person in my room +fell like pebbles on my brain; and nights I would often have to be +raised in bed to prevent smothering to death. It is impossible for me to +describe my sufferings at that time but I know that if it had not been +for Dr. Pierce's Favorite Prescription I would to-day have been in my +grave. + +I began the use of the "Favorite Prescription" in March--three years +ago, as well as I can remember. Continued till summer when I wrote to +you--received your advice and a few simple prescriptions which I had +filled at the drug store. I also began the use of the "Golden Medical +Discovery." My nerves became quiet: I slept well; my stomach began to +heal; my strength returned and I began to feel like a new person. And, +to-day, while I am not as strong as the strongest, I can do any kind of +work that other women do, and each season I can say I am stronger than I +was the last. I used thirty bottles of your medicines. Some may say that +was a great deal, but I will never regret the money and patience it took +to cure me. It has enabled me to once more enter school where I am +trying to make up for those lost years of my life, and as I join the +girls in their romps, I can say that "life is now sweet." + +Any one desiring particulars may address me. + + Respectfully, + MISS LUCY MOYERS, + Kelso, Lincoln Co., Tenn. + + +NERVOUS EXHAUSTION. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: W.H. Keesler, Esq.] + +_Gentlemen_--I was thought to be beyond all help and had but very little +hope myself, but at the urgent entreaty of my wife I let her write to +you for me and began taking special treatment from you. I could eat but +very little and could keep nothing on my stomach, and was vomiting up +bile once or twice every day; muscles all gone and too weak to get +about. But to-day I think I am a sound healthy man. I owe it all to your +treatment, and a loving Saviour who blessed the means in your hands to +the healing of this body of mine. And I gladly recommend the sick and +suffering to try Dr. Pierce, and pray God to bless you and your work. + + Yours respectfully, + W.H. KEESLER, + P.O. Box 185, Harriman, Roane Co., Tenn. + + +NERVOUS EXHAUSTION. + +Farina, Fayette Co., Ill. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +_Gentlemen_--It gives me great pleasure to add my testimony to that of +many others in behalf of the great success of your Institution. I had +been breaking in general health for years and had got so that I could +not properly attend to my business. Was very forgetful and easily +irritated and excited, and was unable to attend to my business a good +part of my time. I doctored with country and city M.D.'s., and took +patent medicine, but without any permanent good. I was induced to write +to you, which resulted in my taking about one and one-half months' +treatment from you, when I felt so much better that I discontinued the +treatment. For the last six months I have felt like my old natural self +again, and am able to attend strictly to business all the time for which +I am very thankful. + + Yours truly, + C.H. West. + + +KIND WORDS. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: J. Hurst, Esq.] + +_Gentlemen_--Having spent four weeks in your Institution, it gives me +great pleasure to state that during that time I received the most +courteous and faithful care and treatment, and I bear willing testimony +to the skill and ability of the surgeons and the faithful care of the +nurses. + +Wishing you continued success, I recommend all persons suffering from +chronic diseases to give you a trial. + + Respectfully yours, + JOHN HURST, + Marquette, Bighorn Co., Wyo. + + +SICK HEADACHE, GENERAL DEBILITY, MALARIA. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. J.H. Lansing.] + +_Gentlemen_--I am happy to say that your valuable medicine has been a +great benefit to me. I was suffering from general debility, malaria and +nervous sick headaches, and after my third child was born (a beautiful +baby boy of ten pounds) I only recovered after a long illness; I barely +gained strength enough in two years time so that I was able to crawl +about to accomplish the little housework that I had, by lying down to +read many times each day; had sick headaches very often; and many pains +and aches, all the time complaining of getting no better. I finally +asked my husband to get a bottle of Dr. Pierce's Favorite Prescription, +which he promptly did. After I had taken one bottle I could see a great +change in my strength, and fewer sick headaches. + +I continued taking the medicine until I had taken eight bottles--seven +of the "Favorite Prescription" and one of the "Golden Medical +Discovery." For some time past I have not used it, but I am now able to +do the housework for myself, husband and two children (aged nine and +five years). I also take in dressmaking, and enjoy walking a mile at a +time, and I think it Is all due to the medicine, for I know I was only +failing fast before I commenced to take it. I take great pleasure in +recommending the "Favorite Prescription" to all women who suffer from +debility and sick headache. + + Respectfully yours, + MRS. J.H. LANSING, + Fort Edward, Washington Co., N.Y. + + +HEADACHE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: E. Vargason, Esq.] + +_Gentlemen_--I have used your medicines for a number of years, and know +that they do for me all that is claimed for them. I am employed mostly +at my desk, and not infrequently have an attack of the headache. It +usually comes on in the forenoon. At my dinner I eat my regular meal, +and take one or two of Doctor Pierce's Pleasant Pellets immediately +after, and in the course of an hour my headache is cured and no bad +effects. I feel better every way for having taken them--not worse, as is +usual after taking other kinds of pills. Your "Pleasant Pellets" are +worth more than their weight in gold, if for nothing else than to cure +headache. + + Very respectfully, + E. VARGASON, + Otter Lake, Lapeer Co., Mich. + + +HEADACHE AND CONSTIPATION. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Miss Wolfe.] + +_Gentlemen_--I suffered from loss of appetite, constipation, neuralgia, +and great weakness, and had terrible attacks of sick headache very +frequently; also nose bleed. My health was so poor that I was not able +to go to school for two years. I took Dr. Pierce's Pleasant Pellets and +"Golden Medical Discovery," and in a short time I was strong and well. +Many friends are taking your medicines seeing what they have done for +me. + + Respectfully yours, + Miss BERTHA WOLFE, + Markham, Cattaraugus Co., N.Y. + + +TERRIBLE PAIN IN HEAD AND FAINTING SPELLS. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Jacobs.] + +_Gentlemen_--When I commenced taking your medicine I was very sickly. I +had frequent spells of fainting, terrible pain in my head, and life was +a burden to me. I was attended by one of the best physicians in our +town, but with no good results. At last a neighbor advised me to try Dr. +Pierce's Favorite Prescription, which I did, and after taking one bottle +I felt greatly benefited. I would advise all ladies similarly afflicted +to try "Favorite Prescription." + + Yours truly, + MRS. SAMUEL A. JACOBS, + Mechanicsburgh, + Cumberland Co., Penn. + + +SICK HEADACHE, BOILS. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, NO. 663 Main St., Buffalo, N.Y.: + +[Illustration: Wm. Ramich, Esq.] + +_Gentlemen_--I was troubled with boils for thirty years. Four years ago +I was so afflicted with them that I could not walk. I bought Dr. +Pierce's Pleasant Pellets, and took one "Pellet" after each meal. The +boils soon disappeared and have had none since. I have also been +troubled with sick headache. When I feel the headache coming on, I take +one or two "Pellets," and am relieved of it. + + Respectfully yours, + WILLIAM RAMICH, + Minden, Kearney Co., Neb. + + +SICK HEADACHE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION. Lt'd: + +[Illustration: Mrs. Baker.] + +_Gentlemen_--Having suffered several years with very bad bilious attacks +and all kinds of headaches, I tried different kinds of medicines but +found nothing to cure me. Having read about Dr. Pierce's Pleasant +Pellets, I commenced taking them. Before I had finished one phial I +found benefit; they have done me great good. I have recommended them to +all my friends and will continue to do so where I have the chance. + + Yours truly, + MRS. JAMES BAKER, + Furneaux, Pelham, Nr. Buntingford, Herts. + + +OBSTINATE NEURALGIA. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, NO. 663 Main St., Buffalo, N.Y.: + +[Illustration: A. Habenicht, Esq.] + +_Gentlemen_--This is to certify that I had the neuralgia several years, +and was not able to perform labor nor attend to business. I was induced +to try your medicines, which I took and they effected a permanent cure. +I am now well and hearty, and able to do a good day's work, and weigh +one hundred and eighty pounds,--and thanks to you for it. I used your +medicines three months and was cured. + + Yours truly, + AUGUST HABENICHT, + Fort Pierce, Brevard Co., Fla. + + +PARALYSIS AND UTERINE DISEASE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, 603 Main St., Buffalo, N.Y.: + +[Illustration: Mrs. Mann.] + +_Gentlemen_--I will say that your Institute is all that you claim for +it, and more too. The Doctors are courteous gentlemen and the best +Physicians I have ever met with in my life. My treatment while at the +Institute did me more good in one month than all the doctors everywhere +else combined. My ailment was Paralysis and Female Weakness. Your +treatment did me good while at the Institute, and I have also been +greatly benefited by the home-treatment I have received from you since. +I am much better than I was; I am able to do considerable work now. When +I came to you I could not do anything. + +I herewith send you my heartfelt thanks for all you have done for me, +and should I need more treatment I will write you as before. I would +advise all people who have chronic diseases to go to the Invalids' Hotel +and Surgical Institute for help, for it is a grand place and prices are +reasonable. We use your Family Medicines--your "Pellets" and Golden +Medical Discovery--and find they are all you claim for them. + +Again I thank you and remain, your friend, + + MRS. S.B. MANN, + Sutton, Clay Co., Neb. + + +PARTIAL PARALYSIS FROM UTERINE DISEASE. + +Buffalo, La Rue County, Ky. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +_Gentlemen_--I am still having very good health. I value Dr. Pierce's +Golden Medical Discovery and his "Favorite Prescription" very highly and +often recommend them to others. I do not think I would ever have got +well if it had not been for your medicines. I was in a sad condition. My +bowels and half of my body (the left side), was nearly paralyzed, +besides nearly my whole system was out of order. I suffered all the +time; but after taking six bottles of "Golden Medical Discovery" and the +same of "Favorite Prescription," and using two bottles of Sage's Catarrh +Remedy as an injection, I felt like a new person. I have never seen +anyone suffering in the same way as I did. If anyone with female trouble +of any kind will use your medicines I am satisfied they will help them. + + Yours truly, + Mary A. Sallee. + + +LOCOMOTOR ATAXIA. SPECIAL TREATMENT. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Ltd., No. 3 New Oxford Street, +London, W.C.: + +[Illustration: C.F.G. Castleman, Esq.] + +_Gentlemen_--In the latter part of 1890, I was struck down with that +terrible--and by many members of the medical profession pronounced to +be, incurable disease, locomotor ataxia. My family doctor declared that +nothing could be done for me, but for the sake of satisfaction advised +me to go to London, and see an expert, whom he named. I did so, with the +result of being told as above. This was in November, 1890. The symptoms +were first numbness in hands and feet, which soon extended as far as the +thighs, joined with the most intense feeling of cold that it can be +possible to imagine. For six months I felt as though I had stood in ice +up to my thighs. I soon became unable to walk or to stand, and crawled +up stairs on my hands and knees, I thought for the last time, as I then +thought I should die. Stomach troubles then set in, and for more than +three months, I endured the utmost agony. Night and day sweats absorbed +my little remaining strength, and I became helpless. I had taken leave +of my family, not expecting to last the day out, when I was seen by a +young doctor, who is fast becoming an eminent man, who said he thought +he could alleviate my sufferings--though he did not expect to cure me. +He commenced to treat me, and in about one month I began to improve, +though very slowly. This was in February, 1891, and before the end of +the year I was able to walk down stairs again. It was in March, 1892, +that I began taking Dr. Pierce's Golden Medical Discovery, and on +sending to you for a bottle in reply to your inquiry, I began your +special treatment, with the happy result that I gradually improved in +health and strength; and on the 26th of October, 1892, I was able to +call on you in London, and you advised me to continue your treatment, +and use a battery as well, which I did until April, 1893, when I could +walk about quite nicely, and I now enjoy better health than for the past +eight years. I am thankful too, that my eldest daughter has derived the +greatest benefit from Dr. Pierce's Favorite Prescription. She took it +for painful menstruation, and is now well and healthy. I am + + Yours very truly, + C.F. GOODWIN CASTLEMAN, + Bursledon, Southampton, England. + + +PARALYSIS, NERVOUS PROSTRATION, ETC. + +From the records of the WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, +N.Y.: + +[Illustration: F.M. Brasher, Esq.] + +This gentlemen had a severe attack of grip in January, 1890. His health +gradually declined until June, at which time he was taken very much +worse. Had nervous shocks three or four times a day. Slight paralysis of +lower limbs. Respiration and pulse slow and irregular. Bowels +constipated and tongue coated. Indigestion. Ringing in the ears. Legs +wasting. Dimness of vision. Lost flesh rapidly and reduced to "skin I +and bones." Chills and sweats; dizzy. Had great distress in bowels. Pain +about the heart. Had been confined to his bed 46 days, at the time the +case was submitted to us. We sent only one month's course of special +medicines. He writes us afterwards: + +"I am at regular farm work, after my doctor here having told me that I +must die and that Dr. Pierce was a gigantic humbug." + + Yours truly, + F.M. BRASHER, + Homer, Logan Co., Ky. + + +EPILEPTIC "FITS." + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, No. 663 Main St., Buffalo, N.Y.: + +[Illustration: Miss Swinehart.] + +_Gentlemen_--My daughter, Sadie, is eighteen years old; has been +afflicted with that dreaded disease, Epilepsy, for fourteen years. She +received treatment from seven different doctors without any material +benefit. She has only had one spasm after commencing with your +treatment, now almost two years. Three boxes of epilepsy medicine, +followed up with your "Favorite Prescription" cured her. She took about +six months' treatment in all. + +This places us under a world of obligation to you as the instrument of +our great relief under a kind Providence. Should there be any signs of +it returning we would with unshaken faith send for more medicine. You +can use her or my signature as you wish. + + Yours truly, + GEORGE SWINEHART, + Lake, Stark Co., Ohio. + + +EPILEPSY. + +CURED BY SPECIAL TREATMENT. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Ltd., No. 3 New Oxford St., +London.: + +[Illustration: G.H. Plumbstead, Esq.] + +_Gentlemen_--I have great pleasure in announcing to you my heartfelt +thanks for the benefit derived from your treatment, having suffered from +epileptic fits for six years. I have experienced as many as five and +seven fits a day, some lasting two hours at a time. I am glad to say +since trying your medicine which is now five months, I have not had one. +Thanking you for your kindness. + + Gratefully yours, + GEO. HERBERT PLUMSTEAD, + 67 Fishgate Street, + St. Edmunds, Norwich, England. + + +SPASMS OR FITS. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.: + +[Illustration: Master Johnnie Maxwell] + +_Gentlemen_--I desire to express my gratitude for the wonderful results +of your treatment with my little son John. He was very bad, as we +thought, for the physician could do nothing for him any more, and I got +discouraged and went to my daughter, Mrs. D.T. Knappenberger, of +Jeannette, Pa., (who has been a terrible invalid and was cured at your +Institute), for advice. 'Oh, father,' she said, 'don't doctor here, but +go to Dr. Pierce. So the result was I gave her money and she sent for +medicines. You sent two bottles of medicine and he never has taken a +drop since and is perfectly well and never had a spell since. I do not +know what you call the disease, but we called it spasms or fits. With my +experience I can heartily recommend the Invalids' Hotel, and think if a +case can be cured at all, you can cure it. And unless they can cure or +greatly benefit the patient, they will not undertake it; this is my +experience with the World's Dispensary. My daughter, Mrs. D.T. +Knappenberger, and my son Johnnie, feel very grateful toward the +Dispensary for their cure. + + Yours truly, + D.A. MAXWELL, + Greensburgh, Westmorland Co., Pa. + + +EPILEPSY, "FITS." + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Miss McCarty.] + +_Gentlemen_--My little girl was delicate from birth, nervous and +irritable. When three and one-half years old we discovered she had that +terrible disease "epilepsy," inherited from her father's family; she had +spasms or fits once in two or three days, and grew worse so rapidly that +in four months she had from four to eight fits in twenty-four hours. +Home physicians did no good, and just then one of your little pamphlets +came to me as they had come often before. As my need was great I wrote a +description of her case, and though your answer did not seem very +encouraging, I did not dare to lose any chance of saving my child, so I +commenced the treatment. On November 6, 1891, she had seven fits; +November 7th gave her your medicines; she had four fits that day, and +never one since. She took your medicines less than four months. She is +nearly six years old, a strong, hearty, bright child, attending school +every day. + +What more can I say than that I thank Dr. Pierce and the Faculty of the +World's Dispensary Medical Association for having saved the life of my +child, and I thank God that he gave them the knowledge and skill to do +so. + + Respectfully yours, + MRS. J. MCCARTY, + Gouldsville, Washington Co., Vt. + + +ST. VITUS'S DANCE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Master Ira D. Ponsler.] + +_Gentlemen_--My boy had been in bad health for a long time. We called +our home doctor, but he got no better. Finally he had the St. Vitus's +Dance, and our doctor did not know what to do. So I wrote to you and did +as you told me; I got two bottles of your "Favorite Prescription," and +one bottle and a half did the work all right. At that time, eighteen +months ago, his weight was 85 pounds, now it is 135 to 140; he is +fourteen years old. + + Yours truly, + JEREMIAH PONSLER, + Zenas, Jennings County, Ind. + + +EPILEPSY. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Miss Thulin.] + +_Gentlemen_--My daughter, Josephine E. Thulin, is now six and a half +years old. She had been afflicted with epilepsy for three and a half +years, and received treatment from three different doctors, and from one +especially, for the space of two years steady, without any benefit. +Before taking your treatment she had as many as six or seven spells a +day. The child could not have stood it much longer. After taking your +treatment one month the spells stopped. With four months' special +treatment from you, and two months' use of Dr. Pierce's Favorite +Prescription she was entirely cured. In one year and three months she +has not had a drop of medicine, and she is in the best of health and +vigor. + +I would say to any sufferer from obstinate or chronic disease, and +especially epilepsy, that we have a living witness. You can come and see +for yourself that the doctors connected with the World's Dispensary +Medical Association _do_ understand how to prescribe. + +You can use this as a testimonial from me, of what you have done for us. +I remain, + + Yours truly, + JOHN THULIN, (for daughter,) + Kearney, Buffalo Co., Nebr. + + +A STRONG ENDORSEMENT. + +[Illustration: H.E. Bankston, Esq.] + +_To whom it may concern_: + +This is to certify that I took treatment at the Invalids' Hotel and +Surgical Institute, Buffalo, N.Y., and I was cured of a chronic trouble +that had been maltreated by other physicians. While there I saw a man +who had been cured by the specialists, who had before been given up to +die by the best doctors in Troy, N.Y. Of course, the case must have been +a very stubborn one. I afterwards saw a man here, in Georgia, die, who, +if he had been in Pierce's Surgical Institute under the treatment and +care of his skilled doctors and nurses, I know would have most assuredly +got well. Why? Because it was only a case of _stone in the bladder_, and +they are easily cured at Dr. Pierce's Surgical Institute. I think almost +any chronic disease can be cured there, if taken in time, judging from +my observations while an inmate of that Institution. + + H.E. BANKSTON, + Barnesville, Pike Co., Ga. + + +COMPLICATION OF DISEASES. + +[Illustration: A. Holes, Esq.] + +Without solicitude or hope of pecuniary reward, with heart-felt +gratitude and a desire to aid my fellow-man to health and happiness, +allow me to state, that as an inmate for more than a month of the +Invalids' Hotel and Surgical Institute at No. 663 Main Street, Buffalo, +N.Y., I feel warranted in its highest recommendation. While there I saw +and talked with a groat number of people who came there as a last +resort, to be cured of almost every chronic disease to which flesh is +heir, and they were unanimous in their praise of the Institution and the +skilled specialists who constitute its professional staff. + + ANDREW HOLES, + Moorhead, Minn. + + * * * * * + + + + +[Illustration: + +OUTLINE OF THE FEMALE URINARY AND GENERATIVE ORGANS. + +The above cut is introduced here to assist in conveying a correct idea +of the Urinary and Generative Organs of Woman, their form and relative +positions, together with the bones, muscles and other tissues forming +the cavity of the pelvis in which the organs rest, and by which they +are protected. By dividing that portion of the body directly through +the middle from before backward, we first cut through the cushion of +fat (mons veneris) covering the pubic bone, then in succession the +bone, bladder, womb, vagina, rectum, front half of spine, spinal +marrow, rear half of spine, and lastly the muscles and skin. Just +underneath the bone in front is revealed that sensitive organ, the +clitoris, a facsimile of the male organ in miniature, the head of +which protrudes, while the body is covered with tissue, but is readily +traced with the finger. Further back is the urethra, or water passage, +which is one and a half inches long. Next is the vagina. When closed, +its mucous lining is folded in upon itself, and requires dilating in +order to be cleansed and to apply remedies. On the vagina rests the +hollow, pear-shaped womb, the small end of which protrudes into the +vagina, and in which is a small opening, leading through the neck into +the cavity of the organ. On either side of the womb, near its top, are +the Fallopian tubes leading to the ovaries, situated between the womb +and hip bones. At every menstruation these organs throw off a +germ-cell, which passes through the Fallopian tubes into the uterine +cavity.] + + + + + +THE DOOR OF LIFE. + + +[Illustration] + +The fear of pain and the dangers of childbirth fill many a woman's +breast with dismay. In the olden days of leeches and witchcraft, it was +considered sacrilegious to lessen the pains of labor. Latterly, +anæsthetics have been used at the time of parturition, and now people +are beginning to find out that pain and danger can be almost wholly +avoided. + +Proper preparation during gestation will make both as rare as they used +to be common. There is no reason why childbirth should be fraught with +danger and distress. It is a perfectly natural function, and should be +performed in a natural way without undue suffering. Nature never +intended that women should be tortured when doing the one thing which +makes them wholly womanly. The perversion of nature's laws has brought +this suffering about, and a return to right living will stop it. + +Nine out of ten women are troubled more or less by weakness and diseases +peculiar to their sex. It is so because they do not take proper care of +themselves--because they neglect little ills and little precautions. A +woman in perfectly hearty health goes through her time of trial with +comparative ease. The thing to do then, is to make all pregnant women +healthy--to strengthen them generally and locally. The medicine and +tonic to do it with is Dr. Pierce's Favorite Prescription. + +It is a powerful invigorant and nervine. It soothes and strengthens the +nerves and acts directly on the feminine organism in a way which fits it +for the proper and regular performance of all its functions at ill +times. + +Taken during gestation it robs childbirth of its dangers to both mother +and child, by preparing the system for delivery, thereby shortening +labor, lessening pain and abbreviating the period of confinement. The +Favorite Prescription also promotes the secretion of an abundance of +nourishment for the child, if taken after confinement, besides building +up the mother's strength and making her recovery more perfect. + + +ABORTION. (MISCARRIAGE.) + + +The term _abortion_ is used to denote the premature expulsion of the +foetus. If the expulsion takes place within four months after +impregnation, it is termed _abortion_; if between the fourth and seventh +month, _miscarriage_; if after the seventh month, but before the +completion of the full period of gestation, _premature labor_. + +Abortion may be due to those agents which act directly upon the uterus +and cause the expulsion of the foetus; to those which occasion the death +of the foetus, thereby effecting its ejection; and it may be _criminal_, +that is, produced intentionally by direct agencies intended for that +purpose. + +SYMPTOMS. The premonitory symptoms are pain in the loins and lower part +of the back, a dull pain in the abdomen and thighs, nausea, chills, and +palpitation. The membranes and blood-vessels of the uterus become +lacerated, causing profuse hemorrhage. The discharge of blood from the +vagina is sometimes attended with excessive pain. + +THE CAUSES which act directly upon the uterus to produce abortion may be +violent exercise, lifting, accidents, or injuries from blows or falls. +Nervous susceptibilities, a plethoric condition of the system, anæmia, +exhaustive discharges, use of improper food, uterine displacements, +congestion caused by excessive sexual excitement, general debility or +muscular irritability, which is sometimes so great as to produce +contractility of the uterus before the term of pregnancy is completed, +inflammation of the cervix, ulcerations of the uterus, or any previously +existing disease may produce abortion. When it has once taken place, it +is apt to recur at about the same time in subsequent pregnancies. + +The death of the foetus may be occasioned by a diseased condition of the +embryo, amnion, or placenta, and also by convulsions or peritoneal +inflammation. + +CRIMINAL ABORTION is secretly practiced by women who desire to rid +themselves of the evidence of immorality, and by those in wedlock who +wish to avoid the care and responsibility of rearing offspring. +Statistics show that it is very prevalent, undermining the health of +women and corrupting the morals of society. We cannot pass over this +subject in silence. Those who frustrate the processes of nature by +violating the laws of life incur just penalties. All the functions of +life and body are vitally concerned in reproduction. Any infraction of +the Divine law, "Thou shalt not kill," is inevitably followed by +punishment. The obligations to nature cannot be evaded without +inevitable penal effects. Furthermore, all such transgressors carry with +them the consciousness of guilt and the feeling of secret woe. + + "O God! that horrid, horrid dream + Besets me now awake! + Again, again, with dizzy brain. + The human life I take, + And my red right hand grows raging hot, + Like Cranmer's at the stake."--HOOD. + +What shall we say concerning abortionists, men and women who are willing +to engage in the murder of innocents for pay? True, there may be +circumstances in which it is not right to continue in the pregnant +condition, such as when the children of an unfortunate marriage are +idiots, or the pelvis of the woman is so deformed that she cannot bear a +living child. All such cases should be submitted to the _family_ +physician, who ought to be made acquainted with all the circumstances +and facts relating to the case, when he can summon other physicians for +counsel, and their deliberations may determine the propriety or +necessity of bringing on an abortion. + +Parties have written to us and others have made personal application +under circumstances when it might have been right for their _family +physician_ to have induced abortion. We wish to have it distinctly +understood that we will not under any circumstances prescribe medicines +or perform any operation to relieve women of pregnancy. + +Mechanical means are resorted to by abortionists, and many women produce +abortion upon themselves. It always terminates in lasting injury and +sometimes in speedy death. Certain medicines will sometimes produce +abortion but they are very unsafe. An opinion is very prevalent that if +abortion be produced before the movements of the foetus are felt, there +is no crime committed. It should be remembered that _life begins with +conception_, and, at whatever period of pregnancy abortion is committed, +_life is destroyed_. Whoever disobeys the Divine injunction cannot +escape his own consciousness of the deed, and the anguish and bitter +remorse which ever after disturb the soul. + +TREATMENT. In threatened abortion, there is pain in the back or lower +part of the abdomen, and later some flow of blood. The first object is +to obtain perfect rest and quiet, and assume the recumbent position. By +lying down, the blood will be more easily diverted to the surface of the +body. Gallic acid, in doses of five grains every two or three hours, is +often a valuable agent to arrest the hemorrhage, but opium in some form +should be relied upon principally. A Dover's powder, ten grains, may be +administered, to assist in determining the blood to the surface and +extremities of the body and to allay irritation. The room should be +cool, the patient should lie on a hard bed, and all company should be +avoided, for excitement favors abortion. If the flow of blood equals a +gill in amount, there is little hope of preventing abortion, and the +treatment of the case should be entrusted to the family physician. + + * * * * * + + + + +WOMAN AND HER DISEASES. + + +An imaginative poet avers that woman is the link connecting Heaven and +earth. True it is, we see in her the embodiment of purity and heavenly +graces, the most perfect combination of modesty, devotion, patience, +affection, gratitude and loveliness, and the perfection of physical +beauty. We watch with deep interest the steady and gradual development +from girlhood to womanhood, when the whole person improves in grace and +elegance, the voice becomes more sonorous and melodious, and the angles +and curvatures of her contour become more rounded and amplified, +preparatory for her high and holy mission. + +The uterus, or womb, and ovaries, with which her whole system is in +intimate sympathy, render her doubly susceptible to injurious influences +and a resulting series of diseases, from which the other sex is entirely +exempt. By their sympathetic connections they wield a modifying +influence over all the other functions of the system. Physically and +mentally, woman is man modified, perfected,--the last and crowning +handiwork of God. When, therefore, this structure so wonderfully +endowed, so exquisitely wrought, and performing the most delicate and +sacred functions which God has ever entrusted to a created being, is +disturbed by disease, when the nicely-adjusted balance of her complex +nature deviates from its true and intended poise, the most efficient aid +should be extended, in order that the normal equilibrium may be +regained, her health restored, and her divine mission, on which human +welfare so largely depends, be fulfilled. Its importance should elicit +the best efforts of the highest type of mind, the ripe development of +genius, and the most scientific administration of the choicest, rarest, +and purest medicinal elements in the whole range of nature. + +A VAST EXPERIENCE. As the remedial management of diseases of women has, +for many years, entered very largely into our practice at the Invalids' +Hotel and Surgical Institute, located at 663 Main Street, Buffalo, N.Y., +comprising the treatment of many thousands of cases annually, we have +been afforded great experience in perfecting and adapting remedies for +their cure, enabling us to meet their requirements with increased +_certainty_ and _exactness_. + +TREATING THE WRONG DISEASE. Our improved and perfected system of +diagnosing, or determining, the _exact_ nature and extent of chronic +affections, which, in most cases, we are able to do at a distance, and +without a personal examination of the patient, as will be more +particularly explained in the appendix, or latter part of this little +book, has enabled us to avoid the blunders so often committed by the +general practitioner, who not infrequently treats those afflicted with +chronic ailments peculiar to women, for long weeks, and perhaps months, +without ever discovering their real and true disease, or condition. +Thus, invalid women are often uselessly subjected to treatment for +dyspepsia, heart disease, liver or kidney affections, sick headaches, +and various aches and pains, as if they were _primary_ diseases, when in +reality, they are only so many local manifestations, or _symptoms_, of +some overlooked derangement, or disease, of the womb. For, as we have +already intimated, every organ of the system is in _intimate_ sympathy +with the uterus, or womb. Any disease, either functional or organic, of +this organ, is at once manifest through several, if not all, the +sympathizing organs of the system. When we receive a sharp blow upon the +elbow, the pain is felt most keenly in our little finger. Just so in +diseases of the womb; often the most distress is felt in organs or parts +of the system quite distant from the real seat of disease. On this +account, thoughtless, easy-going and ignorant physicians are misled, and +very commonly mistake the invalid's disease for some affection of the +stomach, heart, liver, kidneys, or other organ, when really it is +located in the uterus. Cure the disease of the womb, and all these +disagreeable manifestations, or symptoms, vanish. Their cause being +removed, the various dependent derangements, and disagreeable nervous +sensations and sufferings rapidly give way, and vigorous health is +firmly re-established. + +TIME AND PERSEVERANCE IN TREATMENT REQUIRED TO CURE. Most chronic +diseases of women are slow in their inception, or development, and their +removal or cure must necessarily be gradual. Disease that has been +progressing and becoming more firmly established for months, or perhaps +years, cannot, except in rare cases, be hastily dislodged, and the +system restored to perfect health. The process of cure, like the +development and progress of the disease, must be a gradual one, +accomplished step by step. Often, too, the use of medicines that, if +_persisted_ in, will prove beneficial and curative, will, for a +considerable time, arouse in the system very disagreeable sensations, +and many times this leads unthinking persons to become frightened or +discouraged, and to quit the treatment best adapted to their cases if +only faithfully carried out. In many forms of womb disease, their are +organic lesions or changes, that can be repaired only by a gradual +process, just as an external wound would heal,--not suddenly, but by a +constant, slow filling in and building up, or by the gradual development +or growth of one cell upon another. Just as a great breach in a wall +would be repaired by filling in brick upon brick, until the defect is +effaced, so must these lesion's be removed by gradual processes. When +fully repaired, the dependent, sympathetic derangements, disagreeable +sensations, and all the long train of consequential symptoms are, one by +one, abolished. + +NOT LIMITED IN OUR REMEDIAL RESOURCES. It should be borne in mind that, +while we recommend, in this little volume, certain courses of treatment +for ordinary cases, the remedies mentioned do not by any means embrace +all our resources in the way of medicines and other curative agencies, +especially for complicated, difficult, or very obstinate cases. In many +of the latter class we can send medicines that are exactly adapted to +the case, if the invalid will fill out one of our "Applications for +Treatment," which may be found folded in the latter part of this book, +or which will be sent to any address, on application, by mail. In most +womb diseases, the chemical and microscopical examination of the urine +also furnishes valuable aid in determining the exact condition of the +patient, as well as the precise stage of the local organic disease. Full +directions for putting up and sending such samples may be found in the +"Appendix" of this little volume. Every case submitted to us, either by +letter or in person, receives the careful and deliberate consideration +of a full Council of specialists before a decision as to the nature of +the malady, or the proper course of treatment to be employed, is +determined upon. The great advantage of this system of practice must be +obvious to every intelligent, thoughtful person. No experimenting is +ever resorted to. The treatment is _specially_ and _exactly_ adapted to +each individual case, which requires such judgment, skill, and nicety of +discrimination, as has only been acquired by our specialists through +long and diligent study, and an experience embracing the treatment +annually of many thousands of cases of those chronic diseases which are +peculiar to women. + + WORLD'S DISPENSARY MEDICAL ASSOCIATION, + 663 Main Street, Buffalo, N.Y. + + * * * * * + + + + +MENSTRUATION AND ITS DISORDERS. + + +The function of the ovaries is to furnish ova or germs, and the +functions of the uterus or womb are to secrete mucus; to exude the +menses; to secrete the decidua; to contain and nourish the foetus and to +effect its expulsion. + +Menstruation, or the menses, monthly visitation, catamenia, menstrual +flow, courses, or periods, usually makes its appearance in the female +between the twelfth and fifteenth years, at which time the reproductive +system undergoes remarkable changes. A marked characteristic of +menstruation is its regular return about every twenty-eight days. The +menstrual flow usually continues from three to six days, and the +discharge seems to be ordinary blood, which, during its vaginal passage, +becomes mixed with mucus, and is thereby deprived of the power of +coagulation. The quantity exuded varies from two to eight ounces, but +the amount consistent with the health of one person, may be excessive +and weakening in another. This function is regarded as "being regular +when its effect upon the system is favorable, for whatever organic +process directly contributes to the health should be considered as +normal. It occurs at regular intervals for about thirty years, when +menstruation and the aptitude for conception simultaneously cease. + +The departures from healthy menstruation are numerous. The most +important of these are _amenorrhea, dysmenorrhea_, and _menorrhagia_. + + +AMENORRHEA. + + +The term _amenorrhea_ signifies the absence of menstruation when it +should occur. It may be considered under two general heads: when it +fails to be established at the proper age, and when, after having made +its appearance, it ceases to return at the usual periods. The term +_retention_ has been applied to the first, and that of _suppression_ to +the latter. Menstruation may fail to be established in consequence of +organic defects, or from some abnormal condition of the blood and +nervous system. + +MALFORMATION OF THE VAGINA. Retention of the menses may result from +malformation of the vaginal canal, which sometimes terminates before it +reaches the womb, being simply a short, closed sac. If the uterus and +ovaries are perfect, all the feminine characteristics are manifest, and +a vaginal exploration discloses the nature of the difficulty. If, +however, the sides of this passage adhere in consequence of previous +inflammation, they may be carefully separated by a surgical operation, +and this function restored. + +ABSENCE OR MALFORMATION OF THE WOMB. The uterus may be deformed or +entirely absent, and yet there be an inclination, or symptoms indicative +of an effort, to establish this function. The individual may be delicate +in organization, graceful in bearing, refined and attractive in all +feminine ways, and yet this organ may be so defective as to preclude the +establishment of the menstrual function. Sometimes there is merely an +occlusion of the _mouth_ of the uterus, the perforation of which removes +all difficulty. In others, the _neck_ of the womb is filled with a +morbid growth, or the walls of its canal are adherent, as the result of +inflammation, and may be separated by a small silver or ivory probe, and +the menses be thus liberated. + +IMPERFORATE HYMEN. The hymen is a circular, or semilunar membrane, which +imperfectly closes the outer orifice of the vagina in the virgin. When +of a semilunar shape, it usually occupies the lower or posterior portion +of the canal, leaving an opening in the upper or anterior portion, +varying from the size of a quill to that of a thimble, through which the +menstrual fluid exudes. This membrane is usually ruptured and destroyed +by the first sexual intercourse, and, hence, its presence has been +considered evidence of virginity. Its absence, however, must not be +considered a conclusive evidence of sexual intercourse, for, as Dr. +Dunglison says, "many circumstances of an innocent character may +occasion a rupture or destruction of this membrane. It is often absent +in children soon after birth; while it may remain entire after +copulation. Hence, the presence of the hymen does not _absolutely_ prove +virginity; nor does its absence prove incontinence, although its +presence would be _prima facie_ evidence of continence." + +Sometimes this membrane, when not imperforate, is so thick and strong as +to render sexual intercourse impossible, and requires a cutting +operation to open the vagina. Several such cases have been operated upon +at the Invalids' Hotel and Surgical Institute. + +It occasionally happens that the hymen is entire, or imperforate, at +birth. This may not be discovered before puberty. But when this period +arrives and the menstrual discharge takes place into the vagina, the +female will suffer from the retention and accumulation of this +secretion, and ultimately a tumor or a protrusion of the membrane which +closes the vagina will occur, giving rise to severe pain and other +serious symptoms. The retained menstrual fluid, increasing in quantity +at every monthly period, dilates the womb as well as the vagina, and +even the Fallopian tubes become distended, presenting at length an +urgent necessity for relief. + +TREATMENT. This condition admits of relief only by operative surgery. +The operation consists in dividing the hymen by a crucial incision, thus +allowing the accumulated fluid to be discharged, after which the vagina +is cleansed by syringing it with warm water. + +ABSENCE OF THE OVARIES. Let us suppose the case of a young woman who has +fully reached the period of puberty without having menstruated. All the +organs which we have described, are manifestly developed, she is +healthy, vigorous, robust, and able to exercise freely or to engage in +laborious occupations. But we notice that her voice is not sweetly +feminine, nor is her presence timid, tender, and winning; there is +wanting that diffident sexual consciousness, which gently woos, and, at +the same time, modestly repels, and tends to awaken interest, curiosity, +and desire. Considering also that she has never manifested any +inclination to menstruate, we are irresistibly led to the conclusion +that the ovaries are wanting; the delicate mustache upon the upper lip, +the undeveloped breasts, the coarse features, and her taste for +masculine pursuits, all concur in this diagnosis. Thus we account for +the harshness of the voice, fitted for command rather than to express +the mellow, persuasive cadences of love. Such a malformation cannot be +remedied. + +RETENTION AND SUPPRESSION FROM MORBID CONDITIONS OF THE BLOOD. +Non-appearance, as well as suppression of the menses, may result from an +abnormal state of the blood. The first condition which demands our +attention under this head is _plethora_. In robust, plethoric females +the menses are sometimes very tardy in their appearance, and every month +the attempt to establish this function is attended with pain in the +head, loins, and back, chilliness, nausea, and bloating of the abdomen. +Sometimes there is intolerance of light or sound, and cerebral +congestion, amounting almost to apoplectic symptoms. The pulse is full +and strong, the blood abundant and surcharged with red corpuscles. Such +persons may be accustomed to luxurious living, and there is evidently a +predisposition to abnormal activity of the alimentary functions. + +TREATMENT. We may briefly suggest that such subjects should engage in +laborious physical exercise in order to expend the surplus of vitality, +and should lessen the daily amount of food taken, and use that which is +light and unstimulating. We should also prevent the determination of +blood to the head, by keeping it cool and the feet warm, and by +increasing the flow of blood to the extremities. The volume of the +circulation may be diminished by acting upon the natural outlets, such +as the skin, kidneys, and bowels. The proper means and appliances for +quickening the circulation of the blood are indicated, and friction upon +the surface, bathing, the daily use of such cathartics as Dr. Pierce's +Pleasant Pellets, and, finally, the use of some general uterine +stimulant, such as Dr. Pierce's Favorite Prescription, will generally +prove successful in cases of amenorrhea resulting from plethora. + +RETENTION AND SUPPRESSION FROM ANÆMIA. To describe the condition of the +patient whose blood is low and deprived of the richness, warmth, and +bloom, it once possessed when it kindled admiration and enthusiasm in +others, is but to give a picture of a numerous class of female invalids. +It is sad to see beauty fading, vigor waning, and Bright's disease or +consumption slowly wasting the blood and consuming the vital cells, +until the spirit can no longer dwell in its earthly abode and death +claims the skeleton for dust. + +CHRONIC DECLINE, with its attendant anæmia, may be induced by bad +habits, destitution, or constitutional depravity. Sickly forms, wrecks +of health, address our senses on every side. All these subjects +evidently once had a capital in life, sufficient, if properly and +carefully husbanded, to comfortably afford them vital stamina and length +of days. Alas! they have squandered their estate, perchance in idleness +and luxurious living, or have wasted it in vanities or misdirected +ambition. Having become bankrupts in health, there is necessarily a +failure of the menstrual function, and then follows a _panic_. All the +blame of the insolvency and general derangement, is unjustly attributed +to the non-performance of the duties of the uterus. Thus, this organ is +altogether _dependent_ Upon the general health for its functional +ability, yet frequently treatment is instituted to compel menstruation, +regardless of the condition of the system. Thus the enfeebled uterus is +wrongfully held responsible for general disorder, because it ceases to +act, when _by acting_ it would further deplete the blood and thus +materially contribute to the already existing chronic decline. + +No matter what are the causes of this decline, whether they are the +follies of fashion, the effect of indolence, debility in consequence of +insufficient food, perversion of nutrition by irregular habits, lack of +exercise, or the taking of drastic medicines, the result is anæmia and +amenorrhea. + +TREATMENT. We would suggest in such cases a nutritious diet, increased +exercise, cleanliness, regular habits, hard beds, and useful employment. +The diet may be improved by animal broths, roasted meats, fresh beef, +mutton, chicken, or eggs, and the dress should be comfortable, warm, and +permit freedom of motion. The patient should indulge in amusing +exercises, walking, swinging, riding, games of croquet, traveling, +singing, percussing the expanded chest, or engage in healthful +calisthenic exercises. The hygienic treatment of this form of +amenorrhea, then, consists in physical culture, regular bathing, and the +regulation of the bowels, if constipated, as suggested in this volume +under the head of constipation. + +The _medical treatment_ should be directed to enriching the blood, +improving nutrition, toning up the generative organs, and the health of +the whole system. This requires the employment of uterine and general +tonics, and Dr. Pierce's Favorite Prescription, which is sold by +druggists, happily combines the properties required. It improves +digestion, enriches the blood, exercises a tonic and gently stimulating +effect upon the uterus and ovaries, and thus promotes the function of +menstruation. It is not a strong emmenagogue, but operates slowly, yet +surely, and in accordance with physiological laws, being eminently +congenial in its effects upon the female system, and, hence, not liable +to do harm. There is danger in employing active driving medicines, +besides, no emmenagogue, however powerful, can establish the menstrual +function so long as the system is in a debilitated condition and the +blood reduced. The restorative effects of the "Favorite Prescription" +should be secured by administering it regularly, in from one to two +teaspoonful doses, three or four times a day, for several weeks, and as +the system is built up and those symptoms appear which indicate a return +of the menses, their visitation may be encouraged by the use of hot foot +and sitz-baths, and free doses of Dr. Pierce's Compound Extract of +Smart-weed. But the latter should only be used when symptoms of +approaching menstruation are manifested. By following out this course of +treatment, a soft flush will gradually take the place of the pallor of +the cheeks, the appetite will return and the health will be restored. + +ACUTE SUPPRESSION OF THE MENSES may be caused by _strong emotions,_ as +excessive joy, or by violent _excitement_ of the _propensities_, as +intense anger, sudden fright, fear, or anxiety. Suppression may result +from sudden exposure to cold, immersion of the hands or feet in cold +water, drinking cold water when the body is heated, sitting on the cold +ground or damp grass, or from a burn or wound. It is not uncommon for +women to labor in the heated wash-room, pounding, rubbing, and wringing +soiled linen, thereby overtaxing the delicate physical system. While +feeling tired and jaded, all reeking in perspiration, they rinse and +wring the clothes out of cold water and hang them upon the line with +arms bare, when the atmosphere is so freezing that the garments stiffen +before they finish this part of the task. Is it any wonder that acute +suppressions occur or that inflammations set in? + +The symptoms which naturally follow are a quick pulse, hot skin, thirst, +fever, headache, and dizziness, and the inflammation may locate in the +ovaries, uterus, lungs, bowels, brain, or other parts. No matter what +organs are attacked the menses are suppressed. The suppression can +generally be attributed to an adequate cause, resulting in +constitutional disturbance. The severity and duration of the attack and +the power of the constitution to resist it, must determine the gravity +of the consequences. + +TREATMENT. As acute suppression of the menses is due to derangement of +the circulation of the blood, caused by taking cold, by violent +excitement of the propensities or excessively strong emotional +experience, the prominent indication is to secure its speedy +equalization. Give a hot foot, a warm sitz, or the spirit vapor-bath and +administer full doses of Dr. Pierce's Compound Extract of Smart-weed, to +produce free perspiration. Dr. Eberle, a very celebrated medical author, +says that he used the Extract of Smart-weed in twenty cases of +amenorrhea, and affirms, "with no other remedy or mode of treatment have +I been so successful as with this." Our experience in the use of the +Extract has been equally satisfactory. Should this treatment not +establish the function, Dr. Pierce's Favorite Prescription should be +given three times a day until the system is invigorated, say for +twenty-eight days, when the above course may be repeated, and generally +with success. Should the case be complicated with inflammation of the +lungs, brain, or other vital organs, manifesting alarming symptoms, the +family physician should be called. The treatment should be active and +suited to the indications of each particular case. When the disease +becomes chronic, the active stage of symptoms having passed, and it +continues to linger without making the desired improvement, all the +means suggested for the treatment of suppression from anæmia should be +employed. Their use will be followed by the most gratifying results. It +should be borne in mind, however, that when we have suggested any +treatment in this volume, it is generally such as the family may +institute and apply, and does not, by any means, represent the variety +or extent of the remedial resources which we employ when consulted in +person or by letter. We refer our readers to only a few of the safe and +reliable remedies which we have prepared and placed within their reach, +and give them just such hygienic advice as we think will best serve +their interests. + + * * * * * + + + + +DYSMENORRHEA. + +(PAINFUL MENSTRUATION.) + + +_Dysmenorrhea_, from its Greek derivation, signifies a _difficult +monthly flow,_ and is applied to menstruation when that function becomes +painful and difficult. Menstruation, like other healthy operations of +the body, should be painless, but too frequently it is the case, that +discomfort and distress commence twenty-four hours before the flow +appears, and continue with increasing pain, sickness at the stomach, and +vomiting, until the patient has to take to the bed. When the discharge +does occur, speedy relief is sometimes obtained, and the patient suffers +no more during that menstrual period. With others, the commencement of +the function is painless, but from six to twenty-four hours after, the +flow is arrested and the patient then experiences acute suffering. Pain +may be felt in the back, loins, and down the thighs. Sometimes it is of +a lancinating, neuralgic kind, at others, it is more like colic. +Frequently the distress causes lassitude, fever, general uneasiness, and +a sense of lethargy. There are those who suffer more or less during the +entire period of the flow, while the distress of others terminates at +the time when a membranous cast is expelled. For convenience of +description, dysmenorrhea has been divided into the following varieties: +_neuralgic, congestive, inflammatory, membranous_, and _obstructive_. + +_The neuralgic variety_ of dysmenorrhea, sometimes called _spasmodic_ or +_idiopathic_, occurs when there is excessive sensibility of the ovaries +and uterine nerves, which sympathetically _respond_, especially to +cutaneous, biliary, and sexual irritation, and when ovarian or uterine +irritation is communicated to distant nerve-centres. In the first class, +usually comprising lean persons of an encephalic temperament, whatever +disorders the functions of the general system, instantaneously reflects +upon the ovaries and uterine nerves, and the menstrual function Is +correspondingly disturbed, and, instead of being painless, the flow +becomes spasmodic, with paroxysms of distress. In the second class, +which includes those persons who are plethoric, the ovarian and uterine +nerves seem to be the origin and centre of irritation, which is +sometimes so severe as to cause indescribable pain. We have known women +who affirmed that the severity of labor pains was not so great as that +from this cause. In one instance, the subject suffered thus for eleven +years, and then became a mother, and has ever asserted that her periodic +suffering was far more intense than the pain experienced during her +confinement. These neuralgic pains fly along the tracks of nerves to +different organs, and capriciously dart from point to point with +marvelous celerity, producing nausea, headache, and sometimes delirium. + +IN THE CONGESTIVE VARIETY of dysmenorrhea, the menstrual period may be +ushered in without pain; after a few hours, the pulse becomes stronger +and more rapid, the skin grows hot and dry, the menses stop, there is +uneasiness, restlessness, and severe pelvic pains. Evidently, the mucous +membranes of the Fallopian tubes and uterus have become congested, and +the pain results from the arrest of the functional process, the +exudation of blood. + +THE CAUSES are plethora, exposure to cold, excitement of the emotions or +passions, and a morbid condition of the blood. Sometimes congestion +arises in consequence of a displacement of the uterus. + +IN THE INFLAMMATORY VARIETY, the mucous membrane of the uterus is the +seat of irritation. The blood flows into the capillary vessels in +greater abundance than is natural, and those vessels become over-dilated +and enfeebled and so altered in their sensibility as to produce local +excitement and pain. It may be associated with inflammation of the +ovaries, peritoneum, or bladder. Upon the return of the menses, there is +a dull, heavy, fixed pain in the pelvis, which continues until the +period is completed. There is generally tenderness of the uterus, and +also leucorrhea during the intervals between each monthly flow. + +IN THE MEMBRANOUS VARIETY of dysmenorrhea, the entire mucous membrane +which lines the cavity of the uterus, in consequence of some morbid +process, is gradually detached and expelled at the menstrual period. + +SYMPTOMS. There are steady pains at the commencement of the menstrual +flow, and they increase in violence and become decidedly expulsive. The +mouth of the uterus gradually dilates, and finally, the membrane is +forced out of the uterus, attended with a slight flow of blood and an +entire subsidence of the pain. + +THE TREATMENT, in all the preceding varieties of dysmenorrhea, should +consist of measures to determine the circulation of the blood to the +surface, and increase the perspiratory functions. Congestion and +inflammation of the internal organs are generally induced by exposure to +cold or from insufficient clothing. Sometimes they follow from neglect +of the skin, which is not kept clean and its excretory function +encouraged by warm clothing. The domestic treatment at the monthly +crisis should be commenced by the administration of hot foot, and +sitz-baths, after which the patient should be warmly covered in bed, and +bottles of hot water applied to the extremities, back, and thighs. Dr. +Pierce's Compound Extract of Smart-weed should be given in full doses, +frequently repeated, to secure its diaphoretic, emmenagogue, and anodyne +effects, which, for this painful affection, is unsurpassed. For the +radical cure of this disease, whether of a congestive, inflammatory, or +neuralgic character, Dr. Pierce's Favorite Prescription, which is sold +by druggists, is a pleasant and specific remedy, which will most +speedily correct the abnormal condition that produces the trouble, and +thereby obviate the necessity of passing this terrible ordeal at every +monthly period. The patient should take two teaspoonfuls of the medicine +three times a day, and keep up its use in these doses for weeks. +Frequently, one month will suffice to cure, but in most cases, a longer +season is required. In the end, the suffering patient will not be +disappointed, but will become a new being, ready for the enjoyment and +duties of life. The bowels should be kept regular throughout the +treatment by the use of Dr. Pierce's Pleasant Pellets, if necessary. A +hand or sponge-bath should be used daily to keep the skin active, and be +followed by a brisk rubbing of the surface with a rough towel or +flesh-brush. A wet sheet pack will cleanse the pores of the skin and +invite the blood into the minute capillaries of the surface, and thus +prove of great benefit. It should be repeated after an interval of seven +days, but ought to be omitted if near the approach of a menstrual +period. The clothing should be warm, to protect the system against +changes of temperature; especially should every precaution be taken to +keep the feet dry and warm. The patient should walk in the open air, and +the distance should be regularly lengthened at each succeeding walk. If +the course of treatment which we have suggested be faithfully pursued, a +permanent cure will be effected. + +IN THE OBSTRUCTIVE VARIETY of dysmenorrhea, some organic impediment +hinders the exit of the menstrual blood from the uterus, which, +consequently, becomes distended and painful. The pain may be constant, +but is most acute when the uterus makes spasmodic efforts to discharge +the menstrual blood. If these efforts prove successful, there is an +interval of relief. Flexion or version of the womb may produce partial +occlusion of the canal of the neck of the uterus, thus preventing the +free flow of the menstrual fluid through it. Tumors located in the body +or neck of the uterus often cause obstruction to the free discharge of +the menses. Imperforate hymen and vaginal stricture also sometimes cause +obstruction and give rise to painful menstruation. As these several +abnormal conditions and diseases will be treated of elsewhere in this +volume, we omit their further consideration here. + +Partial adhesion of the walls of the neck of the womb may result from +inflammation of the mucous lining, and prevent a free and easy exit of +the menstrual fluid. In many cases, the contracted and narrowed +condition of the canal of the cervix seems to be a congenital deformity, +for we can trace it to no perceptible cause. It is also true that +contraction and partial, or even complete, stricture of the cervix, or +neck of the womb, often results from the improper application of strong +caustics to this passage by incompetent and ignorant surgeons. Every +person has observed the contraction of tissue caused by a severe burn, +which often produces such a distortion of the injured part as to +disfigure the body for life. A similar result is produced when the neck +of the womb is burned with strong caustics. The tissues are destroyed, +and, as the parts heal, the deeper-seated tissues firmly contract, +forming a hard, unyielding cicatrix, thus constricting the neck of the +womb, through which the menses pass into the vagina. + +[Illustration: Fig. 3. + +THE UTERINE DILATOR. + +This instrument is +introduced into the +canal of the uterine +neck with its blades +closed. By means +of the thumb-screw +the blades are then +separated as shown +in this illustration, +the cervical canal +being thereby dilated +to the required +extent.] + +TREATMENT. From the nature of this malady, it will readily be seen that +no medical treatment can effect a radical cure. We must therefore resort +to surgery. In a small proportion of cases, the stricture may be cured +by repeated dilations of the constricted part of the cervical canal. +This may be accomplished by using a very smooth probe which is fine at +the point, but increases in size, so that its introduction will widen +and expand the orifice and canal. The stricture may be overcome in many +cases by using different sized probes. In some instances, we have +employed the uterine dilator, represented by Fig. 3. We have also +introduced sea-tangle and sponge tents into the neck of the womb, and +allowed them to remain until they expanded by absorbing moisture from +the surrounding tissues. The latter process is simple, and in many cases +preferable. By means of a speculum (see Figs. 15 and 16), the mouth of +the womb is brought into view, and the surgeon seizes a small tent with +a pair of forceps and gently presses it into the neck of the womb, where +it is left to expand and thus dilate the passage. If there seems to be a +persistent disposition of the circular fibers of the cervix to contract, +and thus close the canal, a surgical operation will be necessary to +insure permanent relief. In performing this operation, we use a cutting +instrument called the hysterotome (see Figs. 4 and 5). By the use of +this instrument, the cervical canal is enlarged by an incision on either +side. The operation is but slightly painful, and, in the hands of a +competent surgeon, is perfectly safe. We have operated in a very large +number of cases and have never known any alarming or dangerous symptoms +to result. After the incision, a small roll of cotton, thoroughly +saturated with glycerine, is applied to the incised parts, and a larger +roll is introduced into the vagina. The second day after the operation, +the cotton is removed, the edges of the wound separated by a uterine +sound or probe, and a cotton tent introduced into the cervix, and +allowed to remain, so that it will expand and thus open the wound to its +full extent. This treatment must be thoroughly applied, and repeated +every alternate day, until the incised parts are perfectly healed. + +[Illustration: Fig. 4. +WHITE'S HYSTEROTOME. + +In operating, this instrument is introduced into the canal of the neck of the +womb, when a thumb screw in the end of the handle is turned, by which a small +blade is thrown out from each side, and as the instrument is withdrawn from the +canal an incision is made on each side, thus enlarging the passage. The upper +figure illustrates the instrument closed, ready for introduction; the lower one, +with the blades projected for cutting.] + +Many times patients cannot understand why it is that the operation of +cutting the constricted cervix causes no pain; they often being entirely +unconscious of the making of the incision. The explanation is easy. The +cervix uteri, or neck of the womb, is supplied with but few nerves of +sensation, and is almost as destitute of sensation as the finger or toe +nails, the paring of which causes not the slightest pain. On this +account we never find it necessary to administer chloroform or any other +anæsthetic when undertaking this operation. If the patient be extremely +sensitive the application to the cervix of a weak solution of cocaine is +quite sufficient to completely benumb or anesthetize the parts so as to +entirely avoid all pain from the operation. + +[Illustration: Fig. 5. + +STOHLMAN'S HYSTEROTOME. + +This instrument has two cutting blades which shut past each other, as +seen in the lower figure, so as not to cut when introduced into the +canal of the uterine neck. After introduction, the cutting blades are +separated, as shown in the upper figure, the extent of the incision +being regulated by the thumb-screw attached to the handles, as +represented in the lower figure.] + + * * * * * + + + + +MENORRHAGIA. + +(PROFUSE MENSTRUATION.) + + +The word _Menorrhagia_, which is of Greek derivation, literally means +_monthly breaking away_, and is employed to designate profuse +menstruation. This disorder must not be confounded with those +hemorrhages which are not periodical, and which are due to other causes. +The term _menhorrhagia_ is restricted to an immoderate monthly flow. The +menstrual flow may occur too often, continue too long, or be too +profuse. It induces a feeble pulse, cold extremities, weak respiration, +general debility, and may occur in opposite states of the system, +_i.e._, in women who have a plethoric and robust habit, or in those of +flaccid muscles and bloodless features. When the menstrual discharge is +natural, it is so gradual that by mixing with the vaginal secretions it +is prevented from coagulating, while in this disease, clots are often +formed. + +SYMPTOMS. In women of a _plethoric_ habit, it is ushered in by itching +and heat in the vagina, pain and a feeling of weight in the loins and +lower part of the abdomen, and, at times, the breasts become hot and +painful. There is considerable thirst, headache, and giddiness. At last, +the blood appears and flows profusely, and all the violent symptoms at +once subside. The rest of the period is marked by an inordinate flow, +leaving the system weak from the loss of blood. It oftener occurs, +however, in persons who are naturally weak and delicate, in which case +the periods are more frequent and continue longer, and after a time they +are renewed by any bodily exertion or mental emotion, so that a constant +drain exists. If the flow of blood is not continuous, leucorrhea +intervenes. The patient gradually loses strength and becomes languid, +her face is pale and usually bloated, livid circles appear around the +eyes, the appetite is impaired, the bowels are constipated, and the feet +and ankles swollen. Lack of blood in the brain is indicated by headache, +ringing in the ears, and dizziness. The patient is nervous and +irritable, being disturbed by the slightest noise, and the heart +palpitates after the least exertion. + +CAUSES. The _first_ form is caused by eating too much rich and +highly-seasoned food, drinking wine, porter, ale, or beer, want of +exercise, in brief, whatever induces plethora; the _second_ results from +an insufficient or poor diet, leucorrhea, frequent abortions, want of +ventilation, inherent feebleness, and whatever depresses the vital +powers. Either form may be due to syphilitic taints, excessive sexual +indulgence, accidents of pregnancy, or organic diseases of the womb. The +morbid affections of the womb most likely to induce menorrhagia, are +granular ulceration of its mouth and neck, fungous degeneration of its +lining membrane, and tumors within that organ. As these subjects will be +severally considered hereafter, we shall here dismiss them with this +brief notice. + +Profuse menstruation is very prone to occur in young women of a +lymphatic temperament, whose organs are sleazy in texture. + +TREATMENT. To control the excessive flow, the patient should remain in +her bed, and assume the recumbent position until the period is passed. +If circumstances prevent strict compliance with this rule, it should be +observed as nearly as possible. Warmth should be applied to the feet, +and cold cloths, which ought to be removed as soon as they become warm +by the heat of the body, should be repeatedly placed upon the back and +abdomen. A strong tea made from cinnamon bark, or witch-hazel leaves or +bark, taken freely, will prove very efficacious in checking the flow. +The fluid extract of ergot, in doses of from half a teaspoonful to a +teaspoonful, in a little water or cinnamon tea, is one of the most +effectual remedies in this affection. Another valuable remedy for +arresting menorrhagia is an infusion of Canada fleabane; or the oil of +this plant may be administered in doses of from five to ten drops on +sugar. Gallic acid is also a good styptic to employ in these cases. If +there is febrile excitement, a hard pulse, frequent and throbbing, and +if there is headache, thirst, parched lips, hot and dry skin, as is +sometimes the case, then menorrhagia is due to an augmented action of +the heart and arteries, and the indication of treatment is to diminish +vascular action. This may be temporarily accomplished by the use of +veratrum viride, which should be continued until the flow is +sufficiently diminished. + +The means already suggested will generally prove effective in +controlling the inordinate flow at the time. Treatment that will produce +permanent relief should then be adopted. The condition of the skin, +kidneys, and bowels, requires attention for noxious elements should not +be retained in the system. To give tone to weakened pelvic organs we +know of nothing more specific in its effects than Dr. Pierce's Favorite +Prescription, which is sold by druggists. It should be taken +continuously for weeks, in order to fully correct the extremely weakened +condition of that organ. It also aids nutrition, and thus tones up the +general system, so that in the form of profuse menstruation, resulting +from debility, the patient is strengthened, her blood enriched, and her +nervousness quieted, which constitutes the necessary treatment to make +the cure permanent. + +As women approach the critical age, and menstruation ceases, if they are +anæmic, their condition is pitiable. This period is popularly +denominated the _turn of life_. Under favorable circumstances, the +vitality is decidedly enhanced, and the decline of this function is +attended with a revival of the bodily powers. But when this crisis has +been preceded by excessive labor, when intemperance or excesses of any +kind have deranged the bodily functions and perverted nutrition, when +the mind has been long and deeply depressed, or when the insidious +progress of disease of the heart, liver, or other Important organs, +occurs in consequence of irregularities of living, then there is danger +of congestion of the uterus and a protracted and profuse menstrual flow, +which favors a decline. + +The treatment of this form of menorrhagia does not differ from that +already suggested. The diet should be light and nourishing, and daily +exercise, such as walking, riding, change of air and scenery, all will +contribute to restoration. Especial attention should be directed to the +condition of the bowels and liver. If the latter be deranged, Dr. +Pierce's Golden Medical Discovery will be a most efficacious remedy. +When there is a diminution of vital force, resulting in impaired +nutrition and disorders of blood, an alterative is required which will +insensibly and gradually restore activity by removing the causes of +derangement. Impairment of nutrition is very frequently associated with +functional or organic disease of the liver, and curative measures +consist of the use of alteratives, friction baths, exercise, nutritive +diet, and diversion of the mind. Whenever innutrition depends upon +deprivation of the blood or torpor of any of the secretory organs, the +"Golden Medical Discovery" will prove to be an invaluable remedial +agent, for it is an alterative and at the same time a blood restorative. +If the bowels be costive small laxative doses of Dr. Pierce's Pleasant +Pellets should be employed. The "Favorite Prescription" regulates the +menstrual function by toning up the tissues of the uterus and +restraining the escape of the menses from the orifices of the +blood-vessels. While the diet should be nourishing, consisting of wild +game, mutton, chicken, and wine, the patient ought not to debilitate the +stomach by the use of strong tea or coffee. The circulation of the blood +should be quickened by riding, walking, exposure to sunlight, and fresh +air. The patient ought to engage in some light occupation, in which the +mind will be constantly as well as agreeably employed, but not +overtaxed. By pursuing the course of treatment, invalids suffering from +menorrhagia may be permanently restored to health. + + * * * * * + + + + +THE TURN OF LIFE. + +(CESSATION OF THE MENSES.) + + +Menstruation commonly occurs at regular monthly intervals, during a +period of about thirty years. The time for its cessation depends +somewhat upon the date of its first appearance. In the temperate zones +it commences at about the fifteenth year, and, consequently should +terminate at the forty-fifth year. Instances are common, however, in +which it has been prolonged until the fiftieth and even to the +fifty-fifth year. In warm climates it commences and terminates at an +earlier age. + +As women approach the critical period of life, if the general health and +habits be good, the discharge may gradually diminish, and, at length, +totally disappear, without producing any particular inconvenience, but +this seldom happens. More frequently, the discharge is entirely absent +for six or seven weeks, and when it does return, it is more copious than +usual. In some cases, the flow is not only too profuse, but too +frequent. Many months may elapse before the menses return, and, even +then, they are apt to be very pale and deficient in quantity. + +The fluctuations of this function occasion irregularities and +disturbances of the general health. When the flow of blood is diverted +from the uterus, it is liable to be directed to the head or some other +part of the body. In fact, there appears to be constitutional agitation, +and disorders of all the organs. Perhaps one reason for calling this a +critical period is, that if there is a morbid tendency in the system, a +disposition to develop tumors of the breast or uterus, these are very +liable to make rapid progress at this time, since they are not relieved +by the customary, local exudation of blood. It is a time favorable to +the awakening of latent disorder and morbid growths, for, at the decline +of the menstrual function, the uterus is not so capable of resisting +vitiating influences. + +There is greater liability to irritation of the bladder and rectum, and +the menstrual flow may be superseded by a white, acrid discharge, caused +by an inflammation of the mucous membrane of the vagina. Even if the +system be not enfeebled by excessive losses of blood, debility may +result from a continued irritation of the uterine organs, and cause the +morbid discharge. The nervous system sympathetically responds, becoming +exceedingly irritable, and thus implicating in this derangement every +bodily organ. In some constitutions, the change of any habit is almost +impossible, particularly if it is improperly acquired, or detrimental to +health; and so we have sometimes thought respecting this function, that +the more it has been abused and perverted during the time of Its natural +activity, the greater is the disturbance occasioned when it ceases. + +TREATMENT. There should be regularity in all the habits of life. Women +are too apt to approach this important period without due care and +consideration. When the physical system is about to suspend a function, +it is folly to endeavor to perform the labor or assume the +responsibilities which were permissible when the constitution was more +robust. + +How the duties of each day and hour weigh upon the energies of the +mother! What intense solicitude and yearning she experiences! How +unselfish is that mother who each day works steadily and faithfully for +others, and who is conscious of the hidden dangers that lurk around her +pathway! With confiding faith and love, she commends the interests of +her children to Him who doeth all things well. She anticipates the wants +of her family and strives to supply the desired comforts, thus wasting +her strength in the labors prompted by her loving nature. Would it not +be a greater comfort to those children to have the counsel of their dear +mother in later years, than to have the bitter reflection that she +sacrificed her health and life for their gratification? + +Unconsciously, perhaps, but none the less certainly, do women enter upon +this period regardless of the care they ought to bestow upon themselves. +Without sufficient forethought or an understanding of the functional +changes taking place, they over-tax their strength, until, by continuous +exertion, they break down under those labors which, to persons of their +age, are excessive and injurious. Is it strange, when woman has thus +exhausted her energies, when her body trembles with fatigue and her mind +is agitated with responsibilities, that the menses capriciously return, +or the uterus is unable to withstand congestion, and capillary +hemorrhage becomes excessive? If the physical system had not been thus +exhausted, it would have exercised its powers for the conservation of +health and strength. It is better to be forewarned of the ills to which +we are liable, and fortify ourselves against them, rather than squander +the strength intended for personal preservation. Let every woman, and +especially every _mother_, consider her situation and properly prepare +for that grand climacteric, which so materially influences her future +health and life. + +The general health should be carefully preserved by those exercises +which will equalize the circulation of the blood, and the regular action +of the bowels should be promoted by the use of those articles of diet +which contribute to this end. Relieve the mind of responsibility, keep +the skin clean, and enrich the blood with tonics and alteratives. For +the latter purpose, use Dr. Pierce's Favorite Prescription and "Golden +Medical Discovery." If these remedies fail, seek professional advice. A +careful regulation of the habits, strict attention to the requirements +of the system, and the use of tonic medicines, will very frequently +render the employment of a physician unnecessary + + * * * * * + + + + +LEUCORRHEA. + +("WHITES.") + + +Leucorrhea is the symptomatic manifestation of some uterine or vaginal +affection, vulgarly called "whites." We say _symptomatic_, for the white +or yellowish discharge, which we term leucorrhea, is not a disease, but +a symptom of some uterine or vaginal disorder. We call it a _white_ +discharge to distinguish it from the menses and uterine hemorrhages. It +varies, however, in color and consistency from a white, glairy mucus to +a yellow or greenish, purulent, fetid matter. Sometimes it has a curdled +appearance, at others, it is of the consistency of cream. Leucorrhea is +the most common symptom of uterine derangement, and there are few +females who are not affected by it at some period of life. It may +originate either in the vagina or uterus, and it is accordingly termed +either vaginal or uterine leucorrhea. The nature of leucorrhea is +analogous to that of nasal catarrh. In a healthy state, the lining +membrane of the genital organs secretes sufficient mucus to moisten +them; but, if the mucous membrane is temporarily congested or inflamed, +the secretion becomes profuse, irritating, and offensive. Vaginal and +uterine leucorrhea are essentially different in character, the former +being an acid, and the latter an alkaline secretion, and, while the +first is a creamy, purulent fluid, the latter is thick and ropy, like +the white of an egg. In fact, the latter discharge is rich in albuminous +matter and blood-corpuscles, hence, its great debilitating effect upon +the system, and, if not promptly arrested it is likely to produce +_vaginitis, pruritus vulvce_, or _vulvitis_. + +VAGINITIS is indicated by intense inflammation of the mucous membrane of +the vagina. When this affection is present the patient experiences a +sense of burning heat, aching and weight in the region of the vagina, +violent and throbbing pains in the pelvis, and the discharge is profuse +and very offensive. There is also a frequent desire to urinate, and the +passage of the urine causes a sensation of scalding. + +PRURITUS VULVAE. The discharge irritates the nerves of the external +genital parts, thus producing an almost unendurable itching. Scratching +or rubbing the parts only aggravates the affection. The patient is +tormented night and day, is deprived of sleep, and naturally becomes +despondent. Pruritus vulvae, in its severest forms, is often developed +when the discharge is scarcely noticeable. It is the most common result +or accompaniment of leucorrhea. + +VULVITIS. This term indicates an inflammation of the lining membrane of +the external genital parts. Sometimes the inflammation extends to the +deeper tissues, causing great pain, and even suppuration, resulting in +the formation of an abscess. The attack is indicated by redness, +swelling, and a feverish state of the affected parts, which is quickly +followed by a profuse flow of yellow pus, and, in some instances, small +ulcers are formed on the affected parts. + +SYMPTOMS. The sufferer from leucorrhea becomes pale and emaciated, the +eyes dull and heavy, the functions of the skin, stomach and bowels +become deranged, more or less pain in the head is experienced, sometimes +accompanied with dizziness, palpitation is common, and, as the disease +progresses, the blood becomes impoverished, the feet and ankles are +swollen, the mind is apprehensive and melancholy, and very frequently +the function of generation is injured, resulting in complete sterility. +Exercise produces pain in the small of the back and the lower portion of +the spine, and, owing to a relation of the vaginal walls, the womb falls +far below its natural position, or turns in various directions, +according to the manner in which the weight above rests upon it. Ulcers +are apt to appear upon the mouth of the womb, the matter from which +tinges the discharge and stains the linen. Hysteria is often an +attendant of this disease. + +CAUSES. The immediate cause of leucorrhea is either congestion, or +inflammation of the mucous membrane of the vagina or womb, or both. The +exciting causes are numerous. Among others, deranged menstruation, +prolonged nursing of children, pregnancy, abortions, excessive +indulgence in sexual intercourse, uncleanliness, piles, uterine ulcers, +and displacement of the womb, are the most common. In brief, it usually +accompanies every uterine disorder which vitiates and reduces the +system. During childhood, particularly in scrofulous children, +discharges from the vagina are not unfrequent, owing to worms or other +intestinal irritation. + +Among the organic causes of leucorrhea, are ulceration of the mouth or +neck of the womb and tumors. These will be considered hereafter. + +TREATMENT. We have dwelt upon leucorrhea because of its prevalence and +in order to exhibit the various forms it may assume. These reasons long +ago prompted us to investigate it; and, ascertaining the derangement to +consist in a relaxation of the walls of the vagina, attendant upon +depressed vitality, for many years we experimented with various +medicines to find those that would exercise specific properties in +restoring the tissues involved to a natural condition, thereby arresting +the abnormal discharge. Our efforts in that direction have been very +successful, and our expectations more than realized. The treatment which +we shall recommend is rational, based upon the pathological conditions +of the disease, and has been attended with the greatest success. + +It embraces the use of those general restoratives and specific uterine +tonics, so harmoniously combined in Dr. Pierce's Favorite Prescription, +a remedy which has achieved unparalleled success in the cure of this +affection and won the highest praise from thousands of grateful women. +It many cases, it is well to accompany its use with alterative +treatment, for which the "Golden Medical Discovery" will be found +especially effective. It is an absurd practice to arrest the discharge +with astringent injections _alone_. The weak and lax walls of the +vagina, as well as the other tissues of the system, require strength, +and this can be gained only by the use of general and special tonics. +Appropriate injections as _auxiliary_ treatment will very much _assist_ +in the cure. The "Favorite Prescription" is a special tonic for the +affected parts, and the "Golden Medical Discovery" is the best general +alterative of which we have any knowledge. They may be taken in +alternate doses every day. If the patient is very pale and anæmic, one +drachm of the carbonate, or two drachms of the citrate or pyrophosphate +of iron, may be advantageously added to each bottle of the "Favorite +Prescription." If the carbonate be employed, as it is insoluble, the +bottle should be well shaken every time before using. The functions of +the skin should be kept active by frequent baths, and the patient, if +able, should walk or ride in the open air, and freely expose herself to +the sunshine. If the invalid be too weak to exercise much, she should go +out in warm weather and sit in the open air. Sunshine is no less +important in maintaining animal, than in supporting vegetable growth and +health. The human being, like the plant, sickens and grows pale, weak +and tender, if secluded from the sunlight. The apartments occupied +should be thoroughly ventilated. Many women are sickly and feeble +because they live in badly ventilated rooms. + +We cannot too strongly urge in this, as in all other chronic diseases +peculiar to women, that the bowels be kept regular. Frequent, but small +doses of Dr. Pierce's Pleasant Pellets will prove most beneficial. If +the vaginal passage is tender and irritable, an infusion, or tea of +slippery-elm bark is very soothing, and may be used freely with a +vaginal syringe. Whatever injection is employed, should be preceded by +the free use of Castile soap and warm water, to thoroughly cleanse the +parts. One part of glycerine to six parts of water is a soothing lotion +when there is much tenderness, heat, and pain in the vagina. If there be +no great tenderness in the vagina, or if the acute, inflammatory +symptoms have yielded to the lotions already suggested, then a tonic and +astringent injection should be employed. + +For this purpose a wash made by dissolving one of DR. PIERCE'S PURIFYING +AND STRENGTHENING LOTION TABLETS, in one pint of hot water is a superior +application and will not fail to be of great benefit in controlling the +disagreeable drain. If your medicine dealer is not supplied with these, +mail 25 cents in one-cent stamps to us and we will forward a box of the +Lotion Tablets by return post. + +These Lotion Tablets have for many years been used in the treatment of +obstinate cases of leucorrhea at the Invalids' Hotel and Surgical +Institute, and their efficiency has been alike gratifying to both +patient and physician. + +If _pruritus_ or severe itching, be also a symptom, the itching will +readily yield if the parts be cleansed with Castile or other fine soap +and warm water, followed by the application of a compound composed of +two ounces of glycerine, one ounce of rose-water, and one drachm of +sulphite of soda; or, for the sulphite of soda, two drachms of borax may +be substituted. The following lotion is a good one to relieve pruritus: +sugar of lead, two drachms; carbolic acid, half a drachm; laudanum, four +ounces; glycerine, four ounces; water, four pints; mix. This may be +applied to the itching parts, and also injected into the vagina. + +[Illustration: Fig. 6. +FOUNTAIN SYRINGE.] + +HOW TO USE VAGINAL INJECTIONS. We usually recommend the Fountain Syringe +illustrated in Fig. 6, as the most convenient instrument for +administering vaginal injections. The fountains supplied by us are of +soft rubber, and have extra nozzles, with which to make rectal, nasal or +ear irrigations. There is also a large, long nozzle for vaginal +injections. + +[Illustration: Fig. 7. +SOFT RUBBER-BULB SYRINGE] + +It is channeled so is to permit the free clearing away of the secretions +as the Douche is employed. The Fountain Syringe can he used without +assistance, the flow of fluid is gradual, and with a force that can be +varied, by raising or lowering the reservoir, yet is never so great as +to be liable to produce injurious effects. + +The syringes usually sold with small nozzles or pipes are of little or +no value for vaginal injections. In many instances so small a tube will +pass readily into the canal of the uterus, and hence there has +frequently resulted an injection of a portion of the fluid into the +uterus itself, producing severe pain. It is important, therefore, in +using the Vaginal Douche to employ only a large tube that has grooves in +its surface for the free clearing away of the fluid as it runs from the +fountain. + +Where it is desired to obtain relief from a congested, inflamed or +sensitive and irritable state of the mucous surface, the employment of a +large quantity of water as hot as it can be borne, is of the greatest +remedial value. It rapidly diminishes the size of the blood vessels, and +aids in bringing about a normal circulation in the parts. + +As a rule, in taking the Douche with the Fountain Syringe the rubber bag +is filled, and suspended from a nail or hook at a height of from two to +five feet above the patient, and the fluid passes through the tube by +force of gravity, thus requiring no muscular exercise. The force of the +stream depends upon the height of the fountain above the outlet nozzle. +It is only necessary that the patient should assume a comfortable +position where the fluid which comes from the vaginal canal can flow +into a water closet, or any convenient vessel. + +After a thorough cleansing of the vaginal surfaces of mucus, by means of +the warm or hot water, it is sometimes advisable to inject remedial +fluids. These injections may readily be made with the fountain or bulb +syringe, introducing not less than from two to four ounces. This may be +retained sufficiently long to exert its remedial effects upon the mucous +surface, which usually takes from five to eight minutes. The hips should +be elevated, and the nozzle of the syringe surrounded by a napkin or +other similar material, upon which moderate compression can be made so +as to retain the fluid in the vagina for the necessary period. + +When suffering from any uterine trouble, it is necessary to avoid severe +fatigue. The amount and character of exercise should be suited to the +condition of the patient; while, most important of all, the strictest +abstinence from sexual intercourse should be observed. + +To those who are unable readily to obtain the Fountain Syringe above +recommended we can send by mail, post-paid, one of these instruments on +receipt of $2.00. + +A Soft Rubber-bulb, or Pump Syringe (illustrated in Fig. 7), not so good +for making vaginal injections, can be sent by us, post-paid, for from +75cts. to $1.50, the price varying with the quality and size. + + * * * * * + + + + +STERILITY. + +(BARRENNESS.) + + +Real sentiment and interest center in fecundity, since the desires and +happiness of mankind are consummated in marriage and procreation. How +dreary would life be without love, companionship, and the family! How +precious are the ties that bind our hearts to father, mother, daughter, +and son! The love of children is innate in the heart of every true man +and woman. Each child born supplements the lives of its parents with new +interest, awakens tender concern, and unites their sympathies with its +young life. + +How dreary is the thought that one may attain a ripe old age with +neither son nor daughter to smooth the decline of life, or sorrow for +his or her departure! How many women desire a _first-born_ of love, the +idol of their waiting hearts, a soul, which shall be begotten within, +clothed with their own nature, and yet immortal! It is a natural +instinct, this yearning of the heart for offspring; and yet little is +said upon this subject, in which so much is experienced. All that is +beautiful and lovely in woman, finds its climax in motherhood. What +earthly being do we love so devotedly as our mother? + +[Illustration: Fig. 8.] + +Men and women exhibit but little concern, mere idle curiosity, perhaps, +on this subject, unless, perchance, there is no evidence of their own +reproductive powers. If, however, these appear to be deficient, then few +topics are more deeply interesting or investigated with greater personal +solicitude. Such persons will seldom submit their condition to the +family physician, for it is a delicate subject, involving personal +considerations, and, therefor, they prefer to consult with one who +cannot connect their unfortunate situation with any of the incidents +which enter into the history of their lives. This is very natural, and +sometimes is the only way to keep private matters profoundly secret. +Being widely known as specialists, devoting our undivided attention to +chronic affections, and having unusual facilities for the investigation +and management of such cases, we have been applied to in innumerable +instances, to ascertain the causes of barrenness and effect its removal. + +It is admitted that the question of a woman's sterility is practically +decided in the first three years of married life, for statistics show +that less than ten out of a hundred women who do not indicate their +fertility in the first three years of wedlock ever bear children. We +have treated many who gave no evidence of fertility for a much longer +period of married life, and who afterwards gave birth to children. We +are unable to state the proper ratio of the number of the married who +are childless; much less have we the right to assume that all who +decline the responsibilities of motherhood are necessarily barren. + +CAUSES. The causes of barrenness may be obliteration of the canal of the +neck of the womb, sealing up of its mouth, or inflammation resulting in +adhesion of the walls of the vagina, thus obstructing the passage to the +uterus. In the latter case, the vagina forms a short, closed sac. In +some instances, the vaginal passage cannot be entered in consequence of +an imperforate hymen. Again, the cause of barrenness may either be a +diseased condition of the ovaries, preventing them from maturing healthy +germs, or chronic inflammation of the mucous membrane of the neck of the +uterus, which does not render conception impossible, but improbable. It +is one of the most common causes of unfruitfulness, because the female +seldom, if ever, recovers from it spontaneously. It has been known to +exist for twenty or thirty years. + +Chronic inflammation of the vagina also gives rise to acrid secretions, +which destroy the vitality of the spermatozoa. Suppression of the +menses, or any disorder of the uterine functions, may disqualify the +female for reproduction. Flexions of the uterus, displacements, +congestions, and local debility, may likewise prevent fertility. +Sterility may result from impaired ovarian innervation or undue +excitement of the nerves, either of which deranges the process of +ovulation. Even too frequent indulgence in marital pleasures sometimes +defeats conception. Prostitutes who indulge in excessive and promiscuous +sexual intercourse, seldom become pregnant. Any thing that enfeebles the +functional powers of the system is liable to disqualify the female for +reproduction. + +TREATMENT. An extensive observation and experience in the treatment of +sterility, convinces us that, in the majority of cases, barrenness is +due to some form of disease which can be easily remedied. If the +passages through the neck of the uterus be closed or contracted, and +this is the most frequent cause of sterility, a very delicate surgical +operation, which causes little if any pain or inconvenience to the +patient, will remove the impediment to fertility. In many of these +cases, we have succeeded in removing the contraction and stricture of +the neck of the womb by dilatation. When the vaginal walls are so firmly +united as to prevent copulation, a surgical operation may be necessary +to overcome their adhesion. When the hymen obstructs the vaginal +orifice, a similar operation may be necessary to divide it. Vaginismus, +which will be treated elsewhere, sometimes causes sterility. + +It is proper that we should suggest to the barren, that if sexual +intercourse be indulged in only very abstemiously, conception will be +more likely to occur than if moderation be not exercised. We may also +very properly allude to the fact that there is greater aptitude to +fecundation immediately before and soon after the menstrual periods than +at other times. In fact, many medical men believe that it is impossible +for conception to occur from the twelfth day following menstruation up +to within two or three days of the return of the menses. + +ELONGATION OF THE NECK OF THE WOMB. An elongated condition of the neck +of the womb, illustrated by Fig. 9, is frequently a cause of sterility. +If this part is elongated, slim and pointed, as shown in the +illustration, it is apt to curve or bend upon itself, thus constricting +the passage through it and preventing the transit of seminal fluid into +the womb. An eminent author says, "Even a slight degree of elongation, +in which the cervix, or neck, has a conical shape, has been observed to +be frequently followed by that condition [sterility]." Our own +observations, embracing the examination of hundreds of sterile women +annually, lead us to believe that this condition is among the common +causes of barrenness. But, fortunately, it is one of those most easily +overcome. + +[Illustration: Fig. 9. +Conoid Neck.] + +TREATMENT. If the neck is only slightly elongated, this consists in +dividing the slim projecting part, by the use of the _hysterotome_, If +it be a more aggravated case, a portion of the womb must be removed. +This operation is perfectly safe and simple, and, strange as it may seem +to those who are not familiar with operations upon the womb, is not +painful. We have never seen any bad results follow it, but have known it +to be the means of rendering numerous barren women fruitful. + +[Illustration: Fig. 10. +Flexion, u, Uterus, B, Bladder.] + +[Illustration: Fig. 11. +Version, u, Uterus, B, Bladder.] + +FLEXIONS AND VERSIONS OF THE WOMB. Flexion of the uterus, in which it is +bent upon itself, as illustrated in Fig. 10, produces a bending of the +cervical canal, constricting or obliterating it, and thus preventing the +passage of spermatozoa through it. Version of the uterus in which its +top, or _fundus_, falls either forward against the bladder +(anteversion), as illustrated in Fig. 11, or backward against the rectum +(retroversion), may close the mouth of the uterus by firmly pressing it +against the wall of the vaginal canal, and thus prevent the passage of +spermatozoa into the womb. 'The treatment of these several displacements +will be considered hereafter. We may here remark, however, that they can +be remedied by proper treatment. Our mechanical movements, +manipulations, and kneadings are invaluable aids in correcting these +displacements. + +DISEASE OF THE OVARIES. Sterility may be due to disease of the ovaries. +Chronic inflammation of the ovaries may result from uterine disorders or +peritonitis, and is commonly attended with a sense of fullness and +tenderness, and pain in the ovarian region. These symptoms are more +apparent upon slight pressure, or during menstruation. This disease is +curable, although it may require considerable time to perfectly restore +the health. When this chronic affection is the result of other +derangements, the indications are to restore health in the contiguous +organs, and to relieve excessive congestion and nervous excitement in +the ovaries. The patient should be very quiet during the menstrual +period and avoid severe exercise or fatiguing occupations, not only at +those periods, but during the intervals. All measures calculated to +improve the general health should be adopted. Use injections of warm +water, medicated with borax, soda, and glycerine, in the vagina every +night and morning. The surface of the body should be kept clean by the +daily employment of hand-baths, followed by brisk friction. The bowels, +if constipated, should be regulated as suggested for constipation. The +system should be strengthened by Dr. Pierce's Favorite Prescription, +and, if the blood be disordered, no better alterative can be found for +domestic use than Dr. Pierce's Golden Medical Discovery. If the patient +does not in a few months improve under this treatment, the case should +be placed under the immediate care of some physician well qualified by +education and experience to critically examine and successfully treat +this affection. + +CHRONIC INFLAMMATION AND ULCERATION OF THE UTERUS, A CAUSE OF STERILITY. +When enumerating the causes of barrenness we mentioned that chronic +inflammation of the mucous membrane of the mouth and neck of the womb +was the most common affection that defeats conception. Of all diseases +of female organs, this is, without doubt, the most common, and, since it +does not at first produce great inconvenience or immediately endanger +life, it does not excite the attention which its importance demands. It +is overlooked, and, when the attention is directed to the existence of +this long-neglected disease it appears so trivial that it is not +regarded as being the real cause of infertility in the patient. + +When this disease has existed for a long time, the very structure of the +parts involved becomes changed. The glands of the cervical membrane +secrete a glairy mucus, resembling the white, or albuminous part of an +egg. The secretion is thick and ropy, and fills the entire mouth and +neck of the uterus, thus preventing the entrance of the spermatozoa. The +mucous membrane becomes thickened, the inflammation extends to the +deeper structures, and, on examination through the speculum, we find the +mouth of the uterus inflamed, hardened, and enlarged, as represented in +Fig. 22, Colored Plate IV, or in Fig. 23 of same plate. Fig. 25, Plate +IV, shows the mucous follicles just as they are found all along the neck +of the womb, in a state of inflammation and enlargement, and filled with +a fluid resembling honey, giving rise to ulceration and a thick +discharge, as illustrated in Fig. 23, Colored Plate IV. + +Feebleness of the constitution, impoverishment of the blood, a +scrofulous diathesis, want of exercise, uncleanliness, tight lacing, +disappointment, excessive excitement of the passions, the use of +pessaries for displacement of the uterus, overwork, and taking cold, all +predispose the cervical membrane to chronic ulceration. + +The inflammation may be so mild, and the discharge so trifling in +quantity, as scarcely to attract attention. But after it obtains a +firmer hold, and, in most cases, it is aggravated by exposure or +neglect, the patient experiences dragging sensations about the pelvis, +and pain in back and loins, accompanied with a bearing-down sensation +and numbness or pain extending to the thighs. + +The discharge is thick, starch-like, and generally irritating. The +patient becomes irascible, capricious, querulous, and sometimes moody +and hysterical. She is easily discouraged, her appetite and digestion +become impaired, and she grows thin and does not look or act as when in +health. + +TREATMENT. In offering a few hints for the domestic management of these +abnormal conditions, we would at the same time remark, that, while +health may be regained by skillful treatment, recovery will be gradual. +We especially wish to guard the patient against entertaining too strong +expectations of a speedy recovery. Although she may employ the best +treatment known, yet from three to five months may elapse before a +perfect cure can be effected. In persons of scrofulous diathesis, in +whom the recuperative forces are weakened, it is very difficult to +effect a radical cure. It is equally true, however, that under domestic +management alone, thousands have been restored to perfect health and +fruitfulness. + +Hygienic management consists in toning the functions of the skin by +daily bathing the surface of the body, and quickening the circulation by +brisk friction. The patient should rise early in the morning, and +exercise in the fresh and invigorating air. Those who sleep in warm +rooms, or spend much of their time in bed, will continue to have +congestion of the uterus, and habitual discharges from this enfeebled +organ. The patient should take daily walks, increasing the length of the +excursion from time to time, but not to the extent of producing fatigue. +The bowels, if constipated, should be regulated. Strengthen the system +by using Dr. Pierce's Favorite Prescription, to each bottle of which add +two drachms of citrate or pyrophosphate of iron. The mouth and neck of +the uterus should be thoroughly cleansed by the use of the syringe, as +suggested for the treatment of leucorrhea. The use of the solution of +Dr. Pierce's Purifying and Strengthening Lotion Tablets there advised +will also be beneficial, if thoroughly applied. + +A most valuable course of local treatment, which may be adopted by any +intelligent lady without the aid of a physician, and one that will +result in the greatest benefit when there is morbid sensibility, +congestion, inflammation, or ulceration about the mouth or neck of the +womb, consists in applying to those parts a roll of medicated cotton or +soft sponge, allowing it to remain there for twelve hours at a time. A +piece of fine, soft, compressible sponge, as large as a hen's egg, or a +roll of cotton batting of two-thirds that size, is thoroughly saturated +with pure glycerine. Securely fasten to it a stout cord a few inches +long. The vagina and affected parts having been thoroughly cleansed with +warm water and Castile soap, as advised in the treatment of leucorrhea, +the sponge or cotton should be passed up the vagina with the finger, and +pressed rather firmly against the mouth and neck of the womb, which, +being enlarged, and, consequently falling below its natural position, +will generally be low down in the vagina, and so hardened as to be +unmistakably distinguished from the surrounding parts by the sense of +touch. The glycerine, having a very strong affinity for water, will +absorb large quantities of the _serum_, which has been effused into the +affected tissues in consequence of their congestion and inflammation, +and thus reduce the inflammation and enlargement. This is the cause of +the profuse, watery discharge which follows the application. In twelve +hours after the sponge or cotton has been applied, it should be removed +by means of the attached thread, one end of which has been purposely +left hanging out of the vagina. Then thoroughly cleanse the vagina with +warm water, use the solution of Dr. Pierce's Lotion Tablets as suggested +for the treatment of leucorrhea, and repeat the glycerine application +the following day or every other day. + +If there is no irritation or tenderness of the vagina, add one drachm of +tincture of iodine to each ounce of the glycerine, alternating the use +of this with that of pure glycerine; or, the iodine and glycerine may be +used every third day, and the glycerine alone on the two intervening +days. As the iodine will color the finger somewhat, it is well to know +that this unpleasant effect may be almost or entirely avoided by coating +that member with lard, sweet oil, or vaseline. The stain may be readily +removed with a solution of iodide of potassium. The use of Dr. Pierce's +Antiseptic and Healing Suppositories as advised on an other page under +the head of Ulceration of the Uterus will aid greatly in effecting a +cure. + +If your medicine dealer does not have these Suppositories in stock, mail +25 cents in stamps to Dr. R.V. Pierce, Buffalo, N.Y., and a box will be +sent you by return post. + +It is well to alternate Dr. Pierce's Golden Medical Discovery with Dr. +Pierce's Favorite Prescription, taking of each three times a day. By +persevering in this course of treatment, nine-tenths of those who are +thus afflicted will improve and be fully restored to health, +fruitfulness and happiness. If barrenness continue, the case should be +unreservedly submitted, either in person or by letter, to a physician +skilled in the diagnosis and treatment of these affections. + +From the foregoing remarks, the reader will perceive that there are a +variety of diseased conditions, any one of which may produce sterility. +It is equally true that nearly all these conditions may be easily cured +by proper medical or surgical treatment. A frequent cause of barrenness +is stricture of the neck of the uterus. No medicine that a woman can +take or have applied will remove this unnatural condition. Fortunately, +however, the means to be employed cause no pain, are perfectly safe, and +the time required to effect a cure is short, rarely over twenty or +thirty days. + + * * * * * + + + + +DISPLACEMENTS OF THE WOMB. + + +The relative positions of the womb and surrounding organs, when in a +state of health, are well illustrated by Fig. 1, page 680. The womb is +supported in its place by resting upon the vaginal walls, and by a broad +ligament on either side, as well as by other connective tissues. By +general debility of the system, the supports of the womb, like the other +tissues of the body, become weakened and inadequate to perfectly perform +their duty, thus permitting various displacements of that organ. + +PROLAPSUS, OR FALLING OF THE UTERUS, is a common form of displacement. +It has been erroneously regarded as a local uterine disease, requiring +only local treatment instead of being considered as a symptom of general +derangement, and, therefore, requiring constitutional treatment. Hence, +variously devised supporters have been invented to retain the womb in +position after its replacement. It is a law of physiology, that the +muscular system is strengthened by use, and that want of exercise +weakens it. The blacksmith's arm is strengthened and developed by daily +exercise. Support his arm in a sling, and the muscles will be greatly +weakened and wasted. So when artificial supports are used to retain the +womb in position, thereby relieving the supporting ligaments and tissues +of their normal function, the _natural_ supports of the uterus are still +further weakened, and the prolapsus will be worse than before when the +artificial support is removed. Besides, all these mechanical +contrivances are irritating to the tissues of the womb and vagina, and +frequently produce congestion, inflammation, and even ulceration, thus +rendering the patient's condition much worse than before their +employment. These worse than useless appliances should never be resorted +to for the temporary relief which they sometimes afford. Constitutional +treatment together with appropriate applications is the only effectual +method of remedying this morbid condition. + +SYMPTOMS. When the displacement is sufficient to cause any serious +disturbance, the prominent symptoms are a sensation of dragging and +weight in the region of the womb, pain in the back and loins, inability +to lift weights, great fatigue from walking, leucorrhea, a frequent +desire to urinate, irritation of the lower bowel, and derangement of the +stomach. The womb may protrude from the vaginal orifice; in very rare +cases, wholly protrudes, and may be inverted. + +CAUSES. As we have already stated, general debility favors prolapsus of +the womb, but various general and local circumstances and conditions +also favor its occurrence. Wearing heavy garments supported only by the +hips, compressing the waist and abdomen with tight clothing, thus +forcing the abdominal organs down upon the womb, are fruitful causes of +this affection. Excesses in sexual intercourse give rise to leucorrhea, +producing a relaxed condition of the vagina, upon which the womb rests, +and, in this way, one of its supports is weakened. Enlargement of the +uterus from congestion, and inflammation or tumors also favor prolapsus. +Abortion may leave the womb enlarged, its supports weakened, and result +in this displacement. + +[Illustration: Fig. 12. +Retroflexion, U, Uterus (Womb), +B, Bladder.] + +FLEXIONS AND VERSIONS. Instead of sliding down into the vagina, as in +prolapsus, the uterus is liable to fall or be forced into other +unnatural positions. When the uterus is bent upon itself, it is called +_flexion_. If the bending is backward, it is called _retroflexion_; if +forward, _anteflexion._ Fig. 12, represents the former condition, the +uterus being flexed backward so that the fundus, or upper part of the +womb, is pressed against the rectum, while the neck of the uterus +remains in its natural position. This is a common form of displacement, +and generally occurs between the ages of fourteen and fifty. + +SYMPTOMS. The prominent symptoms of retroflexion of the uterus are a +sense of weight in the region of the rectum, difficulty in evacuating +the bowels, and, sometimes a retention of the feces. There may be +suppression of the urine and the menses may be diminished in quantity. +If retroflexion is due to a chronic enlargement of the uterus, caused by +abortion or parturition, the patient suffers from an immoderate +menstrual flow. + +CAUSES. The principal causes of retroflexion are congestion, enlargement +and tumors of the uterus. Congestion is liable to occur in women +possessing an extremely active temperament, as well as in those of +sedentary and indolent habits. Retroflexion is a common displacement in +both married and unmarried women; it is a secondary affection, and, when +it is caused by congestion, the menses are painful and reduced in +quantity, and there is pain in the back and a sense of weight in the +region of the rectum. In some instances, there is a reflex irritation of +the mammary glands, and a consequent secretion of milk. There may also +be nausea and vomiting, which often lead to the erroneous opinion that +the patient is pregnant. + +_Anteflexion_ of the uterus denotes a bending forward of the body and +fundus of the uterus, while the neck remains in its natural position. + +In versions of the uterus, neither the body nor the neck of the womb is +bent upon itself, but the whole organ is completely turned backward or +forward. + +[Illustration: Fig. 13. +Retroversion. B, Bladder. +U, Uterus (Womb).] + +_Retroversion_ of the uterus, illustrated by Fig. 13, signifies a change +in the position of the womb, so that the upper, or fundal portion of the +organ drops back toward the concavity of the sacrum, while the neck +preserves a straight line in the opposite direction. The fundus presses +forcibly against the rectum, while the upper part of the vagina bends +abruptly and forms an acute angle near the mouth of the uterus. + +SYMPTOMS. Retroversion is indicated by bearing-down pains in the loins +and difficulty in evacuating the bowels. The feces may accumulate in the +rectum, because they cannot pass this obstruction. + +CAUSES. Jumping, falling, or undue pressure from the contents of the +abdomen, may suddenly cause retroversion of the uterus. Sometimes +retroversion results from obstinate constipation. + +_Anteversion_. This term designates another unnatural position of the +uterus, in which the fundus, or upper part of the organ, falls forward, +as illustrated by Fig. 14, while the neck points towards the hollow of +the sacrum. This position of the womb is the reverse of that of +retroversion. In its natural position, the fundus of the uterus is +slightly inclined forward, and any pressure, or forward traction, is +liable to cause it to fall still further in that direction. + +[Illustration: Fig. 14. +Anteversion, U, Uterus, B, Bladder.] + +SYMPTOMS. One of the most common symptoms of anteversion is a frequent +desire to urinate, in consequence of the pressure of the uterus upon the +bladder. The free flow of the menses is sometimes obstructed. + +CAUSES. The causes are tight lacing, prolapse of the abdominal organs, +weakness of the supporting ligaments, and enervating habits. + +TREATMENT. In treating all the various displacements of the uterus, the +prominent indication is to tone up the general system, for by so doing +we also strengthen the uterine supports. + +Digestion should be improved, the blood enriched, and nutrition +increased, so that the muscles and ligaments which retain the womb in +position may become firm and strong. The womb will thus be gradually +drawn into position by their normal action and firmly supported. It is a +great mistake, made by physicians as well as patients, to consider a +displacement of the uterus a _local_ disease, requiring only local +treatment. A restoration of the general health will result in the cure +of these displacements, the uterus will regain its tone and muscular +power, and the local derangement, with its attendant pain and morbid +symptoms, will disappear. + +It is true that displacements of the womb may be associated with +inflammation and ulcers, which require local treatment, as elsewhere +suggested; but simple displacement of the uterus may be remedied by +pursuing the following course of sanitary and medical treatment. Sleep +on a hard bed, rise early, bathe, and take a short walk before +breakfast. Dress the body warmly and allow sufficient space for the easy +and full expansion of the lungs. Eat moderately three meals a day, of +those articles which are nutritious and readily digested. Keep the +bowels regular by the use of proper food. If they are constipated, use +Dr. Pierce's Pellets to keep them open and regular. Avoid retaining the +standing position too long at a time, especially when the symptoms are +aggravated by it. Many energetic women disregard their increasing pains, +and keep upon their feet as long as possible. Such a course is extremely +injurious and should be avoided. + +As a general restorative and uterine tonic, nothing surpasses Dr. +Pierce's Favorite Prescription, which is sold by druggists and +accompanied with full directions for use. If leucorrhea is an attendant +symptom, the treatment suggested for that condition should be employed. +The use of Dr. Pierce's Antiseptic and Healing Suppositories, applying +one every third night After having first cleansed the vagina and neck of +the womb thoroughly by the use of warm water and soap as an injection, +will prove of great benefit in giving strength to the supports of the +womb and its appendages. + +[Illustration: +Fig. 22. +Fig. 21. +Fig. 23. +Fig. 24. +Fig. 25. +Fig. 26.] + +By persevering in the rational treatment which we have suggested for the +various displacements of the womb, nearly all who suffer from such +derangements may be fully restored to health. The patient should not +expect _speedy_ relief. Considerable time will be necessary to bring the +general system up to a perfect standard of health, and, until this is +accomplished, no great improvement in the distressing symptoms can be +expected. Mechanical movements are especially effective in this class of +cases. We have successfully treated many obstinate cases in which the +displacements were very serious. + + * * * * * + + + + +ULCERATION OF THE UTERUS. + + +Ulceration is the process by which ulcers, or sores, are produced. It is +characterized by the secretion of pus or some fetid discharge, and is +continued as a local disease through the operation of constitutional +causes. Ulcers are generally symptoms of other morbid conditions. + +Ulcers may form in the _mouth_ or _neck_ of the uterus, and, omitting +cancerous ulcers and those of a syphilitic character, which are +considered elsewhere, may be classified as _Granular_ and _Follicular_. + +[Illustration: Fig. 15. +The Ferguson Speculum.] + +GRANULAR ULCER. This variety of ulcerative degeneration is the most +frequent, and may exist for some time without exciting any suspicion in +the mind of the patient that she is afflicted with any such morbid +condition. There is local inflammation, and the mouth of the uterus is +uneven, rough, and granular. If an examination be made with the +speculum, the mouth of the uterus is often found in the condition +represented in Fig. 22, Colored Plate IV. + +Figs 15 and 16 represent two different forms of specula. The one +represented by Fig. 15 consists of a tube of glass coated with +quicksilver and covered with India rubber, which is thoroughly +varnished. That represented by Fig. 18 is made of metal and plated. By +using one of these instruments, the condition of the mouth of the womb +can be distinctly seen. + +[Illustration: Fig. 16. +An Expanding Uterine Speculum.] + +FOLLICULAR ULCER. When the mucous follicles of the neck of the uterus +are inflamed they enlarge and become filled with a fluid having the +color and consistency of honey, presenting the appearance illustrated by +Fig. 25, Colored Plato IV. This secretion, because of the presence of +the Inflammation, is not discharged. The follicles, therefore, continue +to enlarge until they burst, and we then see in their place the red, +elevated, angry-looking eminence, which is called a _follicular ulcer_. + +SYMPTOMS. The severity of the symptoms depends upon the character of the +ulceration. It may be simple or associated with purulent leucorrhea and +hemorrhage. If ulceration be slight and local, few symptoms will be +present; but if it be associated with uterine debility, congestion and +inflammation of the mucous membrane of the uterus, the discharge will be +profuse, and there will be fixed pain in the back and loins, a +bearing-down sensation, and great difficulty in walking. The discharge +is weakening, as it impoverishes the blood, and thus reduces the +strength. + +CAUSES. Ulceration may be induced by any thing that excites inflammation +of the lining membrane of the mouth and neck of the uterus. The use of +pessaries, excessive sexual indulgence, injuries occasioned by giving +birth to children, congestions, enlargements and displacements, may all +operate as causes. + +TREATMENT. We cannot too strongly condemn the practice so popular at the +present time with physicians generally, of indiscriminately burning all +uterine ulcers with strong caustics, such as nitrate of silver, chromate +of potassium, and other similar escharotics, regardless of the condition +of the general system. Ulcers of the womb must be healed in the same +manner as those upon any other part of the body. It is an irrational +practice to repeatedly cauterize them, expecting thereby to promote +healing, while the system is vitiated and the vitality far below the +standard of health. Enrich the blood, tone up the system, keep the +ulcers cleansed by the frequent use of lotions, and they will generally +heal. Caustics often aggravate the irritability and interfere with the +healing processes of nature. Ladies should not unnecessarily submit to +the exposure of their persons. If they perseveringly employ the +treatment which we shall suggest, other local treatment will _very +rarely_ be found necessary. This modern warfare which physicians are +waging upon the unoffending womb is a most irrational practice. Our +grandmothers got along very well without exposing themselves to the +humiliation and tortures of this new-born empiricism. We do not wish to +be understood as undervaluing or denying the necessity, in rare cases, +of examinations of the uterus, or as being unappreciative of the aid +afforded in such investigations by the speculum, and the beneficial +effects of local applications made directly to the womb through that +instrument. What we affirm is, that such examinations and applications +are, in the practice of most modern physicians, made unnecessarily +frequent, resulting many times in lasting injury to the patient. + +GENERAL MEANS. As has already been indicated, constitutional treatment +should be principally relied upon to cure ulceration of the neck of the +womb. Put the system in perfect order and the local ulceration cannot +fail to heal. If you have a sore or ulcer upon the leg you very +naturally reason that there is a fault in the system at large or in the +blood. You do not apply caustics to the sore, but you go to work to +restore the blood and system to a normal or healthy condition and as +soon as this is accomplished the open and rebellious sore, or ulcer, +heals of its own accord. All you have to do locally, to stimulate the +ulcer to heal, is to keep it well cleansed by the use of Castile soap +and warm water. Just so with ulceration of the womb. Thoroughly cleanse +the vagina and neck of the womb once a day by the use of warm water and +a little soap, applying this _thoroughly_, as directed on page 704, +under the head of treatment for leucorrhea, and using a solution of Dr. +Pierce's Purifying and Strengthening Lotion Tablets as there directed. +After thus thoroughly cleansing and purifying the parts, a piece of soft +sponge as large as a hen's egg, to which a bit of cord or strong thread +is attached to facilitate removing it, may be thoroughly wet in pure +glycerine and introduced into the vagina, pressed against the mouth of +the womb, and allowed to remain there for twelve hours, when it should +be gently removed by pulling on the attached string. The cleansing +lotion of soap and warm water should be used daily and followed by the +glycerine application. + +Every third night instead of the glycerine tampon apply one of Dr. +Pierce's Antiseptic and Healing Suppositories, pressing it well up +against the mouth of the womb, and letting it remain there to slowly +dissolve. This will give far better curative results than the +application of nitrate of silver or other caustics so generally used by +physicians. Besides it has the great advantage of being entirely +harmless in any condition of the parts to which it is applied. These +Suppositories are powerfully antiseptic, destroying all offensive odors +and have a soothing and at the same time tonic or strengthening effect +upon the neck of the womb and the vagina. + +In cases where there is prolapsus or falling of the womb, or Anteversion +or Retroversion, or other displacements the use of the Antiseptic and +Healing Suppositories will be found to be of great benefit in giving +strength to the supports of the womb and its appendages. + +If your dealer is not supplied with the Suppositories, inclose 25 cents +in one-cent stamps to us at Buffalo, N.Y., and a package will be sent +you, post-paid. + +We are fully aware that this thorough and _systematic_ course of +treatment is slightly troublesome in its application, but what system of +treatment that can promise similar success is not? + +This course of treatment must be _rigidly_ adhered to for several weeks +before we can expect a complete cure of the ulcers and the arrest of the +consequent leucorrheal discharge. + +THE SHEET ANCHOR OF HOPE. Do not fail to bear in mind that no difference +how good the lotions and other local applications may be, your _chief_ +reliance in all cases of ulceration of the womb, as well as in those of +simple leucorrhea, must be upon _thorough constitutional_ treatment. To +this end Dr. Pierce's Golden Medical Discovery should be taken three +times a day in doses of from one to one-and-a-half teaspoonfuls one hour +before each meal, and in the middle of the forenoon, in the middle of +the afternoon, and just before retiring for the night, a like amount of +Dr. Pierce's Favorite Prescription should be taken. The use of these +blood cleansing and invigorating tonic medicines should be kept up +_persistently_ for several weeks; for you must not expect a perfect cure +too soon in a malady that has become chronic and seated. The disease +does not become established hastily, but is slow in its inception and +progress, and will only gradually and slowly yield to the best of +treatment, which we believe we have already pointed out. Followed +_earnestly, faithfully_ and _persistently_, the use of the means which +we have suggested will rarely, if ever, fail. + + * * * * * + + + + +URINARY FISTULA. + + +A fistula, or false passage, is sometimes formed between the bladder and +the vagina, between the bladder and the uterus, or between the urethra +and the vagina. This passage allows the urine to escape through it into +the vagina, and is a source of great annoyance and suffering. This +affection is most commonly due to sloughing, caused by severe and +long-continued pressure upon the parts during child-labor. It is also +sometimes produced by the unskillful use of forceps and other +instruments employed by midwives. Syphilitic and other ulcerations may +so destroy the tissues as to form a urinary fistula. + +TREATMENT. The treatment is purely surgical, and consists in paring the +edges of the opening so as to make them raw, bringing them together and +holding the parts thus by means of stitches until they heal. By the aid +of a speculum, properly curved scissors, needles with long handles, fine +silver wire, and a few other instruments and appliances, the skillful +surgeon can close a urinary fistula with almost as much ease as he can +close a wound on the surface of the body. + + * * * * * + + + + +DISORDERS INCIDENT TO PREGNANCY. + + +While some women pass through the whole period of pregnancy without +inconvenience, others suffer from various sympathetic disturbances, as +"morning sickness," impaired appetite, constipation, diarrhea, headache, +"heart-burn," fainting fits, difficult breathing, and sometimes +convulsions. A strong nervous sympathy exists between the uterus and +every part of the system and this sympathy is greatly intensified by +pregnancy, causing the distressing symptoms above mentioned. + +TREATMENT. By proper treatment, most of these evils can be obviated and +the patient made comfortable. By the moderate use of such a nervine and +uterine tonic as Dr. Pierce's Favorite Prescription, this nervous +irritability may be controlled or subdued, and the disagreeable symptoms +thus avoided. + +While the female is pregnant, she should avoid all compression of the +waist and abdomen. For this reason tight clothing, stays, or corsets +must be discarded. She should also carefully regulate her diet, +selecting that which is most nutritious and easily digested. + +The nausea which occurs in the morning may generally be avoided by +partaking of a little light food and a cup of tea or coffee before +leaving the bed. If vomiting occurs, and the ejected matter be very +acid, carbonate of magnesia, taken in tablespoonful doses, or some +alkali with aromatics, or pulverized charcoal, which can be obtained at +any drug store, will afford relief. If constipation or diarrhea be +experienced, small doses of Dr. Pierce's Pellets should be employed--one +or two only at a time. Want of appetite, headache, or a tendency to +convulsions, can be generally overcome by a persistent use of Dr. +Pierce's Favorite Prescription, which should be taken in teaspoonful +doses three or four times each day. Indeed, this valuable medicine not +only relieves the distressing symptoms which frequently attend the +pregnant state, but also prepares the system for the ordeal of +parturition (delivery). One or two bottles of this nervine and tonic +used previous to confinement, will, in many cases, save hours of +terrible suffering, besides regulating the system, and thus insuring a +speedy recovery. We have received the heartfelt thanks of hundreds of +grateful mothers for the inestimable benefit thus conferred. The +Favorite Prescription is perfectly safe and harmless to use _at all +times_ and under all circumstances in the doses above prescribed. + + * * * * * + + + + +OVARIAN AND UTERINE TUMORS. + + +We have space only to give a brief outline of the characteristics and +treatment of the most frequent classes of tumors which affect the +ovaries and uterus. + +OVARIAN TUMORS generally consist of one or more cysts or sacs, developed +within the ovary, and filled with a fluid, or semi-fluid matter, which +is formed in their interior. The cysts vary in size, in some instances +being not larger than a pea, while in others they are capable of +containing many quarts of fluid. In one case operated upon at the +Invalids' Hotel and Surgical Institute, thirty-five pints of fluid were +taken from three cysts. + +The effect of ovarian tumors on the duration of life is shown by the +statistics of Stafford Lee. Of 123 cases, nearly a third died within a +year, more than one-half within two years from the first development of +reliable symptoms, while only seventeen lived for nine years or upwards. + +FIBROID TUMORS of the uterus are composed of fibrous tissue, identical +in structure with that of the uterine walls. They are met with in all +sizes, from that of a small shot to that of a mass capable of filling +the entire cavity of the abdomen. Cases are on record in which these +tumors have attained the weight of seventy pounds. + +The manner in which fibroid tumors terminate life is generally by +prostration and debility produced by pressure on, and consequently, +interference with, the function of some one or more of the organs +essential to life; or by anæmia and debility, produced by the severe +hemorrhages, which the intra-uterine or sub-mucous form not infrequently +induces. + +POLYPI OR POLYPOID TUMORS of the uterus are of three kinds, cystic, +mucous and fibrous. They vary greatly in size, sometimes being as large +as a tea-cup; and their point of attachment may be extensive or consist +only of a small pedicle. The cystic and mucous varieties may spring from +any portion of the mucous surface of the uterus, but they are more +frequently met with growing from the mucous membrane lining the cervical +canal, and pendent from the mouth of the womb, as represented in Fig. 21 +and in Fig. 26, Colored Plate IV; while the fibrous variety generally +grows from the sub-mucous tissue at or near the fundus, or upper +portion, of the uterus. + +The most prominent symptoms of polypoid growths are hemorrhage, which is +almost invariably present, leucorrhea, pain, backache, and a sense of +weight and dragging in the pelvis. + +The best method of treatment, and, in fact, the only effectual one, is +removal with the _écraseur_, polypus forceps, or galvano-cautery. The +operation is usually attended with little or no pain. + +FOR MORE THAN TWENTY-FIVE YEARS the physicians of the Invalids' Hotel +and Surgical Institute, have been successfully treating tumors by means +of electricity. More recently, the medical profession has quite +generally adopted electrical applications in response to the advice of +Apostoli, of Paris. The plan used however is crude. It does not compare +in results with the successful and safe procedure that our surgeons have +invented and pursued. + +Electrical treatment will destroy the life of ovarian and fibroid tumors +if applied early and after the improved methods so long used at our +Institution. The destructive effect of electricity is modified by the +introduction of certain electro-chemical applications so that it attacks +and kills only the cells of the tumor. + +THE VERY LARGE OVARIAN TUMORS, however, are not amenable to treatment by +this process. The walls of their cysts become so thin and weak, while +the pressure of the fluid from within is so great, that sudden and +spontaneous rupture is liable to occur at any time and produce death. +Removal by a cutting operation is necessary in such cases. Fortunately +this procedure, as skillfully modified and perfected by experience, has, +in the hands of our surgeons, proven free from the dangers and hazard +common to Ovariotomy. This is due to skillful operation and to the fact +that in our Institution the sanitary arrangements are as perfect as it +is possible to make them. Everything is at hand in the way of +instruments and appliances likely to be required, and the entire +procedure is conducted upon the principles of perfect cleanliness and +antisepsis, which obviate the risk of inflammation and blood-poisoning. + +Furthermore, our nurses have had such fine training and such a vast +experience in their attendance upon such cases, that wants are +anticipated, and details, that would escape those not so well qualified, +are looked after so thoughtfully and vigilantly that the convalescence +is rapid, as well as being in every way comfortable and safe. Under such +conditions + +OUR SURGEONS HAVE COMPLETED A LONG LIST OF REMOVALS OF OVARIAN TUMORS +WITHOUT A SINGLE DEATH! + +We are, therefore, _warranted_ in stating that + +THE DANGERS DUE TO THE PRESENCE OF THESE TUMORS ARE FAR GREATER THAN THE +SLIGHT RISKS OF REMOVAL BY THE SKILLFUL METHODS EMPLOYED BY OUR +SURGEONS. + +Owing to a change made in the anæsthetic used, the painful and +persistent vomiting that often follows abdominal operations is +prevented. This does away with the greatest of all the dangers attendant +upon the operation of Ovariotomy, and favors speedy recovery. Food, as +administered in the form of artificially digested and concentrated +nourishment, is readily retained. The strength is thus rapidly restored, +and the healing process hastened. + +It is generally supposed that the size of the opening made through the +abdominal walls is large, proportionate to the size of these tumors. +This is an error. Even in the largest cystic tumors where the +development is immense, a small incision only, is made--simply +sufficient to bring the walls of the tumor in view and admit, perhaps, +two or three fingers. The tumor is then rapidly emptied of its contents +by means of a powerful suction apparatus. Adhesions, if any exist, are +then carefully removed, and hemorrhage therefrom prevented; after which +the large sac of the tumor, which when collapsed is like a thin bag, is +readily drawn out through the small opening in the abdomen and removed. +The small pedicle or cord-like mass of vessels that supplies the tumor, +are then carefully treated after a plan invented by, and peculiar to, +ourselves, which effectually prevents any bleeding, and, at the same +time, does not leave any irritating substance, such as burned and +charred flesh, rubber, silk, or any other unabsorbable material, within +the abdomen. The parts are left unbruised and without any poisonous +germs in contact. + +Our surgeons have met with phenomenal success in removing Ovarian +Tumors, by the operation of Ovariotomy. Thus far, in a career extending +over a long period of time and embracing the removal of a long list of +these morbid growths, they have not had a single fatal case. + +The following cases illustrate our method of treatment in a few of the +many cases that have been under our care. Each case is typical of a +class: + +[Illustration: Fig. 17. +The shape and position of the Tumor are shown by the dotted line.] + +CASE I A married woman, aged 38. Had never given birth to a child. About +four years before coming under our observation, she discovered a small +bunch, as she expressed it, in the left ovarian region, which gradually +increased in size until, when she consulted us, it caused considerable +pain in the region of the liver from pressure, and interfered with +respiration. Her general health was becoming much impaired. She stated +that she had consulted a prominent gynecologist in this city, who had +told her that the attachments of the tumor were so extensive that +ovariotomy (removal with the knife) was out of the question, and that, +therefore, he could only give her palliative treatment. This unfavorable +prognosis only added mental anguish and despair to her physical +suffering. On examination, we found a large multilocular cystic tumor, +represented by Fig. 17, with very thick walls, extending from the left +ovarian region obliquely upwards and to the right, so that it pressed +more upon the short ribs on the right side than it did upon the left, +but which filled the entire cavity of the abdomen. The attachments, as +the doctor whom she had previously consulted had stated, were so +extensive that its removal with the knife could not be thought of. We +were not disposed, however, to give the case up as hopeless. We told her +that we would do what we could for her, but as to what the result of our +treatment would be, we could not definitely say. She placed her case in +our hands, and we resorted to the above described treatment. She was +treated two and three times per week for more than two months, at the +end of which time, the tumor had decreased in size fully two-thirds. It +has ever since remained stationary, and has given her no trouble or +inconvenience whatever. It is now seven years since we treated her. + +[Illustration: Fig. 18. +U, Uterus. B, Bladder. R, Rectum. T, Tumor.] + +CASE II. A young lady of 23; unmarried. About six months previous to +consulting us, she had discovered a tumor of about the size of an egg, +In the region of the left ovary, which had been gradually increasing in +size. On examination, we found the morbid growth to be about the size of +a quart bowl, and evidently composed of several cysts with thick walls. +She experienced no pain, and but slight inconvenience from its presence, +but she was in great mental distress. She was an only daughter, and her +mother had died a few years previously from the shock and hemorrhage +resulting from an operation for the removal of a large ovarian tumor, +performed by the late lamented Dr. Peaslee, of New York. The same course +was pursued in this case, and at the end of six weeks' treatment, the +tumor was reduced to the size of an egg, and has remained so ever since, +now more than three years. + +CASE III. A woman,37 years of age; married six years; no children. She +had suffered for eight years from profuse menstruation and dysmenorrhea, +with a membranous discharge, and, for several months before consulting +us, she had experienced severe pain and a soreness in the pelvic organs. +Her bowels were obstinately constipated, it being next to impossible for +her to have an evacuation, and she possessed a pale and careworn +countenance. Upon examination, we discovered a hard, incompressible +tumor, represented in Fig. 18, attached to the posterior wall of the +uterus, which caused anteversion of the womb, and which pressed upon the +rectum so as to produce great obstruction. She was treated by means of +electrolysis, with injections into the substance of the growth, for one +month, at the end of which she resumed home, with the tumor reduced from +the size of a pint bowl to the size of an egg, and her health greatly +improved. After going home the tumor continued to grow less until, at +the end of a few months, her home physicians could detect no trace of +it, and she has remained well since, for more than five years. + +[Illustration: Fig. 19. +U, Uterus. T, Tumor.] + +CASE IV. A lady aged 36: married 13 years; no children. She complained +of severe pain in the back and a frequent desire to urinate. +Menstruation was profuse, and the bowels were constipated. On +examination, we found an inter-mural fibroid tumor, represented in Figs. +19, developed in the anterior wall of the uterus, and pressing upon the +bladder. The womb was enlarged, measuring three inches in depth, and was +slightly anteflected. A month's treatment, with electrolysis and +injections into the tumor, arrested the growth and diminished the size +more than one-half, and caused the unpleasant symptoms to disappear. + +[Illustration: Fig. 20. +U, Uterus. T, Tumor.] + +CASE V. A married lady, 26 years of age; had borne no children, but had +had several abortions, brought about intentionally. Six months before +consulting us, a tumor, about the size of an egg, was discovered by her +home physician. It grew steadily from the time of its discovery until, +when we made an examination, it was found to be about the size of an +ordinary tea-cup. It was developed in the posterior wall of the womb, as +represented in Fig. 20. Three weeks' treatment reduced the tumor two +thirds. + +[Illustration: Fig. 21. +U, Uterus. P, Polypus.] + +CASE VI. A widow lady, aged 52. She was examined ten years ago by two of +the most distinguished physicians of New Haven, Conn., who pronounced +her sufferings due to cancer of the uterus. She was then suffering from +repeated hemorrhages, and other symptoms. They gave her palliative +treatment, and told her that to interfere with the morbid growth would +only shorten her life, and that by leaving it alone she might live +several years. By and by the hemorrhages ceased and she passed the +change of life, but she continued to be troubled with a sensation of +fullness in the pelvis, pains in the back, and frequent headaches. On +examination we found not a cancer, but a large polypus, as represented +in Fig. 21, which had caused all the trouble. It was quickly removed, +without pain, and her health restored. Thus, through an error of +diagnosis, she was made to suffer physically and mentally for ten, long +years of her life, in constant dread of a horrible death. + + * * * * * + + +TESTIMONIALS. + + +While we have a great cloud of witnesses testifying to the efficacy of +our treatment of the diseases described in this volume, yet for lack of +space we can here introduce only the following: + + +LARGE FIBRO-CYSTIC TUMOR. + +[Illustration: Miss Duke.] + +PRONOUNCED INCURABLE BY MANY EMINENT SURGEONS. HEALTH RESTORED AND TUMOR +REMOVED WITHOUT CUTTING. + +WORLD'S DISPENSARY MEDICAL, ASSOCIATION, Buffalo, N.Y.: + +_Gentlemen_--I cheerfully send you the following testimonial, and hope +it may induce some sick person to seek relief where it is sure to be +found. + +We never truly appreciate health until it forsakes us. + +For six years, I suffered all the tortures and fears attendant on the +growth and development of a fibro-cystic tumor. I tried to have the +tumor removed, but found it impossible. I had the very best medical +advice the South affords, but every physician rendered the same verdict, +'incurable.' How that word, for months, rang in my ears--'INCURABLE.' It +seemed stamped on my mind in letters of fire. What I suffered, both in +mind and body, cannot be imagined. But for my unbounded faith in God's +goodness and mercy, I doubt not, I would have given up and died. But I +trusted in Him to direct me in the way to find relief. One hope stood +out before me like a beacon light; and that was to find the means to go +to Buffalo, N.Y., to Dr. Pierce's famous Invalids' Hotel and Surgical +Institute. At last the opportunity came, and I bid my loved ones a sad +farewell, (not one of them ever expected to see me again, alive) and +with a sister to relieve me of every care on the journey, we started for +the Institute. + +On arriving at the Invalids' Hotel, I was too sick and fatigued to treat +with civility the sweet-faced, lady-like housekeeper who received me, or +the gentle nurses who tried so patiently and kindly to minister to my +wants. + +I had read a good deal about the Invalids' Hotel, and expected to see +wonderful things; but like Sheba's Queen, I could truthfully say, 'the +half had never been told.' The many ways, means, and appliances, for the +relief of poor sufferers surpassed a thousand fold anything I had ever +imagined could come within the scope of human skill. The skilled +physicians were not only able and attentive, but on meeting one, if it +were every day, they always had a ready smile, a warm hand clasp, and an +encouraging word, which alone, would make one feel better and at home. +The trained nurses were attentive and kind. + +Every department was cleanliness itself, and kept at such an even +temperature, even to the halls, that during my four months' stay, I +never had the slightest cold. Not only the comforts of life, but every +luxury that the most exacting could demand, were fully supplied. I saw +many poor sufferers, from various diseases, made well and happy, and I +too, with the other happy ones, found relief, and that without the use +of the knife or an anæsthetic of any kind. I would urge all poor chronic +sufferers, it matters not what the trouble may be, to go to Dr. Pierce's +Institute and be cured. If any one similarly afflicted cares to know +more of my case, I will gladly answer any questions, if she will only +write me, and enclose addressed and stamped envelope in which to reply. +During my stay at the Invalids' Hotel I never lacked for anything that +willing hands and warm hearts could supply, and I came away feeling that +I was leaving a sweet, luxurious home and many warm friends, but with a +new lease of life and perfect confidence in the ability of the +physicians, for I know I could not possibly have lived two months +longer, had I not found relief. To-day I am well, rosy and happy, with a +heart full of lasting gratitude for the kind treatment and cure which I +received at the Invalids' Hotel and Surgical Institute. + + Yours truly. + Miss DELAINE DUKE, + Clanton, Chilton Co., Ala. + + +POLYPOID TUMOR OF UTERUS WEIGHING OVER FIVE POUNDS. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Miss Bolin.] + +_Gentlemen_--After many trials my doctors here had given up all efforts +to cure me. A tumor that had existed almost from my childhood was +gradually killing me. From frequent hemorrhages, I had become as pale +and bloodless as a ghost, and so weak as to be scarcely able to stand or +walk. Frequently the loss of blood was so great as to cause such long +fainting spells that my family thought me past mortal help. How I lived +to get to your place is yet a matter of wonder. + +We appreciated the fact that in the skill of your surgeon lay my last +and only hope. The result proved his abilities. The restoration of my +health, when it was so generally and for so long despaired of, was +miraculous, and I cannot sufficiently express my gratitude and thanks. + +The comfort that was given by the kindly attention of your nurses is one +of the very agreeable memories of your home-like and pleasant +Institution. With much gratitude, I am, + + Respectfully yours, + Miss ANNIE BOLIN, Leon, Kan. + +NOTE--The above case had been pronounced cancer of the womb by home +physicians. + + +FIBROID TUMOR. CURED WITHOUT CUTTING. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Drennen.] + +_Gentlemen_--I cheerfully give a testimonial of my treatment at your +Institution, hoping it may induce others to avail themselves of your +skill. In December, 1890, I went to you, after suffering five years with +two fibroid tumors of the uterus. The tumors had grown rapidly for six +months prior to my going to you for treatment, and had become quite +painful. Under your treatment they entirely disappeared and my health +was entirely restored. The treatment I received from your able corps of +physicians and nurses was all that could be desired, and I would further +state that your Hotel and Surgical Institute possess all the +requirements for making invalids comfortable and happy. + + Yours truly, + VANIA E. DRENNEN, + Nelson, Portage Co., O. + + +OVARIAN TUMOR OF 62 POUNDS WEIGHT REMOVED. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Matson. ] + +_Gentlemen_--I hereby certify that I had safely removed, without +realizing any pain, a large cyst, or Multilocular Tumor (ovarian) +weighing 62 pounds, by your surgeons. Then, with kind and watchful +treatment, the care of good and faithful nurses, and by the blessing of +an all-wise Providence, I was sitting up in twelve days from that time; +had no inflammation or fever, kept gaining, and in five weeks returned +home. I am feeling better than I have for two or three years. I +cheerfully and truthfully recommend the Invalids' Hotel and Surgical +Institute to all afflicted as I was--with tumors, or any chronic +disease. The rooms are large and pleasant, the best of food is served, +and everything possible is done by the physicians, nurses, and +attendants connected with the Institution, to render the visits of the +afflicted pleasant and desirable. + +Accept the grateful thanks of my husband and myself for your good care +and great kindness to me during my stay at your Hotel, and I wish you +all great success. + + Very respectfully, + MRS. ELISHA MATSON, + Watte Flats, Chautauqua Co., N.Y. + + +UTERINE FIBROID TUMOR. + +THE FOLLOWING IS FROM THE EMINENT LADY PHYSICIAN AND POPULAR LECTURER, +MRS. JENNIE V.S. WILCOX, MD + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Jennie V.S. Wilcox, M.D. ] + +_Gentlemen_--The _least_ return one can render for an invaluable +service, the saving of a life, is an acknowledgment of the same. Mine +was a long-standing, stubborn, constitutional difficulty; chronic, and +defying _all_ previous treatment. Under the care of the doctors of the +elegantly appointed Invalids' Hotel and Surgical Institute the disease +yielded. Could I persuade some of my fashionable friends to spend a +summer or winter at Dr. Pierce's rather than at "resorts" more or less +unsuited to weary or sick people, there might rise up an improved +generation. The electrical appliances at the Invalids' Hotel are +probably the finest in the world. With them the administration of +electricity for the absorption and removal of all abnormal growths, +especially in my sex, is an _assured science_, and no experiment. I +cordially commend all my fellow sufferers to the tender care of the +Invalids' Hotel. + + Yours very respectfully, + JENNIE V.S. WILCOX, M.D. + Saratoga Springs, N.Y. + + +OVARIAN ABSCESS. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Keach.] + +_Gentlemen_--It is with pleasure that I can testify to the skillful +treatment received at the hands of your surgeon specialists. I had been +given up to die, with an abdominal tumor and abscess. My case was not +understood, before coming to you. Although operated upon twice +unsuccessfully by others, my life was despaired of. I am happy to state +that after a few weeks' stay in your Institution, with a skillful +operation which owing to my extreme feebleness, was performed without +any Chloroform or Ether (local anæsthesia only being employed), and +which resulted in the removal of the tumor and abscess, I was perfectly +cured, and have since enjoyed excellent health. I am now restored to my +children and family, and have much to thank you for. The kindness and +attention received from your physicians and nurses while in the hotel +could not be better, and I wish to praise them all highly. + + Very truly yours, MRS. ANNA KEACH, + 60 Bissell Ave., Buffalo. + + +SUFFERED FOR 20 YEARS. + +OVARIAN DISEASE WITH INFLAMMATION OF ABDOMINAL ORGANS AND GREAT NERVOUS +PROSTRATION. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Gibbons.] + +_Gentlemen_--I most gladly express my appreciation of the treatment I +received at the Invalids' Hotel and Surgical Institute at Buffalo. When +I first applied to you for treatment I could sit up but a few minutes +each day, and my physician had told me I never could be any better. I +began to improve very soon after receiving and commencing to use your +medicines. I continued to use them for some months, following the +special instructions faithfully as I could, and steadily improved in +health. My trouble was of such a nature that it was necessary for me to +receive personal treatment, and I spent six weeks at your Institute. The +kindness of physicians and attendants is everything that can be wished. +It is now two years since I have had any of your medicines, and I have +taken no others since, and my health is very good indeed. I can hardly +realize that I am the same person that used to suffer so much for twenty +years or more. + + Very respectfully, + MRS. M. GIBBONS, Franklin, Delaware Co., N.Y. + + +DISEASED OVARY. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, 683 Main St., Buffalo, N.Y.: + +[Illustration: Mrs. Tanner.] + +_Gentlemen_--In the Autumn of '88, I had an ovary removed at the +Invalids' Hotel and Surgical Institute, Buffalo. The operation was +performed with consummate skill. The Hotel is first-class in every +respect, being at once a Christian Hospital and Home. The skill of man, +as exercised there, seems all that God designed it to be. + +I cheerfully add my testimonial as I consider the Institution first +class in every respect. + + Yours truly, + MRS. ELLEN F. TANNER, + Leavenworth, Kans. + + +FIBROID TUMOR OF UTERUS. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Sleeper.] + +_Gentlemen_--There is no endorsement that the faculty of your Institute +could ask that I would not willingly give. I fully realize that I owe +not only my good health, but my life to the wonderful treatment received +at the Invalids' Hotel and Surgical Institute, and would earnestly +recommend any person needing the best medical or surgical attention to +go for relief and cure to your Institution at Buffalo, N.Y. Words are +inadequate to express the gratitude I owe you in so successfully +treating my case. + + Very truly yours, Mrs. C.B. SLEEPER. + Brainerd, Minn. + + +OVARIAN TUMOR MADE UP OF SMALL CYSTS (MULTILOCULAR). + +[Illustration: Mrs. Crissman.] + +It grew to enormous size in but five months. The patient, a young +unmarried woman, left home expecting to die. She had several physicians. +None of them could give her any definite information as to the nature of +the growth or other than unfavorable expectations as to its probable +effects. + +It was successfully removed. The patient being able to be up and around +in about two weeks with no unfavorable symptoms. Cure perfect. WORLD'S +DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +_My Dear Doctors_--Many months have passed since I have written you +concerning my health. I have remained perfectly well, and, in fact, my +health was never better than since the tumor was removed. + +You will remember my case: The tumor had only grown about five months, +but it was of immense size, and I had despaired of life, and my family +thought that I would not return alive from your Institution. Your +skillful operation and removal of the tumor, which weighed over thirty +pounds, with the kind nursing and good attention given me afterwards, +brought me through sound and well. To you I feel that I owe all thanks. +My prayer is for the success of the World's Dispensary Medical +Association. You saved my life after I had given up all hope. The kind +care that all gave me was something that could not be paid for with +money. It was like being at home. I send you my picture, which will give +you some idea of the change for the better in my looks. I am now married +and am very happy. + + Very respectfully, MRS. P.S. CRISSMAN. + Montrose, Henry Co., Mo. + + +OVARIAN TUMOR. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Ortez.] + +_Gentlemen_--I am pleased to inform you that I have had no trouble since +the removal of the tumor five years ago--that my general health is +perfectly restored, and I grow stronger and stronger. And since that +time I have two boys, healthy, and growing as strong as can be, and I +feel very well satisfied with the care of the good and faithful nurses +and physicians. + +I cheerfully and truthfully recommend the Invalids' Hotel and Surgical +Institute to all afflicted as I was with tumors, or any chronic disease. +I send you my picture which will give you some idea of the change for +the better in my looks. + +Accept the grateful thanks of my husband and myself for your good care +and great kindness to me during my stay at your hotel and our wishes for +your best success. Respectfully, + + MRS. J. NESTOR ORTIZ, + Ortiz, Conejos Co., Colo. + + +FIBROUS TUMOR. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Dean.] + +_My Dear Doctors_--My husband had to carry me into your place but in +thirty days I walked out of the Invalids' Hotel sound and well. The +tumor that caused my sufferings had gradually developed during a period +of several years. The trouble induced an inflammation of the bladder and +I had to endure that torment in addition. There were times when I could +not touch my feet to the floor. Walking was an agony that I could hardly +bear. I faithfully tried good physicians and the various remedies and +treatments that were recommended to me without any satisfactory relief. +So I made up my mind to go to your institution. I am now very thankful. +Every one I met with in your place seemed to help me to get well. + +You have got not only the most skillful physicians and nurses but they +are also the kindest and most agreeable that I have ever met. Your hotel +is comfortable, home-like and perfectly clean. + +The treatment was wonderfully successful in my case. The removal of the +tumor was accomplished without pain. I can highly endorse local +anesthesia instead of using chloroform or ether. My recovery was rapid +and I continue in good health and think of you all with thanks and good +wishes. + + Very truly yours, + MRS. ADELAIDE DEAN, + 246 Garden Street, Lockport, N.Y. + + +FIBROID TUMOR OF THE UTERUS + +INVOLVING BOTH BODY AND NECK OF THE WOMB. + +[Illustration: Mrs. Johnson.] + +The tumor was of many years' standing; had grown within a few months +till it was about the size of a child's head. + +From anxiety and worry, the patient had grown nervous and generally +miserable. It was successfully removed by electrolysis, no knife nor +other cutting instrument being employed. In ten days the patient was +able to be about and to return home. + + _Yanceyville, N.G_. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +_Gentlemen_--I have thought of you and prayed for your welfare ever +since I left your Institution. I am perfectly well and enjoying as good +health as ever I did. The treatment you so skillfully applied has +completely restored my health, and I feel that I owe you a debt of +gratitude that I can never repay. I am constantly sounding your praise +among my friends, and know that I can never speak of you in too high +terms. I once despaired of ever feeling well,--to-day, I am jolly and +like another being. May you long be spared to minster to the afflicted. + + Very respectfully, + MRS. HANNAH JOHNSON. + + +NERVOUS PROSTRATION; DEBILITY; DYSPEPSIA; "FEMALE WEAKNESSES," CURED BY +SPECIAL HOME-TREATMENT. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Nicholson.] + +_Gentlemen_--For a number of years I suffered with a complication of +female troubles; I tried various remedies from physicians but nothing +seemed to do me any permanent good. + +About three years ago, I suffered an attack of nervous prostration, +being the result of repeated miscarriages; this was a severe shock to my +nervous system, resulting in a complication of other troubles among +which was nervous dyspepsia. Words fail to express what I endured at +this time. Only those who have passed through a similar experience can +imagine the distressing symptoms accompanying this disease; I could +neither eat nor sleep, was growing very thin in flesh and life seemed a +burden to me. + +This was my condition when I wrote to your Institution for help. I +received a very encouraging letter and commenced treatment at once. I +had not used their remedies a week before I began to feel better, and as +I continued the treatment my health gradually improved. All the +distressing symptoms have disappeared and my general health is restored. +Accept my sincere thanks for the interest manifested in my case and the +happy results obtained. I am now the mother of a fine baby girl, and I +shall ever remember to whom I owe my present health and good fortune. + + Yours truly, + MRS. J.D. NICHOLSON, + La Hoyt, Henry Co., Iowa. + + +BED FAST FROM WOMB DISEASE AND URINARY TROUBLES. + +DR. R.V. PIERCE, Buffalo, N.Y.: + +[Illustration: Mrs. McClain.] + +_Dear Sir_--When I began your treatment, I was unable to be up any at +all, being troubled with womb and urinary diseases; but I can gladly say +that had it not been for your medicine I could not have lived a great +while longer. + +I hereby give your medicine a high recommendation for the marvelous work +it has wrought. + + Yours respectfully, + MRS. PHEBE MCCLAIN, + Earnest, Jefferson Co., Ala. + + +UTERINE AND RECTAL DISEASE. + +HOME PHYSICIANS FAILED. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Clawson.] + +_To whom it may concern_--I was greatly afflicted with Uterine and +Rectal disease. My disease was of very long standing and had baffled the +skill of our home physicians. I went to the Invalids' Hotel and Surgical +Institute, and received treatment of their specialist. Under his +skillful care and kind attention I soon regained my strength and felt +that my former life and ambition were again restored to me. I cannot +speak in too high praise of this famous Institution; the rooms are large +and cheerful, the food of the very best, the nurses kind and attentive, +and the staff of physicians and surgeons skillful and of large +experience. + + Yours respectfully, + MRS. CHAS. CLAWSON, + Middlesex, Yates Co., N.Y. + + +FALLING OF THE WOMB, LEUCORRHEA. + + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Covell.] + +_Gentlemen_--I was sick two years with "Falling of the Womb" and +leucorrhoea or whites, previous to taking your medicines. I took six +bottles of your "Favorite Prescription," and was entirely cured of both +in six months; it is four years this month, since I was entirely well of +both those diseases and have never had any signs of their appearance +since, and I am satisfied the "Favorite Prescription" saved my life, for +I could hardly walk around, when I commenced taking your medicine, and I +think it is a God's blessing to me, and a great credit to you that I +ever took your medicine, for had I not taken it, I think I would have +been in the grave now, and I can highly recommend it to all who suffer +from these two complaints. + +I was pronounced incurable by the best doctors here in the West. I gave +up all hopes and made up my mind that I was to be taken away from my +husband and baby of two years old. I was sick all of the time--could not +eat anything at all. In one week, after beginning the use of your +medicine, my stomach was so much better that I could eat anything; I +could see that I was gaining all over, and my husband then went and got +me six bottles: I took three of them and my stomach did not bother me +any more. + +We sent to you and got the People's Common Sense Medical Adviser, and +found my case described just as I was; we did what the book told us, in +every way; in one month's time I could see I was much better than I had +been; we still kept on just as the book told us, and in three months I +stopped taking medicine, only three times a day, and continued for some +time in that way, and to-day, I can proudly say I am a well woman. Yes, +am well, strong and healthy. I am so glad and thankful to you, Doctor, +for my good health, for well do I know you are the one that cured me. + +When I began to take your medicine my face was poor and eyes looked +dead. I could not enjoy myself any where, I was tired and sick all the +time. I could hardly do my housework, but now I do that and tend a big +garden, help my husband and take in sewing. + + Yours respectfully, + MRS. MARY F. COVELL, Scotland, Bon Homme Co., So. Dak. + + +SEVERE NERVOUS PROSTRATION. + +"OUT OF DARKNESS INTO LIGHT." + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Austin.] + +_Gentlemen_--About eighteen years ago, after the birth of one of my +children I was left in a weak, run-down condition; it seemed to me that +my nerves were unstrung very bad: I did not suffer much pain, but I +think I suffered everything any one could suffer with nervousness; my +life was a misery to me. I doctored with seven different doctors and got +no relief; then I took almost all kinds of patent medicines and got no +relief from them, but got worse all the time, when I chanced to get one +of your little pamphlets. + +I thought I would write to you, and waited as I thought to hear that +there was no help for me; when my answer came and you said you could +cure me great was my joy. I had taken your medicine about a month when I +began to improve and in a few months was entirely cured. + +My recovery was like coming out of the dark into the light, so great was +the change. I will advise all sufferers to go to you for relief--I don't +think they will be disappointed. When I commenced taking your medicine I +weighed 94 pounds, now I weigh 125 pounds. + +I do not know how to thank you for all the good your remedies did me, +With heart-felt thanks I am, + + Sincerely yours, MRS. AMANDA C. AUSTIN, + Burden, Cowley Co., Kansas. + +P.S.--I have a lady friend who is taking Dr. Pierce's Favorite +Prescription now, and last summer every one thought she was going with +consumption; four of her father's family had died with it in five years: +she has taken one bottle of "Favorite Prescription," and now she is +better in health than she has been in three years. Her address is Mrs. +Laura Paugh, Burden, Cowley Co., Kas. A.C.A. + + +MONTHS OF SUFFERING AND TORTURE. + +"LEFT TO DIE A HOPELESS WRECK." + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Moody.] + +_Gentlemen_--A grateful heart and an appreciation of your medical skill +prompts me to make a statement of my case. + +At the birth of my last baby (a boy weighing 14 pounds at his birth), I +contracted womb disease. And for three years previous to treatment, I +had been a great sufferer from prolapsus. Owing to a more serious injury +than prolapsus, received at childbirth, my physicians told me that "I +could never hope for recovery." + +After delivery, I kept my bed for seven weeks. At the expiration of that +time I tried to walk. I found that I could not even stand straight; +there seemed to be a "tight cord" or "drawing" from my left side +extending down into my groin, accompanied by great soreness. + +After repeated attempts, with my body inclined to that side and yielding +to the drawing, I finally succeeded in walking--a violent trembling all +the while in the parts affected. + +Three months after the birth of my baby, I tried to take hold of my +household duties--then my troubles increased, and with them came a +series of "Doctors' bills." + +I consulted two of the best physicians, besides trying all the medicines +I heard tell of, that were recommended for such diseases; but failed in +obtaining a cure from any of them; my relief was only temporary. My +condition was growing worse each day; the womb was so low and the +"bearing down" weight so great that I could scarcely stand on my feet at +all. I was irritable and nervous with a dull headache and constipation; +hands and feet cold and clammy, except the palms and soles; a burning on +top of my head. At this stage of my disease my bladder was badly +affected--the "neck" becoming enlarged and the water collecting there +caused a protrusion to over half the size of a tea cup, leaving it so +dry and harsh, that it was with the greatest difficulty I could walk at +all; a sudden jar, sneeze, or even the slightest pressure, would force +the water out, leaving me in a spasm of pain. At this stage (22 months +after confinement) menstruation returned for the first time since the +birth of my baby. I had already suffered as much as I thought it +possible to bear, and live, but my sufferings were even greater after +this; my womb was ulcerated and inflamed; nervousness increased to +violent shaking, over which I had no control; circulation so feeble that +the extremities were scarcely supplied with blood, they were constantly +cold and clammy. My sleep broken and disturbed, life was fast becoming a +burden to me, For months, however, I endured this torture; I had +abandoned work altogether; I could be up but a few moments at a time and +could not walk across the floor without excruciating pain. There was no +sleep, no rest, and after a week and even more, would pass during which +I would never close my eyes in sleep, even when morphine, opium and +chloral, were administered. My body seemed a dead weight, while my mind +was alive to all my sufferings. There seemed to be a burning pressure +about my head all the while. + +I would have shaking spells frequently, leaving me perfectly exhausted, +my heart the while beating so rapidly, I could not count the pulsations; +it seemed to cease altogether after that, with a sinking, fainting +feeling over me, making it difficult to breathe at all. During my +menstrual periods I suffered a "thousand deaths." My appetite was gone, +mind and sight impaired, strength and flesh all gone. I was a pitiable +object to look at, divested of all that made life endurable for me. I +had baffled the skill of two physicians, and was left, after three years +of agony, to die, a "hopeless wreck," worse than death. + +Such was my condition when I applied to you for treatment. After using +medicines only six days I began to improve; my nerves were steadier; +circulation better, hands and feet warm. Nine days after taking your +medicines they restored the function again. I will confess I expected to +suffer death again--I did not think the medicines had had time to effect +a change within so short a time. Imagine my joy and surprise upon waking +next morning to find it had "stolen like a thief upon me in the night," +I knew not when. I spent the day in grateful tears--how could I help it? +It passed off as quietly as it came, leaving my head clear of that +_dreadful, burning pressure_! My nerves were steady; indeed, my +improvement was so remarkable, that it seemed almost a delusion. My +appetite had returned, and I was hungry for the first time in over a +year. I slept well--awoke refreshed and feeling stronger. After two +weeks, I was able to walk around the house and yard without support; a +day or two after that I walked a hundred yards, visiting and spent the +day. In three weeks time I went home (I had gone to my mother's before +treatment, as I and many others thought, to die). + +At the end of one month there was no symptom, nor sign, of the old +disease. I was able to be up all day, resting a short time at noon. To +be sure of permanent results I continued treatment for one month longer, +and have never had a return of the disease nor any symptom of it since. +Before the end of the second month, I was able to be about the house, +helping the children with the cooking, and milking. My weight increased +fourteen pounds in five months after treatment. I have taken no medicine +since except one bottle of Dr. Pierce's Favorite Prescription, four +years ago. At this time (nine years after treatment), I find my health +still good, having no aches nor pains, a splendid appetite, sleep well, +no headache, no backache and no womb trouble. I am able to do my house +work and everything; can do a day's work with less fatigue than I have +for years before treatment. I feel sure that I would have been in the +grave years ago if it had not been for your medicines. I advise all +other ladies who are troubled with the same disease to apply to you for +treatment. + +Be assured, that whenever I have it in my power I shall recommend your +invaluable remedies. I thank you a thousand times for what you have done +for me, and for the kindness which you have extended to me throughout. + +Wishing you long life and continued success, I am, with much gratitude, + + Very truly yours, Mrs. JENNIE S. MOODY, + Isney, Choctaw Co., Ala. + + +COMPLICATED CASE OF WOMB DISEASE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Knappenberger.] + +_Gentlemen_--When I went to the Invalids' Hotel for treatment I was in a +very critical condition. I could scarcely walk for inward troubles--but +I cannot stop to speak of one disease, for I had such a complication of +diseases. Now I am doing my own housework and in the past four weeks I +have entertained forty-seven people, and I think I certainly am doing +well. It is with the greatest pleasure that I recommend all who are +afflicted to go to the Invalids' Hotel and Surgical Institute. The +Surgeons are honorable, trustworthy gentlemen, who will do all they +promise; and, being men of large experience, they know just what course +of treatment to pursue from first to last, so that an invalid can rest +assured that no experimenting will be done. + +For seventeen years I was an invalid and never had better health than at +the present day, for which I am grateful to your Institute. + + Yours respectfully, + Mrs. D.T. KNAPPENBERGER, + Jeannette, Westmoreland Co., Pa. + + +UTERINE DISEASE. + +[Illustration: Mrs. Reel and Daughters.] + +_Gentlemen_--For eight years I was a sufferer from female derangements. +I have been permanently cured by your specialist, and with only thirty +days' treatment. I am happy to say there is no return of the old +trouble, and all my friends were so surprised to see me so well after +being an invalid so long. I shall never regret the day I went to the +Invalids' Hotel. You ought to see me now--I am so healthy, I shall never +forget your kind treatment of me, and the nurses too were so kind and +attentive--I cannot say too much in their praise. + + Respectfully, + MRS. J.W. REEL, + Idaho City, Boise Co., Idaho. + + +PAINFUL MENSTRUATION AND CONSTIPATION. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Miss Doran.] + +_Gentlemen_--In April, 1891 I came to your Invalids' Hotel for +examination and treatment. I was at that time suffering from profuse and +painful menstruation, complicated with obstinate constipation, from +which I had suffered many years. I cannot speak too highly of your +treatment of my case, as it was both prompt and thorough and resulted in +a radical cure of the above named diseases, and I desire to recommend +all who are thus afflicted to apply to your eminent staff of physicians +for relief, as they cure when others fail. My advice to all who are +afflicted is, if you wish to get well, go where they make such diseases +a specialty. I hope that many others may be as thoroughly cured as I +have been. + + Yours truly, + Miss ELLA DORAN, + Tiffin, Seneca Co., O. + + +COMPLICATION OF DISEASES CURED BY SPECIAL HOME-TREATMENT. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Sheen.] + +_Gentlemen_--I suffered from female complaint; my kidneys, stomach and +nerves were also affected. My physician told me I had Bright's Disease +of the Kidneys. I suffered a great deal in various ways, at times. I +felt as if life were a burden to me; about that time Dr. Pierce's Common +Sense Medical Adviser came into my possession. I read it carefully, and +I thought if Dr. Pierce can not cure me perhaps he can give me some +relief. I wrote to him, describing my symptoms and feelings as well as I +could, and asked him if he could cure me. He said he thought he could, +but it would take a long time for my disease was deep seated. He sent me +a box of medicines enough to last one month, especially prepared for my +case. + +I continued taking his medicines for about thirteen months, and at the +end of that time I felt like a new woman; that has been almost seven +years now and my health is still good. + +The benefits derived from Dr. Pierce's Medicines are lasting, and I +advise all women suffering as I did, to give his medicines a fair trial. + + Gratefully yours, + MRS. MARY SHEEN, Council Bluffs, Iowa. + + +PARALYSIS AND UTERINE DISEASE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Mann.] + +_Gentlemen_--I will say that your Institute is all that you claim for +it, and more to. The Doctors are courteous gentlemen and the best +Physicians I have ever met with in my life. My treatment while at the +Institute did me more good in one month than all the doctors everywhere +else combined. My ailment was Paralysis and Female Weakness. Your +treatment did me good while at the Institute, and I have also been +greatly benefited by the home-treatment I have received from you since. +I am much better than I was; I am able to do considerable work now. When +I came to you I could not do anything. + +I herewith send you my heartfelt thanks for all you have done for me, +and should I need more treatment I will write you as before. I would +advise all people who have chronic diseases to go to the Invalids' Hotel +and Surgical Institute for help, for it is a grand place and prices are +reasonable. We use your Family Medicines--your "Pellets" and "Golden +Medical Discovery"--and find they are all you claim for them. + +Again I thank you and remain, your friend, + + MRS. S.B. MANN, + Sutton, Clay Co., Neb. + + +BARRENNESS CURED. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: A.H. Bain, Wife and Child.] + +_Gentlemen_--With pleasure I can recommend your medicines and treatment. +At the time of my treatment I was barren, and had no signs of ever +having any children until after the time of your treatment. + +We now have two little boys, and we are happy. This picture shows my +husband, myself and our eldest child. + +I pray for your continued success, and thank you for your skill. + + Very truly yours, + MRS. A.H. BAIN, + Cozad, Dawson Co., Neb. + + +INDIGESTION, CONSTIPATION, AND UTERINE DISEASE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Miss Joslyn.] + +_Gentlemen_--Some months ago I consulted your specialist concerning my +health, which had at that time become very much impaired from the +effects of uterine disease, indigestion and chronic constipation. I was +also troubled with frequent attacks of nervous headache which rendered +me very miserable. + +A line of treatment was outlined by your specialist, which I followed +closely, and I immediately began to improve under the use of the +medicine advised. The benefits were so marked that within two or three +months I was able to discontinue the use of the medicine, and have since +that time been enjoying good health. I attribute my cure to the use of +your medicines, and I heartily thank you for the benefits received, as +well as for the kind attention given me by your specialist. + + Respectfully yours, + IDA M. JOSLYN, Groton, Conn. + + +NERVOUS AND GENERAL PROSTRATION. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Miss Morrison.] + +_Gentlemen_--It is with pleasure that I add my testimony to your list, +hoping it may contribute to your success and induce others to avail +themselves of the benefit of your invaluable medicines. In June, 1890, I +took typhoid fever of malignant type; for two months I hovered between +life and death; at length the fever left me in a prostrated condition. +Then I was taken with a severe pain in my back and general nervous +prostration; could not move myself in bed nor bear to be moved by the +most careful nurses without experiencing excruciating pain. I had the +best medical attention in the community, but they failed to give relief. +My friends wrote to Dr. Pierce, stating my condition and requesting +treatment for me. He treated me for two months; by that time I had so +much improved that I did not think it worth while to continue the +treatment longer, and my health has been such that I have not had +occasion to lie in bed two days together since. I feel under lasting +obligations to Dr. Pierce, and thank God for blessing the world with so +able a physician. + + Very respectfully. + MISS MAGNOLIA MORRISON, + Abernethy, Iredell Co. N.C. + + +GENERAL DECLINE. + +"FEMALE WEAKNESS," HEART DISEASE AND RHEUMATISM. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Ashman.] + +_Gentlemen_--For years I had been a great sufferer from general +declining health--female weakness, heart disease and rheumatism--and +despaired of ever getting well. Physicians afforded me only temporary +relief. It was not until I commenced doctoring with Dr. R.V. Pierce that +I experienced any decided benefit. My health has gradually improved +until now I feel like a new being. Language fails to express my +gratitude for this cure, which is due wholly to your life-saving and +life-giving medicines. + + Respectfully, + MRS. CALEB ASHMAN, + Du Bois, Clearfleld Co., Pa. + + +NERVOUS AND GENERAL DEBILITY. + +DR. R.V. PIERCE, Buffalo, N.Y.: + +[Illustration: Mrs. Linn.] + +_Dear Sir_--My case was a complication of diseases--a general +break-down, lasting three years. I placed myself under the treatment of +four different physicians. At last, giving up all hope of recovery at +home, I was making arrangements to go to a Sanitarium in Michigan for +special treatment. One of your small books with blank enclosed was +handed to me; I filled out the blank, and thought I would try rather +than leave home and little ones,--"Happy decision;" two months' special +treatment and I was well and happy, and to-day, I have the very best of +health. + + Yours respectfully, + MRS. LOMA LINN, + Ladoga, Montgomery Co., Ind + + +FEMALE WEAKNESS; LEUCORRHEA. + +DR. R.V. PIERCE, Buffalo, N.Y.: + +[Illustration: Mrs. McClure.] + +_Dear Sir_--I was troubled with "female weakness" and leucorrhea for +three years before I applied to you. I had tried several doctors but +they did me no good, and I grew worse all the time. Finally I wrote to +you for special treatment, and thanks to Dr. Pierce for being the means +of my recovery. I am forty-five years old and do all my housework. + + I remain, + MRS. MARTIN J. MCCLURE, + Thomasville, Oregon Co., Mo. + + +"FEMALE WEAKNESS." + +Dr. R.V. PIERCE, Buffalo, N.Y.: + +[Illustration: Mrs. Moses.] + +_Dear Sir_--Having been treated by one of your associate physicians, at +the Invalids' Hotel and Surgical Institute, and greatly benefited, I do +not hesitate to recommend you and your Faculty to all who may need the +services of honest and skillful physicians. + + Yours truly, + MRS. D.S. MOSES, + Fremont, Ohio. + + +"FEMALE WEAKNESS." + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Fitch.] + +_Gentlemen_--I have been taking Dr. Pierce's Favorite +Prescription--three bottles of it and am getting well fast; I can do my +own work, which I have not done for almost two years; I do my own +washing and all of my house work; I have gained about six pounds taking +your remedy. You cannot know how glad I am that I tried your "Favorite +Prescription." + + Yours truly, + MRS. ANNIE B. FITCH, + Johnstown, Cambria Co., Pa. + + +WOMB DISEASE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Ulrich.] + +_Gentlemen_--I enjoy good health thanks to Dr. Pierce's Favorite +Prescription and "Golden Medical Discovery." I was under doctors' care +for two years with womb disease, and gradually wasting in strength all +the time. I was so weak that I could sit up in bed only a few moments, +for two years. I commenced taking Dr. Pierce's Favorite Prescription and +his "Golden Medical Discovery," and by the time I had taken one-half +dozen bottles I was up and going wherever I pleased, and have had good +health and been very strong ever since--that was two years and a half +ago. + + Yours truly, + MRS. ANNA ULRICH, + Elm Creek, Buffalo Co., Neb. + + +A MOST WONDERFUL CURE. + +TERRIBLE ULCERATION AND FALLING OF WOMB. DROPSY AND OTHER COMPLICATIONS. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Smith.] + +_Gentlemen_--I am a farmer's wife. My husband hired hands to work on his +farm--I had them to cook for--to wait upon, and my family to care for. I +worked very hard till my health and strength gave way. Six years ago the +"turn-of-life" began in the worst form with other disease which I knew +not; I had a severe misery in my back, pain in my head; the monthly flow +became so excessive--came on too often; lasted eleven days. When the +flow would stop then there would be yellow discharge of thick mattery +appearance. I had bearing down in the lower portion of the womb--great +pain all through my body: the pain in my womb was more like "labor-pain" +than anything I can compare it to; I had palpitation of the heart, light +chills, hay fever; had pain in my stomach like colic. My womb was very +low down; the mouth was a large hard knot--was so sore I was compelled +to have a soft seat to sit on; severe pains in my thighs; pain down the +sides of the abdomen; pain in my breast, pain between my shoulders; my +bowels costive; my nervous system prostrated; my digestion impaired; I +had a desire to urinate all the time, could not pass only a few drops at +a time; on standing a few hours, it would form a crust on the +chamber--red, grainy substance; I was bloated all over my body. My feet +and legs were swelled tight, and I was in so much pain day and night I +could not sleep; I could not eat any food only a little sweet milk and a +little corn-bread; I lived in this way for four years; I could not walk +across the room. I was treated by four of the best doctors in the land; +the first three gave me no relief--the fourth built up my health to some +extent; none of them could cure me--none of the four could regulate the +menstrual flow, they could not cure those offensive discharges. I was +given up to die by all four of them; my family and friends expected +every day I would die. + +I got one of your Memorandum Books; I read it carefully, and I was +hoping all this time for some relief--I hoped all the time for relief. +My husband decided to write to you--ask your advice, believing you could +give me relief; though I felt ashamed to tell a gentleman, a doctor I +never saw, those things concerning my afflictions; but I was suffering +terribly. I hoped for relief and I found it. I am happy to tell you I am +well. I was spared to be cured by your good advice and good medicine and +to spread your fame. + +When I received the book you sent me and a letter telling me what to +take, and what it would do for me, I was very feeble; I had just got up +from one of those bad spells--so weak that I could not sit up for more +than an hour at a time. My husband went and got the medicine and a +syringe. I began its use, as you advised, and took the medicine as you +directed; I have taken your medicine seven months; the first month my +improvement was slow; I began to have strength; my pain began to banish; +my appetite began to come; I commenced to sleep sound and the bloating +began to go down; the pain in my head was gone; palpitation of the +heart, also the misery in my back disappeared; the pain in my womb began +to banish; the first time the monthly flow appeared, it was +controlled--it was regulated--it went so light with me that I could go +all the time without a cane. I have not had one spell to confine me to +bed in seven months; I have done all the cooking for my family all the +year; the pain in my stomach disappeared; the yellow discharge also--the +bearing down banished. I have no pain, no aches, no bad feelings. I feel +better to day, than I have in ten years. I now enjoy life, enjoy my +family, enjoy my friends. I enjoy the pleasure of telling my friends who +cured me, and what medicine it was that cured me; he should have the +honor. It is Dr. Pierce! + +I was at death's door when I began to take his medicine, and followed +his advice. It was his "Favorite Prescription," "Golden Medical +Discovery" and the "Pleasant Pellets" that cured me. I also used the +lotion, or wash advised, with a syringe. + +Now, I wish you to accept my best wishes, and hearty thanks for what you +have done for me. + +Last winter I gave my sick friends the pamphlets which were around the +bottles of medicine; some of them are going to take it; it gives great +satisfaction here; I will take no other myself; it will come the nearest +to raising the dead of any medicine I ever saw in my life; it saved my +life, when four doctors gave me up to die. My God bless you in your +work, as He has done in my case. + + Yours truly, MRS. MARY SMITH, + Oakfuskee, Cleburne Co., Ala. + + +SEVERE FLOWING. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs Clark.] + +_Gentlemen_--I suffered terribly with leucorrhea, my monthlies would +nearly always send me to bed; I would lose from two to four quarts of +blood. I had womb trouble pretty bad and my bladder would trouble me +nearly all the time, by continually wanting to urinate, with smarting, +burning pains. My husband got me a bottle of Dr. Pierce's Favorite +Prescription. I took nineteen bottles and now feel very well indeed. + + Your friend, MRS. LULU CLARK, + No. 208 West 3d Street, Sioux City, Ia. + +Mr. Homer Clark, the husband, writes: "My wife was troubled with +leucorrhea and female weakness, and ulcers of the womb. She has been +doctoring with every doctor of any good reputation, and has spent lots +of money in hospitals, but to no purpose. She continued to get worse. +She was greatly prejudiced against patent medicines, but as a last +resort we tried a bottle of Dr. Pierce's Favorite Prescription. We had +seen some of your advertisements, and Mr. Cummings, a west-side +druggist, advised us to try a bottle. We tried it with the following +results: The first bottle did her so much good that we bought another, +and have continued until she has been cured." + + +INFLAMMATION AND "FALLING OF WOMB." + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Camfield.] + +_Gentlemen_--I deem it my duty to express my deep, heart-felt gratitude +to you for having been the means, under Providence, of restoring me to +health, for I have been by spells unable to walk. My troubles were of +the womb--inflammatory and bearing down sensations and the doctors all +said they could not cure me. + +Twelve bottles of Dr. Pierce's wonderful Favorite Prescription has cured +me. + + Yours, + MRS. FRANK CAMFIELD, + East Dickinson, Franklin Co., N.Y. + + +GENERAL DECLINE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Duncan.] + +_Gentlemen_--I believe I owe my life to Doctor Pierce's remedies. Six or +seven years ago, my health began to gradually fail; some of my friends +as well as myself thought I was going into consumption. I began taking +Dr. Pierce's Favorite Prescription, "Golden Medical Discovery" and his +"Pellets," and was greatly benefited; took half a dozen bottles at that +time, did not take any more for several years, when I began to go down +again. I was married November, 1889. The next September had a +miscarriage. The summer following my health was very bad; I then got one +dozen bottles and took as directed. My health was much improved and am +now the proud mother of a healthy boy 22 months old. My health is now +much better than I thought it ever would be. + + Yours truly, + MRS. ALICE V. DUNCAN, + Rees Tannery, Mineral Co., W. Va. + + +ERYSIPELAS AND WOMB DISEASE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. White.] + +_Gentlemen_ I am forty-eight years old, and have had four children. +Three years ago the doctor said I had womb trouble, which was +accompanied with backache and a tired and miserable feeling all over; +left side hurt me very much, and could not lie on that side, and the +doctor said it came from affection of the spleen; had a great deal of +headache; was costive, and suffered terribly from erysipelas; it nearly +set me crazy, so great was the burning and itching; sometimes +experienced severe burning in the stomach. I took twelve bottles of your +medicines, six bottles of Dr. Pierce's Golden Medical Discovery and the +same amount of his "Favorite Prescription." was using them for about six +months, and can say that they did their work well. I have ever since +felt like another person, and do not think I can say enough in their +praise. I have no more weakness, and all evidence or erysipelas has +disappeared. + + Respectfully yours, + MRS. SARAH E. WHITE, + Kennon, Belmont Co., O. + + +FALLING OF WOMB. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Givens.] + +_Gentlemen_--Having suffered for years with what my doctor called +"Falling of the Womb" I was advised to try Dr. Pierce's Favorite +Prescription. The effect has been simply marvelous; a single bottle +relieved me of all pain and enabled me to sleep at night, which I had +not been able to do for a long time. For three months I have not had any +return of the complaint above named. I feel as well as I ever did. I +shall heartily recommend "Favorite Prescription" to all afflicted as I +was. Yours truly, + + MRS. SAMUEL GIVENS. + Leesburg, Harrison Co., Ky. + + +DYSPEPSIA, UTERINE DISEASE. + +[Illustration: Mrs. Martin.] + +MRS. J.A.MARTIN, of _Cleburne, Texas_, had not had good health since the +birth of her child, eight years before; had a headache with burning and +throbbing sensations; and a hurting in her stomach; there was a dead +aching and gnawing or drawing of the stomach as she described it; sharp +pain in the stomach extending to her right breast and shoulder. Weighed +in health 135 pounds, but was reduced to 95 pounds; was weak; could +scarcely walk at all, was sick at stomach a great deal; when her monthly +sickness came on had much pain and the sickness of the stomach remained +until menstruation stopped. She writes: + +WORLD'S DISPENSARY MEDICAL ASSOCIATION Buffalo, N.Y.: + +_Gentlemen_--"I have taken about six bottles of your 'Golden Medical +Discovery' and 'Favorite Prescription,' and am glad to say that I feel +better and stouter than I have felt in a long time. I can work all day +now and not be tired at night. My head don't trouble me now. When I +commenced the use of the medicine I weighed 89 pounds, and to-day I +weigh 98 pounds. I feel better than I have for months." + +COUGH AND NIGHT SWEATS. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: H.M. Detels and Wife. ] + +_Gentlemen_--In regard to your medicines I will say that they are always +in the house. I shall never forget those nights when I was down with +pneumonia. Had it not been for Dr. Pierce's Golden Medical Discovery I +would not be a well man to-day. One bottle stopped the cough and night +sweats. + +My wife was troubled with leucorrhea so bad that we did not know what to +do until Dr. Pierce's Favorite Prescription was brought into the house +and gave her rest. + + Yours truly, + H.M. DETELS, + Travor, Tulare Co., Cal. + + +"CHANGE OF LIFE." + +WORLD'S DISPENSARY MEDICAL, ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. M.E.E. Prichard.] + +_Gentlemen_--It was four years ago that I applied to you for treatment. +My family physician did me no good. When I began your treatment I was +nearly bed-fast; my life was a misery to me. I have taken eight bottles +of your medicine and it has cured me. If I could tell the whole world of +your medicine I would do it. If any woman undergoing the "change of +life" will take Dr. Pierce's Golden Medical Discovery and his "Favorite +Prescription," according to directions, they will cure her. When I began +taking them I could scarcely do anything and now I can do all my +housework and pick two hundred pounds of cotton a day. + + Yours truly, + MRS. M.E.E. PRICHARD, + Thornton, Limestone Co., Texas. + + +COMPLICATION OF DISEASES. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Robertson.] + +_Gentlemen_--For twenty years, I suffered with womb disease and most of +the time I was in constant pain which rendered life a great burden. I +cannot express what I suffered. I had eight doctors and all the medicine +I had from them failed--the one after the other. + +I was nervous, cold hands, feet, palpitation, headache, backache, +constipation, leucorrhoea and no appetite, with bearing down pains. I +got so weak I could not walk around. I had to keep my bed, thinking I +would never get any better. + +One day my husband got one of your little books and read it to me. He +said there was nothing doing me any good. I said I would try Dr. +Pierce's Favorite Prescription. I did try it. After the first few weeks +my appetite was better; I was able to sit up in bed. I wrote to the +World's Dispensary Medical Association, at Buffalo, N.Y., and described +my case; they sent me a book on woman's diseases. I read carefully and +followed the directions as near as I could, and took the medicine for +two years, With the blessing of God and your medicines I am entirely +cured. That was three years ago: + + Yours most respectfully, + MRS. ALEX. ROBERTSON, + Half Rock, Mercer Co., Mo. + + +VAGINITIS--IRREGULAR MENSTRUATION. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Parker.] + +_Gentlemen_--I was married in April, 1893. Soon after I discovered that +I was a sufferer from a very painful condition of the vagina and from +irregular menstruation. In fact the latter was true from its first +appearance. I consulted our family physician but he gave me no relief. +At last I applied to Dr. Pierce for aid: he advised me to take his +"Favorite Prescription," which I did faithfully. I bought seven bottles +of it and one of the "Golden Medical Discovery." After I had taken two +bottles of the "Favorite Prescription," my menses began to be more +regular and I was also relieved of the other diseases. Before I began +taking the medicine, I felt great lassitude and weakness at times, but I +now feel quite strong. + +I can confidently recommend Dr. Pierce's Favorite Prescription to any +one suffering as I did. + + Yours truly, + MRS. MARIA L. PARKER, + Aten, Cedar Co., Neb. + + +CONSUMPTION. + +DR. R.V. PIERCE, Buffalo, N.Y.: New London, Union Co., Ark. + +_Dear Sir_--Some five or six years ago I had a bad cough and got so low +with it that I could not sit up long at a time. We called our family +physician, and he said I had consumption. All our neighbors thought so +too. I had pains through my chest and spit up blood. I commenced with +your "Golden Medical Discovery" and had only taken it two or three days +when I felt like a different person. I took four bottles of the medicine +and it cured my cough. Have not been bothered since, until a short time +ago I took cold and commenced to cough again; I got a bottle of the +"Discovery" and it relieved me at once. I think it is the best medicine +in the world. It saved my life. I don't think any one would die of +consumption if they would take Dr. Pierce's Golden Medical Discovery. I +recommend it to all my friends, and tell them what it did for me. Yours +respectfully, + + Mittie Gray + + +LEUCORRHEA, "FEMALE WEAKNESS." + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Jones.] + +_Gentlemen_--I have used your "Favorite Prescription" and must +acknowledge to you and the public also, the benefits I received from the +use of a half dozen bottles of it. My condition was pitiful before I was +persuaded to use it. I had leucorrhea, no appetite, cold feet, weakness, +fainting spells, melancholy. I felt that I would soon leave my children +motherless. I fell off in flesh to a pitiful looking object. My friends +around said I must be consumptive. My family doctor gave me nearly all +kinds of blood medicine for over a year--all kinds of tonics to build up +flesh, but nothing seemed to benefit me. + +Last September--one year ago, I began using Dr. Pierce's Favorite +Prescription, being convinced that my disease was female weakness. I had +only used it three days when I began to feel better and, after using +three bottles accompanied by the "Discovery," I felt as though I was +well, and continued its use until I had used half a dozen bottles for +fear of a relapse. + +Was a living picture of surprise to my friends. They had all expected my +death. I have given birth two months ago to a baby and no return of my +old disease. I hope that all females, dragging about with pain and +weakness, dyspepsia, melancholy feelings, restlessness at night, and not +feeling like getting up in the morning, may commence the use of Dr. +Pierce's Favorite Prescription, and be well again. Yours respectfully, + + MRS. ANNIE H. JONES, + No. 316 Effingham Street, + Portsmouth, Norfolk Co., Vt. + + +FEMALE WEAKNESS, ASTHMA, SEVERE COUGH. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Monroe.] + +_Gentlemen_--I had been ailing for a year or more, being troubled with +"Female Weakness" and leucorrhoea, when I took a severe cold which +settled on my lungs, and I had a very severe attack of asthma, which was +so bad that for three weeks I could not lie down in bed at all. I had a +terrible cough, in fact, every one thought I had consumption and nothing +gave me relief until I took your medicines, using two bottles of +"Favorite Prescription" and two of "Golden Medical Discovery." They +cured me and I have had no return of the dreadful cough since, and that +has been two years now and I have had good health ever since. + +I am in possession of a copy of the Common Sense Medical Adviser, which +I would not part with for anything. + + Respectfully yours, + MRS. S.A. MONROE, + 315 S. Regester Street, + Baltimore, Md. + + +LEUCORRHEA. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Chapel.] + +_Gentlemen_--I have been troubled with falling of the womb for years, +and was hardly able to drag around. The doctors said I had ovarian +tumors and leucorrhea; the treatment they gave me only produced +temporary relief. I grew worse with leucorrhea all the time until I +chanced to see your remedies. + +I consulted you; you pronounced my trouble leucorrhea, and advised Dr. +Pierce's Favorite Prescription. You sent me some prescriptions to have +filled here, which I used with great success. I am entirely free from my +old trouble--leucorrhea. I only used three bottles of "Favorite +Prescription." + +I could not thank you enough for the cure. When I commenced with your +remedies I weighed one hundred and nine pounds; I now weigh one hundred +and forty-six. + + Respectfully, + MRS. MATTIE L. CHAPEL, + Dawson, Hopkins County, Ky. + + +"FEMALE WEAKNESS," THE RESULT OF GRIP. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y. + +[Illustration: Mrs. Speer.] + +_Gentlemen_--I was taken sick with the grip on the first day of January, +1892. I employed a doctor, until in May I was some better, but could not +do any work. The Grip left me with a weakness, my head felt very badly +and I would get so discouraged and despondent. It affected my back, +hips, and legs, and made me miserable indeed. My stomach was very bad; +it soured and burned after eating. My heart, also, gave me much distress +by beating so fast and loud at times. + +In May I commenced using Dr. Pierce's Favorite Prescription; took seven +bottles of that, and then, by your advice, began taking Dr. Pierce's +Golden Medical Discovery. I took five bottles of that, making twelve +bottles in all. + +My niece lives with me, and she, also, took the "Favorite Prescription," +which did her a great deal of good. + + Yours respectfully, + MRS. E.J. SPEER, + North Barton, + Tioga Co., N.Y. + + +"FEMALE WEAKNESS" PERMANENTLY CURED. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Ramsey.] + +_Gentlemen_--My trouble was "female weakness" and womb disease. I +suffered greatly for twelve years. Four years ago my health became so +poor I was confined to my bed most of the time from May until September. +I was treated by our family physician but received no benefit; I then +consulted Dr. R.V. Pierce, of Buffalo. Through his good advice I began +using his "Favorite Prescription," having taken in all eight bottles of +"Prescription" and two of his "Golden Medical Discovery." I am at +present enjoying better health than I have for twelve years. As it is +now three years since I quit using those medicines and I have no return +of my old trouble. I consider myself permanently cured. + + Yours truly, + MRS. MOLLIE L. RAMSEY, + Liberal, Barton County, Mo. + + +TORPID LIVER, SUPPRESSED MENSTRUATION. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs Fotzgerald.] + +_Gentlemen_--I had suffered so much for years from "Liver Complaint" +that I did not care whether I got well or not, but my husband urged me +to take your "Golden Medical Discovery." I had not had my courses for +six months; after I had taken your medicine about two months, I was +well. + +When one of my daughters with a baby two weeks old was in so much pain +that she could not rest day or night, I went to her as quickly as I +could, and commenced giving her your "Favorite Prescription." The next +morning the pains were all gone. She said, "oh, mother, I would have +died if you had not come. I do feel so good." Your medicine makes people +feel like they wanted to live. There is a woman at Verdi who had several +children who died with consumption of the bowels and _chronic diarrhea_. +She had another one who was going the same way. The doctor said it was +bound to die. I went there and gave it five drops of Dr. Pierce's +Extract of Smart-Weed, and increased the dose every time its bowels +moved, until I got to a half teaspoonful. The next morning the child was +almost well. That woman says I saved her baby's life. + +I could write a week and not tell half the good your medicines have done +through my hands. Two weeks ago, a young man at my house was taken with +_cholera morbus_. He thought he was surely going to die, but as quickly +as I could get some hot water, I put hot applications on his stomach and +bowels, and gave him a few doses of your Extract of Smart-Weed. He got +well immediately. + + MRS. MARY ISABELL FITZGERALD, + Reno, Washoe Co., Nev. + + +SUPPRESSED MENSTRUATION AND NERVOUS DEBILITY. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Clark.] + +_Dear Sirs_--My health is quite good, so I have been able to do all my +own work, and I know Dr. Pierce's Favorite Prescription is what helped +me. + +We never think of doing without Dr. Pierce's Pleasant Pellets in the +house. I give them to my children when they need anything of the kind, +and they never fail to do good. Gratefully yours, + + MRS. WARREN CLARK, + Mount Pleasant, Isabella Co., Mich. + + +DISEASE OF WOMB. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Wilson.] + +_Gentlemen_--I cannot say too much for Dr. Pierce's Favorite +Prescription. I feel it my duty to say to all women who are suffering +from any disease of the womb that it is the best medicine on earth for +them to use; I cannot praise it too highly for the good it did me. If +any one doubts this, give them my name and address. + + Respectfully, + MRS. CORA S. WILSON, + Carlisle, Sullivan Co., Ind. + + +"HER FAVORITE". + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y. : + +[Illustration: Mrs. Collines.] + +_Gentlemen_--Dr. Pierce's Favorite Prescription is my favorite medicine. +I recommend it highly to my friends. Mrs. James Grant of Fort Fairfield, +Maine, one year ago was a very sick woman. I told her what your medicine +had done for me and others whom I know, and I think it raised her from +the death-bed; her husband thinks it a miracle that she got better. My +health at present is good. + + Respectfully yours, + MRS. GEORGE A. COLLINES, + Maysville Centre, Aroostook Co., Maine. + + +WORDS OF PRAISE. UTERINE DISEASE. + +DR. PIERCE, Buffalo, N.Y.: + +[Illustration: Mrs. Pierce.] + +_Dear Sir_--Years ago you sent a box of medicine to my sister, Mrs. +Cynthia P. Freer in New Albion, N.Y., which did so much for her that +after I was married I used them in my own family. Two different times I +have used the "Discovery" when physicians told me they could only patch +me up--I was so bad and getting steadily worse. I sat down and wrote to +you; even after the letter was written I felt so worthless it seemed +foolish to try, so kept my letter for some time thinking it better not +to trouble you with it, but finally mailed it little thinking your +advice and the "Discovery" could so speedily restore me to my usual +health. + +A near neighbor used it for a cough occasioned by a sudden cold, and +less than one bottle stopped the cough. We use the "Pellets" for malaria +and the numberless ills and epidemics that go the rounds, always with +happy results; it saves us physicians' bills and much suffering. We +consult your Common Sense Medical Adviser as our family physician. It +saves much anxiety and fruitless journeyings after a physician, perhaps +to find them gone or unwilling to breast the storm or heat, to say +nothing of the delay and danger of being too late. + +Both my sister and myself have used your "Favorite Prescription" and +know it to be what it is represented by you to be. I can conscientiously +recommend those of your remedies we have used. I am willing to answer +letters of inquiry, if stamps are enclosed for reply. + + Respectfully. + MRS. ABBIE J. PIERCE, + Box 22, Waterbury, Dixon Co., Nebraska. + + + "FEMALE WEAKNESS". + +DR. R.V. PIERCE, Buffalo, N.Y.: + +[Illustration: Mrs. Hoover.] + +_Dear Sir_--I had been a great sufferer from "female weakness;" I tried +three doctors; they did me no good; I thought I was an invalid forever. +But I heard of Dr. Pierce's Golden Medical Discovery and his "Favorite +Prescription," and then I wrote to him and he told me just how to take +them. I commenced last Christmas and took eight bottles. I now feel +entirely well. I could stand on my feet only a short time, and now I do +all my work for my family of five. My little girl had a very bad cough +for a long time. She took your "Golden Medical Discovery" and is now +well and happy. + + Yours respectfully, + MRS. WILLIAM HOOVER, + Bellville, Richland Co., Ohio. + + +STERILITY CURED + +WORLD'S DISPENSARY MEDICAL. ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. King.] + +_Gentlemen_--I will always recommend Dr. Pierce's Favorite Prescription, +it cured me when all 'other' medicines failed. For ten years I suffered +untold misery. I commenced taking your medicines and found relief before +finishing one bottle. After using your medicine eleven months, I made my +husband the present of a twelve pound boy. I think it is the best +medicine in the world. + + Yours truly, + MRS. CAROLINE KING, + New Boston, Scioto Co., O. + + +"WOMB TROUBLE." + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Demby.] + +_Gentlemen_--For three years I suffered from what my doctor called womb +trouble. I cannot find language to describe the tortures I suffered. + +Sixteen weeks ago I began to use your medicine and now feel better and +stronger than I have felt for years, in fact my health is thoroughly +restored and there are no signs of any return of my former trouble. I +owe it all to your wonderful "Favorite Prescription" which I shall +always praise wherever I go. + + Yours truly, + MRS. MAMIE DEMBY, + 1503 Saratoga St., Baltimore, Md. + + +UTERINE DEBILITY CURED + +AFTER SIXTEEN YEARS OF SUFFERING. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Hards.] + +_Gentlemen_--I must tell you that I have enjoyed better health since I +began treatment with Dr. Pierce's Favorite Prescription, for Leucorrhea +and Uterine Debility than I have for sixteen years. I am cured of my +trouble and now weigh one hundred and sixty-six pounds, whereas my +weight for many years stood at one hundred and twenty-five pounds. With +pleasure, I remain, + + Yours truly, + HARRIET HARDS, + Montpelier, Idaho. + + +FEMALE WEAKNESS, NERVOUSNESS AND DYSPEPSIA. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Ross] + +_Gentlemen_--I suffered everything from bearing-down sensations, +headaches, cold feet and hands, leucorrhea, backache, and general +weakness. Was exceedingly nervous and very gloomy and despondent; had +poor appetite, constipation, distress in stomach after eating, and could +not sleep well. Began using "Favorite Prescription" alternately with +"Golden Medical Discovery" in April, and by July was cured. + + Respectfully, + MRS. S.F. ROSS, + No. 200 Market Street, + Amesbury, Mass. + + +THREATENED MISCARRIAGE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Miller.] + +_Gentlemen_--I cannot say enough in praise of Dr. Pierce's Favorite +Prescription, as it has done me a world of good and undoubtedly saved my +baby's life, as I came near losing him twice before the proper time. + + Respectfully, + MRS. C.P. MILLER, + No. 1638 Frederick Ave., + St. Joseph, Mo. + + +WAS A GREAT SUFFERER. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Kempson.] + +_Gentlemen_--When I began to take your medicine I could not do any work +to speak of. I was in such misery that many times, as I lay down for the +night, have I prayed that I might never see the rising of another sun. +It was almost death to me to stand on my feet. + +When I began using your medicines, I weighed 103 pounds. I have taken in +all, ten bottles of your Dr. Pierce's Favorite Prescription, six of +"Golden Medical Discovery," and some of your "Extract of Smart-Weed." +To-day I am well, and weigh 148½ pounds, and am doing the work for my +family of nine. + + Respectfully, MRS. FRED KEMPSON, + Cambria, Hillsdale Co., Mich. + + +TROUBLES INCIDENT TO "CHANGE OF LIFE." + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Carpenter.] + +_Gentlemen_--I can testify to the efficacy of Dr. Pierce's medicines. I +have been using his "Golden Medical Discovery," "Favorite Prescription," +and "Pellets" for several years, for troubles incident to the "turn of +life." I have found them to be of very great benefit to me, and +cheerfully recommend them to all similarly afflicted. + + Respectfully, + Mrs. M.C. CARPENTER, + Berlin, Sangamon Co., ID + + +DYSPEPSIA AND "FEMALE WEAKNESS." + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Hutchinson.] + +_Gentlemen_--Words fail to describe my sufferings before I took your +"Golden Medical Discovery" and "Favorite Prescription." I could not walk +across the room without great suffering, but now I am able to do my own +work, thanks to your wonderful medicines, I am a well woman. I suffered +all the time with a weight in the bottom of my stomach, and the most +severe bearing-down pains, low down, across me, with every step I +attempted to take. I also suffered intense pain in my back and right +hip. At times I could not turn myself in bed. My complexion was yellow, +my eyes blood-shot, and my whole system was a complete wreck. I suffered +greatly from headaches, and the thought of food would sicken me. Now I +can eat anything, and at any time. My friends are all surprised at the +great change in me. Every one thought I would not live through the month +of August. Two of my neighbors are using your medicines, and say they +feel like new beings. + + Truly yours, + MRS. ANNIE HUTCHINSON, + Cambridge, Dorchester Co, Md. + + +WOMB DISEASE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y. + +[Illustration: Mrs. Cummings.] + +_Gentlemen_--I am now entirely cured by the use of your medicines. I +think, and so do my relations, that if it had not been for your +medicines that I could never have lived. I had many physicians before +but got no relief until I began to take Dr. Pierce's Favorite +Prescription and his "Golden Medical Discovery." I then commenced to get +better right away. I kept getting better and am now entirely cured. They +are the best remedies for women and all their ailments. + +I suffered from severe pain in back and region of womb, frequent +headache, was pale and sallow, with dark circles around eyes, was very +nervous, cross, fretful, had spells of crying, and was out of sorts +generally. + + Respectfully, + MRS. SUSAN CUMMINGS, + Shawano, Shawano Co., Wis. + + +"FEMALE WEAKNESS." PERIODICAL PAINS. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Tanner.] + +_Gentlemen_--I was sick for four years. For two years I could do no +work. I had five different physicians, who pronounced my case a poor or +impoverished condition of the blood, and uterine trouble. I suffered a +great deal with pain in both sides, and much tenderness on pressing over +the womb. I bloated at times in my bowels and limbs. Was troubled with +leucorrhea. I could not sleep, and was troubled with palpitation of the +heart. Suffered a great deal of pain in my head, temples, forehead and +eyes. I had a troublesome cough, and raised a great deal, and at times +experienced a good deal of pain in my chest and lungs. My voice at times +was very weak. I suffered excruciating monthly, periodical pains. Since +taking seven bottles of your "Favorite Prescription" some time ago, I +have enjoyed better health than I have for more than four years +previously; in fact, for several months past I have been able to work at +sewing. I have gained in weight thirty-nine pounds since taking your +medicines; the soreness and pain, of which I formerly complained so +much, have disappeared. Yours truly. + + Miss MARY TANNER, + North Lawrence, St. Lawrence Co., N.Y. + + +FALLING OF WOMB. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION. Buffalo, N.Y.: + +[Illustration: Mrs. Lewis.] + +_Gentlemen_--I cannot tell you how my wife has improved since she began +the use of your "Favorite Prescription," coupled with "Golden Medical +Discovery." She has no more trouble with falling of the womb, and she +never feels any pain unless she stands too long. She has no bearing-down +pains since she began the use of your remedies. She does nearly all of +her own housework now, but before she commenced taking your remedies, +she could hardly walk across the room. + +I do not know now to thank you for all the good your remedies have done +her, for the best doctors had given her case up as incurable. + + Yours truly, + ALFRED LEWIS, + Fairport Harbor, Lake Co., Ohio. + + +UTERINE DEBILITY. + +PERMANENTLY CARED, AFTER TAKING FIVE BOTTLES OF "PRESCRIPTION." + +_Dep't of Photography, U.S. Artillery School_, Fortress Monroe, Va. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: + +[Illustration: Mrs. Sargent.] + +_Gentlemen_--My wife cannot speak too highly of your Dr. Pierce's +Favorite Prescription, it having completely cured her of a serious womb +trouble of long standing. She took five bottles altogether, and she has +borne a large, healthy child since. There has been no return of the +complaint. + +She only wishes every poor, suffering woman should know of the +inestimable value your "Favorite Prescription" would be to them, and +thanks you, gentlemen, from the bottom of her heart, for the benefit she +has received. + + Yours very truly, + EDWARD F.F. SARGENT. + + +"FEMALE WEAKNESS." + +DR. R.V. PIERCE, Buffalo, N.Y.: + +[Illustration: Mrs. Davis.] + +_Dear Sir_--I am enjoying good health, and I deem it my duty to send you +my testimonial. I can conscientiously recommend your medicines to any +suffering woman. I think they are indeed the best medicines for "female +complaint" that has ever been invented. Had it not been for them I +surely would have died. + +I tried numbers of remedies from doctors but without getting any relief; +I then took Dr. Pierce's Golden Medical Discovery and his "Favorite +Prescription" and I feel confident that I am permanently cured. + +I told my mother to try it; she has taken four bottles--two of the +"Golden Medical Discovery" and two of the "Prescription." She says it is +the best medicine she has ever tried for her case; she is in better +health than she has been for fifteen years. Mrs. Shelton also used it, +says it has done her more good than all the doctors' medicine ever did; +she has "female complaint." + + Yours respectfully, + MRS. NORA DAVIS, + Noble, Ozark County, Missouri. + + +UTERINE DISEASE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Coventry.] + +_Gentlemen_--I had "Female Weakness" very bad--in bed most of the time, +dragging down pains through my back and hips; no appetite; no energy. +The family physician was treating me for liver complaint. I did not get +any better under that treatment so I thought I would try Dr. Pierce's +Favorite Prescription and "Golden Medical Discovery." I felt better +before I used one bottle of each. I continued their use until I took six +bottles of each. In three months' time I felt so well I did not think it +necessary to take any more. In childbirth it does what Dr. Pierce +recommends it to do. I would like to recommend Dr. Pierce's Extract of +Smart-weed to those who have never tried it; it surely is the best thing +for cholera morbus, or pain in the stomach I ever used; it WORKS like a +charm. I try never to be without it. + + Yours respectfully, + MRS. IDA COVENTRY, + Huntsville, Logan Co., O. + + +LEUCORRHEA, IRREGULAR MENSTRUATION. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Kenison.] + +_Gentlemen_--After years of suffering I have been cured by your +wonderful medicine, when I commenced your medicines I could neither eat +nor sleep; my hands and feet were constantly cold. I had leucorrhea for +twenty years and my monthly periods were never regular, occurring about +once in three weeks. I used three bottles of Dr. Pierce's Prescription +and two of his "Golden Medical Discovery," and am a well, hearty woman +to-day--thanks to your kind advice and excellent medicine. Our family +doctor said to-day, "I can't beat Dr. Pierce's Favorite Prescription; it +is a wonderful medicine." + + Yours respectfully, + MRS. MARY KENISON, + Catlin, Otero County, + Colorado. + + +"CHANGE OF LIFE," ORGANIC HEART DISEASE, WOMB TROUBLE. + +Dr. R.V. PIERCE, Buffalo, N.Y.: + +_Dear Sir_--I feel that I would be doing an injustice to you and to +suffering humanity if I did not write you a statement of my case. + +I have been a constant sufferer all my life, and for the past five years +have been under the care of many good physicians, who, I must say, have +only given me relief for a short time. I cannot describe the constant +pain and torment to which I was subjected every moment of my life, and I +was so reduced in flesh and strength that I could scarcely walk across +the floor and had little hope of ever being any better. + +I was induced, by the advice of a friend, to take your "Favorite +Prescription," as she had been cured after taking several bottles of it. +My physicians said I was suffering from the effects of "change of life," +organic heart disease and womb trouble. + +I sent for your Common Sense Medical Adviser and then wrote to you. You +advised me to take six bottles more of the "Favorite Prescription," +which I did, and in a reasonable length of time after taking it, I felt +very grateful for the happy relief I obtained. I do not suffer near so +much with my heart as I did before taking the "Favorite Prescription." I +had not been able to do any kind of work at all for two years, and I am +now able to attend to my household duties without suffering any pain. + +I have two daughters--17 and 19 years old, that have been in very bad +health for twelve months or more. I gave them each several bottles of +the "Favorite Prescription," and it entirely cured them. + +I would send you my photo., as you request, but have none, and there is +no place nearer than Natchez, Miss., thirty miles distant, where I could +have one taken. + +I now thank you most kindly for the happy relief and cure which myself +and daughters received from taking your "Favorite Prescription." + +With many thanks and wishing you success, I am. + + Yours respectfully, + Mrs N.E. Reily, + Bougere, Concordia Parish, La. + + +ULCERATION OF THE WOMB. + +[Illustration: Mrs. McAllister.] + +_Gentlemen_--This is to let you knew what your medicine is doing here. I +was In bad health; age was working upon me, and had ulceration of the +womb; I could not get about; I took Dr. Pierce's Favorite Prescription +and it cured me; I felt ten years younger. I have not had any return of +my trouble. I am the mother of thirteen children and I am fifty-three +years old, have never seen a better woman's friend than your medicine. I +have recommended it to my friends here, and it has never failed in any +case, so let me thank you for the good it did me. + + Yours, + MRS. M.A. MCALLISTER, + Lim Rock, Jackson County, Ala. + + +REV. W.J. WALKER'S PRAYER. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Rev. W.J. Walker.] + +_Gentlemen_--I wish to inform you of the benefit my wife has received +from the use of your medicines. I must say that your "Favorite +Prescription" is the best female regulator on earth; my wife has been +cured by the timely use of it. I have been using the "Golden Medical +Discovery" and "Pleasant Pellets," and I am fully satisfied they are all +you claim them to be; so I wish you abundant success, and hope that the +Almighty God will continue His blessings toward you in your noble work. + + Respectfully, + REV. W.J. WALKER, + Vancleave; Jackson Co., Miss. + + +TERRIBLE PAIN AND FAINTING SPELLS. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Jacobs.] + +_Gentlemen_--When I commenced taking your medicine I was very sickly. I +had frequent spells of fainting, terrible pain in my head, and life was +a burden to me. I was attended by one of the best physicians in our +town, but with no good results. At last a neighbor advised me to try Dr. +Pierce's Favorite Prescription, which I did, and after taking one bottle +I felt greatly benefited. I would advise all ladies similarly afflicted +to try "Favorite Prescription." + + Yours truly, + Mrs. SAMUEL A. JACOBS, + Mechanicsburgh, + Cumberland County, + Pennsylvania + + + "WAS THE PICTURE OF DEATH." + +PHYSICIANS FAILED. + +[Illustration: Mrs. Loyd.] + +DR. R.V. PIERCE: _Dear Sir_--My daughter has been sick all her life, and +the older she grew, the worse she was until she was the picture of +death: the physicians could not do her any good. + +I heard of your "Favorite Prescription," for women, and I gave her three +bottles, and now she is a perfectly healthy girl. + +Have recommended it to a great many sufferers from "female complaints," +and it has cured them. + +I think it is the greatest medicine in the world, and I have never found +anything to compare with it. + + Yours truly, + MRS. M.J. LOYD, + Wesson, Copiah Co., Miss. + + +UTERINE DISEASE OF YEARS' STANDING. + +SUFFERED FOR TWELVE YEARS. + +[Illustration: Mrs. Wilson and Child] + +_Oreide, (formerly Enterprise,) Taylor County, W. Va._ + +_Gentlemen_--A heart overflowing with gratitude prompts me to write you. +Twelve long weary years I suffered greatly from Uterine derangement and +at last was given up by my physician to die, besides spending almost all +we had. After five months' treatment with your Doctor Pierce's Favorite +Prescription, I now enjoy most excellent health. I would, to-day, have +been in my grave, and my little children motherless, had it not been for +you and your medicine. I will recommend your medicine as long as I live. +If any one doubts this, give my name and address. + + Yours sincerely, + MRS. MALVINA WILSON. + + +ST. VITUS'S DANCE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: St. Vitus's Dance.] + +_Gentlemen_--My boy had been in bad health for a long time. We called +our home doctor, but he got no better. Finally he had the St. Vitus's +Dance, and our doctor did not know what to do. So I wrote to you and did +as you told me: I got two bottles of your "Favorite Prescription," and +one bottle and a half did the work all right. At that time, eighteen +months ago, his weight was 85 pounds, now it is 135 to 140; he is +fourteen years old. + + Yours truly, + JEREMIAH PONSLER, + Zenas, Jennings County, Ind. + + + "FALLING OF WOMB." + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Sharrard and Son.] + +_Gentlemen_--I take great pleasure in recommending Doctor Pierce's +Favorite Prescription for "Falling of the Womb." I was troubled with +bearing down pains and pains in my back whenever I would be on my feet +any length of time. I was recommended to try Dr. Pierce's Favorite +Prescription, which I did with happy results. I feel like a new person +after taking three bottles of it. + + Respectfully, + MRS. ALLEN SHARRARD, + Hartney, Selkirk Co., Man. + + +UTERINE DISEASE, "CHANGE OF LIFE." + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Fletcher.] + +_Gentlemen_--I am happy to say that my health remains good since my +sickness four years ago. I took several bottles of "Pellets," one of +"Golden Medical Discovery," and two of "Favorite Prescription" and +gained right along after I had been taking them. I am at a loss to give +my sickness a name, as my physician called it a "Complication of +Diseases," resulting from change of life and over-work. I take great +pleasure in recommending your remedies to suffering women. May you live +many years to administer to the suffering and afflicted is the wish of +your sincere friend. + + Yours, etc., + MRS. J.T. FLETCHER, + Pony, Madison Co., Montana. + + +MAKES CHILDBIRTH EASY. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Guthrie.] + +_Gentlemen_--I never can thank you enough for what your treatment has +done for me; I am stronger now than I have been for six years. When I +began your treatment I was not able to do anything. I could not stand on +my feet long enough to wash my dishes without suffering almost death; +now I do all my housework, washing, cooking, sewing and everything for +my family of eight. + +Your "Favorite Prescription" is the best medicine to take before +confinement that can be found; or at least it proved so with me. I never +suffered as little with any of my children as I did with my last, and +she is the healthiest we have. I recommend your medicines to all of my +neighbors, and especially "Favorite Prescription" to all women who are +suffering. Have induced several to try it, and it has proved good for +them. + + Very respectfully, + MRS. DORA A. GUTHRIE, + Oakley, Overton Co., Tenn. + + +SHORTENS LABOR. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Baker.] + +_Gentlemen_--I began taking your "Favorite Prescription" the first month +of pregnancy, and have continued taking it since confinement. I did not +experience the nausea or any of the ailments due to pregnancy, after I +began taking your "Prescription." I was only in labor a short time, and +the physician said I got along unusually well. + +We think it saved me a great deal of suffering. I was troubled a great +deal with leucorrhea also, and it has done a world of good for me. + + Yours truly, MRS. W.C.BAKER, + South Bend, Pacific Co., Wash. + + +"FEMALE WEAKNESS." + +DR. B.V.PIERCE, Buffalo, N.Y.: + +[Illustration: Mrs. Shepherd.] + +_Dear Sir_--My wife was hardly able to walk about the house when she +began using Dr. Pierce's Favorite Prescription, and by the time she had +used one bottle of it and one bottle of his "Pellets," she could walk a +half a mile with more ease than she could walk across the house before +she began to take it; she says she thinks it is just what all weakly +women ought to have. + + Yours truly, + GEORGE W. SHEPHERD, + Sigman, Putnam Co., W. Va. + + +"FEMALE WEAKNESS." + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Inman.] + +_Gentlemen_--I began taking "Favorite Prescription" about a year ago. +For years I have suffered with falling and ulceration of the womb, but +to-day, I am enjoying perfect health. + +I took four bottles of the "Prescription" and two of the "Golden Medical +Discovery." Every lady suffering from female weakness should try the +"Prescription" and "Golden Medical Discovery." + + Yours respectfully, + Mrs. F.L. INMAN, + Manton, Wexford Co., Mich. + + +"FEMALE WEAKNESS". + +"COULD SCARCELY DRAG AROUND." + +[Illustration: Mrs. Baker.] + +DR. R.V.PIERCE: _Dear Sir_--Several years ago I took your "Favorite +Prescription." At that time, I was so miserable (and had been so for +many years) that I could scarcely drag myself around. Concluded to try +your medicine. I took half a dozen bottles and I have not had a return +of my old trouble. + +Hoping others will be benefited as I have been, I remain, + + Sincerely, + MRS. C.H. BAKER, + Freytown, Lackawanna Co., Pa. + + +OBSTINATE CHRONIC DISEASE CURED. + +MINISTERS ENDORSE IT. + +[Illustration: Mrs. Stimpson.] + +DR. R.V. PIERCE: _Dear Sir_--For some six or seven years my wife had +been an invalid. Becoming convinced that it was her only hope, we bought +six bottles of Dr. Pierce's Favorite Prescription and "Golden Medical +Discovery." To the surprise of the community and the joy of myself and +family, in one week my wife commenced to improve, and long before she +had taken the last bottle she was able to do her own work (she had not +been able to do it before for seven years), and when she had taken the +last of the medicine she was soundly cured. + + Yours truly, + REV. T.H. STIMPSON, + Donnoha, Forsyth Co., N.C. + + +NERVOUS DYSPEPSIA; UTERINE AND SPINAL WEAKNESS. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Nay.] + +_Gentlemen_--I had nervous dyspepsia for twenty years, followed by +uterine and spinal weakness with irritation of the same. In the Spring +of 1890 I became so exhausted that I was compelled to keep to my bed +with symptoms of paralysis in the lower limbs, and many other +distressing symptoms. I accidentally obtained one of Dr. Pierce's +Medical Advisers from a friend, and finding my ailments so well +described therein, I wrote to Dr. Pierce for his advice, which he sent +by return mail. For my recovery he requested me to use his "Golden +Medical Discovery," his "Favorite Prescription," and his "Pleasant +Pellets." He also gave me some directions for every-day living. These +means accomplished my complete cure. I am thankful that we can have such +reliable medicines brought into our homes without great expense. + + Yours truly, + MRS. AMERICA NAY, + Volga, Jefferson Co., Ind. + + +THICK NECK (GOITRE), + +NERVOUS DEBILITY AND WEAKNESS CURED. + +[Illustration: Miss Houghton.] + +MISS ELLA A. HOUGHTON, of _Theresa, Jefferson Co., N.Y._, was cured of +Thick Neck, Nervous Prostration, Weakness and a complication of ailments +by Dr. Pierce's "Discovery" and "Favorite Prescription." She says: "My +health is now as good as it was before I was sick. The swelling (goitre) +has all gone from my neck. I don't have any bad feelings. My gratitude +for the benefit I have received from your treatment has induced me to +recommend you to all whom I know to be sick." "I have known of two or +three middle aged ladies residing near here, who have been cured by your +'Favorite Prescription.'" + + +SUPPRESSED MENSTRUATION. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +_Gentlemen_--It is almost two years ago that my little girl was taken +with a spasm which frightened me so that my menses became suppressed. I +suffered severely with pressure on the brain so that I often thought I +should go insane. I also had severe pain in the ovaries, and bearing +down pain. I consulted a physician, who treated me for awhile till I +began to feel worse, and consulted another physician whom I knew had +treated several women for like ailments. He gave me medicine which did +me no more good than that prescribed by the first physician. + +Finally, after an examination, the doctor said that he should have to +operate on me in order to have my health restored. + +As my husband and I had heard and read so much about Dr. Pierce's +medicines we decided to try them. We had Dr. Pierce's Common Sense +Medical Adviser. I took three or four bottles of Dr. Pierce's Favorite +Prescription and one bottle of "Golden Medical Discovery" and one vial +of "Pellets." After using these I felt perfectly cured. As I am always +troubled more or less with biliousness, I keep your little "Pellets" on +hand and find relief by using them. One of them taken after meals acts +splendidly for indigestion. + + Respectfully, MRS. B.H. KAMFERBECK, + Holland, Ottawa County, Michigan. + + +THICK NECK (GOITRE). + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.: + +[Illustration: Master Sumner.] + +_Gentlemen_--I am willing and pleased to have you publish anything I +have written in regard to the cure of my little son of Goitre (that a +surgeon of N. Adams said could never be cured). + +I do hope that by so doing some little one may escape the misery my +little one suffered for over a year until I began the use of the "Golden +Medical Discovery." I followed your directions found in the little book +around the bottles. Before the first bottle was gone, he could eat and +sleep without that coughing and choking that, before the use of the +"Discovery," was impossible. + +The tumor began to lessen in size, and after the third bottle I would +never have known he ever had a tumor there. He is now hearty and +healthy. Sleeps as good as any child and is full of life. He does not +take anything to prevent a return, and has not for over a year. + +I have one of your Common Sense Medical Advisers, and found it worth +five times what I gave for it; I have helped others to get it and the +"Medical Discovery" and "Favorite Prescription" have brought relief to +many through me. I use the "Prescription" off and on; it has given me +strength; I think I should have been an invalid long ago without it. + +Every one here knows the truth of this letter, and I would tell it to +the world if I could. + + Respectfully, + MRS. ANNIE SUMNER, Heartwellville, Bennington Co., Vt. + + +DROPSY, SICK HEADACHE, DYSPEPSIA AND BLOODY PILES. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Knavel.] + +_Gentlemen_--In the winter of 1881, I became irregular in my monthly +courses. Of course at first I paid but little attention to it, hoping it +would amount to nothing and probably wear away. But I slowly but surely +grew worse, and at last resolved to apply to the doctors for help. My +water came often, and in small quantities, and with great pain, and with +red brick-dust deposit. I was attacked with severe womb trouble, bloody +piles and dropsy of the ovary. I was treated by five different doctors. +I was compelled to wear an inside support for a year, but it still +seemed impossible for me to get well and I began to feel exceedingly +alarmed and very uneasy, not knowing what course to pursue, or what the +consequences might be. I had heard of Dr. Pierce, and concluded to make +one more trial, so I sat down and wrote a letter to him, stating matters +as near as I could, and in due time I received a favorable reply; then I +commenced with his medicine. I commenced somewhere in February 1891 with +the "Golden Medical Discovery" and "Favorite Prescription," in alternate +doses. A strange occurrence followed. My limbs felt like what we call +"asleep," and I felt as if I were in a strange land and wondered what +was going to take place. I kept on till I took nine bottles. The first +relief I felt was from sick headache, which I had been troubled with for +many years; I was also cured of a very bad cough which I had been +troubled with for many years, and of dyspepsia of long standing. I was +entirely cured of a very singular and severe itching on my back, between +my shoulders, which our doctors called winter itch and which they +pronounced incurable. I had suffered with this for twenty years; it +would come in the winter and go away in the summer. I was also cured of +the worst form of bloody piles and of womb disease. At present I feel +like a new person. + +When I first commenced with Dr. Pierce's medicines, I could not walk +half a mile without a pain. The other day I walked to Mercersburgh +post-office, a distance of twelve miles, and the next day walked back +again, and felt no bad results from the journey. I am now 51 years old. + +Mrs. Knavel further writes, that "To any person desiring to know more +concerning my case and its wonderful cure, and who will enclose to me a +return self-addressed and stamped envelope for reply, I will be pleased +to write further information." + + Yours respectfully, + SARAH A. KNAVEL, + Indian Springs, Washington Co. Md. + + +WOMB DISEASE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: MRS. GUNEKEL.] + +_Gentlemen_--I have been a sufferer from womb trouble for eight years, +having doctored with the most skillful physicians, but finding only +temporary relief from medicines prescribed by them. I was advised by a +friend to take the "Favorite Prescription," which I did, and found, in +taking six bottles of the "Prescription" and two of the "Discovery," +that it has effected a positive cure, for which words cannot express my +gratitude for the relief from the great suffering that I so long +endured. + + Respectfully, + MRS. W.O. GUNEKEL, + No. 1461 South 7th St., + Terre Haute, Ind. + + +GENERAL DEBILITY. "FEMALE WEAKNESS." + +DR. R.V. PIERCE, Buffalo, N.Y.: Hardy, Cascade Co., Mont. + +_Dear Sir_--I have enjoyed pretty good health for the past three years. +Before I took your "Golden Medical Discovery" and your "Favorite +Prescription" I was so weak that I could hardly do my housework. I took +seven bottles in all of the two medicines; they did me a world of good; +I do not think I should have been here to-day were it not for your +medicines. + +I would send you my photograph, but I have none, and live sixty miles +from a photographer. + + Gratefully yours, + Mr. Thomas Prewett + + +TUMOR OF BREAST AND WOMB DISEASE. + +[Illustration: MRS. GOLDEN. ] + +Mrs. Jane Golden, of Durand, Pepin Co., Wis., writes Dr. R.V. Pierce, +Chief Consulting Physician, at the Invalids' Hotel and Surgical +Institute at Buffalo, N.Y., as follows: "It is my heart's desire to +write to you of what your medicines have done for me. I was in a very +bad state when I wrote to you, and you prescribed for me and I took your +medicines according to directions and am a well woman again. I had +uterine disease and tumor in the breast. The doctors said they could do +nothing for me any more and must resort to the knife. I would not +consent and so wrote to you, and followed your advice. I took two dozen +bottles of your 'Favorite Prescription,' seven bottles of your 'Golden +Medical Discovery' and my health is now better than it had been in +twenty years; my neighbors said I could not live three months, and I +know that your treatment and medicine cured." + + +ULCERATION OF WOMB. IRREGULAR MENSTRUATION. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Spicer.] + +_Gentlemen_--Please accept my heartfelt thanks for your medicines, which +I have every reason to believe have cured me. I was afflicted for more +than five years with falling of the womb and ulceration of the same, +connected with very painful and irregular menstruation with chills +during the same. Rush of blood to the head, sometimes falling down in +insensibility and remaining so for several hours; and part of the time +could not bear my weight on my limbs to stand up or walk at all for +several days at a time. I was a burden to myself when I commenced taking +Dr. Pierce's Favorite Prescription and "Golden Medical Discovery," and +his "Pleasant Pellets" and "Smart-weed;" I used the glycerine and iodine +as you prescribed for me also. I think I used one dozen bottles of +"Prescription," half a dozen "Discovery" one dozen "Pills," one-half +dozen "Smart-weed," at first and some more afterwards, only a few +bottles, I don't remember how many. + +I am now well, doing my own work, and do not suffer any more pain, and +don't need any more medicine. + + Respectfully, + MRS. MARY J. SPICER, + Boulder, Boulder Co., Colo. + + +SAVE DOCTORS' BILLS. + +DR. R.V. PIERCE, Buffalo, N.Y.: Arcadia, Manistee Co., Mich. + +_Dear Sir_--We received your kind letter, with the "Pellets," and are +very much obliged for the same. We know they are just what you recommend +them to be. We have used your medicines for about seven years and have +depended almost entirely on them for five years. Before we began the use +of your medicines, we used to have to employ a doctor every little +while; now we do not have to. We have four children. We give them Dr. +Pierce's Golden Medical Discovery when they take cold and I think it is +far better than most cough medicines, for the "Discovery" helps the +appetite and the cough medicines make one sick. I like your idea of +keeping the blood pure and the "Discovery" is the medicine for that. I +take a bottle twice a year, in the spring and fall, and I have +recommended it to several other ladies who have tried it and they all +think highly of it. I have bought thirteen bottles of the "Discovery" +and three bottles of Dr. Pierce's Favorite Prescription and nine bottles +of the "Pellets" in five years, so you see our doctor-bill has not been +very large. Our oldest boy hurt himself, lifting, and I depended upon +Dr. Pierce's Compound Extract of Smart-weed for external application, +and it cured him. I bought two bottles of that. + + Yours truly, + Mrs. S. Keillor + + +"FEMALE WEAKNESS." + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Cummings.] + +_Gentlemen_--I took your Dr. Pierce's Favorite Prescription when I was +run-down and through the warm weather. It worked like a charm on my +system and I am a good deal heavier in flesh now. It is the best +medicine in the world for "female troubles," for I took almost all kinds +of Patent Medicines, and doctors' prescriptions without benefit. There +is hardly a day passes but that I recommend it to some of my lady +friends. + + Yours truly, + Mrs. CORA CUMMINGS, + No. 74 E. Yates St., Ithaca, N.Y. + + +CHILDBIRTH MADE EASY. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Johnson.] + +_Gentlemen_--Your medicines have my greatest praise as they did me a +great deal of good. I was sick for nearly three years. Sometimes I +thought I would go crazy I was so weak, nervous, and down hearted, and +sour in spirits, that I was afraid I would die every day, and such mean +feelings I could not describe to any one. I remained in this stage for +nearly three years, doctoring with every home doctor and trying every +medicine that I thought would help me, and I could get no relief. I +could not sleep at times and had palpitation of the heart so that I +would have to get up, for my heart would beat so fast I thought every +minute I would die. The misery I went through no one could describe. + +A lady friend handed me Dr. Pierce's Common Sense Medical Adviser, and I +wrote to you about myself, and you told me to take "Favorite +Prescription" and "Golden Medical Discovery." I commenced in the spring +and took three bottles of each of your medicines, and I felt so much +better I thought that was enough, and ever since I have had my health. I +grew stronger, and could run and skip about like a child, and was happy +all day long. I felt so well I could hardly believe it was myself. I +just used the two kinds of medicines--"Golden Medical Discovery" and +"Favorite Prescription," and followed the "Common Sense Medical +Adviser," took regular baths, and dieted for about a year, and the +result was a bright baby boy which brightens our home. I took the +"Favorite Prescription" before, and the result was a few hours' labor +and got along splendidly; my baby weighed twenty-four pounds at seven +months--a brighter, healthier baby than he is there never was. + + Respectfully yours, + MRS. MINA JOHNSON, + Riverside, Ravalli Co., Mont. + + +PARTIAL PARALYSIS FROM UTERINE DISEASE. + +Buffalo, Larue County, Ky. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +_Gentlemen_--I am still having very good health. I value Dr. Pierce's +Golden Medical Discovery and his "Favorite Prescription" very highly and +often recommend them to others. I do not think I would ever have got +well if it had not been for your medicines. I was in a sad condition. My +bowels and half of my body (the left side), was nearly paralyzed, +besides nearly my whole system was out of order. I suffered all the +time; but after taking six bottles of "Golden Medical Discovery" and the +same of "Favorite Prescription," and using two bottles of Sage's Catarrh +Remedy as an injection, I felt like a new person. I have never seen +anyone suffering in the same way as I did. If anyone with female trouble +of any kind will use your medicines I am satisfied they will help them. + + Yours truly, + Mary A. Sallee + + +IRREGULARITY AND UTERINE DEBILITY. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Miss Henderson.] + +_Gentlemen_--I cannot say enough for your Dr. Pierce's Favorite +Prescription. For years I suffered from irregularity and uterine +debility, but now I feel as well as I ever did in my life. Thanks to you +for your "Favorite Prescription," for it has performed a permanent cure +of me. With gratitude, I remain, + + Yours, + L.M. HENDERSON, + Springfield, South Dakota. + + +WOMB DISEASE. + +DR. R.V. PIERCE, Buffalo, N.Y.: + +[Illustration: Mrs. Sprigs.] + +_Dear Sir_--I think your "Favorite Prescription" was the preservation of +my life. I was under the doctor's care for three months with womb +disease and a gradual wasting all the time. I was so weak that I could +not be raised in bed when I commenced taking the "Prescription," and by +the time I had taken three bottles I was up and going wherever I +pleased, and have had good health and been very strong ever since. That +was four years ago. I have recommended it to a good many of my friends, +and they have taken it and are highly pleased. + + Yours truly, + G.A. SPRIGGS, + Long Savannah, James Co.. Tenn. + + +ULCERATION OF WOMB. + +St. John, Whitman Co., Wash. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +_Gentlemen_--For three months I was almost prostrated with ulceration of +the womb. I began the use of Dr. Pierce's Favorite Prescription and his +"Golden Medical Discovery," and other remedies that are prescribed in +his treatise on womb diseases. After three months' use of same I was +cured. I have implicit faith in their medicines and can recommend them +to others who are similarly afflicted. + + Yours truly, + Mrs. Geo. Thornton. + + +LESSENS MISERY. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Lindsey.] + +_Dear Sirs_--I think Dr. Pierce's Favorite Prescription the best +medicine in the world for females; I consider myself entirely well. I +can do as much work as any woman. I gave birth to a healthy girl; your +medicine is the best in the world for pregnant ladies--_it lessens the +misery of that critical period_. I cannot praise it too much. I have +gained ten pounds since I began using your valuable remedy. + + Yours respectfully, + MRS. MARY LINDSEY, + Williams Station, Escambia Co., Ala. + + +OVARIAN DISEASE. + +Bridgeport, Putnam Co., Fla. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +_Gentlemen_--I received the Common Sense Medical Adviser and I am well +pleased with it. I return many thanks to you for your kindness. My +complaint was pain in my back, and in my side, that moved from the right +side to the left; shortness of breath and pain in the lower part of the +stomach, and my doctor said I had ovaritis and I took two bottles of the +"Favorite Prescription" and one bottle of the "Golden Medical +Discovery," and I am relieved of all pains in the back and sides, and of +womb complaint. I shall always speak good words for you. I suffered with +those pains for five years. + + Yours truly, + Mrs Nancy Brooks + + +LEUCORRHEA. + +Brooklyn, Jackson Co., Mich. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Parker] + +_Gentlemen_--I am more than willing to say your most valuable medicine +has cured me of a very disagreeable complaint, leucorrhea. I suffered +for years with pain in my back, never a night was I free. At your +request I commenced a course of Dr. Pierce's Favorite Prescription and +"Golden Medical Discovery." I could not sleep on a mattress; it seemed +as though it would kill me. Since taking the medicine I can sleep +anywhere; I am perfectly well. I would not be placed in my former +condition for any money. I bought six bottles, or $5.00 worth. I took +but four, my husband took the "Golden Medical Discovery." At this time I +had a servant girl who suffered badly from pain at the time of her +monthly periods; she took the other bottle of "Favorite Prescription," +which was a great help to her. + + Gratefully yours, + Mrs. J.H. Parker + + +SEVERE FLOWING (MENORRHAGIA.) + +Lewistown, Mifflin Co., Penn's. + +_Gentlemen_--Seven years ago this month, I was taken sick--was bed-fast +six months, and during that time, many times, was not able to eat alone. +I had the best doctor that could be got. I would have sinking spells. My +nerves were prostrated and I had female weakness and ulceration of the +womb, which caused such excessive flowing that they thought I would die; +then I would take sinking spells. My stomach was too weak, the medicine +could not do its part as it should have done. I had torpid liver and +right side of lungs affected; catarrh of the throat and piles; +palpitation of the heart, and kidneys were somewhat affected. My doctor +got me up and able to walk through the house, but the flowing would +still be so bad that I would have to take the bed; then would be able to +be up again and learn to walk a little again till the time would come +again. + +My doctor treated me for the ulcers. A lady came to see me. She told me +to try Dr. Pierce's Favorite Prescription. I got it but did not tell my +doctor. He soon remarked the improvement and I then told him what I was +using; he told me to use it, that it would be good for me. I used eleven +bottles of the "Favorite Prescription," and two of the "Golden Medical +Discovery." The flowing was not so bad. I got so I could sit up and be +about at all times, and walk about in the house. I am still improving, +and can do light house work. I am able to walk out to church every +Sunday. + + Yours truly, + Mrs Abner Knepp + + +"FEMALE WEAKNESS." + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Danard.] + +_Gentlemen_--A few years ago my health failed. I was troubled with +female disease in its worst form having been afflicted about fifteen +years. I was also troubled with constipation, loss of appetite, +dizziness and ringing in my head, nervous prostration, hysteria, loss of +memory, palpitation of the heart together with "that tired feeling" all +the time. I consulted several physicians--no one could clearly diagnose +my case and their medicine failed to give relief. After much persuasion +I commenced taking Dr. Pierce's Favorite Prescription--have taken five +bottles and am a well woman doing all my housework; from a run down +condition I have been restored to health. I feel it my duty to recommend +your "Favorite Prescription" for ladies afflicted with female diseases +as I have been. + + Gratefully yours, + MRS. BYRON DANARD, + Milford, Prince Edward Co., Ont., Canada. + + +INDIGESTION, IMPOVERISHED BLOOD. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Miss Sampson.] + +_Gentlemen_--After suffering for over a year with indigestion and low +condition of the blood I was advised to try Dr. Pierce's Favorite +Prescription. I had hardly finished the first bottle when I felt a great +change, so I continued on until I had taken three bottles, and at the +end of that time I was completely cured. My health was so much impaired +that I feel I owe a great deal to your wonderful medicine. Thanking you +for the advice which you so kindly gave me while taking your medicine, I +am, + + Most gratefully. + Miss CASSIE SAMPSON, + No. 347 McHaren Street, + Ottawa, Ottawa County, Ontario. + + +"FEMALE WEAKNESS." + +DR. R.V. PIERCE, Buffalo, N.Y.: Nixon, Hardin Co., Tenn. + +_Dear Sir_--I am in very good health now. I think your "Favorite +Prescription" is wonderful. I brought forth a fine son the first day of +December--the fattest baby I ever saw, and that is why I think your +medicine is such a fine one for poor sickly females. I know I never +would have become pregnant, if I had not got in better health. I feel it +my duty to do all that I can to praise you and your wonderful "Favorite +Prescription." I can highly recommend it to all females who are +suffering with leucorrhea, for I don't think any one suffered any worse +than I did when I made my case known to you. May God bless you, and your +great medicine--the "Favorite Prescription." + + Yours truly, + _Sallie L. Howard_ + + +ULCERATION AND FALLING OF WOMB. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Lyon.] + +_Gentlemen_--I had been suffering from ulceration and abscess in the +womb, and falling of the womb, for several years or since the birth of +my youngest child. I consulted all the physicians around here and they +gave me up and said there was no help for me. + +At last, almost discouraged, I found in a little book your medicines +advertised. I did not have any faith in them--I had tried so much and +failed to get relief. But I began taking Dr. Pierce's Golden Medical +Discovery and his "Favorite Prescription," and took five bottles of +each, and used two bottles of your Sage's Catarrh Remedy for vaginal +injections. It is three years since and I have not had any return of the +trouble. I feel very grateful, and in fact, owe you my life, for I do +not think I should have been alive now if I had not taken your remedies. + + Respectfully, + Mrs. ABRAM LYON, + Lorraine, Jefferson County, N.Y. + + +BARRENNESS, DYSPEPSIA, "LIVER COMPLAINT." + +Basin, Cassia Co., Idaho. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +_Gentlemen_--I first had dyspepsia and "liver complaint" for five years, +and I took six bottles of Dr. Pierce's Golden Medical Discovery and his +"Pleasant Pellets," which Entirely cured me of that complaint. I also +had painful menstruation, and took about eight bottles of Dr. Pierce's +Favorite Prescription and two bottles of his Compound Extract of +Smart-weed, which cured me. The symptoms of this disease were very +severe, pain in the region of the womb, back and thighs, Chilliness and +nausea; this disease was so severe that I was barren for two years of +married life, and after taking the "Favorite Prescription," I became the +mother of a boy. + + Yours respectfully, + Mrs Emma Mcintosh + + +GENERAL DEBILITY, MALARIA, SICK HEADACHE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. J.H. Lansing.] + +_Gentlemen_--I am happy to say that your valuable medicine has been a +great benefit to me. I was suffering from general debility, malaria and +nervous sick headaches, and after my third child was born (a beautiful +baby boy of ten pounds) I only recovered after a long illness; I barely +gained strength enough in two years' time so that I was able to crawl +about to accomplish the little housework that I had, by lying down to +read many times each day; had sick headaches very often; and many pains +and aches, all the time complaining of getting no better. I finally +asked my husband to get a bottle of Dr. Pierce's Favorite Prescription, +which he promptly did. After I had taken one bottle I could see a great +change in my strength, and fewer sick headaches. + +I continued taking the medicine until I had taken eight bottles--seven +of the "Favorite Prescription" and one of the "Golden Medical +Discovery." For some time past I have not used it but I am now able to +do the housework for myself, husband and two children (aged nine and +five years). I also take in dressmaking, and enjoy walking a mile at a +time, and I think it is all due to the medicine, for I know I was only +failing fast before I commenced to take it. I take great pleasure in +recommending the "Favorite Prescription" to all women who suffer from +debility and sick headache. + + Respectfully yours, MRS. J.H. LANSING, + Fort Edward, Washington Co., N.Y. + + +OVARIAN PAINS. + +Ligonier, Westmoreland Co., Pa. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +_Gentlemen_--The doctors never gave any name for my disease except that +one doctor said it was severe pain in the ovaries. His medicine did me +no good; but whatever ailed me I was in such misery I could not describe +what I suffered. The first thing that gave me any relief was Dr. +Pierce's Favorite Prescription. The first half bottle made me feel much +better. I used two or three bottles and thought I was cured, but it came +back in three or four months, and as soon as I began to take the +medicine again I got better. I took two or three bottles again, and +never felt anything of it since; and that is nearly four years ago, and +I give all thanks to Dr. Pierce's Favorite Prescription. I use no other +medicine at all for stomach trouble but Dr. Pierce's Golden Medical +Discovery. I have been troubled some with rheumatism, when nothing else +would do any good, "Golden Medical Discovery" cured me; I had not taken +more than one-half bottle when I felt like another woman, and I would +advise any who has any trouble with his stomach, or who has rheumatism, +to try it as there is not its equal to be found. + + Yours truly, + Mrs S.A. Beatty + + +"GIVES A NEW LEASE OF LIFE." + +Jamestown, Chautauqua Co., N.Y. + +DR. R.V. PIERCE, Buffalo, N.Y.: + +[Illustration: Miss Crowley.] + +_Dear Sir_--Both your communications have been received. I have +neglected to answer them. I am glad to say in this letter that my sister +is very much improved in health, and says she feels as if she had a new +lease of life. She feels so much better since she commenced taking your +medicine. I think it was just the medicine she needed, and am more than +thankful to you for the kindly interest you have taken, and hope that +others will find the same benefit from your valuable books and +medicines, that my sister has. I will close with gratitude to you. + + Yours respectfully, + Miss MOLLIE M. CROWLEY, + (for sister) care Sherman House, Jamestown, N.Y. + + +MOTHERS' RELIEF. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Simmons.] + +_Gentlemen_--Doctor Pierce's Medicines have been our family medicines +for twenty years. They are all they have been represented to be, and +untold benefits have been derived from them. + +Have been treated by you with your Special Remedies, and cured of +difficulties that our family doctor failed to cure; and when ailing, by +the use of a few bottles of "Golden Medical Discovery," have been always +benefited. + +I recommend Dr. Pierce's Favorite Prescription to every one who is +having a family--taken as directed, it works like a charm in +confinement. + + Respectfully, + MRS. A.D. SIMMONS, + Emporia, Lyon Co., Kas. + + +"FALLING OF WOMB." + +Clover Hill, Coahoma Co., Miss. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +_Gentlemen_--I cannot tell you how I have improved since I have used Dr. +R.V. Pierce's Favorite Prescription and his "Golden Medical Discovery." +I had been suffering for four years and I began to get worse and worse +until I commenced using these medicines, and then I began to get better, +and now I feel like a new woman. + +I suffered much from "falling of the womb," and headache, and pains in +my back, and I thank you kindly for the good your medicines done me. I +can do my housework now and not feel bad from it. I hope others will +find the same benefit from your valuable books and medicines that I +have. + + Gratefully yours, + Eliza Allen. + + +"WOMAN'S ILLS." + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Bates.] + +_Gentlemen_--A few years ago I took Dr. Pierce's Favorite Prescription, +which has been a great benefit to me. I am in excellent health now. I +hope that every woman, who is troubled with "women's ills," will try the +"Prescription" and be benefited as I have been. + + Yours truly, + MRS. W..R. BATES, + Dilworth, Trumbull Co., Ohio. + + +AN OLD LADY'S TRIBUTE. BETTER THAN CALOMEL. + +Clinton, Hinds Co., Miss. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +_Gentlemen_--It gives me much pleasure to say that I have been greatly +benefited by Dr. Pierce's Pleasant Pellets. They act on the stomach and +liver, and clear the complexion better than calomel, and you are +relieved of that awful sickness and constipation which other medicines +produce. + +Dr. Pierce's Golden Medical Discovery is the greatest tonic in the +world, to build up the broken-down constitution. I am an elderly lady, +sixty-six years old. I feel that my days are of short duration and would +not give a word of recommendation if I did not feel it my duty to +suffering humanity. + + Yours truly, + Mrs. N.A. Watts. + + +A YOUNG LADY'S ADVICE TO INVALIDS. + +"A SURE AND CERTAIN CURE." + +DR. R.V. PIERCE, Buffalo, N.Y.: + +[Illustration: Miss Fugate.] + +_Dear Sir_--Please accept my thanks for the good your medicines have +done me. I truly believe the "Favorite Prescription" saved my life; it +is a sure and certain cure. I am having perfect health; I am stout and +can do all my housework. + +Every invalid lady should take Dr. Pierce's Favorite Prescription and +"Golden Medical Discovery." + + Yours respectfully, + ROZZIE FUGATE, + Madisonville, Hopkins Co., Ky. + + +BETTER THAN "SUPPORTERS." + +Leesville Cross Roads, Crawford Co., Ohio. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +_Gentlemen_--Four years ago, I became afflicted with womb trouble--knew +nothing but pain and suffering. Began doctoring right away with our home +doctor. He not doing me any good, I went to another doctor who advised +me to wear an inside supporter, _which really did me more harm than +good_. Last spring was taken down sick and laid on my back for ten +weeks; when I heard of Dr. Pierce's wonderful Favorite Prescription. The +first bottle helped me. I have now taken four bottles and feel perfectly +cured. I cannot find language to express my gratitude for being restored +to perfect health from a condition worse than death. + + Yours truly, + Mrs F. Holmes. + + +SUPPRESSED MENSTRUATION. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Miss Burk.] + +_Gentlemen_--When I was fourteen years old I took a bad cold and there +resulted internal troubles. I was a great sufferer for four years. I had +tried two physicians but neither gave me any relief. After taking Dr. +Pierce's Favorite Prescription I can't say enough for it. It cured me so +I have no more pains. I am now nineteen years of age. + + Respectfully, + Miss MAMIE BURK, + Everett, Bedford Co., Pa. + + +HOW TRAVELING INVALIDS MAY BE IMPOSED UPON. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +_Gentlemen_--It is now about five years since I spent eight days at the +Invalids' Hotel and Surgical Institute, under treatment for a chronic +disease of eighteen years' standing. I had given up to die. Going to +your Dispensary was a last resort with me; I had undergone a surgical +operation at the hands of my family physician from which I grew worse +every day for eight months, so that I very despondently started for your +institution; and when I had traveled eleven hundred miles I was made +more despondent by inquiring of a man how far I had to travel to reach +Buffalo, N.Y.: He answered, "Just one hundred miles." I then inquired of +him if he had ever been in Buffalo, N.Y. He replied, "Many a time." I +then asked him, what about Dr. Pierce's world-famed Surgical Institute? +"Oh, it's a humbug. They have some drawings or pictures taken from some +government buildings, that's where they get that fine building you see +pictured in their books and pamphlets." + +I don't suppose there ever was a sadder heart entered the door of the +Invalids' Hotel than that heart of mine; but it was soon made glad to be +glad ever since. During the first night in the Invalids' Hotel I met and +talked with patients afflicted as I was. Many of them were cured and +talking of going home next day, and sure enough, they went; but I never +missed them in number for others kept coming. + +I can honestly and truthfully say that the World's Dispensary Medical +Association of Buffalo, N.Y., is anything else than a humbug. The reason +why they are not humbugs is plain. They continue to perform wonderful +cures and treat their patients with unsurpassed nursing, and a kinder +lot of physicians, surgeons and nurses I don't believe can be found in +the world. + +I cheerfully advise all persons suffering from chronic diseases not to +stop to count the distance from where they live to Buffalo, N.Y., but go +straight to the Invalids' Hotel and Surgical Institute without delay, +for it is by the will of God and their skill that I am living to-day. + + Yours truly, + L.M. McPhail, + Autun, Anderson County, S.C. + + +NERVOUSNESS, "FEMALE WEAKNESS," NASAL CATARRH. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Sanderson.] + +_Gentlemen_--My health was utterly gone. Was suffering from nervousness, +female troubles and nasal catarrh; life was almost a burden to me, but a +glorious change came, due solely to Dr. Pierce's Favorite Prescription +and Dr. Sage's Catarrh Remedy. I have suffered more than tongue can ever +tell. I have been treated by good physicians but they only help me +temporarily. I have taken a great many patent medicines with the same +result. In 1890, I began taking Dr. Pierce's Favorite Prescription and +Dr. Sage's Catarrh Remedy, which gave me immediate relief and a +permanent cure. + + Respectfully, + MRS. BELLE SANDERSON, + Sprout, Nicholas Co., Ky. + + +MADE HER "STRONG AND WELL." + +DR. R.V. PIERCE, Buffalo, N.Y.: + +West Liberty, Ohio. + +_Dear Sir_--I can cheerfully recommend your valuable medicine, the +"Favorite Prescription," to suffering females. Three years ago my health +became so poor that I was scarcely able to help with the household +duties. I was persuaded to try your medicine, and purchased six bottles. +That, with the local treatment you advised, made me strong and well. My +sister has used it in the family with like results. + + Yours truly, + L.E. Johnson + + +MADE LIFE A BURDEN. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Miss Crawford.] + +_Gentlemen_--For years I suffered monthly from periodic pains which at +times were so acute as to render life a burden. I began using Dr. +Pierce's Favorite Prescription. I used seven bottles in as many months +and derived so much benefit from it and the home-treatment recommended +in his Treatise on Diseases of Women, that I wish every women throughout +our land, suffering in the same way, may be induced to give your +medicines and treatment a fair trial. + + Gratefully yours, + Miss G.F. CRAWFORD, + Limestone, Me. + + + "FEMALE WEAKNESS," LEUCORRHEA. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration] + +_Gentlemen_--I will write you a few lines to-day and feel thankful that +I can say I enjoy good health most all the time. When I first commenced +using your medicine I was suffering from female weakness, leucorrhea, +bearing-down pains and a soreness across me that at times I could hardly +stand up straight when I would get up off of my chair to walk across the +room. I got a bottle of your "Favorite Prescription" and by the time I +had used half of it, the soreness began to get better. I used three +bottles altogether, and since that, you might say I am enjoying the best +of health most of the time. I have had two baby boys since--both +healthy, although the baby is only three weeks old, and I am doing all +of my own work since he was two and one-half weeks old. + +I always speak highly and recommend your medicine because I know it +deserves a good name; and I feel certain it will cure female diseases if +they give it a fair trial. + + Yours respectfully, + MRS. RICHARD REED, + Springfield, Kings Co., N.B. + + +FEMALE IRREGULARITIES. + +Cuscowilla, Mecklenburg Co., Va. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +_Gentlemen_--I take pleasure in adding my testimonial to the great list, +and hope that it will be of interest to suffering humanity. I tried +three doctors and none of them seemed to do me any good. When at last I +almost despaired of health any more, I saw in a paper one of your +advertisements, and I sent for and got two bottles of Dr. Pierce's +Golden Medical Discovery, and I improved so rapidly that I sent for and +got three bottles of your "Favorite Prescription," and now I am as well +as I have been since I was a child. + +I had been a sufferer for three years when I commenced taking Dr. +Pierce's medicines. When I commenced taking it, I was not able to walk +across my room without help, or rise from my chair. I suffered from +nervousness very much, and with the least excitement I would faint; and +I think, in short, I suffered with female irregularities and that your +medicine has brought me through. I don't think I can say enough for it. +I have used five bottles of your medicine in all. + +If any one wishes to know what I have to say, they can address me in +person, enclosing stamps. With respect, I am, + + Yours, + Sarah E. Ineker + + +"JUST A MERE SKELETON." + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Roberts. ] + +_Gentlemen_--If I had not taken your medicine I would not be here now. +The doctors did me no good, I was just a mere skeleton, could not eat. I +would have awful pain in my stomach--pain in my side, bowels and chest; +soreness in my back and womb; was weak, nervous and could not sleep. + +After I took your "Favorite Proscription" and "Golden Medical +Discovery," I commenced to improve. In two weeks could walk about the +house--could eat--did not have any more pain in my stomach--threw away +my morphine powders. When I first commenced taking the medicine it made +me feel worse. I was hoarse, could not speak aloud for three days; as I +got better my pains and bad feelings left me and I could sleep good; my +nerves got better. Before I took your medicine I kept my bed four +months--got worse all the while. I am now quite fleshy and can work all +day. + + Respectfully, + MRS. WILLIAM ROBERTS, + Bridgeport, N.Y. + + +CONSTANT SUFFERER FOR MANY YEARS. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Scott.] + +_Gentlemen_--For many years my wife has been a constant sufferer from +indigestion, sick headache, nervous prostration and all other complaints +that the female sex is heir to, and, after trying many remedies and +doctors with but little or no relief, I persuaded her to try Dr. +Pierce's Favorite Prescription and "Golden Medical Discovery." She was +so out of heart, she returned the answer that it would be like all the +rest--of no good; but on my account, she said she would try it, so I got +one bottle each; and before she had used half of a bottle she felt that +it was benefiting her, and she has continued to improve ever since, and +now thinks it the most wonderful remedy on earth for her sex, and +recommends it to all suffering females. She has not been so well in ten +years. + +I write this without any solicitation and with a free, good will, so +that you may let all who may suffer know what it has done for her. + + Yours truly, + M.W. SCOTT, + U.S. Marshall's Office, + Atlanta, Ga. + + +A MOTHERS' FRIEND. + +Tanks, Cottle Co., Texas. + +DR. R.V. PIERCE, Buffalo, N.Y.: + +_Dear Sir_--I took your "Favorite Prescription" previous to confinement +and never did so well in my life. It is only two weeks since my +confinement and I am able to do my work. I feel stronger than I ever did +in six weeks before. + + Yours truly, + Corda Culpepper + + +BED FAST. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.: + +[Illustration: Mrs. Tappan.] + +_Gentlemen_--For about two years I was a constant sufferer from diseases +peculiar to my sex. I had to be carried from my bed, had horrible +dreams, sinking sensations, was very nervous and had little or no +appetite. In short, my whole body was racked with pain. I had frequent +attacks of hysteria, and was completely discouraged, for I found no +medicine did me any good. At last I determined to give your "Favorite +Prescription" a trial. I had taken but two bottles before I felt so much +better! I took eleven bottles. To-day I am well. I have never felt the +least trace of my old complaint in the last six years. We use the +"Golden Medical Discovery" whenever we need a blood-purifier. By its +use, eruptions of all kinds vanish and the skin is rendered clear and +soft, almost as an infants. + + Respectfully, + MRS. HARRY TAPPAN, + Reynolds, Neb. + + +AT DEATH'S DOOR. + +Abita Springs, La. + +DR. R.V. PIERCE, Buffalo, N.Y.: + +_Dear Sir_--My wife suffered from laceration of the womb and +inflammation--she was completely bed-ridden and lingered about one year +at death's door. Local applications were given her and Dr. Pierce's +Favorite Prescription; she gradually regained strength and continued to +do so until she recovered. I am convinced that any case of womb disease +can be certainly and permanently cured by the use of your remedies. + + M. Green + Agt. Southern Exp. Co. + + +HEART, LIVER, AND STOMACH DISEASE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mrs. Landrum.] + +_Gentlemen_--About nine years ago my health began to fail; had a +continual pain and aching under my right shoulder and in or under my +right breast; I could not eat anything but a little milk or bread, and +even that made my stomach pain and hurt me so I could not rest; I kept +getting weaker all the time and I could no longer sit up; I sent for our +family physician; he said I had dyspepsia and inflammation of the liver, +and gave me medicine two or three months, but I kept getting weaker all +the time; it seemed to me that I was diseased all over; thought I had +heart disease; had the doctor examine my heart several times. I became +so discouraged that I gave up all hope of ever getting well, but +consented to send to Dr. Pierce for medicine. I commenced taking it and +in a short time I was able to sit up; continued to take his medicine +three months and felt like a new person--didn't need any more medicine +and have not yet. I can eat anything I wish; am sixty-three years old; +can walk a mile without any trouble, and I can truly say that I believe +it was Dr. Pierce's medicines that saved my life. + + Respectfully yours, + MRS. VIRGINIA LANDRUM, + Merino, Logan Co.. Col. + + +UTERINE DISEASE. + +Creston, Iowa. + +DR. R.V. PIERCE, Buffalo, N.Y.: + +_Sir_--My wife improved in health gradually from the time she commenced +taking "Favorite Prescription" until now. She has been doing her own +housework for the past four months. When she began taking it, she was +scarcely able to be on her feet, she suffered so from uterine debility. +I can heartily recommend it for such cases. + + Yours truly, + H.H. Snyder + + +THE PICTURE OF HEALTH. + +DR. R.V. PIERCE, Buffalo, N.Y.: + +[Illustration: Mrs. Meeker.] + +_Dear Sir_--My daughter, Miss MEEKER, was sick and we called in one of +the best doctors here. She got so weak that I had to help her out of bed +and draw her in a chair. She then tried some of Dr. Pierce's Favorite +Prescription. In less than a week she was out of bed and has been +working about five weeks now, and looks the picture of health. As for +myself I am much better of my female complaint. Before taking the +"Favorite Prescription," I suffered most of the time from catarrhal +inflammation. + + Yours respectfully, + MRS. NANCY MEEKER, + Dunraven, Delaware Co., N.Y. + + +LIFTED THE BURDEN. + +Nye, Putnam Co., W. Va. + +DR. R.V. PIERCE, Buffalo, N.Y.: + +_Dear Sir_--Mine is a case of eleven years' standing, which baffled the +skill of the best medical aid procurable. I obtained no good effect, +until I began the use of the "Favorite Prescription," which lifted the +burden which was seeking my life. My gratitude I owe to the +"Prescription." I hope that all suffering humanity (as in my case) may +profit by the result of my experience. + + Yours truly, + Evoline Neil + + + * * * * * + + + + +SPERMATORRHEA + +(SEMINAL WEAKNESS), + + +or emission of semen without copulation, is generally induced by the +early habit of masturbation. It is one of the evidences that passion, +instead of prudence, has held sway. Passion may aptly be termed the +voice of the body, by which, if we listen, we are enchanted and led +astray. Conscience is the voice of the soul, which remonstrates, and if +we obey, we shall be guided aright. We cannot reconcile these +conflicting voices, and if we indulge the passions when conscience +forbids gratification, the remembrance of the wrong remains forever, and +constant fear is an everlasting punishment. + +WRECKED MANHOOD. Man possesses few powers which are more highly prized +than those of virility, which is the very essence of manhood. "He is but +the counterfeit of a man, who hath not the life of a man." + +THE SEMEN is a milky fluid of the consistency of mucus. It is secreted +by the testicles and is intermixed with the fluids secreted by the +prostate and by Cowper's glands. Its fertilizing property depends on the +presence of minute bodies, termed _spermatozoa_. These consist of little +polliwig-shaped bodies (Fig. 3), having large heads and long filaments +or tails. Under the microscope these little bodies are seen to describe +movements not unlike those of polliwigs. + +WHY EMISSIONS OF THE VITAL FLUID DEBILITATE. The seminal fluid consists +of the most vital elements in the human body. It not only assists in +maintaining the life of the individual, but communicates the essential, +transforming principle which generates another mortal having an +imperishable existence. Its waste is a wanton expenditure, which robs +the blood of its richness and exhausts the body of its animating powers. +No wonder that its loss enfeebles the constitution, and results in +impotency, premature decline, St. Vitus's dance, paralysis, epilepsy, +consumption, softening of the brain, and insanity. No wonder that +conscience and fear become tormenting inquisitors, and that the symptoms +are changed into imaginary specters of stealthily approaching disease. + + "There is no future pang + Can deal that justice on the self-condemned + He deals on his own soul." + +THE PRACTICE OF ONANISM squanders the vitality and bankrupts the +constitution. Indigestion, innutrition, emaciation, shortness of breath, +palpitation, nervous debility, are all symptoms of this exhaustion. +Subsequently, the yellow skin reveals the bones, the sunken eyes are +surrounded by a leaden circle, the vivacious imagination becomes dull, +the active mind grows insipid--in short, the spring, or vital force, +having lost its tension, every function wanes in consequence. Excessive +lustful enjoyment produces feebleness, and finally terminates in disease +and impotency. + +SEMINAL WEAKNESS may be the result of marital excesses. A _proper_ +sexual gratification contributes to the health and happiness of both +parties. On the other hand, intemperate indulgence not only prevents +fruitfulness, but ultimately, if persisted in, renders the husband +entirely impotent, and undermines and destroys the constitution of the +wife. Spermatorrhea may be induced by spinal irritation, intestinal +worms, or piles. It may also result from inherited, as well as acquired, +constitutional weakness. + +NOCTURNAL OR NIGHT EMISSIONS. Involuntary emissions of semen most +frequently occur during amorous dreams at night, and are therefore +termed _nocturnal emissions_. Although they are at first occasioned by +lascivious dreams, attended by erections and pleasurable sensations, +yet, as the disease progresses, the erections become less perfect and +the losses are only revealed by the depression of spirits experienced +the following morning, and by the stiffened and stained spots on the +linen. At first, these emissions may occur but once in two or three +weeks, unless the patient be excited by company, stimulation, food, +drinks, or other causes; but, at a later stage of the disease, they +sometimes take place every night. In aggravated cases, the seminal sacs +are so weakened that the warmth of the bed, friction of the clothing, +reading obscene literature, viewing indecent pictures, indulging in lewd +conversation, or even being in the presence of women, produces a waste +of semen--many times unattended by erections. When there is great +weakness, seminal discharges may be induced by lifting heavy weights, +pressure upon the genital organs, horseback riding, straining at stool, +or even upon urinating, as observed when muscular efforts are made to +expel the last drops, which appear thick and viscid. If the urine be +allowed to stand for a few hours, the seminal discharge will be +precipitated, and will form a light-colored deposit at the bottom of the +vessel. If the sediment be examined with a microscope, spermatozoa can +readily be detected in it. + +WASTING AWAY OF THE TESTICLES. Masturbation not only occasions loss of +semen, but frequently the testicles and other generative organs waste +and become reduced in size as a result of the abuse. Fig. 1 shows the +testicle in a healthy condition, while Fig. 2 represents one much +reduced, as a result of self-abuse. + +The celebrated Dr. Drewery, of London, speaking of the reason why +masturbation is so extremely injurious in its effects upon both body and +mind, says: + +"This is a question which I have often been asked by patients, and it is +one which is rather difficult to explain to any one not acquainted with +the phenomena of reflex nervous action. + +"Perhaps the simplest mode of putting it is to say that the effects +produced by the excitement of the parts are not the direct result of the +stimulation, but that the excitement of the extremities of the nerves is +conveyed through them to the spinal cord and brain, and that the +emission which occurs, when sufficient stimulus has been applied, is the +result of nervous force reacting upon the parts from the spinal cord +back again. This action is termed reflex, and is similar to that of +vomiting, which is only produced through the medium of the great nervous +centres; so that if the nervous communication between the stomach and +spinal cord and brain is cut off, nothing in the stomach could possibly +cause vomiting, whereas if the communication remains intact, this action +can be immediately produced by irritation of nerves far away from the +stomach, viz., by tickling the fauces, as every drunkard is well aware +who has ever put his finger down his throat for the purpose of emptying +his stomach of the contents which are poisoning him, but which without +the additional stimulus he is unable to expel. It will be seen, +therefore, from this that the act of emission is only produced through +the agency of the spinal cord, and not by any direct nervous action +between the parts which are stimulated, and those which are concerned in +the emission. + +[Illustration: Fig. 1. +The Testicle in a healthy condition.] + +[Illustration: Fig. 2. +A Testicle wasted by Masturbation.] + +"The brain is also concerned to the fullest extent in the production of +these phenomena, as are all the senses of the body; this is proved by +the fact that emissions occur during sleep, without any excitement +beyond the engorgement of the parts with blood, produced by the +cerebellar congestion of the brain, usually found to follow lying upon +the back during sleep. This, however, is unnatural and unhealthy, and is +usually the result, as before pointed out, of masturbation. But these +two important points must be remembered--that emission may be produced +by friction merely as a purely spinal reflex action, and it may be +caused by the action of the brain without any friction whatever. Both +these results are unhealthy and injurious. A true natural and healthy +act of sexual intercourse demands the excitement of brain, spinal cord, +and every nerve in the body simultaneously, and resembles the lightning +flash which restores the equilibrium of electric force disturbed during +a thunderstorm. + +"It is useless to endeavor to describe the marvelous actions of nervous +force, but from what has been said it is not difficult to comprehend +that if a convulsive action is produced in any part of the body by the +sole excitement of the spinal cord, when it is necessary for its healthy +and natural production that the brain and senses generally should be +equally excited, the balance of nerve power is destroyed, which fact +alone is proved by the effects upon the nervous system always following +masturbation, which is the irritation of the spinal cord without the +assistance of the brain." + +VARIOUS COMPLICATIONS are likely to arise in the progress of this +malady. + +STRICTURE of THE URETHRA, or water passage, is a very common +complication and, even when quite slight, generally interferes very +seriously with the cure of the spermatorrhea when overlooked by the +attending physician, as is very commonly done, especially when the +constriction of the water passage is only slight. Very often it occurs +in our practice that on examining a case of this disease that has been +the rounds of the doctors, we find a stricture, which had been entirely +overlooked by other practitioners, being so slight as not to occasion +serious obstruction to the flow of urine but yet sufficient to interfere +very much with the cure of the spermatorrhea. The size of the urethra, +or water passage, should bear an exact and proportionate relation to +that of the penis, and when from any cause the urethra is contracted +below this normal size, it should receive attention, as otherwise the +stricture is likely to increase and the passage becomes so constricted +as to produce serious disease of the bladder, and not fail to perpetuate +spermatorrhea, when this disease exists. + +HYDROCELE (_Dropsy of the Scrotum_) consists of an undue secretion of +the fluid which moistens the _tunica vaginalis_, and may arise from an +irritation of the testicle, produced by masturbation. This subject is +fully considered in the Medical Adviser. + +VARICOCELE is a dilatation of the veins of the spermatic cord and +scrotum, and is frequently a result of masturbation. It is readily +distinguished under the form of a soft, doughy, compressible, knotty, +and unequal enlargement of the veins, and a tumid condition of the +adjacent parts. One writer, speaking of the enlargement of the spermatic +vessels, describes them as "feeling like a coiled up bundle of worms." + +DISEASE OF THE PROSTATE GLAND is frequently caused by solitary +indulgence. Venereal excesses produce congestion and the gland is +overnourished. It becomes greatly enlarged, a condition called +_hypertrophy_. This affection gives rise to a heavy feeling or pressure +in the region below the bladder, and often interferes seriously with +urination, and gives great pain and uneasiness, and often results in +grave and dangerous complications. + +PROSTATORRHEA consists of an unnatural flowing or wasting of the +prostatic secretion, which may be known by its mucous-like appearance, +and, when placed within the field of the microscope, by the absence of +_spermatozoa_ or fecundating germs. It is often mistaken for +spermatorrhea, or for gleet, by inexperienced and careless physicians. +For a full consideration of diseases of the prostate gland, see Part IX +of our Dime Series of pamphlets, which will be sent on receipt of ten +cents in postage stamps. + +Again, the habit of self-pollution weakens all the structures of the +genital organs, and induces seminal waste, which may lead to a morbid +diminution in the size of the prostate gland. This condition, which is +exactly the opposite of the one above described, is _atrophy_. Any +disease which renders the circulation in the prostate gland languid and +feeble interferes with the nutrition of that organ and impairs its +function. + +IMPOTENCY (_Loss of Sexual Power_). Masturbation prevents the +excitability of the nervous system and sexual organs and causes +debility, which is indicated by the premature discharge of semen during +sexual intercourse. These premature emissions indicate not only partial +impotency, but also that the nerve-centres have become morbidly +sensitive by the practice of solitary vice, or marital excesses. At +length the powers of the erectile tissues are diminished, and there is +weakness which prevents the act of copulation, or the erection may be +slow and not last long enough, on account of a faulty functional +condition of the spinal cord. + +A PECULIAR FORM OF IMPOTENCY is associated with certain abnormal +nutritive changes which give rise to a lymphatic or fat condition of the +system. Not that the temperament in all these cases is originally +lymphatic, but the system degenerates in consequence of nutritive +perversion. With the loss of sexual ardor, there is also apathy of mind, +loss of manliness, and the victim becomes cold, dispassionate, and +treacherous, devoid of any admiration or love for the opposite sex. He +acquires rotundity of person, the face is fat, smooth, often beardless, +and the voice is feminine. + +The victims of this disease represent two distinct classes, viz.: (1) +those who are fearfully tormented by the consciousness that they are +losing their virile powers, and become irritable, jealous and often +desperate; and (2) those who are completely indifferent to this +deprivation. + +(1.) Patients of the former class are readily restored to health by +proper treatment, for they are willing to make an effort for the +recovery of their manly powers. There is not complete loss of sexual +desire, yet their disappointment is so great that they may entertain +suicidal thoughts. They are moody, fickle, discontented, excitable, and +remarkably impulsive. With proper treatment, they regain tone of body, +vigor of mind, an increase of sexual desire, and become more attentive +to business affairs, and less indifferent to the gentler sex. With the +restoration of the general health and the sexual functions, remarkable +constitutional changes occur. It is often the case that their intimate +friends hardly recognize them by looks or acts. + +(2.) It is equally true that those who are wholly indifferent to the +loss of virile power, uninterested in the evidences of their manhood, +are sometimes incurable. In fact, it is useless to treat the latter +class, because they will neither co-operate with the physician, nor +persist in the treatment necessary to effect a radical and +constitutional change. + +Masturbation perverts and finally destroys the secretory functions of +the testicles. It sometimes causes chronic inflammation, which may +result in obliteration of the minute seminal canals, or obstruction of +the conveying ducts. The sperm is imperfectly elaborated and totally +unfit for procreative purposes. Sometimes the spermatozoa are entirely +absent, and, when present, are very few in number, incomplete in +structure, diseased, and deficient in power as well as in organization. +Fig. 3 represents the spermatozoa in a healthy condition, and Fig. 4, +when they are sickly, deficient and inanimate. The husband may appear to +be healthy, and _his_ inability to procreate may be erroneously +considered a defect in his wife. + +SYMPTOMS OF SPERMATORRHEA. The indications of abuse of the sexual organs +are loss of nervous energy, dullness of the mental faculties, and +delight in obscene stories. The expression of the face becomes coarse, +and the movements slow; the eye is sunken, the face bloated and pale, +and the disposition is fretful and irritable; the appetite is +capricious, the throat irritated, and the patient makes frequent +attempts to clear it, in order to speak distinctly. There are pains in +the chest, wakefulness, and during the night lascivious thoughts and +desires. The relish for play or labor is gone, and a growing distaste +for business is apparent; there is a determination of blood to the head, +headache, noises and roaring sounds in the ears, the eyes may be +blood-shot and watery, weak or painful, the patient imagines bright +spots or flashes passing before them, and there may be partial +blindness. There is increasing stolidity of expression, the eye is +without sparkle, and the face becomes blotched and animal-like in its +expression. The victim is careless of his personal appearance, not +unscrupulously neat, and not unfrequently a rank odor exhales from the +body. + +There are troublesome sensations, as of itching and crawling, in and +about the scrotum. Subsequently, there is obstinate constipation, and +all the symptoms of dyspepsia follow. Gradually the pallor deepens, the +patient becomes emaciated. There is a shortness of breath, palpitation +after even moderate exercise, trembling of the knees, and eruptions on +the skin. There may also be cough, hoarseness, stitch in the side, loss +of voice. The sleep is not refreshing, the patient has frequent +nightmare, or the dreams are lascivious, and the involuntary emissions +of semen become more frequent. The weakness increasing, the sufferer +experiences a weakness in his legs and staggers like a drunken man, his +hands tremble and he stammers. + +[Illustration: Fig. 3. +Microscopic appearance of healthy semen.] + +[Illustration: Fig. 4. +Microscopic appearance of semen which will not fecundate.] + +The victim is unable to concentrate his thoughts, cannot remember what +he reads, and is mentally indolent. He begins to be suspicious of his +friends, has less confidence in others, and desires to be alone, is +despondent and has suicidal thoughts. He has pain in the back, does not +like to walk, and is inclined to lie down. The semen is prematurely +discharged upon attempting coition, and if there be offspring, it is apt +to be feeble or subject to scrofula, consumption, or convulsions. The +genital organs, especially the penis and testicles, diminish in size, as +the disease progresses, lose their energy, and the glands of the penis +become cold and flaccid. There is frequent desire to urinate, chronic +irritation in the neck of the bladder, and pain in the spermatic cord +and testicle, and sometimes in the end of the penis. The microscope +shows that semen involuntarily discharged may be devoid of spermatozoa, +or if present, they are defective, their heads being without tails. The +urine is loaded with mucus or bears up a filmy, membranous, transparent +matter, or it may be covered with a thin fluid having an oily +appearance, but in rare cases is clear. Again, it may hold substances in +solution, which are deposited in crystals or incrust the urine, or it +may precipitate a material having the appearance of brick-dust, and +sometimes semen tinged with blood. The dyspeptic symptoms when present +are followed by diarrhea. The limbs are cramped and rigid, the feet +bloated, and the patient becomes melancholy and relinquishes all hope of +recovery. As the disease progresses, the patient lacks firmness and is +absent-minded. + +When the erections are imperfect and the semen is prematurely +discharged, or when a lengthy coition is required before the sperm can +be ejected, it is evident that the patient is rapidly becoming impotent; +the virile powers are vanishing and manhood is surrendering sway to a +merciless foe. We frequently witness this condition in men, even at the +age of thirty-five, when the summit of vigor and strength should only +have been reached. How often are we solicited to restore these lost +hopes and powers! To what tales of ignorance and recklessness, or +submission and remorse, do we repeatedly listen from these unfortunate +sufferers! In patients of this class, sexual intercourse prevents +spontaneous emissions, but it does not remove the functional and organic +derangements of the nerve-centres; hence, at a time when the victims of +this disease should be in the prime of life, they are impotent, and +epilepsy, apoplexy, paralysis, softening of the brain, or insanity, +frequently results. + +EPILEPSY (OR FITS). This dread disease is one of the most common and +serious complications of the more advanced stages of spermatorrhea. The +injury done to the nerve-centres by the practice of masturbation is +manifested in epileptic convulsions, more or less frequent. If proper +treatment be early adopted, and faithfully pursued, the case is not yet +hopeless; though, in the majority of cases, the patient never recovers +after the disease assumes this phase. + +PARALYSIS. Paralysis, or Palsy, when occurring as a complication of +spermatorrhea, may be preceded by an attack of apoplexy, in which the +patient loses consciousness, and lays in a condition of profound stupor +for a time, and on recovery from his unconscious state, finds himself +unable to use one or more of his limbs, or the disability and loss of +power, which may also be accompanied by more or less loss of sensation, +may come on gradually, without any premonition or marked manifestation +of its approach. In either case, its appearance is to be regarded as a +matter of serious importance. Paralysis, when occurring as a consequence +of masturbation or sexual excesses, is usually difficult of cure; yet, +now and then, cases are cured at our Institutions even after this grave +malady has appeared as a complication. + +SOFTENING OF THE BRAIN. This malady, although less common as a result of +masturbation than the complications mentioned in the preceding +paragraphs, is of sufficiently frequent occurrence to entitle it to a +passing notice here. This condition usually results ultimately in +complete dementia, or loss of reason. It is an incurable disease. + +INSANITY. This deplorable malady is not a very uncommon result of +masturbation and its various resultant morbid conditions, as the records +of the many institutions for the unfortunate class of sufferers from +this disease bear abundant witness. Sometimes it manifests itself in the +milder forms of hallucination, or monomania, but in the majority of +cases, the patient sinks into a despondent hypochondria, which is many +times followed, sooner or later, by a raving mania. + +In cases of monomania resulting from masturbation, the mental +derangement is often so slight as to escape detection by the patient's +friends, the peculiar freaks of disposition being regarded rather as +eccentricities of character than as symptoms of serious disease. Fits of +despondency are usually common with such sufferers. The mental +derangement is not always accompanied or preceded by spermatorrhea or +frequent seminal emissions, the injury done to the nervous system by the +practice of self-abuse, or sexual excesses, being first noticeable in +various phantasms or imaginings on the part of the patient. These are, +in different cases, so various, both in character and degree, as not to +admit of any classification, each case presenting phases peculiar to +itself. In many cases, the patient imagines that his best friends are +conspiring to injure him, or that some great calamity is about to befall +him. In most cases there is danger of the patient's committing suicide, +if not closely watched. Especially is this true of those who suffer from +fits of hypochondria. + +Except in its milder forms, insanity resulting from masturbation and +sexual excesses, is rarely curable. + +DON'T BE ALARMED. A nocturnal seminal emission now and then, or at long +intervals is not, in and of itself, evidence of the existence of +spermatorrhea or other serious disease. A full blooded, strong, +passionate man, in vigorous health, and who has never abused himself, +may now and then, at long intervals, if his sexual passions be not +gratified naturally, or if he permit his mind to run much upon +lascivious subjects, experience an emission while asleep and dreaming. +As to whether such occurrences are evidence of disease or not, in any +given case, depends upon their frequency, and as to whether they are the +result of a weakness of the organs and are followed by more or less +depression and debility, or are merely the overflow of a robust system, +or the outburst of restrained, pent-up, and ungratified passions. In the +latter case, and when only occurring at long intervals, the emissions +are not followed by any perceptible enervating or weakening effects. + +QUACKERY RAMPANT. This country is flooded with cheap circulars and +pamphlets, circulated openly and broadcast, wherein ignorant, +pretentious, blatant quacks endeavor to frighten young men who may never +have practiced self-abuse, or been guilty of excesses in any way, and +yet who experience, now and then at long intervals, nocturnal seminal +emissions. In such cases, it is the duty of the conscientious, honest, +and sympathetic practitioner of the healing art to give assurance, and +not to unnecessarily alarm those who experience nothing inconsistent +with a state of fairly good health. To frighten such young men into +believing themselves diseased, when in reality they experience nothing +but what may occasionally occur in the experiences of any robust, +healthy man, is the most detestable, downright quackery. + +TREATING THE WRONG DISEASE. Not only are many men subjected to useless +treatment by general practitioners who overlook the real disease, caused +by pernicious youthful habits pursued in solitude, or later excesses in +venery, but the female sex are also quite as often subjected to +treatment for diseases which do not exist, the real trouble being +nervous debility and other weaknesses that have resulted from the +youthful pernicious practices common to both sexes, or later excesses in +marital pleasures. + +MORAL CONSIDERATIONS. Masturbation is a habit which tyrannizes over the +mind, perverts the imagination, and forces upon the victim venereal +desires, even while he is forming the strongest resolutions to reform. +It constrains into its service the higher faculties, such as friendship, +confidence, love, reason, and imagination, to make its ideal graceful +and beautiful. + +SENSUAL LUST. The fancy creates an attractive partner, possessed of +girlish beauty, a perfect type of goodness, blended with sexuality, and +whom the subject worships with all the ardor of passion. Around this +_beau ideal_ all his affections are clustered; to her the purest of his +blood is offered in sacrifice, and it is no wonder that female +associates seem tame and unattractive when such imaginary and consummate +divinity is courted. In the sensual delirium is conceived an elysium of +carnal bliss, where half-nude nymphs display their charms and invite to +sensual enjoyments. Thus we see how this habit makes the spiritual +faculties subservient to morbid passion, and by what means elevating +influences are prostituted to vulgar and base-born creations. + +SYMPTOMS VARY IN DIFFERENT CASES. We can only partially delineate the +terrible effects resulting from the abuse of the sexual organs. The +symptoms are multitudinous, but, as we have before stated, no two +persons are similarly influenced by this disease. The symptoms will vary +according to the severity of the affection, the age of the patient, and +his constitutional peculiarities. The presence of only a few of the +symptoms which we have enumerated is evidence of abnormal weakness, +which demands treatment. + +Montaigne says: "We must see and get acquainted with our sins if we +expect to correct them." Virtue presupposes trials just as much as +victory implies warfare. The triumph of virtue is to defeat morbid or +excessive passion, for virtue is only realized when it is a conquering +force. Innocence is passive but virtue is an active quality, purified in +the fiery furnace of temptation. As men have in all ages been influenced +by passions, so temptation has ever found its victims. It is an +obligation that one owes to himself to overcome every evil passion or +weakness to which he is subject, and the discharge of this personal duty +requires moral courage. + +THE REWARD OF VIRTUE. Our Saviour invited all erring mortals to enter +upon a higher life when He said, "Come unto Me, all ye that labor and +are heavy laden, and I will give you rest." The invitation is +accompanied with a promise. To all who are weary of excess and bowed +down by passion, rest and restoration are promised, if they will but +reform and employ proper means to that end. + +THE SUFFERERS MUST REFORM. Just as there is no spiritual restoration +without obeying the Saviour, so there can be no physical restoration +unless we fulfill nature's imposed conditions. There can be no salvation +unless sin be discarded, and so there can be no redemption from the bad +effects of a practice, so long as it is continued. It is no easy task to +master a despotic passion. Appetite is often stronger than the will. The +treatment must begin with moral reformation. Every manly impulse, and +all the higher qualities of the patient's nature, must be enlisted in +the struggle for virtue and health. + +If the passions are restrained, then the capital of health increases, +for the saving of the vital secretions is equal to compound interest. +This illustrates the truth of the Latin proverb: "_No gain is so certain +as that which proceeds from the economical use of what you have"!_ The +patient actually acquires confidence and manly courage by the retention +of the seminal fluid, which directly increases his virile powers. + +HYGIENIC ADVICE TO PATIENTS. Daily physical exercise and regular habits +must be established. It is important that the mind, as well as the +physical powers, be directed into active and wholesome channels. There +must be restraint and discipline. It is useless to begin medical +treatment while the patient continues to read exciting, amorous stories +and obscene books, which are suggestive of lewd thoughts. Something +practical ought to occupy the thoughts and engage the hands. + +Regular and vigorous physical exercise is necessary to assist the +circulation of the blood, and compel its determination into the minute +and extreme parts of the vascular system. When the blood is thus +directed, nutrition is more vigorous and the activity of all the +functions is augmented. + +Not only should there be regularity in eating, but sound discretion +should be exercised in selecting a plain, wholesome diet, consisting of +such articles of food as best favor a daily and free evacuation of the +bowels. Avoid the use of those articles of food which produce excessive +acidity of the stomach. Hearty or late suppers are not allowable. The +patient should use no alcoholic beverages, and should abstain from such +stimulants as tea, coffee, beer, wine, and tobacco. We cannot even +recommend their _moderate_ use, for total abstinence is the better plan. + +The patient should sleep in a well-ventilated room, on a hard bed, and +have only sufficient covering for warmth and comfort. He should not lie +upon the back, because in this position nightly emissions are more +likely to occur. The patient should go to bed when he feels sleepy, and +not resist the inclination until wakefulness is induced. + +He should rise early in the morning and immediately take a cold hand +bath. For this purpose a quart or two of water and a common hand towel +only are required. After bathing, rub the surface of the body with the +dry hand or a crash towel, and continue the friction until the skin is +red and a reaction is established. Do not excuse yourself from following +these hygienic suggestions. A refreshing bath changes the morbid +sensibilities to a more healthful state by the reaction of the nervous +system. + +It is beneficial to apply a towel saturated with cold water to the +genital organs fifteen minutes before leaving the bed. Douching, or +showering the genital organs with cold water once or twice a day will +also be beneficial. It should not be practiced, however, just before +going to bed. It is well to bathe the head with cold water, and this can +be done much better if the hair be kept closely cut. + +Horseback riding, climbing, and all exercises which rub, chafe, or +excite the genital organs, should be avoided. Even the clothing should +be loose, so that walking will not produce friction or cause any +excitement of these organs. The calls of nature should receive prompt +attention, and the urine be voided at any time (especially during the +night) when there is an inclination. If there be irritation of the +bladder and lower bowels, the patient will receive decided benefit from +the daily use of an injection of cold water into the bowels. From a half +pint to a pint of cold water may be used at one time, and the injection +should be retained for a few minutes before going to bed. The bowels +will thus be relieved, the heat and irritation subdued, and the +liability to seminal emissions lessened. + +Patients afflicted with spermatorrhea should not allow their thoughts to +dwell upon their ailments, for they are apt to become moody, +self-deceived, and even insane upon this subject. To avoid this, +harmless amusements should be indulged in, and good moral company +cultivated. They become suspicious, skeptical, and believe that they are +victims of imposture. When they lose self-reliance, their faith and +trust in others begins to waver, especially if their health does not +improve so rapidly as they had anticipated: As much depends upon the +faithful observance of the hygienic rules as upon the constant and +proper use of medicines. The rapidity of recovery depends upon the +constitutional energies and the vigor of the vital resources. If the +blood be greatly impoverished, or the nervous system much impaired, +recovery will be necessarily slow. Time, patience, and perseverance, are +just as essential to a recovery from the effects of these abuses as the +best medical treatment that can be employed. + +THE MEDICAL TREATMENT OF SPERMATORRHEA AND IMPOTENCY. Few diseases +require so many modifications of treatment, to suit the peculiarities of +individual cases as spermatorrhea, because it is attended with so many +complications and morbid functional and structural changes. Every +complication must be considered, and great judgment exercised in the +selection of remedies. As this selection must depend upon the +peculiarities of the case involved, it is impossible to impart to the +non-professional readers sufficient medical knowledge to enable them to +choose the appropriate remedies for these intricate disorders. Hence it +would be useless to specify the various medicines which our specialists +employ in treating them. It would only lead to many fruitless +experiments, which might result in great harm to the afflicted. For +remedies powerful enough to effect cures of spermatorrhea and impotency +are capable, when improperly employed, of doing great harm. Especially +should all ready-made, proprietary or put-up medicines, such as are sold +in drug stores and chemists' shops, be avoided, for reasons already +mentioned. Great harm, also, often results from the employment of +"galvanic belts," "galvanic batteries and pads," and other catch-penny +devices, with which the too confiding are not only duped and swindled, +but terribly injured. They are all worse than useless, and often render +the mildest case very difficult to cure by inducing serious +complications. It is better to take no medical treatment, but rely +solely on the hygienic advice we have given, rather than to resort to +any of the so-called "_specifics"_ found in the drug shops, or to any +such silly, good-for-nothing trash as the various "Pastilles," +"Boluses," "Curative Rings," "Voltaic Belts," or other quackish +medicines and contrivances. + +IMPORTANCE OF HYGIENIC DISCIPLINE. The invalid should restrict his +attention to hygiene, and learn that patient endurance and heroic +perseverance are necessary, even when taking the most efficient +remedies. His entire system having gradually become deranged, corrective +medicines must necessarily be _chronic_ in their operations; in other +words, they must act insensibly, slowly, and progressively. Some of the +symptoms of sexual weakness will, under proper hygienic and medical +treatment, generally begin to disappear within a month. If the nervous +system be very much impaired, however, a longer time will elapse before +the restorative effects of treatment will be observed. Neither the +physician nor the patient should expect that a broken-down constitution +can be immediately repaired. The day of miracles is past. The most +rational method of treating the sick promises nothing supernatural, +nothing which is not in accordance with science. Diseases of this +character are always slow in their inception, or development and +progress, and must be cured in like manner, step by step. Nature never +hurries; atom by atom, little by little, she achieves her work. + +OUR IMPROVED TREATMENT. Tears ago our specialists resolved to pay +particular attention to the investigation and treatment of these +diseases, which are not only alarmingly prevalent, but sadly neglected +and mistreated by the general practitioner of medicine. + +UNFAILING REMEDIES. Having successfully treated many thousands of cases, +we can safely say of our remedies that they are very positive in their +remedial effects. The great success which has attended the employment of +these remedies has led us to rely upon them with implicit faith. By +their persistent use, spermatorrhea and threatened impotency can be +cured as readily as other chronic or lingering diseases. We particularly +solicit those cases which have heretofore been regarded as incurable. +The patient is subjected to no surgical operation, and he can safely and +accurately follow the directions given, while the treatment does not +interfere with any ordinary occupation in which he may be engaged. These +delicate diseases should not be intrusted to physicians who advertise +under fictitious names, or to those of ordinary qualifications. The +general practitioner may be thoroughly read in these diseases, but he +cannot acquire the skill of a specialist who annually treats thousands +of cases, while the former seldom, if ever, has occasion to prescribe +for them. + +SIGNS OF IMPROVEMENT WHEN UNDER TREATMENT. Under our peculiar and +improved system of treatment, gradual improvement in the patient's +condition will be manifested. The eye becomes more brilliant and +sparkling, the patient is less morose, his digestion improves, he is +less listless and despondent, takes more interest in business and other +affairs, his sleep is less disturbed and more refreshing, the strength +improves, and, if the sexual organs had become wasted in size, weak in +function, and flaccid and soft, they begin, by and by, to have more tone +and firmness, and to develope and increase in size, as their nutrition +is restored, by the checking of the exhausting drain which they have +sustained. If nocturnal emissions occur occasionally, the discharge +will, under the microscope, be found to be less watery, and to contain +increased numbers of _spermatozoa_, with heads and filaments perfect. +The patient now begins to gain in self-confidence, courage, and other +manly attributes, and, instead of the bashful, retiring, nervous, +languid hypochondriac, we see a man of ambition and energy, competent to +battle with the adversities of life. Who can estimate the value of such +a transformation from nervousness and despondency to vigorous manhood? +Who would begrudge all their earthly goods and treasures when thus +afflicted, to be so restored to health and enjoyment for of what avail +are the greatest riches when health and manhood itself are lost? + +OUR TERMS BUSINESS-LIKE AND FAIR. Occasionally persona solicit us to +undertake the cure of these ailments, and, in case of failure, receive +no compensation. They write: "If you will _warrant_ that your +prescriptions will result in a _perfect restoration to health_, we will +gladly pay the fees that you ask." The absurdity of such a request is +apparent, and therefore we answer: "We cannot _warrant_ that you will +live even for the next twenty-four hours. We do not bet, play for +stakes, or wager our skill for money. Personal responsibility cannot be +shifted or evaded, and life and health, with all their momentous +considerations, are necessarily individual affairs. Therefore a proposal +to make the conditions of health a subject of speculation is a challenge +to gamble." The patient may not comply with the specified conditions, +and the physician's success depends upon a faithful application of the +prescribed treatment. For these reasons only a quack will be a party to +any such transaction. Ours is not a trading, hazardously speculative +profession. Besides, thousands of our patients reside long distances +away and we cannot know of their responsibility or honesty, nor spend +time inquiring after their financial standing. + +EVIDENCES OF THE CURABILITY OF SPERMATORRHEA AND IMPOTENCY. Many +individuals afflicted with spermatorrhea and impotency, particularly +those who have been swindled by some of the many charlatans who are to +be found in nearly every city, are incredulous, and doubt our ability to +cure these maladies. Others are skeptical, because their physician, who +may be a very skillful general practitioner, but who has had very little +or no experience in treating these delicate maladies, has failed to +relieve them, and, perhaps, has told them the disease is incurable. + +We therefore beg the indulgence of our readers for here offering some +indisputable evidence of the extraordinary success which we have +achieved, by our peculiar methods of treating these affections, as +pursued at the World's Dispensary and Invalids' Hotel and Surgical +Institute. + +This evidence is introduced for the encouragement of an unfortunate +class of invalids, for many of whom existence has ceased to possess any +charms. The grateful manifestations which we have received from this +class of sufferers have afforded us one of the greatest pleasures of our +lives, and have alone been a rich remuneration for the diligent study +and arduous labors devoted to the investigation of these diseases and to +the perfecting of our peculiar and successful methods of treating them. + +SACREDLY CONFIDENTIAL. In introducing the following extracts from our +extensive files of letters, the names of the writers will be omitted, as +we regard all such correspondence, as well as facts communicated to us +in personal consultations, as _sacredly confidential._ + +Lack of space and fear of wearying the reader, prevent us from +introducing more than a few extracts; but these are only fair samples of +_thousands_ that have been received. Those given, present cases in +almost every stage of treatment, some soon after commencing, others +further advanced, and still others which are cured. If we could devote +the space, and had we time to select them, we could insert an almost +unlimited number of those received from patients who have been perfectly +cured; but we think the reader will be more interested in expressions +coming from patients in all stages of treatment, as they are daily +received. Therefore, without regard for literary excellence, we append a +number chosen miscellaneously, and given _verbatim_. They express the +sentiments of persons in all stages of life, and illustrate the views +and feelings generally entertained by those whom we have been called +upon to treat. + +The following extracts are spontaneous acknowledgments, and are, +therefore, more valuable and truthful than if obtained by solicitation, +a practice contrary to our sense of propriety, and, hence, one in which +we never indulge. Although ofttimes less expressive of satisfaction and +gratitude than if the communication were presented in full, yet only +sufficient space can be spared for a brief quotation from each letter. + + + * * * * * + + +TESTIMONIALS + + +CASE 175,827. IMPOTENCY, CONSTIPATION, AND SEMINAL LOSS AT STOOL AND +WITH THE URINE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--Since I have taken +the remainder of a third month's treatment that you gave me I have been +relieved of my trouble. The emissions have ceased and the losses at +stool and in the water have left me. Eighteen months ago I was almost a +complete wreck; now I take an Interest in business and am in excellent +health. + +Respectfully, S., Waveland, Ind. + + +CASE 177,068. SPERMATORRHEA. LOSS OF VITAL STRENGTH. CARED WITH SEVEN +MONTHS' TREATMENT. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--You have +undoubtedly wondered at my long silence. Since last I wrote you there +has been a marked change in my life (of which I will speak further on), +under your skillful treatment. I improved so rapidly, notwithstanding +the many interruptions which misfortune on my part occasioned, that six +months ago I considered myself cured. I have been married three months +and a half to a worthy woman, who should have gained for herself a +husband who never deviated from a virtuous path as much as I; but the +attachment formed was so strong that no misfortune seemed powerful +enough to sever it. The barrier which seemed insurmountable, and which I +had erected myself by early indiscretions and excesses, has given way, +thanks to your superior medical knowledge and skillful treatment. Again +I can hold up my head and say, "I am a man. I never fail to call the +attention of my friends to your Institution as the best in the world, +for I have reason to know that it is truly so. I have recommended two +friends of mine to you, who are under your treatment, and are getting +well. One has tried all the local physicians, and many firms, but with +no success. May God bless you, and may your Institution meet with all +the success it so richly deserves, is the prayer and wish of one you +have caved. J., Leadville, Colo. + + +CASE 178,666. EMISSIONS, AND LOSS OF WEIGHT AND STRENGTH. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I have had no +emissions now for some time, and feel well in every way. I am gaining in +strength and weight, and find I shall not need further medical +treatment. The four months' medicines that you have sent me have +effected a radical regeneration in my health, and I thank you for it. +M., Hartford, Conn. + + +CASE 111,477. SPERMATORRHEA AND IRRITABLE BLADDER; CURED BY TWO MONTHS' +TREATMENT. + +This was a badly complicated case of spermatorrhea, the patient being +also troubled with frequent urination, partial impotency, mucous +discharges from the urethra, and a burning sensation in the testicle and +groin. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--I +took the two months' treatment sent me by you as directed. After taking +the first month's treatment the emissions ceased entirely, my appetite +increased, and I slept much better. Eight months ago I finished the +second month's treatment and have since been in perfect health. I am +fully convinced that you do every thing that you promise. I am, +gentlemen, yours respectfully, + + R., Fort Totten, Dakota. + + +CASE 266,080. SPERMATORRHEA. THREATENED IMPOTENCY. A SEVERE CASE, CURED +BY SIX MONTHS' TREATMENT. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I have received the +last medicine sent me, and have taken all with the best results. I have +so improved in health that I think it unnecessary for me to take any +more medicine. It is now several days since I took the last of the +medicine, and have not had any return of the disease. The desire to +masturbate seems to have left me, and I feel well, happy and strong. +When I look back to the time before I commenced to take your medicine, +the change that has taken place seems wonderful. I had lost all hope of +being restored from the ruinous habit I had practiced for many years +without knowing how fatal it was to health. I tried hard to stop the +practice, but it had grown so strong on me that I would always practice +it again, and was fast becoming impotent. Had emissions at night; was +nervous, downhearted; and I lost flesh, and felt miserable in many ways +too numerous to mention. But now I feel healthy and well. If I had been +more careful, and had not stopped treatment so soon before, I might have +been cured in four or five months. Nevertheless, I am well satisfied, +and thankful that I am restored to health in six months; and I wish to +express my sincere thanks to you and your Institution, for I owe my +restoration to health and happiness to you. If in the future I need any +medical skill, I shall always apply to your Institution, being certain +of receiving the best attention. Yours thankfully, S., Pittsburgh, Pa. + + +CASE 62,365. VERY BAD CASE OF SPERMATORRHEA AND IMPOTENCY. CURED WITH +SIX MONTHS' TREATMENT. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--It has now been +nine months since I stopped your treatment, and as there has been no +return of former symptoms, I judge there can be no doubt as to my cure +being permanent. I must confess that, having been duped and swindled by +so many previous to visiting you, I had not much confidence when I went +to Buffalo to see you. But your specialists, and your Manager, seemed to +talk so straightforwardly and without making any of those extravagant +promises that I have become so used to, that I became convinced of your +skill before I had been long in your wonderful Institution. I think +almost any invalid who will visit your Hotel, and see for themselves the +wonderful appliances that you have accumulated for the cure of disease, +must soon become convinced that if there can be any hope of relief it +can be secured there, if anywhere. There I saw those who told me they +had been brought there on beds or couches for hundreds of miles, and +that they had not been able to walk for two to four years, and yet with +two or three months' treatment were able to go about everywhere, and +were about ready to return home. Such experiences as these established +my confidence, and to-day I bless the day I first visited the Invalids' +Hotel. True, it took six months to cure me, but I presume you seldom +have cases to equal in severity the condition I was in when I applied to +you. I was so bad, as you will remember, though I do not suppose you +rely upon any thing but your records in referring to cases, having so +many under treatment at all times, at all events, if you will turn to +the record of my case, which is "File No. 62,365," you will see that I +had discharges of semen every time my bowels moved and without +erections. In fact, I was completely impotent. I am now as strong and +vigorous as any man. You told me it would probably take a year to cure +me, but as you accomplished it in five months, though I continued to +take medicine a month longer to insure against a relapse, I think myself +very fortunate. Should any of your staff have occasion to come this way, +I should be only to glad to do any thing I can to entertain them. + + Gratefully yours, + C., St. Louis, Mo. + + +CASE 183,998. GENERAL DEBILITY. EMISSIONS AND LOSS OF ENERGY. URINARY +IRRITATION. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--The reason for my +not continuing treatment further than the fourth month, is the fact that +my health is so much improved that I do not need it. I feel like a new +being. All of my bad symptoms are gone, and I feel that I am cured. For +eight months my health has continued to improve all the time. I owe you +and your staff a debt of gratitude that I can never pay. + +Yours with thanks, H., Johnson's Bayou, La. + + +CASE 152,504. SPERMATORRHEA. + +Mr. S., of Bagwell, Texas, writes as follows: "language fails to express +my gratitude for what your treatment has done for me. I have gained +forty-two pounds since coming under your care. My cure is perfect." + + +CASE 174,628. SPERMATORRHEA. EXTREMELY BAD CASE. LOSS OF VOICE; +THREATENED WITH CONSUMPTION. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I am thankful to +say that as a result of eight months' treatment you have given me, the +symptoms of my disease have been entirely removed. My voice has got +strong and clear, and my breathing is easy and natural. My weight is +increased, and in every way I am feeling well. I cannot refrain from +penning a few lines. + +H., Port Hope, Ont. + + +CASE 113,274. SPERMATORRHEA. + +Mr. K., of Kalamazoo, Mich., writes: "I feel that you have proven to be +the best friend I have on earth. It is about three weeks now since I +finished the last month's medicines, and I feel as strong as I ever did +in my life. When I commenced taking your medicines I only weighed 155 +pounds, but now I weigh 170 pounds. I feel strong and rugged; my step is +firm and bold; and I feel altogether a new man, for which I return you +my sincere thanks." + + +CASE 173,399. EMISSIONS. LOSS OF WEIGHT AND APPETITE; DYSPEPSIA. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Dear Sirs_--I write to let you +know that my health is improved, and to thank you for the same. The +emissions occur only at intervals of several months, and I do not have +any more polluting dreams. I am better in every way. My appetite is +improved, and my digestion is perfect. Have gained in weight, and sleep +well. I have not required all of the last supply of medicine, the sixth +month, and I think I will pull through all right. Please accept my +thanks for the benefit effected. + +D., Valparaiso, Ind. + + +CASE 45,757. SPERMATORRHEA. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--Received yours +dated Oct. 27th, and am happy to say that I have so far recovered as to +believe further treatment unnecessary. I feel like a new man; am able to +do a full day's work without pain or laziness. I am very thankful for +the benefits I have received through your skill, and should I think it +necessary at any time for me to renew the treatment, I will be glad to +call on you. + +Yours with great respect. A., Zanesville, O. + + +CASE 175,315. SPERMATORRHEA; DIZZINESS AND BILIOUSNESS; DYSPEPSIA. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I am in good +health, and can say that I am cured. The emissions have stopped, and I +have no unnatural discharges, nor dizziness in the head. My health is +good in general, and I work hard every day. Physically, I have a good +appetite and digestion, which is a great change from what it was when +you first treated me. Although I continued the treatment for eight +months, owing to the complications and severity of my case, yet I am +thankful for the great relief. + +D., Newport, Ark. + + +CASE 39,625. SEMINAL AND NERVOUS DEBILITY. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--My case was one of +long standing, and had brought me to think and meditate more of dying a +consumptive's death, than living. The ill success I had met in trying to +recover my lost manhood, had put me in such a constantly low-spirited +condition, that nothing was interesting or pleasurable. I am highly +pleased to report the improvement in my condition. My voice, weak and +hoarse when I commenced treatment, is now strong and masculine. Hope and +self-confidence have returned, and my countenance is firm and resolute. +The dull, heavy, pressing pain under my left shoulder, is entirely gone, +long ago. The pain and weakness in hips, back, and side, are never felt. +I am in every way fully restored to perfect health and manhood. + +Yours sincerely, O. Sheboygan, Mich. + + +CASE 67,546. SPERMATORRHEA. CURED IN FOUR MONTHS. + +[EXTRACT FROM LETTER.] + + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--It is with great +pleasure that I write you. I have taken but one month's treatment from +you, and if I should just give you a full history of my case before and +since I have taken your medicine, you would not believe the improvement +could be true. I feel better every way. I am without language to express +my thanks to you for the great work you have done for me. + + Your ever true friend, + B., Blountville, Sullivan Co., Tenn. + + +CASE 22,511. IMPOTENCY. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Dear Sirs_--Accept my thanks +for the great benefit received from your treatment. I never thought I +could be so fully restored. + +G., Peru, Ind. + + +CASE 450,422. SPERMATORRHEA, SEMINAL DEBILITY, MUSCULAR RHEUMATISM. +CURED WITH SIX MONTHS' TREATMENT. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I am thankful to +say that, as the result of the six months' treatment you have given me, +that I am cured of my trouble. Since the beginning of the treatment the +losses became less and less frequent, and now I am entirely relieved, +and desire to return my sincerest thanks to you for the good you have +done and the kind attention that you gave me. + +Sincerely yours, G., Milverton, Ont. + + +CASE 48,927. NERVOUS DEBILITY AND IMPOTENCY. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Dear Sirs_--My head is clear +and I feel like myself again, and now only wish that the money I spent +for useless medicines and experimenting doctors, had at once found its +way to you. By recommending you to others suffering as I did, I hope to +assist in your honorable work. For my restoration to health and manhood, +I am deeply grateful. + +Truly yours, B., Philadelphia, Pa. + + +CASE 154,136. SEMINAL WEAKNESS. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--I +see no further use in continuing your medicines, as I now feel perfectly +well and the emissions have stopped entirely. I used to feel dizzy, +exhausted, and irritable on arising in the morning, but now I feel +nothing of the kind. + +Respectfully, K., Johnstown, Pa. + + +CASE 175,391. SPERMATORRHEA, WITH SYMPTOMS OF BRIGHT'S DISEASE AND +TORPID LIVER. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--When I applied to +you for treatment, although a man of apparently perfect health, yet I +was subject to an exhausting drain, and felt myself gradually declining +in vigor of intellect and constitution. The five months' treatment that +you have sent me has effected a very remarkable change in my health. My +kidneys (which had troubled me so that I feared Bright's disease) and +torpid liver have become natural, and I feel like a new man. The only +precaution I now take is not to sleep on my back; and I feel that I am +cured. I send you the names of some other patients, and close by saying +that I thank you sincerely for the cure, and the great benefit in my +health that has resulted from your treatment. + +M., Manhattan, Kans. + + +CASE 110,837, STRICTURE AND SPERMATORRHEA. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--My seminal trouble +was cured long since, and I had forgotten it. Your medicines relieved me +of that in a short time, and I am satisfied that it will cure the worst +cases in a few weeks. I am also satisfied that you and your faculty +accomplish more in the healing art than any other in the country, and I +cannot say too much in recommendation of your institution. I have tried +your institution, and have found your words true in every sense, and +take pleasure in authorizing you to use my name in any way to suit +yourself. My appetite is good, and I have no pain or trouble whatever. +The neuralgia in the lungs, the tough phlegm, weakness, etc., have all +disappeared. + +A. + + +CASE 111,571. SPERMATORRHEA. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: +_Gentlemen_--Under the influence of your last course of medicine my +health has improved so greatly that I feel any further treatment to be +unnecessary. My health is better now than at any other period for years. +The night emissions have ceased entirely, I not having had one now for +many months. I feel better in every way. + + Respectfully, + P. Pittsburgh, Pa. + + +CASE 57,757. LOST SEXUAL POWER REGAINED. + +[EXTRACT FROM LETTER.] + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--While taking your +medicine I labored physically. I am cheerful, hopeful, joyous, glad, and +grateful for my restoration to sound and vigorous health. My friends +daily express surprise at the great change in my personal appearance, +and declare that I appear younger than I did fifteen years ago. I always +reply that I obtained my new lease of life from the World's Dispensary +Medical Association, Buffalo, N.Y. + +With sincere gratitude and great respect, I subscribe myself W., Canyon +City, Grant Co., Oregon. + + +CASE 3,508. SEMINAL AND NERVOUS DEBILITY OF THIRTY YEARS' STANDING. +CURED IN TWO MOUTHS. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: _My kind Benefactors_--Inclosed +find the case of my daughter-in-law, whom I desire you to treat, +believing that you can cure her. I feel assured that if you fail in the +cure of her case, now so chronic, that no human skill will be of +benefit. + +Some four or five years ago you treated me for general debility and +premature decay, with severe attacks of vertigo. The first month's +medicines, which were sent by express, effected a relief of my case. +Owing to the long standing of my trouble (twenty-five or thirty years), +I concluded to continue the treatment another month. My order was +promptly filled by mail. By these two months' treatment I was perfectly +cured, my whole system renovated and invigorated. I have been repeatedly +asked what I had been doing to cause such an improvement in my personal +appearance, and activity, for an old man. With profound gratitude, +adding love, + + I am your obedient servant, + W., Rusk, Texas. + + +CASE 250,336. SPERMATORRHEA; LOSS OF STRENGTH AND WEAKNESS OF MEMORY. +CURED WITH SEVEN MONTHS' TREATMENT. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I have not taken +any medicine since last December, at which time I had closed the seventh +months' treatment. I am happy to say that, as a result, my mind is clear +and easy. I am steadily gaining in strength, and feel better than I have +for many years, and owe it all to your treatment and advice. I hope you +will live long and prosper, and continue to dispense a balm for +suffering humanity. I will close by giving your faculty my greatest +devotion and sincere thanks, and hope success will crown your business. + +W., Pickens, Miss. + + +CASE 82,127. SPERMATORRHEA. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--Your +last month's treatment has entirely cured me. I have been married three +weeks and am happy, thanks to your unexampled skill. + +B., Blackberry, Kane Co., Ill. + + +CASE 88,736. SPERMATORRHEA. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--Sure +enough I am well, and I desire to thank you for your medical skill. My +strength is very greatly increased, my digestion and appetite are +perfect. I sleep well and awake refreshed, and, in fact, feel better +every way. My eyesight, which was weak, is wonderfully improved, and my +physical condition is now perfect in every way. All the emissions have +ceased. + + Respectfully, + B., Fayette, Howard Co., Mo. + + +CASE 144,241. SEMINAL DEBILITY. CURED WITH FOUR MONTHS' TREATMENT. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I am happy to say +that your treatment, which I have taken four months, has effected a +radical cure of my trouble, and you are at liberty to use my name and +address as a reference. Your treatment has effected a cure in my case. + + Very truly yours, + M., Trout Creek, N.Y. + + +CASE 71,250. SPERMATORRHEA OF THIRTEEN YEARS' STANDING. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--I +can honestly say, as the result of your treatment, that I feel better +now than at any time previous for years. My disease is under complete +control, and I have no fear of any further trouble in that direction. In +a word, I feel that I am cured and well; and you may rest assured that I +shall take great pains to avoid in the future the cause that brought me +to my former condition. I am, indeed, thankful to you, as your treatment +has made it possible for me to lead a better life, and effectually to +resist those passions which so long dominated over me. + + I remain, very respectfully yours, + H, Council Bluffs, Iowa + + +CASE 142,842. SPERMATORRHEA CURED. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--it +is with great thankfulness to you that I pen these few lines. I am +to-day a strong and healthy man, which I never would have been but for +your kind and skillful attention. My health was completely broken down +by the effects of self-abuse, and I doctored with other physicians for +two years, but with no success. However, after a few months of your +treatment I find my health fully restored. I am now in a condition to +enjoy the world and take comfort wherever I am; in a word, I am "a man +among men." I most cordially invite all persons requiring skillful +medical treatment to apply to the World's Dispensary. + +M., Fredericville, Mich. + + +CASE 174,937. SPERMATOZOA. THREATENED WITH IMPOTENCY. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I finished your +three months' course of treatment some weeks ago, and am glad to say +that I am a well man. A thousand thanks to you. + +K., Warm Springs, Mont. Ter. + + +CASE 52,272. SEMINAL DEBILITY. LOSS OF MANHOOD. GENERAL WEAKNESS FROM +EXCESSES. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Dear Sirs_--I took your +medicines according to directions, and I feel that I am fully restored +to health and the enjoyment of my manly powers. My health is better than +it has been for years, and is improving all the time. The headache and +dizziness have entirely left me. You have my honest recommendations to +all sufferers. + +Thankfully yours, M., Hudson, N.Y. + + +CASE 44,573. IMPOTENCY. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Dear Sirs_--As a result of your +three months' treatment, I am feeling better than I have for twenty +years,--more of a man in every way. + +S., Prairie Star, Neb. + + +CASE 56,811. NERVOUS DEBILITY. AFFECTION OF SEVERAL YEARS' STANDING, +PERMANENTLY CURED BY ONE MONTH'S TREATMENT. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Dear Sirs_--Five years have +elapsed since my case was cured by you with one month's treatment. Since +that time I have not had the first symptom of the disease. I know I am +cured. + +Yours with thanks, C., Kalamazoo, Mich. + + +CASE 175,579. EMISSIONS, YELLOW COMPLEXION, BLACK HEADS AND ERUPTIONS ON +THE FACE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION:, _Gentlemen_--I am happy to say +that I have not used all of the last month's medicine. The five months' +treatment that I have had from you has effected my entire cure. I have +had no losses for many weeks, and my complexion is restored to its +natural clearness and purity. The black heads and pimples have all +disappeared. + +K., Neillsville, Wis. + + +CASE 21,437. IMPOTENCY. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Dear Sirs_--I have, as a result +of your treatment, been more of a man than before in six years. I have +felt, worked, and eaten better than ever before. My strength is in every +way fully restored. + +C., Jordanville, N.Y. + + +CASE 38,005. IMPOTENCY. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Dear Sirs_--When I first wrote +you I had given up all hope of ever getting well. I had not worked for +two years. I had not been under your treatment three months before I +went to work, and have been at it ever since. I gain every day. + +C., Hinsdale, N.H. + + +CASE 53,578. SPERMATORRHEA. GREAT LOSS OF STRENGTH AND FLESH, APPETITE +REGULAR, SOMETIMES RAVENOUS AND THEN VERY POOR. INTELLECT AND MEMORY +MUCH ENFEEBLED, THE RESULT OF LOSSES THROUGH THE URINE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--The condition of my +health is highly satisfactory, thank Heaven and you as the instrument. +It has often been a cause of astonishment to me, to think now admirably +your medicines controlled my cage; it seems wonderful even now. I say, +with all my heart, God bless your noble work, for the cure of my disease +and perfect restoration of my health and strength. + +A., Shongo, Allegany Co., N.Y. + + +CASE 52,920. SPERMATORRHEA, RESULTING IN DYSPEPSIA AND HEART DISEASE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I am gratified to +be able to report my cure. My case was a severe one, the insidious drain +upon my system producing general debility, attacks of severe palpitation +of the heart, and obstinate dyspepsia. Since using your medicines, I +have been cured of these troubles. I have no palpitation, digestion +good, not easily worried, able to work hard without undue fatigue, +strength greatly increased. My weight is now 163. I am thankful to God +and to you for the evidence of my final cure. + + Yours devotedly, + R. + + +CASE 51,002. SPERMATORRHEA. RHEUMATIC PAINS, GENERAL LOSS OF MEMORY, +STRENGTH, MANLINESS, AND INTELLECTUAL POWER. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Dear Sirs_--When I sent to you +for medicines, I little expected the remarkable benefit that has +resulted. The rheumatic pains that have so long troubled me, ceased +within a week. I am now able to attend to my business with my former +ability and energy. You have my gratitude for the cure effected in my +case. + + Very respectfully, + P., Bloomington, Ill. + + +CASE 146,406. SPERMATORRHEA, WITH DYSPEPSIA, CATARRH, AND BACKACHE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I am happy to say +that as a result of five months' treatment, the weakness of my urinary +and generative organs has been entirely relieved. My catarrh is so much +better. The difficulty in the head is now gone, and I have no +discomfort. The weakness in the back, and pain in the kidneys, has all +left me, and I rest well at night. There are now no unnatural +discharges, and I am happy to say that your medicines have effected such +a change in my condition that now I continue to improve all the time. + + D., + Medusa, N.Y. + + +CASE 52,121. SPERMATORRHEA. SYMPTOMS: DIURNAL AND NOCTURNAL EMISSIONS, +LOSS OF SEXUAL POWER AND WASTING OF THE ORGANS, GENERAL DEPRESSION AND +EMACIATION. MOST SEVERE FORM OF THE DISEASE. CURE WITH THREE MONTHS' +TREATMENT. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Dear Sirs_--I have waited +several months and find my cure perfect and permanent. Thanks to you my +health and manhood have been perfectly restored, and I am as fat as a +bullock. + + S., + Millbrook, Ont. + + +CASE 4,100. SPERMATORRHEA. ENTIRELY BROKEN DOWN. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--Over eight years +ago I visited you at your office this present month, very melancholy and +thinking perhaps that in six months I would be lying in my cold and +silent grave, and now I am strong and healthy. I never was so healthy in +my life. Am married, and we have two of the nicest children you ever +saw. I am the happiest man in town, and hope to ever be so. My sickness +was contracted through ignorance and self-abuse. I am glad to say that I +have had a permanent cure, and thank God. I feel grateful to you and +thank you kindly. + + Yours very truly, + L., Barnes' Corners, N.Y. + + +CASE 52,004. EMISSIONS. LOSS OF WEIGHT, STRENGTH, AND MENTAL POWER. + +WORLD'S DISPENSARY MEDICAL, ASSOCIATION: _Dear Sirs_--I received the +month's treatment sent for, and took it. It worked like a charm. I have +no more emissions, and my weight, energy and strength, are fully +restored. + + R., + Fort Collins, Colo. + + +CASE 53,859. SPERMATORRHEA. FIVE YEARS' STANDING. SYMPTOMS: FREQUENT +NOCTURNAL EMISSIONS, LOSS OF MEMORY, NERVOUS, NO ENERGY OR STRENGTH. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Dear Sirs_--Pardon me for not +sending you a report of my condition before this. Have been waiting to +see if there would be any relapse. I am assured that my cure is complete +and perfect. None of the symptoms of the disease remain. Your medicines +I can recommend as the most powerful and direct to accomplish good I +have ever taken. I feel it my duty now to give you my heart-felt +acknowledgment for the good done me. + + Respectfully, + H. Goshen N.Y. + + +CASE 38,973. SPERMATORRHEA. EXTREMELY BAD CASE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--You have cured me +sound and well of the terrible effects of early indiscretion. My case +was worse than any I have ever read, and I never expected to get well. +With eight months treatment taken at my home, I have been fully +restored. You have my sincere and hearty thanks. C., Halifax, N.S. + + +CASE 70,648. SPERMATORRHEA AND THREATENED IMPOTENCY. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: _My Dear Benefactors_--Please +accept my sincere thanks. Words at my command are inadequate to express +my feelings when I realize the great beneficial features of your most +excellent remedy. I have spoken to several of my most intimate friends +who are similarly affected, and after I took the first dose I was +completely relieved, and the flesh I gained was in such abundance that I +was scarcely identified by them. I gave part of your _par excellence_ +medicine to a bosom companion of mine, named ----. He became +convalescent, but desires another bottle. Write to him at once. Your +name will be held in the highest esteem by these invalids, and by + + Yours respectfully, H., Cincinnati, Ohio. + + +CASE 143,838. SPERMATORRHEA, WITH PARALYSIS AND DYSPEPSIA. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Sirs_--Your treatment worked +like a charm with me. Before I sent to you I consulted my family doctor, +and asked him what he thought of my case. To give you his own words, he +said. "J., I think you will be an entire cripple." I then thought I +would write to you. I had not taken more than three months' medicine +when I was out in the harvest field. I sleep all night, have a good +appetite, my back has got well, and I can lay all night. My limbs are +stronger, and my nerves are again all right. Upon the whole I am a new +man, and my mental powers are much relieved. In eighteen months from the +time I placed my case under your treatment, I was better than I had been +in ten years, and feel like myself. + + Yours truly, J., Peru Mills, Pa. + + +CASE 93,264. SEMINAL WEAKNESS. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: +_Gentlemen_--Allow me most sincerely to thank you for the great benefit +I have derived from your two months' treatment. When I first wrote to +you I felt as if my life on earth was short, indeed; but, thank God, +through His help and yours, I have been saved from filling an early +grave as the results of self-abuse. Before I began treatment I was pale +and sickly; I had palpitation of the heart so bad that I often expected +to drop dead in the street; I had loss of voice; always felt tired; I +had involuntary emissions of semen in the night, which always made me +feel weak through the next day; whilst quite often my mind was filled +with suicidal thoughts. Such was the price I was compelled to pay for +violating the laws of God and nature. Now every thing is changed. I +thank you a thousand times, Doctor, for the great good you nave done me. +May God bless you. I shall always be pleased to recommend your treatment +to everybody, and I will cheerfully answer any communication that I may +receive in relation to this. W., Lynn, Mass. + + +CASE 140,948. SPERMATORRHEA. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Dear Sirs_--I +believe myself to be free of the trouble for which you have been +treating me. It seems too good to be true, yet I feel satisfied that I +am more of a man than ever before in my life. I have not the time nor +ability to thank you in the high-flown language peculiar to testimonial +writers, but suffice it to say that I am. + + Most gratefully yours, S. + + +CASE 44,464. NERVOUS PROSTRATION. + +This gentleman, engaged as the head of a large academy, suffered +severely from mental depression, weakened memory, nervous exhaustion, +and lack of intellectual power, the result of the delicate drain upon +the nervous system and his severe labors. We append his letter after +four months' treatment: + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--My friends all +notice and speak of my decided improvement. My health and faculties are +again as they were years ago. Yours, H., Philadelphia, Penn'a. + + +CASE 33,928. SPERMATORRHEA, RESULTING IN CONSUMPTION. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Dear Sirs_--I would have been +beyond the reach of aid now but for your treatment. I am now enjoying +perfect health. Yours gratefully. H., Gillie's Hill Ont. + + +CASE 42,921. SPERMATORRHEA, RESULTING IN DYSPEPSIA AND DECIDED LOSS OF +STRENGTH. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I am deeply +indebted to you. The disagreeable head symptoms, dyspepsia and weakness +are all gone. I can now eat and digest as hearty a meal as any one, and +feel well, healthful and energetic. Never have any losses. I was very +sick when I commenced treatment, but was speedily relieved. + + Yours truly, + S., Charles River Village, Mass. + + +CASE 44,866. SPERMATORRHEA, WITH MARKED LOSS OF MEMORY, HEALTH, AND TONE +OF SYSTEM. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I took treatment of +you last summer. The improvement was marked, and I have continued to +grow healthier and stronger, notwithstanding I have been busy all the +time and nave studied very hard. Do not get fatigued as before. I read +six orations of CICERO in seven weeks and passed with honor a very close +examination. My limbs are solid and strong, whereas before I was weak, +and my flesh cold, soft, and clammy. I am in college working hard. +Truly, P. + + +CASE 147,411. APPROACHING IMPOTENCY. RENEWED HEALTH AFTER FIVE MONTHS' +TREATMENT. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I can gratefully +say I am feeling like a new man since taking your prescription for +seminal weakness. While I was in the West two months, my wife received +two months' treatment from you, and on my return home, to my greatest +satisfaction, her cheeks were as red as roses and her health greatly +improved, for which accept our profound thanks. May your honored +President live long and do good unto the sons and daughters of afflicted +humanity, is our prayer. W., Aral, Va. + + +CASE 44,198. NERVOUS PROSTRATION, CAUSED BY SELF-ABUSE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--Your kindness to me +I can never forget. I cannot express half my feelings of gratefulness to +you. I had despaired of ever getting well. Thanks to your skill I am now +a new being. Yours very truly, B., Steuben County, N.Y. + + +CASE 53,816. NERVOUS DEBILITY, CAUSED BY SELF-ABUSE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--My health has +improved so that I no longer need treatment. You have my heart-felt +thanks for the good you have done me, and may you have as good success +in treating the hundreds of others as you have had in mine. I remain +yours very truly, K., Hartford, Conn. + + +CASE 53,913. NERVOUS DEBILITY AND IMPOTENCY. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I shall ever +remember you with gratitude. My relief is perfect and permanent. I feel +_so_ much better. I remain yours truly, J., Jacksonville, Ill. + + +CASE 254,484. SPERMATORRHEA; GENERAL DEBILITY. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I am happy to say +that your medicines and treatment are always ahead of what they are +represented, and I hope you will accept my deep and sincere thanks for +the good you have done me. My weakness and debility have entirely +disappeared, and I can say that the expense of the six months' treatment +I received from you, has been repaid a hundredfold, by the benefits it +has effected in my condition. F., Starkey, N.Y. + + +CASE 54,803. NERVOUS DEBILITY AND IMPOTENCY. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I have taken the +last of the medicine which you sent me, and feel satisfied it has +entirely cured me. I return my thanks to you for the good you have done +me. F., East Liverpool, Ohio. + + +CASE 69,116. SEMINAL WEAKNESS, WITH CANCEROUS TESTICLE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--It has now been +over two years since you treated me and found it necessary to remove one +testicle on account of cancerous disease, that must soon have destroyed +life had the operation not been performed. T feel myself a strong, +healthy man, having had no symptoms of the seminal weakness for months +past. Yours, P., Pittsburgh. Penn's. + + +CASE 51,417. IMPOTENCY. + +I am getting along so well with the medicine that I am a standing wonder +to my friends, and I shall not cease, while life lasts, to praise the +skill that has brought about such miraculous results. + + Yours truly, + K., Chillicothe, Ohio. + + +CASE 67,004. IMPOTENCY. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I am only too happy +to say that I have fully recovered my powers in every particular since +placing myself under your treatment. I would not take $5,000 for the +good you have done me. I am only sorry that I did not go to you before +wasting time and money on the quacks connected with that "Museum of +Anatomy" in New York. + + T., Philadelphia, Penn'a. + + +CASE 67,208. SPERMATORRHEA. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--When placing myself +under your treatment, I was told that my case being an exceedingly bad +one, it would probably require six months in which to effect a perfect +cure. After taking your remedies four months I found myself in perfect +health, and have remained so ever since. I cannot express the gratitude +I feel for you, and can never half repay the debt of gratitude I owe +you. I have given your pamphlet,-"Abuse of the Male Generative Organs +and the Diseases to which it Gives Rise," to quite a number of young men +whom I had reason to suspect it might benefit. + + Gratefully yours, T., Norfolk, Virginia. + + +CASE 67,070. SPERMATORRHEA. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I have now returned +home a now man, after four months' treatment from you. I need no more +medicines now. I would urge all suffering to go to you for help. +Thanking you for your services, + + I remain yours truly, + R., Bunch, Iowa. + + +CASE 431,637. IMPOTENCY, WITH NERVOUS DEBILITY AND LIVER DISEASE. + +This gentleman applied for the relief of the following symptoms: +Exhausting and frequent seminal emissions, losses in the urine, want of +manly strength, nervous prostration, indigestion, torpid condition of +the liver, headache, nausea, and constipation. After a course of five +months' treatment he writes: + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I am very grateful +to you for the good you have done me, and I feel like a man now. It is +sometime since I left off medicine. I have continued to improve, and I +feel better than I have for years before treatment. I am happy at the +restoration of my health and vigor. I shall recommend you to all +sufferers. Hoping you will continue to be successful. + + I remain, + Yours truly, + P., Canaan, Conn. + + +CASE 111,489. SEMINAL EMISSIONS, LOSS OF MEMORY AND GENERAL DECLINE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: +_Gentlemen_--Inclosed please find money for my last supply of medicines. +You seem to understand my condition thoroughly. My color, appetite, and +strength have improved wonderfully, and my sleep is sound, undisturbed +and refreshing. Under the influence of your medicines I have completely +recovered my mental and physical powers, and I feel that I am able to +discontinue further treatment. The emissions have become less and less +frequent until now they do not trouble me at all. + + I remain, yours truly, H., Eagle Springs, Coryell Co., Tex. + + +CASE 51,203. SPERMATORRHEA. PERFECT CURE. HIS LETTER BEFORE TREATMENT, +AND AFTER. + +(First letter.) + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Dear Sirs_--It was my pleasant +privilege to read concerning your skill in the treatment of all kinds of +diseases, and concerning your reputation, which is most justly merited. +Encouraged by these facts to place explicit confidence in you. I beg +leave to state my own case as clearly as I may be able. It is as sad as +it is fatal if no thorough cure can be effected. I have from my twelfth +year onward been practicing, though not excessively, the evil, +_self-abuse._ Although I have been led to abandon the pernicious habit +for several years, my age being twenty-four, the horrible effects have +not disappeared. The serious result is that I am suffering from +spermatorrhea. An involuntary discharge of the seminal fluid occurs +invariably once, not infrequently twice, every week during sleep. The +genital organs have become diminished in size. I will proceed to state +the symptoms which I have been able to observe. They are--disposition to +solitude, inaptitude for study, indolence, forgetfulness, melancholy, +weakness in the back (especially perceptible after standing), a lack of +confidence in my own ability, want of energy, sometimes pain in the +chest, elbow, arm, knees, and loins. Uneasy nights, disturbed and highly +disagreeable dreams becoming more and more irritating as the time for +the discharge of the seminal fluid draws nearer, also a desire to lie +longer in bed in the morning. + +Now, dear Doctors, permit me to ask your kind advice as to what means +are to be taken. I have tried numerous remedies for more than a year, +but to no effect. My suffering grows severer. Please reply as speedily +as you may be able. If you be so kind as to honor me with an answer, +please state the amount of money needed for your services, which shall +be forwarded at once. Please find inclosed one dollar, remuneration for +your kind services. + + Very respectfully, + M., Wheeling, Cook Co., Ill. + +(At the close of treatment.) + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I have finished the +eight months' treatment; had I been able to follow the directions more +closely, three months' treatment would have effected a permanent cure of +my case. Now I am well, body strengthened, mind invigorated, memory +revived, energy to work restored, cheerfulness and bright hopes, once +altogether lost, are now fully regained. Indeed, I feel like a new +being. And now, dear Doctors, in closing our important correspondence, +permit me to render my heart-felt thanks for your kindness to me, and +for the benefit received from your invaluable treatment. Adieu; may God +grant you a long life, that you may benefit many an afflicted one. + + Very truly yours, M., Wheeling, Cook Co., Ill + + +CASE 464,255. MASTURBATION. LOSS OF FLESH AND MENTAL POWER. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--After three months +of your treatment, I find myself cured of one of the worst habits that +it has ever been the lot of man to fall into. My whole system is +invigorated; I have no more weak back nor legs; no more emissions; my +strength is greatly increased, and my weight is more than it has ever +been before. The dull, heavy feeling in my head is entirely past, and I +can truly say that I feel like a new man. Hoping you will do as much +good in the future as you have in the past, is the wish of, Yours truly, +B., Holyoke, Mass. + + +CASE 91,656. SPERMATORRHEA. OBSTINATE CASE OF EIGHT YEARS' STANDING. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--I +have taken seven months' treatment from you, and to-day I am a well man. +My friends are surprised at the great change which has taken place in +me. The emissions have ceased entirely, and I am strong and well. I am a +thousand times obliged to you for the good your treatment has done for +me. + + Respectfully yours, U., Topeka, Kansas. + + +CASE 461,306. ONANISM. MELANCHOLIA; CONTEMPLATED SUICIDE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--Having waited +several weeks after finishing the last medicine, to see if there would +be any relapse, I now send you a report of treatment. I believe I am +thoroughly cured, not only of poor health, but of all desire to abuse +myself. I have regained health, spirits, and confidence. Am married, +something I have long desired, but never before dared to attempt. Please +accept my sincere thanks, gentlemen. Your medicine has saved me from a +suicide's grave. + + H., Denver, Col. + + +CASE 110,838. SEMINAL WEAKNESS AND FISTULA IN ANO. + +A case of anal fistula that had been unsuccessfully treated by +Prof. ----, of Nashville, who had operated with the knife. He had also +been unsuccessfully treated by several home physicians who stated that +his symptoms of spermatorrhea were all that could be described, and more +too. The sensations of crawling and itching in the rectum were very +severe, and as a result of weakness there was a serious palpitation of +the heart, and general debility. The generative organs were unduly +excitable and weak. He complained of weakness in the rectum and loins, +with irregularity of the bowels, trembling and weakness of the entire +system. There was profuse discharge from the fistula and also from the +urethra. We undertook his case without making any promises of a radical +cure, as it seemed that the disease had progressed so that it would be +impossible to effect more than satisfactory improvement in his general +condition, and a palliation of the symptoms of disease. At the end of +seven months' treatment he writes as follows: + + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--The result of the +treatment you have sent me is a permanent cure of the fistula beyond a +doubt, and in a magical manner. My heart is very much improved, so that +it does not trouble me in the least. My health is perfect in every way. +It is unnecessary for me to order any more medicines, but should I think +at any time that a little is required to keep me in good health, I will +order at once. I think that I am entirely through with the fistula and +sympathetic weakness, and I can truly say that your remedies delivered +me from the jaws of death. With sincere thanks to you, I am, yours for +ever. D. + + +CASE 140,056. SPERMATORRHEA. + +The following long-standing and aggravated case of seminal debility +began to yield at once under the specific influence of our medicines. +Frequent nocturnal emissions were present, and the semen also passed +off, unobserved and unsuspected, in the urine; of course a ceaseless +vital drain of this character began quickly and profoundly to impress +the constitution, so that when the patient under consideration applied +to us for relief, the most unmistakable symptoms of commencing organic +disease of the heart and lungs had plainly declared themselves to be +present. Like many hundreds, of similar cases which we cure annually, +the disease yielded promptly and perfectly to the well-directed efforts +of our specialist in this important branch of practice; indeed, so easy, +swift and perfect was the cure that the patient failed to realize the +necessity of continuing the treatment a few weeks in order to insure +himself against the possibility of a relapse, and discontinued his +correspondence with us, whereas it is in precisely such cases that we +recommend the treatment to be not too abruptly discontinued. + + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--Your +kind favor, thoughtfully inquiring after my health, came duly to hand. +In answer, permit me to say that it was not my intention to take further +treatment as I considered my cure to be perfect, all local and general +symptoms having wholly subsided before I had finished the month's +course, and thus far manifesting no disposition to return. However, in +the light of your wisdom and experience, I have reconsidered the matter +and now believe with you that another month's course of treatment is +advisable, in order effectually to guard against the possibility of a +relapse. I accordingly inclose you the price of the additional month's +course. The second morning after commencing the use of your medicines I +awoke refreshed in body and mind, and this experience has been repeated +every morning since. The emissions were arrested at once, and I have not +had a single unnatural discharge since, except once when I experienced a +slight nocturnal emission, which, however, was followed by no depressing +after-effects, but altogether the reverse. I feel so much stronger and +better in all respects that It is a positive pleasure for me to do a +hard day's work now. + + Respectfully, B., Crystal Lake, Wis. + + +CASE 86,291. + +This gentleman had suffered during eleven years from seminal weakness as +the result of indiscretions in youth; nocturnal emissions were present, +and there was also a seminal loss with the urine, and at stool; the +patient's memory was greatly impaired and his mind otherwise affected +from the vital drain; he was dyspeptic, his bowels were costive, and +threatening symptoms of consumption had already begun to manifest +themselves when he came under our care. Two months of our special +treatment, at the patient's home, effected a perfect and permanent cure, +and completely arrested all abnormal seminal losses. The following +grateful letter is from the gentleman in question: + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +_Gentlemen_--Permit me to say that, six months after having discontinued +your treatment, my cure remains perfect. This great permanent and +enduring benefit was secured to me through only two months of your +skillful treatment and careful management of my case. Your medicines had +a wonderful control over my disease, driving away its terrible symptoms +as if by magic; they imparted to me a new power, filled my body and mind +with unusual vigor, and transformed me from one racked with pain and +living death or worse, to a full measure of health and happiness. I feel +that if I had not been opportunely and successfully treated by you, that +my life would have been permanently blighted, and that the happy and +contented mind that now inspires these lines would ere this have been +dethroned of reason. I feel that you have been my savior. I have not had +a single nocturnal emission since leaving your treatment, six months +ago. Thanking you, gentlemen, from the depths of a grateful heart, I +remain. + + Your obedient servant, G., Cayuta, Schuyler Co., N.Y. + + * * * * * + +Did the interest of our readers demand it, we could add to the preceding +list an almost endless number of extracts from letters written by +grateful patients, expressing their heart-felt thanks for having been +cured of spermatorrhea and impotency by our treatment. But we have we +trust given sufficient to illustrate our great success in dealing with +these maladies. + +A CAUTION TO THE AFFLICTED. We are daily consulted by persons suffering +from spermatorrhea and impotency who have been victimized by ignorant +charlatans. Some seek to dupe and swindle the unwary by claiming to have +themselves been cured of spermatorrhea or impotency by some +prescription, which they offer to send free to any sufferer. When the +prescription is obtained it is found to consist of a few articles +well-known to every druggist, coupled with certain arbitrary and +fictitious terms, unknown to everybody and not to be found in any +medical work extant. Following the prescription is a modest suggestion +that if it cannot be filled by the home druggist, the +benevolently-disposed party furnishing the prescription will be pleased +to send the medicine, already prepared, for from three to five dollars. +Of course, the whole scheme from beginning to end being a swindle, when +the "medicine" is obtained and taken it proves entirely useless. Skill +and genuine merit do not go begging. Men who spend hundreds of dollars +for the publication of advertisements offering to give away valuable +information can always be safely set down as swindlers. + +In the public prints will be found advertised various ready prepared, +"put-up," or proprietary, so-called "remedies," "Specifics," "Boluses," +"Pastiles," "Rectal Pearls," "Urethral Crayons," "Voltaic Belts," +"Galvanic Belts," "Batteries," and "Pads," all recommended as infallible +remedies for spermatorrhea and impotency. + +A vast experience in the treatment of these affections has satisfied us +that each case must be studied and treated according to the symptoms +manifested, and that medicines that are adapted to one stage of the +disease are entirely unsuited to other stages of the same case. No "Pad" +or "Battery and Pad," "Galvanic" or "Voltaic Belts," "Battery," "Bolus," +or "Soluble Crayon," ever did or can help a case of this disease, except +it be in the imagination. Although the proprietors of the most popular +proprietary medicines in the market, medicines carefully adapted to the +cure of the diseases for which they are recommended, yet, should we +attempt to get up a general remedy to cure spermatorrhea and kindred +maladies, we are certain it would be an utter failure, and this is +entirely true of all such preparations now and heretofore offered for +sale, and, from the very nature of the diseases they are recommended to +cure, ever must be. Each case must have medicines carefully prepared to +meet the conditions present, and when these conditions, from the effects +of treatment or other causes, change, the treatment must be varied +accordingly. + +POSITIVE INJURY instead of benefit often results from the employment of +some of the nostrums advertised for the cure of spermatorrhea, impotency +and kindred affections. Especially have we found that the use of +"Soluble Urethral Crayons," "Boluses," "Pastiles", and kindred +contrivances, which are so extensively advertised, are exceedingly +injurious, and often render otherwise moderate and simple cases, +complicated and incurable. + +Although of pretended French origin, they are evidently the invention of +an ignoramus, who knows nothing of the delicate anatomy of the +generative organs or of the proper treatment of the diseases incident +thereto, for none other would have thought of such a preposterous plan +of treatment. No man should insert such absurdly devised and mischief +breeding contrivances into his urethra (urinary canal), for thereby he +is almost sure to do himself a permanent injury. So far from having been +invented by an eminent French surgeon, as claimed, such treatment is +entirely unknown in France, and ever has been, as the writer well knows +from personal observation and enquiry while sojourning in that country +and visiting its most noted hospitals and medical institutions. + +All the various "Troches," "Boluses," "Wafers," "Suppositories," +"Pearls," "Rectal Pearls," "Rectal Capsules," and other contrivances +which are recommended for the cure of Spermatorrhea and kindred +weaknesses, and which are designed to be employed by inserting them into +the lower bowel (rectum), and there permitting them to dissolve, are +only so many irrational and filthy devices for duping the ignorant and +innocent sufferers from these maladies. + +AN ALLURING SWINDLE. A still more enticing, and hence more dangerous, +device for swindling unfortunate sufferers, is the widely advertised +"Vacuum Treatment" or "appliance" so loudly and plausibly recommended +for "Developing weak and wasted organs." A simple, little, brass air +pump, connected with a glass tube, or cylinder, fitted with a valve at +one end, which costs not to exceed one dollar and a half, is the +worthless device palmed off on the confiding ones _at from fifteen to +thirty dollars_. This is done under the _false pretense_ that its daily +use to pump blood into the weak or wasted organs, will cause their +development and growth. + +Thousands have invested their hard earned cash in this worse than +worthless, injurious, contrivance. In fact the head of the concern +putting out this alluring device is said to have amassed a fortune out +of the nefarious business. + +So far from benefiting any one, out of several hundreds of cases that +have come under our personal observation, in which this apparatus has +been faithfully used for a long period of time, we have never met with a +single case that had derived the slightest benefit therefrom. On the +contrary, we have been called upon to examine many who had been +_seriously injured_ by its use. + +The sudden congestion or filling and over-distention of the delicate +blood-vessels of the organ operated upon, caused by placing it in a +vacuum, is liable to rupture these minute vessels, causing the +infiltration of blood into the tissues and giving rise to inflammation, +and in some cases, to _suppuration, mortification, sloughing_ and +_death_. + +In other cases, the blood-vessels of the organ and adjacent parts are +so weakened by the _strain_ put upon them as to induce varicocele and +other diseased conditions. In spermatorrhea, it is the worst possible +thing that can be applied, for by forcing an undue amount of blood into +the part the sensitiveness of the organ is increased, irritation is set +up in the deep urethra, and the emissions are increased in frequency. In +this, and other ways, hundreds of men but slightly out of health have +been permanently injured. + +But this is only a small part of the story connected with the +reprehensible business of palming off "The Vacuum Developing and +Strengthening Appliance." The precious rascals, not content with making +from a thousand to fifteen hundred per cent. profit on the miserable +device furnished, while advertising fifteen dollars ($15.00) as the +price of the "appliance" and "accompanying preparations," for "_ordinary +cases_," make a general practice, when they have secured the fifteen +dollars ($15.00), of sending it by express _with a bill to be collected +on delivery_ FOR FIFTEEN DOLLARS ($15.00) MORE. With this bill they send +an explanation, that "on re-examining the case" they "found it +necessary, or thought it advisable, to send their stronger and more +expensive preparations and appliances _for the worst cases_ AND SO HAVE +CHARGED FIFTEEN DOLLARS ($15.00) MORE TO COVER THE EXTRA EXPENSE." + +It is astonishing that there are those who can be induced to part with +their money for such claptrap devices, and still more so that having +been duped and swindled out of their hard earned money through false +pretenses and promises of benefit held out to them, they should submit +quietly to such extortion and not have the swindlers arrested and +prosecuted for obtaining money under false pretenses as they richly +deserve. For what crime can be more deserving of punishment than the +holding out of false hopes and pretenses to the unfortunate? Employing +the United States mails for swindling is a pretty dangerous business, +and sooner or later these rascals will, we predict, find it out to their +sorrow. They are pretty sure to get hold of some men, ere long, who will +invoke the aid of the United States District Attorney to bring them to +justice. + +YOUNG MAN, if you have, through ignorance, fallen into practices that +have arrested your physical growth and development in any of your organs +or parts, shun all such unscientific and worse than worthless +contrivances as you would shun a pestilence. No matter how plausible the +web of arguments woven to entrap you, be assured, they are the utterance +of knaves who care not what false hopes they encourage so they secure +your money. + +Consult only those whose well known skill, experience and integrity will +insure honest dealings and the most scientific treatment known to the +"healing art," and who supply the latter at reasonable cost. + +Be assured also, that when, through proper treatment, your weakness and +functional derangements are overcome, the parts that have suffered +therefrom, will regain all the strength and development possible to +impart to them through the aid of the physician's skill. Nature often +accomplishes wonders in this direction, when aided by the skillful +practitioner. + + * * * * * + + + + +VARICOCELE; + +_OR, ENLARGED VEINS OF THE SCROTUM SOMETIMES CALLED FALSE RUPTURE_ + + +Probably no affection of the generative organs has been given more +attention by surgeons than this. Its great frequency, being present in +about one-third of all cases of spermatorrhea, and its disposition to +result in impotency and wasting away of the testicles, bring it +constantly before the profession. + +[Illustration: Fig. 1. +A healthy testicle.] + +[Illustration: Fig. 2. +Testicle wasted from Varicocele. +The enlarged and +torturous veins are shown +to be about as large as the +testicle.] + +CAUSES.--Varicocele commonly results from long continued fatiguing +exercise, in the upright position, heavy lifting, jumping, straining, +severe constipation, injuries from horseback riding, bicycle riding, +especially the latter, or any obstruction or obstacle to the free return +of blood through the spermatic veins. Self abuse and excessive sexual +indulgence are also prolific causes of varicocele. + +When the spermatic veins are over-distended to such an extent that their +tonicity is impaired, they gradually lose their capacity for +transmitting the blood, and a slowly increasing enlargement and +tortuously of veins results. This goes on, becoming steadily more +marked, until the pressure of the engorged vessels upon the spermatic +cord impedes the full circulation of blood in the testicle and causes a +wasting and softening of this gland. A loss of sexual power and +increasing weakness of the generative organs generally follow this +gradual destruction of the testicle, and sometimes total and incurable +impotency results. + +This affection is also designated by the terms _circocele_ and +_spermatocele_. It consists of an enlargement or varicose condition of +the veins of the scrotum or spermatic cord, and affects the left side +more frequently than the right. This is due to the fact that the +spermatic veins of that side are longer, more dependent and tortuous, +and, consequently, support a greater column of blood than the other +side. The enlarged veins feel like a bundle of earth-worms. The knotty +and tortuous vessels sometimes form quite a large tumor, which is, now +ever, but rarely sensitive to the touch, yet sometimes causes a feeling +of weight in the scrotum and loins, and sometimes produces a sensation +of numbness in the thighs. + +[Illustration: Fig. 3. +Well developed Varicocele.] + +When varicocele of an aggravated or largely developed type is present, +associated with any weakness of the generative organs, as spermatorrhea +or impotency, it must be cured before the organs can regain a healthy +condition, as by the constant pressure of the abnormal quantity of blood +and enlarged veins upon the spermatic cord, arteries, and testicles, the +irritability, weakness, and wasting, are increased. The use of +suspensory bandages, with strongly astringent lotions, will, in mild +cases, produce relief and many times cure. Except in the worst cases, it +is well to try these means before resort is had to operative surgical +treatment, unless the patient is anxious to be cured in a more speedy +manner. The treatment by suspensory bandage and lotions is necessarily +somewhat slow in producing remedial results; yet, many quite well marked +cases have, in our experience, been cured by such means perseveringly +applied. Although many who have been unable to come to us for an +operation, have been cured by suspensory bandages and our improved +lotions applied to the affected parts, in all cases in which the veins +are very much enlarged, we recommend the sufferers to come here and +undergo our surgical treatment, which is painless in its execution and +radical in its results. + +It has been recognized by physicians and surgeons for over a century, +that in bad cases of varicocele a cure can only be certainly and +permanently effected by operation. Many have been the methods of +operation advanced by the prominent surgeons of every age, but all have +met with such an alarming mortality, that they have been one by one +abandoned, except as a last resort in extremely bad cases. A late author +gives the percentage of deaths from the various old operations, now in +general use throughout this country and Europe, as varying from seven to +fifteen per cent. of all cases. In contrast to this, we point with pride +to our records, by which we are shown to have operated upon over a +thousand cases by our original method, obtaining in each and every +instance a perfect cure, without a single alarming symptom or a death +ensuing. This we think is sufficient evidence of the perfect safety of +the operation and its superiority over every other method. So every +sufferer with the disease, we would recommend it as a positive means of +securing a permanent cure. Various worse than useless devices are +advertised by quacks, who, as a class, are afraid to undertake surgical +treatment for the cure of varicocele. One has what he calls a "varix +clamp," or "clasp," to be worn upon the enlarged veins. Many +"compressors" and other equally useless devices are advertised and sold +for the same purpose. These are not only perfectly worthless, but +positively dangerous in their application. The pressure they make upon +the spermatic cord, nerves, and artery, is very apt to result in +impotency and a rapid wasting away of the testicles. Patients should +avoid all the catch-penny devices recommended for varicocele, as none of +them are worth a moment's consideration. + +Even a moderate degree of morbid enlargement of the spermatic veins will +sometimes cause such engorgement and obstruction to the free circulation +of the blood in the testicle, as to cause gradual wasting or shriveling +of that organ. In some cases the morbid condition will give rise to +seminal weakness, or spermatorrhea. Many of these cases that can only be +cured by surgery, are trifled with by quacks, who attribute the +spermatorrhea, or loss of semen, to everything else than its true +cause--varicocele. + +To illustrate, Mr. B., of Colorado, applied at the Invalids' Hotel and +Surgical Institute, a few years ago, and said he had for five years been +troubled with nightly emissions of semen and his testicles were +gradually wasting away. He had been under the treatment of men making +great pretensions as specialists, to whom he had paid several hundred +dollars in the vain hope of getting cured of spermatorrhea. They treated +him with medicines only, and did him no good whatever. On examination, +we found a very varicose or enlarged condition of the left spermatic +veins, and gave it as our opinion that the seminal loss was wholly due +to this abnormal condition and could only be cured by an operation that +would remove the varicocele. The operation was promptly performed. In +two days he was able to leave his bed, and in a week started home to +Colorado. Some months thereafter we received a letter from him wherein +he said: "The enlarged veins continued to absorb and grow less and less, +until, in a few weeks' time, all unnatural enlargement had disappeared. +With a steady improvement in the condition of the veins, I experienced +corresponding improvement in my general health, and the seminal losses +grew less and less, and finally, long ago, disappeared entirely. I feel +that my manhood, with all the powers that should belong thereto, are +mine to enjoy. In other words, my restoration to health is complete. Had +I saved the large amount of money that I fooled away on those quacks, +and given it all to you, I feel that you would then have been only +fairly paid for the great good you have done me." + +The foregoing is but a fair sample of letters that we are almost +constantly receiving from those who have pursued useless treatment for +spermatorrhea, dependent upon varicocele, and have been speedily cured +by our never-failing operation for this malady. Among the great variety +of operations in surgery for various diseased conditions, performed by +our surgeons, none have been attended with more uniform satisfaction, +and perfect success, than has our operation for varicocele. + + +A PAINLESS OPERATION. + +By the injection of a few drops of a medicated solution under the skin, +at the point where the incision is to be made, we are now able to +produce such complete local anæsthesia as to render the operation +_entirely painless_ without the administration of either chloroform or +ether. This is an important consideration, as many are averse to taking +chloroform or ether, and now that we are possessed of an agent that +produces, locally, _complete insensibility to pain_, we are very glad to +be able to dispense with their use in all such minor operations. Many +examinations heretofore very painful, as of the bladder for stone, and +of the deep urethra for strictures, are now rendered _entirely painless_ +by the use of this wonderful agent. + +A great variety of surgical operations are now performed by our surgeon +specialists, without any suffering on the part of our patients, by the +local use of an anæsthetic solution injected into the parts to be +operated upon. Formerly we were obliged either to administer chloroform +or ether, or subject our patients to a great deal of suffering. Our +specialists were among the first surgeons in this country to employ +local anæsthesia successfully. We regard it as a great boon to our +patients, and never withhold it in any case where it can be employed to +prevent suffering, its use being attended with no danger and followed by +no bad or disagreeable results. + + +OUR PAINLESS OPERATION. + +Having operated with unvarying success, during the past twenty-five +years, upon several thousand cases of varicocele, at the Invalids' Hotel +and Surgical Institute, we now invite special attention to the results +of our peculiar operation, which is neither severe nor dangerous, and +from which the patient makes a much more rapid, and in every respect +more satisfactory, recovery than from other operations in use by +surgeons generally. In our practice we have never failed to secure the +happiest results from our operation. The saving of time is also of +importance to the laboring man as well as to the millionaire. Instead of +being confined to his bed for ten to twenty days, and to his room for a +month or more, as is the case following other operations, the patient is +not confined to bed at all, and can generally return home in a week or +ten days at the longest. The only precaution necessary is that he +should, for a reasonable time after the operation, wear a well-fitting +suspensory bandage. This can, in a little time, be entirely dispensed +with. When we contrast these results with those obtained from ligation, +graduated pressure by "clamps," suture pins, or the slicing off of a +part of the scrotum, and suturing, or stitching, the wide gaping wound +so caused, as is practiced to-day by other surgeons, the marked +superiority of the results obtained, through our superior method of +operating on this affection, must be apparent. + +A very large part of those cured by our treatment have previously spent +far more money for worthless "electric suspensories," "equable scrotal +compressors," "scrotal clamps," various "rings," and other "jim cracks," +than was paid us _for a radical and permanent cure_. Some of these +instruments are so formidable as to suggest the racks and thumbscrews of +the middle ages. Such useless appliances often weaken the scrotal +muscles by the unnatural compression which they produce and make the +discomfort far worse when they are discontinued than before their use. + +For such cases as cannot come to us at once for an immediate and +_perfect cure_, we have a common sense method of treatment, +comparatively inexpensive, that gives relief and comfort in all cases, +and in mild cases often effects a complete cure. This treatment leaves +the scrotum and its contents in an improved, strengthened and more +healthful state. + + * * * * * + + +TESTIMONIALS. + + +If the following letters had been written by your nearest, most +respected and trustworthy neighbors, they could not be entitled to more +confidence than they now are, coming, as they do, from intelligent +citizens, each one of whom, in his own neighborhood, enjoys the full +confidence of all his acquaintances. These letters are taken at random +from among hundreds of similar ones, received from former patients of +ours, residing in all parts of the United States and Canada, and if it +would add anything to the endorsement in the way of giving greater +confidence in our ability to treat successfully the malady under +consideration, we could multiply the letters which we here introduce +many times over. To publish more, however, would seem to be tedious +repetition, for there necessarily must be a sameness in all such letters +testifying to our skill, and we must, therefore, be content to rest our +case with the limited number of endorsements which we have room for only +in this volume. + + +VARICOCELE. + +A PERFECTLY PAINLESS OPERATION. PATIENT SMOKES A CIGAR AND TALKS WITH +THE SURGEONS WHILE OPERATION IS BEING PERFORMED. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: A.J. Seth, Esq.] + +_Gentlemen_--I suffered with varicocele at the age of nine years, caused +by a fall, and doctored for same about fifteen years, and obtained no +relief. Renowned surgeons of Pittsburgh, New York, and other cities +pronounced my case incurable. + +I heard of the Invalids' Hotel, No. 663 Main Street, Buffalo, N.Y., and +entered it as a last resource. On the third day after entering the +Institution I was treated, and during the operation (which was a +painless one), I smoked a cigar and talked with the operating surgeons, +feeling _no pain whatever_. I remained in the Hotel one week, and during +that time I never once was unable to walk to the elevator and have my +meals in the dining room. The tables were laden with the best the +country can produce. It is truly "The Invalids' Hotel" (or rather +_home_), as the clerks and nurses are very kind, attentive and social. + +Will add, that I am permanently cured, and advise any person thus +afflicted not to hesitate entering the Invalids' Hotel for treatment. + + Respectfully, A.J. SETH, + Lucinda, Clarion Co., Penna. + + +VARICOCELE. + +Fair View, Sanpete Co., Utah. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: W.F. Petts, Esq.] + +_Gentlemen_--I feel it my duty to thank you for the benefit I received +at your Institution during the month of December, 1892. + +I was afflicted with varicocele on the left side, which caused me a +great deal of trouble and almost made me feel at times that I did not +want to live any longer if I could not be restored to soundness again. +Hearing of your skill in the treatment of varicocele I determined to +give you a trial, which I accordingly did, and with gratifying results +for now I am as sound and well as a gold dollar. + +The operation which was performed on me at your Institution for the +permanent cure of varicocele was, to my great surprise, entirely +painless and performed in a much briefer time than I expected. I only +remained at your noble Institution ten days after the operation, at the +end of which time I returned to my home at Chatham Hill, Smyth Co., Va. +When I got home I experienced very little soreness from the operation +and I felt that I could enjoy life fully. About six months after, I got +married and came to Utah where I now reside, and I am very much pleased +to say that I am now as sound and well as ever, and very happy in my +married state. + +When I went to your Institution I was surprised to see such a great +number of young men from almost every State in the Union, who had come +there to be operated upon for varicocele; and they all told me that the +operation was painless to them, as it also was to me, and they said they +were fast improving and were glad they had come there for treatment. I +never experienced such great and unprecedented kindness as I did during +the ten days I was at the "Invalids' Hotel." I had an excellent +room--well furnished, plenty to eat, and was treated with the kindness +of a mother by the nurses and attending physician. + +I advise all who are afflicted with varicocele to go to your Institution +at once for an operation, which I assure them they will never regret. +Trusting that those who require an operation of any kind, or who are +afflicted in any way, may go to your Institution and be restored to +health, and again thanking you for my restoration to health and YOUR +great kindness and good treatment of me while I was with you, I remain, + + Yours very truly, + William F. Petts + +P.S.--My sister's life was saved by your "Favorite Prescription," W.F.P. + + +VARICOCELE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: A. Ebsary, Esq.] + +_Gentlemen_--It is with great pleasure I recommend those suffering from +varicocele to your skillful hands. I suffered with varicocele for seven +years, caused by standing behind the counter at business from seven in +the morning until ten and twelve o'clock at night. + +In 1888 a friend gave me a copy of your Common Sense Medical Adviser. +After perusing its pages I was convinced of the genuineness of its +doctrine. I immediately started for Buffalo--a distance of 1,900 miles. +During my stay of ten days at your Institution I was treated with the +utmost kindness by the nurses and surgeons, all of whom are expert +specialists. + +The equipment of the Institution is something immense. I often think of +the appetite those healthy exercises in the treatment room gave me when +dinner time came. + +After being in the Institution three days I underwent an operation for +varicocele--an injection of medicine locally making the operation +_absolutely free from pain_. The operation was performed in about thirty +minutes, immediately after which I could walk to my room, and, after +resting an hour, descended to the dining room and took my dinner as +usual. + +While at the Institution I met numerous persons suffering from +varicocele, and it was quite pleasing to contrast their happy looks as +they wished you "goodbye" with the haggard appearance they had upon +entering. + +After leaving the Institution I traveled about 1,400 miles by rail and +500 miles by water without the least inconvenience, which I consider a +fair test of the operation. + +Five years have passed since that time, and I now feel as sound as it is +possible to feel. + +In conclusion, let me say to those suffering from varicocele that it is +impossible for them to do better than follow my example. + + Respectfully yours, ARTHUR EBSARY, + (Care of Hon. Jas. Baird.) Water Street, St. John's, Newfoundland. + + +VARICOCELE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: F.H. Jenkins, Esq.] + +_Gentlemen_--I am a carpenter and some years ago, I fell from a scaffold +which in time almost killed me. I wasn't hurt very much at the time, but +a dull aching pain seemed to take me in the left side of the scrotum, +and after I could stand it no longer, I went to my doctor. He said that +I had a rupture of the blood veins of the left testicle, and it was +incurable. I gave up in despair; but at last, a friend handed me some of +your advertising papers, and I saw the Common Sense Medical Adviser +advertised and sent for the book and studied its contents carefully, and +came to the conclusion that I was suffering from varicocele. I found on +consulting you that my suspicions were right. I at once wrote you for +particulars, and in less than a week I was at the Invalids' Hotel for +treatment. At that time no one knows how I suffered; but I hadn't long +to suffer. In ten days after _an entirely painless operation_ I was a +well man and returned home. + +I cannot say too much in regard to the treatment and care from both +Surgeons and Nurses. Nothing was left undone to promote comfort and good +care. It is the only place on earth that I would feel safe to trust my +life for a severe operation. There were, I think, over 100 patients at +the Invalids' Hotel and Surgical Institute, at the time I was there, and +as I had a good chance to be with them, I found that they were all doing +remarkably well. + +At the date of my operation which was the 7th of March, 1893, I weighed +just 165 pounds; to-day I weigh 189. I have gained in health, strength +and vigor every day, I believe. + +I would just say, in conclusion, that I can give my word as an honest +man to any sufferer that I believe he can be cured of almost any chronic +malady at the Invalids' Hotel and Surgical Institute. + + Respectfully yours, + F.H. JENKINS, + (Box 13), Ascot Corner, Sherbrooke Co., P.Q., Canada. + + +VARICOCELE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: R.C. Martin, Esq.] + +_Gentlemen_--Having been operated upon at the Invalids' Hotel and +Surgical Institute. Buffalo, N.Y., for the radical cure of a varicocele +of the left side from which I had suffered for four years, I take +pleasure in certifying to the speedy and certain relief afforded me, and +the painless nature of the operation, as performed by the surgeons of +the World's Dispensary Medical Association. Fourteen days from the time +of the operation I returned home cured, and went to work. I desire to +express my thanks to the Medical Staff for their skill and attention. I +met several patients while at the Sanitarium, and they all reported as +getting along favorably and well. Respectfully, + + R.C. MARTIN, + Gambril, Scott Co., Iowa. + + +VARICOCELE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Chas. Dove, Esq.] + +_Gentlemen_--I can heartily say that the operation was a great success. +I had rupture of the veins, or Varicocele, ten years. I never thought +that I could be cured so easily. The operation was entirely painless, +and I was only nine days away from home. I am now as well as ever and I +recommend the Invalids' Hotel and Surgical Institute to any one who is +suffering from any chronic disease. Yours, + + CHARLES DOVE, + 33 John St., Wilkes Barre, Pa. + + +VARICOCELE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: J.F. Singrey, Esq.] + +_Gentlemen_--I was successfully treated for varicocele at the Invalids' +Hotel. The operation was made painless by local application, previously +applied, which made the parts insensible, and I returned home the ninth +day. While there I met with patients from all parts of the country, and +all spoke in the highest terms of the treatment received from the +surgeons and nurses and all connected with the Institution. + + Yours respectfully, J.F. SINGREY, + Maryville, Nodaway Co., Mo. + + +VARICOCELE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: H.P. SMITH, ESQ.] + +_Gentlemen_--I feel very thankful to the Association for the benefit +received--due to an operation performed for the cure of a varicocele of +many years' standing. All traces of the disease have disappeared. I was +surprised to know that so little pain was connected with the operation. + +Will say to those who think of visiting the Invalids' Hotel, that they +will be treated well, and their visit will be made as pleasant as +possible during their stay. + + Yours respectfully, + HENRY P. SMITH, + Warren, Huntington Co., Ind. + + +VARICOCELE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: G.R. Southern, Esq.] + +_Gentlemen_--Having been operated upon at the Invalids' Hotel and +Surgical Institute, Buffalo, N.Y., for varicocele of ten years' +standing, I take pleasure in certifying to a speedy and perfect cure. +The operation was made painless by local applications previously +applied, which made the parts insensible to such a degree that the +operation was performed without any suffering on my part. Time of stay, +after operation, was ten days. I cannot speak too highly of the care and +attention I received from the surgeons and nurses while there; +everything that was provided was of the best--the best of food, clean +apartments and pleasant rooms. + +I would recommend your Institution to any one suffering from any kind of +chronic or surgical disease; and if they will only go to your +Institution, they will meet with patients cured and others on the way to +recovery from the same difficulty they have themselves--no matter what +it is, if curable at all. I wish you success, + + Yours truly, GEORGE R. SOUTHERN, + Morris, Otsego Co., N.Y. + + +VARICOCELE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y. + +[Illustration: B.T. Stone, Esq.] + +_Gentlemen_--It is with pleasure that I certify to the success of the +operation performed upon me for varicocele at your Institution some +months ago. This operation was performed by one of your specialists in a +skillful and painless manner. + +I found the Invalids' Hotel just what it is represented to be, and all +patients who were there were well satisfied with the treatment. + +I was not confined to bed at all after the operation, and was able to +leave at the end of ten days in an excellent condition. + +I am unable to express the great relief which your treatment has given +me and I cannot say too much in praise of your Institution. + +I take great pleasure in recommending you whenever I get a chance, and +cannot thank you enough for what you have done for me. With kindest +regards, + + I am sincerely yours, + B.T. STONE, + Fellowsville, Preston Co., W. Va. + + +LARGE VARICOCELE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: C.W. Kelly, Esq.] + +_Gentlemen_--It gives me much pleasure to state that during my stay at +your Sanitarium I was treated with the utmost kindness, and found +everything there just as represented in your pamphlet, if not indeed +better. Your Institution is the best of the kind that I have ever seen +and if it is possible for a person to be cured your specialists will +accomplish it. A visit there convinced me that you do not make promises +which you do not fulfill. After being there and having a surgical +operation successfully performed, I heartily recommend all invalids to +give your place a trial. Much to my surprise the operation which was +performed was perfectly painless, no anæsthetic was given, and I was not +confined to my bed for an hour. I was able to leave your Institution at +the end of ten days completely cured. I can heartily commend your +efforts in the cause of suffering humanity, and shall be pleased to +offer my personal testimony at any time. With best wishes to the World's +Dispensary Medical Association, I am, + + Sincerely yours, + C.W. KELLY, + Riverside, Riverside Co., Cal. + + +VARICOCELE. THE RESULT OF INJURY. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: C.F.L. DeHaven, Esq.] + +_Gentlemen_--Nine years ago I was struck with a springing pole, causing +the spermatic cord to swell badly. I applied for medical aid and was +told that no harm would result. But I grew worse, and spent over one +hundred dollars with quacks and received no help. + +Four years ago while reading a chapter in Dr. Pierce's Common Sense +Medical Adviser, I noticed that no hesitation was made in stating that a +permanent and radical cure of varicocele could be made at the Invalids' +Hotel and Surgical Institute. I went to the Hotel and the result was I +returned home in eleven days permanently cured. I cannot speak in too +high praise of the surgeon, and his delicacy and kindness in performing +a painless operation; or of the nurses, who almost hourly visit the +invalids and minister to their comfort. The Institution is fully +equipped and nothing is left undone that can relieve suffering. I +conversed with a great many patients while at the Invalids' Hotel and +language could not express their delight at their treatment there. + +I earnestly urge all invalids to save time and suffering by being +treated at the Invalids' Hotel and Surgical Institute where the latest +and most improved methods are used, and operations are made painless and +where everything is delightful and comfortable. I owe my life to the +tenderness and skill of the surgeon and nurses at the Invalids' Hotel +and Surgical Institute. + + Very truly yours, CLARENCE F.L. DEHAVEN, + Haynes, Hocking Co., Ohio. + + +VARICOCELE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: F. Brooks, Esq.] + +_Gentlemen_--I can say that while in your Institution I received the +best of care and attention both by doctors and nurses; that your +operation was almost entirely without pain; that my virility has +increased since then as well as the tone of my general health; that your +Institution is as commodious and cheerful as one could wish. Your +patients with whom I became acquainted while there nearly all seemed to +be well pleased with the ease and comfort of their surroundings as well +as the manner in which they were treated for varicocele. + + Respectfully, + FLAVIUS BROOKS, + Sinnamahoning, Cameron Co., Pa. + + +BAD VARICOCELE OF MANY YEARS' STANDING. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: D.E. Moorefield, Esq.] + +_Gentlemen_--I take pleasure in recommending your Invalids' Hotel and +Surgical Institute as first-class in every respect. Some four years ago +I was there and had an operation performed on me for a very bad +varicocele with which I had been troubled some 15 or 20 years. The +operation was made painless by the use of local applications. After +staying at your place about twenty days (longer than is generally +necessary) I was able to make my long trip home. The operation was a +very successful one, considering the long time my trouble had been +neglected, as I have suffered little or no inconvenience since. I saw a +very large number of patients at the Invalids' Hotel from all parts of +the United States and Canada, and all of them seemed to have a very high +opinion of the treatment they were receiving from your Specialists, and +I know personally, of several remarkably successful operations performed +by your skillful surgeons while I was there. + + Respectfully, D.E. MOOREFIEID, + Nathalie, Halifax Co., Va. + + +VARICOCELE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: D.H. Miller, Esq.] + +_Gentlemen_--Having been operated upon at the Invalids' Hotel and +Surgical Institute for the cure of Varicocele, which was caused from +heavy lifting, I take pleasure in informing you that it is entirely +cured; it was a varicocele of a number of years' standing and a bad +case. It has been three years since I was operated upon and I have not +experienced any trouble from it since; in fact, I feel that I am now +entirely cured. _The operation is painless_ and gives entire +satisfaction in every respect. + +I advise all who are suffering from this or any other chronic disease to +take treatment at the Invalids' Hotel and Surgical Institute and they +will be well rewarded by so doing. + + Yours respectfully, + DAVID H. MILLER, + Markle, Huntington Co., Ind. + + +VARICOCELE OR FALSE RUPTURE--DUE TO STRAINING AND OVERWORK. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo. N.Y.: + +[Illustration] + +_Gentlemen_--I can bear testimony to the removal of the difficulty for +which you treated me, for I had been to experts in Philadelphia and they +did not know how to perform the operation, and said I could not be +cured. I was treated by experts in Albany and other cities, but all for +no use. I went to the Invalids' Hotel and Surgical Institute and was +operated upon and find I am cured. The treatment in every other respect +was good; everything was done to make patients happy and pleasant; the +best of care and attention was paid to all. + + Yours truly, + W. McGOWAN, + Orbisonia, Huntingdon Co., Pa. + + +VARICOCELE OR FALSE RUPTURE--TWELVE YEARS' STANDING--CURED IN TEN DAYS. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: N.H. Sharitz, Esq.] + +_Gentlemen_--Having been operated upon at the Invalids' Hotel and +Surgical Institute, Buffalo, N.Y., for the radical cure of a Varicocele +of the left side, from which I had suffered for twelve years, I take +pleasure in certifying to the speedy and certain relief afforded, and +the painless nature of the operation as performed by the surgeon of the +World's Dispensary Medical Association. Ten days from the time of the +operation, I returned home radically and permanently cured. I desire to +express my thanks to the medical staff for their skill and attention. + + Gratefully yours, + N.H. SHARITZ, + Box 22. Rural Retreat, Wythae Co., Va. + + +VARICOCELE AND RESULTANT WEAKNESSES. + +WASTING OF STRENGTH AND MANLY VIGOR--NOW STRONG AND WELL. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Robert B. Wills, Esq.] + +_Gentlemen_--I am unable to find words to express my feelings of +gratefulness and gratitude that I owe to your Institution, for the able +and gentlemanly treatment that I was favored with during my stay with +you, by officials and attendants in their respective capacities, in +every department. Nothing was left undone that could possibly be of +benefit to me or add to my comfort, and to your Institution, your +treatment, which in my own experience I have found to be marvelously +wonderful, I feel to-day as if I owe my health, my strength, my life; +for I firmly believe if it had not been for your timely and painless +treatment, instead of writing to you at this time, being in the +enjoyment of health and strength, I would be filling a place in an +insane asylum or an invalid's grave. And it may not be more than just to +your wonderful treatment to say that the Varicocele and resultant +weaknesses was of about fifteen years' standing, during which time I had +spent time and money with both physicians and quacks, without any result +for the better, and when my life blood was daily wasting away, and the +powers of manly strength and vigor were completely gone, by an act of +Providence I went to your Institution as a last resort, for life or +death. I was painlessly operated upon by you for my complaint, from +which time I have steadily improved in health, strength, weight and +vigor, until I have gone from 135 pounds, my weight when operated upon, +to 174, at which I tip the balance as I write to you to-day. If the +afflicted everywhere could only realize that so many lives may be spared +by your wonderful treatment, none would stay away. + +You are at liberty to give my testimony to the world in whatever way it +may be of most benefit to you. I also enclose a photograph of myself +that has been taken since the effects of your treatment have been shown. +With feelings of much gratefulness, I am, + + Very truly yours, + ROBERT B. WILLS, + No. 23 Elizabeth St., Hagerstown, Md. + + +RUPTURE OF SPERMATIC VEINS. + +VARICOCELE (FALSE RUPTURE)--PREVIOUS OPERATOR LEFT PART OF SURGEON'S +NEEDLE IN FLESH; SUCCESSFULLY EXTRACTED AT INVALIDS' HOTEL. + +[Illustration: Chas. P. Morse, Esq.] + +"WHAT I THINK OF THE INVALIDS' HOTEL AND SURGICAL INSTITUTE:" + +The Invalids' Hotel and Surgical Institute is an Institution first-class +in every respect, presided over by a capable, honest and pleasant lot of +medical experts who certainly know their business. I cannot speak of it +too highly. + +I was treated there in the summer of 1887, for Rupture of the Spermatic +Veins, previous to which I had been operated on two different times, +with no relief, by a doctor here in this place cracked up to be one of +the best in Northern Illinois, and an officer of the Chicago Eye and Ear +Infirmary. The operation at the Invalids' Hotel was perfectly painless, +did not have to take any anæsthetic, neither was I confined to my bed at +all, and the result a perfect success; while in the two previous +operations I had here at home, I was confined to my bed a week each time +and another week scarcely able to move about, be sides getting worse +each time with pain enough to drive one crazy. But the half has not been +told. About two and a half years after I had been cured of my difficulty +at Buffalo, I commenced having terrible pains in my leg and abdomen, for +which I could not account, and after standing it until it seemed as +though I would be glad to die, I again consulted the Invalids' Hotel; +after a thorough investigation they operated on me where my pain seemed +the most apparent, and dug out a piece of a surgeon's needle something +over half an inch in length, that had been broken off in the first +operation I had by the doctor here at home, and so admitted by him when +confronted with it. I have spent lots of money and nearly six years of +the worst pain man ever stood getting relief, while had I known of this +place on the start, an operation with no pain whatever and scarcely more +discomfort than a sore mouth after having a tooth removed, would have +ended it all. + +In conclusion, I will say to any poor sufferer, don't do as I did and +put your trust in the would-be greatest doctor you have at home, but go +to this place at Buffalo, where you will have proof of their ability, +and where you will surely meet patients about to leave, cured; others on +their way to recovery for the same difficulty you may have yourself, no +matter what it is, if curable at all; a place where you will have the +kindest of attention, the best of medical and surgical skill, and where +you can see sufferers going away every day with hearts full of gratitude +and happy. + + Respectfully, CHAS. P. MORSE, + 311 North Avon St., Rockford, Ills. + + +VARICOCELE-FALSE RUPTURE CAUSED BY INJURY. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: G.W. McCollom, Esq.] + +_Gentlemen_--In the year 1866, sometime in July, I jumped from a load of +lumber to the ground, and at once felt a sharp severe pain along the +spermatic cord of left side of scrotum, preventing my walking to the +house without help. The veins near the cord filled to such extent that +they seemed solid, and could not be reduced for some time. I went to a +good doctor and by him was advised to "pay no attention to it, it will +not amount to much." From that time I suffered continually, and will not +try to describe what I endured until I was relieved by a surgical +operation performed on me by the surgeon-specialist of the Invalids' +Hotel and Surgical Institute, of Buffalo, N.Y. After working-hard for +several years my suffering increased and I was advised to consult Prof. +L., of Chicago Hahnemann College (of Homeopathic School) and by him was +informed an operation of tieing the veins (choking them off) could be +performed but 90 per cent (if I remember rightly) of the operations +proved fatal. I decided not to try it. By accident I learned of your +great skill, and though my case was of twenty-one years' time, and my +health and strength gone, I considered the method plausible and +reasonably safe. I had the operation performed, and now after six years +have passed, I can say with satisfaction, there is little to be noticed +or remind me of the past years of misery. The parts are of +healthy-color. Urine has assumed a natural appearance, both sides of +scrotum seem in size alike. No bandage is worn and for two years has +been discarded. My weight increased and for two years prior to the +taking of my photo, I did the work of handling a third-class post +office, doing a money order business of $50,000, not losing a day in +that time, and at the present time in this hot climate, I have been +doing outdoor work, some of it hard, and with mercury at 100 degrees. I +have worked and found no need of a bandage; and no unnatural relaxation +of the scrotum or veins is noticed. + +If anyone wishes to write me, they are at liberty to do so. If my +experience can be of benefit to any, I will answer all enquiries, and in +a general way will now say no one should delay attending to such +difficulty, for if the blood is in a reasonably healthy condition your +surgeon will operate in such a way that the result will be all right in +time. I send photo taken in 1891. + + Respectfully, GEORGE W. McCOLLOM, + Monrovia, Los Angeles Co., Cal. + + +VARICOCELE. + +Sanborn, Barnes Co., N. Dak., Aug. 9th, 1895. + +PROPRIETOR INVALIDS' HOTEL AND SURGICAL INSTITUTE, Buffalo, N.Y.: + +_Dear Sir_--Having been afflicted with varicocele and loss of manhood +and having heard so much of the cure for these troubles at the Invalids' +Hotel. Buffalo. N.Y., I went there and was operated upon. The operation +itself is nothing to bear. It is painless and the result is a radical +cure. For this you have my sincere thanks. I take pleasure in +recommending your Institution to all sufferers and know that it is in +every respect just as claimed to be. I would say to all who suffer from +this trouble: go to the Invalids' Hotel and Surgical Institute, at +Buffalo, N.Y., and you will get relief. You will receive kind attention +from all. + + Very truly yours, + George Bignall. + + +VARICOCELE AND GENERAL DEBILITY. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: J.L. Ridings, Esq.] + +_Gentlemen_--I can bear testimony to the removal of varicocele, for +which you treated me. I had been in the habit of getting out with the +boys and trying to see which could kick the highest with one foot on the +ground, and it caused me to have varicocele. I went to my home doctor +and he treated me with no success. It was getting worse all the time and +I got out of shape all over. My health got bad and I thought my case +hopeless. I had tried two doctors and received no benefit. + +I had one of your little Memorandum Books in my pocket, and one day, +looking through it I saw you treated such cases, and wrote you and +received word in a few days that you would treat me, so I sent off for +one month's treatment; and in five months I had gained my weight back, +and that was eight years ago and I feel sound and well and my health has +been good ever since. + +You are at liberty to use my testimony in whatever way if may be of most +benefit to you. + +I also enclose a photograph of myself that was taken soon after your +treatment. + +With feelings of much gratefulness, I am, + + Very truly yours, + J.L. RIDINGS, + Clarence, Shelby County, Missouri. + + +VARICOCELE AND NERVOUS DEBILITY. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: D.A. Walton, Esq.] + +_Gentlemen_--I commenced treatment, I think, in July or August, of 1888, +and continued four months. My case was nervous debility of fifteen +years' standing. + +I tried home doctors but found they were only aggravating my case. I +also tried the Remedy Company, then of St. Louis, who claimed to perform +wonderful cures with their "Pastiles," but they proved utterly +worthless. Having come in possession of Dr. Pierce's little book and +circulars, a perusal of the same convinced me that my health would not +be trifled with at his Institution. + +I was a poor man and could not afford much experimenting. I ordered one +month's treatment, and at the end of this first month, I found, to my +surprise, that I was feeling different. The second month, still more +surprised at my returning health. Third month thought I was cured, and +engaged myself to a young lady, and wrote you to that effect, and you +advised me with your congratulations to marry, and to order another +month's treatment; and at the end of the fourth month I was a _man_, +something I did not know what it would be like to be before. + +I have now been married five years, and have two healthy children--a boy +and a girl. I would never have dared to marry had it not been for your +medicines. I must add that during this treatment I was troubled with +varicocele on left side. I wrote you this at third month of treatment, +and you sent without extra charge, a Suspensory and Lotion, and two +months' treatment cured me sound and well of this distressing malady; I +have not felt the least symptoms of its return. + +I want the world to know what a competent and honorable firm the World's +Dispensary Medical Association is. I would love to shake you by the +hand. May God let you continue to be a help to mankind is my prayer. + + Yours truly, + D.A. WALTON, + Marion, Grant County, Ind. + + +BAD VARICOCELE OF LONG STANDING. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: J.M. Elam, Esq.] + +_Gentlemen_--I feel many obligations to your noble skill, as physicians. +I was treated with much kindness by physicians and nurses. I was +surprised to find such a speedy cure of such a bad case of varicocele of +long standing; the operation was entirely painless and I felt a great +change in myself, as a result of it. Am so glad to tell any sufferer of +that terrible disease to apply to you at once and be cured, for I am +sure I could not have lived long as the pressure and burden was so great +_I could scarcely be on my feet at all_; any work in an upright position +was impossible. + +Now it has been five years since I was operated upon and I feel well of +that disease--varicocele attended with impotency or weakness of the +generative organs, caused by varicocele. + +Thanks to the good physician who relieved me--hope he may live long and +be able to relieve all that submit themselves to him for treatment, as I +did. I found everything that had been described to be just so in regard +to the Staff and Institution. + + Gratefully yours, J.M. ELAM, + Flat Rock, Scott Co., Va. + + +DOUBLE VARICOCELE AND STRICTURE OF URETHRA. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: C. Hanson, Esq.] + +_Gentlemen_--I have taken treatment from you for several months for +nervous debility, and although I am not quite fully cured as yet, I have +been greatly benefited, and believe, if I had come to you before I was +duped and swindled by different quacks and was more dead than alive, I +would to-day be a thoroughly well man. + +I have also been to your Institute twice for surgical operations, and +cannot too highly praise the Hotel, or the skill and care of the +attending surgeons and nurses. They are gentlemen in every way and the +Invalids' Hotel is just as represented. + +I shall advise all suffering from chronic diseases to go to you for +relief, as I have never seen any one there who was not cured or greatly +benefited. + + Very truly yours, + CHRISTIAN HANSON, + Austin, Mower Co., Minn. + + +INDIGESTION, CONSTIPATION, VARICOCELE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mr. Hodges.] + +_Dear Sirs_--In regard to my condition of health, will say, although I +am not entirely well, yet I have received much and lasting good from +your treatment. My digestion was improved greatly, so that little +trouble is experienced after eating; my liver seems to act reasonably +well, and my bowels are much better. My varicocele I consider entirely +cured, as I have not used the bandage for one half day for more than six +months, and do not experience any inconvenience from that source. + + Yours truly, + HARLAN HODGES, + Keota, Keokuk Co., Ia. + + +BAD VARICOCELE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: W.H. Dellinger, Esq.] + +_Gentlemen_--Having been operated upon at the Invalids' Hotel and +Surgical Institute for the radical cure of a bad varicocele, from which +I had suffered for eight years, I desire to express my thanks to you for +your kindness and skill. And I would advise all persons, needing +surgical or medical treatment, to go to the World's Dispensary Medical +Association. + + Respectfully yours, + WILLIAM H. DELLINGER, + Vincennes, Knox Co., Ind. + + +VARICOCELE. + +Cambridge, Furnas Co., Nebr. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +_Gentlemen_--With great gratitude toward your most valuable Institute, I +feel indebted to you for the cure of varicocele. I was troubled ten +years with this annoying disease, caused, I think, by being thrown from +a horse. My case was of a very obstinate character. I was treated by a +leading specialist of Omaha, Nebr., without success and without being in +the least benefited. I expended the neat little sum of $500, and then +sank back in despair, losing all hopes of a cure. I had previous to my +treatment in Omaha noticed a little hand or Memorandum Book of the +World's Dispensary, and again one came to my notice. I mustered up +courage to write to you, and in June, 1892, I visited your Institute for +treatment. I was treated by the best skilled surgeons and given best +attention by experienced nurses. I met a number of patients while under +treatment troubled with various and complex diseases, who expressed +their gratitude to the Faculty of the Invalids' Hotel and Surgical +Institute. The operation performed was rendered painless, owing to local +applications previously applied. After the operation, which was about 11 +o'clock, A.M., I rested until 12, noon, and responded to the dinner call +as usual. I was required to remain but ten days, then returned home, a +distance of some twelve hundred miles. I wore a neat fitting support for +about six months, and then abandoned it and have gone as nature created +me. Oh, what a relief. I had worn a "suspensory" for about six years. I +have had no return of former trouble, it being now about two years since +the operation. + +To any suffering with varicocele I must say, "don't delay, but place +yourself under treatment at the Invalids' Hotel and Surgical Institute, +Buffalo, N.Y., and you will say as I do, 'The half has never been +told.'" With earnest wishes for your future success, I am, + + Yours truly, + E.L. Brown + + +VARICOCELE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: D.E. Righetti, Esq.] + +_Gentlemen_--I wish to inform you of the success of your treatment of me +for varicocele on the left side and its attendant weakness, etc. I am +now happy to say that through the agency of your surgical skill and the +efficacy of your medicine, I am healthy, strong, and a perfect man. I +suffered for about two years previous to the operation with acute pain +in the parts, and continued mental anxiety. I desire to express my +entire satisfaction that, during the ten days that I remained in the +Invalids' Hotel, I never experienced such uniform kindness and attention +as I did from the attending surgeon and from all the attachees, and that +I recommend all persons similarly afflicted to consult you, and they can +be sure to find the way to happiness. + + Respectfully yours, + D.E. RIGHETTI, + Cayucos, San Luis Obispo Co., Cal. + + +VARICOCELE + +OF TWENTY YEARS' STANDING--CURED "WITHOUT PAIN. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: C.H. Boyle, Esq.] + +_Gentlemen_--I take great pleasure in recommending the Invalids' Hotel +and Surgical Institute. After trying my home physicians without +obtaining any permanent relief, and growing constantly worse, I went to +this famous Institution and submitted to an operation for varicocele. +This was a perfect success, and soon I felt like a new man, and as +strong as I ever did. I feel that nothing I could say would do justice +to this renowned Institution. In every way, it is kept in advance of the +age. The staff of physicians and nurses spare no pains to make the visit +of every one pleasant as well as beneficial in the highest degree. I +would urge all sufferers afflicted as I was, or with any chronic +disease, to avail themselves, without delay, of the skillful treatment +to be obtained of the specialists of the World's Dispensary Medical +Association, for I am confident that they will receive all the benefit +that can be obtained from medical or surgical treatment and care. + + Yours truly, + CHAS. H. BOYLE, + Fort Benton, Choteau Co., Montana. + + +VARICOCELE. + +SPENT $500 WITH OTHER DOCTORS TO NO PURPOSE. + +Bryson, Jack Co., Texas. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +_Gentlemen_--I had been troubled with varicocele for nine years, and had +given up ever being cured. After spending $500.00, with medical quacks I +then went to the World's Dispensary Medical Association as a last +resort. One of their skillful surgeons performed an operation upon me +which was entirely painless. I conversed with several other patients, +who had the same disease. They seemed happy to know that there was such +an Institution that could relieve suffering humanity. The surgeons and +nurses were so good and kind to us and gave us the best of attention and +even the patients had a very fraternal feeling toward each other. + +Your Institution is finely equipped and has the best of accommodations. +Accept my thanks. + + Yours truly, + A.D. Bryson + + +A BAD CASE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.: + +[Illustration: H.C. Decker, Esq.] + +_Gentlemen_--I have been cured of an almost life-long difficulty by the +skill of your specialist, and heartily thank you for the successful +manner in which the operation was performed in my case. The result is +complete and perfect relief, and as time advances I can each day more +fully appreciate the value of your Institution. The time spent there I +shall never forget, as it was a time of extreme pleasure to me. The +operation was _perfectly painless_ and did not confine me to my bed, and +this taken with the extreme kindness of every one connected with the +Institution, made the time pass in a very happy manner. + +I consider your Hotel first-class in every respect, and would heartily +advise all sufferers from chronic ailments to visit you before giving up +their cases as hopeless. + + Respectfully yours, + H.C. DECKER, + Dresbach, Winona Co., Minn. + + +VARICOCELE-CAUSED FROM STRAIN. + +Montague, Sussex Co., N.J. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +_Gentlemen_--In reply to your inquiry concerning my treatment, I +cheerfully give you the following testimonial: "I was troubled for many +years with a very bad varicocele, which I received when a boy while +jumping. The complaint troubled me exceedingly. I tried almost every +known means to effect a cure, but with no avail, for the more I doctored +the more aggravated became the disease. After thus suffering for many +years and knowing of the fame your Institution had attained in curing +such diseases, I at last consulted your specialist in that class of +diseases--was operated upon and returned home in ten days, a sound and +well man. I can recommend your Institution to all suffering humanity as +the most home-like, your nurses the most attentive and specialists the +most skillful the world can offer. May you long be the benefactors of +mankind." + + Yours truly, + F.L. Van Etten + + +VARICOCELE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: E.H. MAHNKEN, ESQ.] + +_Gentlemen_--The result of your operation, performed one year and a half +ago for a case of varicocele of twelve years' standing, and which had +troubled me very much, has cured me entirely. I am thankful to God that +He put it into my mind to visit your Surgical Institute. I cannot +recommend your skill too highly. + + Yours truly, + ED. H. MAHNKEN, + Smithton, Pettis Co., Mo. + + +VARICOCELE. + +Medora, Billings Co., N. Dak. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +_Gentlemen_--Having been operated upon at the Invalids' Hotel and +Surgical Institute, Buffalo, N.Y., for the radical cure of a varicocele +on the left side from which I suffered four years, I take pleasure in +certifying to the speedy and certain relief afforded, and the painless +operation, as performed by the surgeon of the World's Dispensary Medical +Association. Ten days from the time of the operation I returned home +permanently cured. + +I desire to express my thanks to the Medical Staff for their skill and +attention. + + Gratefully yours, + Geo. O. Reid + + +A STRONG ENDORSEMENT. + +_To whom it may concern_: + +[Illustration: H.E. Bankston] + +This is to certify that I took treatment at the Invalids' Hotel and +Surgical Institute, Buffalo, N.Y., and I was cured of a chronic trouble +that had been maltreated by other physicians. While there I saw a man +who had been cured by the specialists, who had before been given up to +die by the best doctors in Troy, N.Y. Of course, the case must have been +a very stubborn one. I afterwards saw a man here, in Georgia, die, who, +if he had been in Pierce's Surgical Institute under the treatment and +care of his skilled doctors and nurses, I know would have most assuredly +got well. Why? Because it was only a cage of _stone in the bladder_, and +they are easily cured at Dr. Pierce's Surgical Institute. I think almost +any chronic disease can be cured there, if taken in time, judging from +my observations while an inmate of that Institution. + + H.E. BANKSTON, + Barnesville, Pike Co., Ga. + + + * * * * * + + + + +HYDROCELE, + +OR DROPSY OF THE SCROTUM. + + +This malady consists of a collection of water in the _tunica vaginalis_, +or membranous sac which contains the testicles. It may affect either one +or both sides. In health the sac-like covering, or investing membrane, +of the testicle secretes a limpid fluid which lubricates its inner +surface. When secreted in excess, it accumulates and constitutes +_hydrocele_. + +The tumor commences at the bottom of the scrotum and grows very +gradually, while hernia, or rupture, with which it is often confounded, +progresses from above downwards and makes its appearance suddenly. + +We were recently consulted by an aged gentlemen, whose disease a +distinguished surgeon had pronounced _double hernia_. On examining the +enlargement, we found the disease to be dropsy of the scrotum, +complicated with varicocele. + +CAUSES. Injuries from blows or bruises are among the most common causes +of this disease. It may also result from inflammation of the testicle or +from excited action in those parts. It has been known to result from +stricture of the urethra, or water-passage, and also from local +irritation along that passage. + + +HYDROCELE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: H.H. Williams, Esq.] + +_Dear Sirs_--In answer to inquiries will say, that any person afflicted +as I was, I would advise them not to listen to any ordinary doctor, but +leave at once for the Invalids' Hotel and Surgical Institute, Buffalo, +N.Y., where he could get the best of treatment and attendance that money +could procure. The table also is loaded with the best of fruits, +vegetables, and the finest meats of the markets. + + Respectfully, + H.H. WILLIAMS, + St. Augustine, Florida. + + +HYDROCELE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: D. Flynn, Esq.] + +_Gentlemen_--Without solicitation, but simply to aid suffering humanity, +I take pleasure in recommending your place to any suffering from +Hydrocele. + +I was cured in a short time, after having the Hydrocele for eighteen +years. Your new process is painless, no knife being used and is certain, +sure and safe. With many good wishes of success, I am, + + Yours truly, DAVID FLYNN, + (Engineer, S.F. & W. Ry.,) + Way Cross, Ware Co., Ga. + + +HEMATOCELE OR RUPTURED VEINS. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: D. Parker, Esq.] + +_Gentlemen_--I was afflicted with Hematocele of large size, caused by an +injury, for which home-treatment gave me no relief. + +Hearing of your Invalids' Hotel I went there and had an operation +performed for its cure. I have the greatest confidence in your +Specialists, as the operation was a perfect success. It was perfectly +painless, and I was able to go home in less than two weeks with the cure +complete. I take pleasure in certifying to the good work you are doing. + +With the best of feeling toward the Invalids' Hotel, I am, + + Yours truly, + DON PARKER, + P.O. Box 155, Oakfield, Genesee Co., N.T. + + +HYDROCELE WITH VARICOCELE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: D. Huntington, Esq.] + +_Gentlemen_--About five years ago, having been a patient at, the +Invalids' Hotel and Surgical Institute and undergone a painless +operation for the cure of hydrocele and varicocele--which was performed +to my entire satisfaction. I desire to express my thanks to the Medical +Stuff for their skillful treatment of my case. Two weeks from the time +of the operation I returned home, radically and permanently cured. + +I recommend all similarly afflicted to consult the World's Dispensary +Medical Association. + + Yours truly, + DANIEL HUNTINGTON, + Huron, Beadle Co., So. Dak. + + +TWENTY-TWO YEARS' STANDING--UNSUCCESSFULLY TREATED BY OTHERS. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: E.L. Waters, Esq.] + +_Gentlemen_--I wish to acknowledge that you have cured me of the worst +case that ever came within my knowledge, it having afflicted me +twenty-two years. After I had suffered much from other surgeons without +any cure being effected, and with only relief for a short time, you +performed a not only painless but very scientific operation, and with +medicine completed the cure. It is now five years since you treated me +and no symptoms of the disease have shown themselves. I will also add +that while with you at the Invalids' Hotel I received the best of care +and attention from the well trained nurses in your employ, for all of +which I feel grateful. + + With respect and best wishes, + EDWIN L. WATERS, + Athol Centre, Mass. + + + * * * * * + + + + +THE URINARY ORGANS: + +THEIR ANATOMY, PHYSIOLOGY AND PATHOLOGY. + + +By reference to Fig. 1 the reader will get a good understanding of the +relative positions of the kidneys, bladder, and adjacent organs. + + +THE KIDNEYS. + +It is hardly necessary to discuss the minute structure of these organs +in a book intended for the non-professional reader. + +The function of the kidneys is to remove certain waste materials from +the blood. As fast as excreted by the kidneys, the urine passes through +the ureters, of which there are two,--one leading from each kidney, into +the bladder. The ureters are lined with a continuation of the mucous +membrane, reflected from the bladder upwards, and this lining also +extends to the cavities of the kidneys. + +Calculi or gravel, and stones, forming, as they sometimes do, in the +kidneys, and passing down through these delicate and sensitive canals, +cause excruciating pain. The symptoms of renal calculi passing from a +kidney to the bladder are, as already indicated, severe cutting pain in +the loins, and along the ureter, attended with considerable fever. A +very rough stone, such, for instance, as a mulberry calculus, passes +with considerable difficulty, and the patient is often suddenly seized +with excruciating agony in the loins and in the groin, the pain also +shooting down into the testicle of the corresponding side, often causing +it to retract. There is usually, also, sympathetic pain shooting down +the thigh. We have seen patients roll on the floor in the greatest +agony, cold sweat meanwhile pouring down their faces, when thus +suffering. The patient may also vomit violently, through nervous +sympathy. The urine is apt to be bloody, and there is a constant desire +to pass it. There is pain in the end of the penis, and also in the lower +portion of the abdomen. + + +THE BLADDER. + +This is a sac, or reservoir, to receive and hold the urine as it comes +from the kidneys through the ureters. Its walls are partly composed of +muscle, and partly of a lining mucous membrane. The muscular coating is +external, and it is by its contraction that the urine is expelled. When +empty, the bladder shrinks down to a small size, as compared with its +distended condition. When filled, it is capable of holding about one +pint. If it is distended by the retention of urine much beyond this +capacity, the muscular coats lose their force, and often the urine +cannot be passed naturally. In health, when the bladder becomes filled +and distended, there is a consequent desire to empty it by passing +water. + +[Illustration: Fig. 1.] + +The voiding of the urine should not be attended with the slightest pain +or disagreeable sensations, and the desire to pass it should not be +frequent. When there is frequent desire to pass it, or when its passage +is attended with pain, there is irritation, or inflammation, in the +coats of the bladder, or in the urethra. This may arise from an +excessively acid or irritating condition of the urine, as well as from +various other causes. Gonorrhea, or clap; stricture of the urethra, +which impedes the free flow of the urine; enlargement or inflammation of +the prostate gland; gravel, and stone in the bladder, are all capable of +creating a frequent desire to pass water. Whatever the unhealthy +condition may be which gives rise to this troublesome symptom, it calls +for prompt and skillful treatment, for the most trivial affections of +these organs often pass into those that are exceedingly intractable, if +not incurable. + +THE EXAMINATION OF THE URINE. The urine itself, when subjected to +microscopical or chemical examination, as we shall hereafter more fully +explain, offers the best means of determining the exact nature of these +distressing affections. When normal, the urine is of a pale straw-color, +and throws down no deposits on cooling. In passing it no difficulty or +pain should be experienced, and it should spurt from the urethra in a +full, round, and regular stream, until the bladder is entirely emptied. +If the stream is forked, checked, or interrupted in any way before the +bladder is completely emptied, it is evidence that something is wrong. +Stricture of the urethra, prostatic disease, and gravel, or stone in the +bladder, are all capable of producing obstruction to the free flow of +the urine. + +HOW SLIGHT AILMENTS BECOME DANGEROUS DISEASES. As we have before stated, +the mucous membrane lining the bladder is reflected upwards into the +ureters, lining these canals. By reason of this continuity of mucous +surfaces, patients suffering from urethral, prostatic, and bladder +affections, often die from disease of the kidneys. It must not be +supposed that because stricture of the urethra does not co-exist with +_Brights_ disease, that the latter may not have been caused by the +obstruction in the urethra due to stricture. Pulmonary consumption, for +instance, often begins in the form of nasal catarrh, but, by the +continuity of the mucous membrane, it travels, so to speak, into the +throat, or pharnyx; from the pharnyx into the larnyx, and then into the +lung structure itself. The disease is transferred from the nose into the +lung tissue. What occurs in the nasal, laryngeal, and pulmonary tract of +mucous membrane, happens, also, in the urinary tract. A gonorrhea, which +is a specific acute inflammation of the urethral canal, leaves behind it +a slight gleet, or chronic inflammation of the mucous membrane of the +urethra. This may give little inconvenience for a number of years, but +gradually it culminates in a stricture, or, implicating the prostatic +portion of the urethra, occasions inflammation of the prostate gland, +and, perhaps, enlargement of this organ. This gradually gives rise to +cystitis, or inflammation of the bladder. From the bladder, the disease +travels up the ureters into the kidneys, and finally _Brights_ disease +is established in these organs. + +The mucous membrane lining the bladder also extends through the urethra. +Throughout the interior of the body, whether it be in the stomach, +lungs, or other parts, this lining mucous membrane serves as a +protection to the parts beneath, just as the skin on the exterior of the +body serves as a protection to the sensitive true skin and the tissues +underneath it. + +THE CAUSE OF CERTAIN DISTRESSING SYMPTOMS. Close to the neck of the +bladder is a triangular space, on which the mucous membrane is smoother, +and devoid of folds, or rugae, and which is far more sensitive and +vascular than other portions of the mucous membrane lining this organ. +It is called the _trigone vesical_. This _trigone_ is the most depending +part of the bladder. If there be stone in the bladder, it naturally +gravitates and rests on this sensitive space, so that, when the bladder +is empty, the foreign body occasions inconvenience, until the urine, +trickling down through the ureters, and intervening between the mucous +membrane and the stone, serves as a temporary protection to the mucous +surface. Hence the pain becomes less as the urine is secreted, until the +water is again passed, and the intervening fluid thereby removed, when +the stone again presses upon, and irritates, the sensitive _trigone_, by +coming into more immediate contact with it. The greater ease with +patients afflicted with stone experience in a recumbent position in bed, +or on a sofa, compared with being in an erect posture, is easily +explained. The foreign body, when the patient is standing, walking, or +riding, falls by its own gravity on this sensitive spot; when in a +recumbent position, it rolls away from this sensitive _trigone_ into the +back part of the bladder, where the mucous membrane is less sensitive; +consequently, the patient suffering from stone in the bladder is more +easy at night, whereas, one suffering from prostatic disease, whether it +be inflammation of the prostate gland, or enlargement of that organ, is +usually worse in bed. + +HOW BLADDER DISEASES COME TO BE CONFOUNDED WITH OTHER DISEASES. The +bladder is largely supplied with blood-vessels, lymphatics, and nerves, +given off from the same systems that supply the rectum or lower bowel, +and in females the uterus or womb, and the ovaries. This accounts, in a +great measure, for the symptoms of bladder disease in those afflicted +with piles, or other diseases of the lower bowel, or of diseases of the +uterus or womb in the female. We have frequently been consulted by +patients who had erroneously supposed themselves to be suffering from +disease of the bladder, or of the prostate gland, but whom we found, on +examination, to be suffering from hemorrhoids, or piles. In these cases, +by removal of the pile tumors, the frequent desire to urinate, and all +pain in the region of the bladder, are promptly relieved. Sometimes, +ulcers located in the rectum, give very little unpleasant sensation in +the bowel, but produce pain in the bladder, with frequent desire to +urinate. Enlargement of the uterus, the womb, or displacements of that +organ, as prolapsus, or anteversion, and all capable of producing +symptoms of bladder disease. A frequent desire to urinate and more or +less sharp pain in the region of the bladder are usually experienced in +these cases. Disease of the bladder, in like manner, often produces an +apparent disease of other organs through sympathy, and without great +care in diagnosticating each case, the _effect_ may be taken for the +_cause_, and the patient treated for a disease which does not really +exist. + + +THE URETHRA. + +The urethra, in the male, is the canal extending from the bladder to the +end of the penis, through which the urine is passed. This canal starts +from the base of the bladder, passes through the prostate gland, and, +entering the penis, continues of about uniform size along the under part +of the penis until it reaches the glans, or head of that organ, where it +expands somewhat into a bulb-like fossa, or cavity, and becomes reduced +again at the orifice. At a short distance from the bladder it receives +the outlets of the seminal ducts. The urethra is a most delicate and +sensitive canal, and is surrounded by tissues of like delicacy, and is +lined with a mucous membrane which is highly vascular, and filled with +sensitive nerves. The introduction of any instrument into this canal is +to be undertaken only when absolutely required, and when necessary. It +should be so skillfully and carefully effected that no pain or +irritation can result. The slightest awkwardness is liable to cause an +unnoticeable injury, which may result in a false passage, or an effusion +of plastic lymph around the canal, which, organizing, forms the most +troublesome kind of organic structure. By proper and early treatment all +danger and pain is avoided, and a cure effected in a very short time. In +an extensive practice, in which we yearly treat thousands of cases, we +have never yet failed to give perfect and permanent relief from +stricture, or disease of the prostrate gland, without the necessity of +using cutting instruments of any kind, when we have been consulted +before injury to the urethra has been produced by the improper use of +instruments. Having specialists who devote their entire time and +attention to the study of these diseases, we are able to relieve and +cure a large number painlessly and speedily, in which the awkward +manipulations of physicians or surgeons, whose hands, untrained by +constant and skillful use, not only fail to effect any benefit, but set +up new, or aggravate existing, disease. + +This subject will receive a more full and complete consideration in +another part of this treatise. + + +THE PROSTATE GLAND. + +The prostate is a gland of about the size and shape of a large chestnut, +lying just in front of the bladder, and surrounding the urethra. The +size of the prostate gland varies considerably with the age of the +person. In early life it weighs but a few grains. As puberty approaches +it becomes larger, and in the adult weighs from half an ounce to an +ounce. In old age it enlarges considerably, and sometimes presses upon +the bladder so as to impede the flow of urine. This condition is often +confounded with stricture, gravel, or stone in the bladder, by +inexperienced physicians. Hypertrophy, or enlargement of the prostate +gland, is not an unfrequent disease in the adult or middle-aged man. +Being in close contact with the bladder, when it enlarges it encroaches +on the bladder, pressing on it, and it has the effect of interfering +with the function of urination. As before indicated, enlargement or +hypertrophy of the prostate gland, is often confounded with stricture, +gravel, and stone in the bladder, by inexperienced physicians, and +treated accordingly. The true condition of this gland is readily +determined by an examination through the rectum or lower bowel, the +finger of the expert surgeon being able to determine at once whether it +is enlarged or not. + +THE DANGER OF BAD TREATMENT. In disease of the prostate gland, as well +as in inflammation of the kidneys and bladder, stricture of the urethra, +and many other forms of urinary disease, the use of stimulating +diuretics, and the much-advertised "kidney cures," "buchus," and similar +preparations, which largely increase the flow of urine, simply +aggravate, and do positive harm. In fact, the most difficult cases that +we have had to deal with have been those that, through such treatment, +either taken on their own account or prescribed by inexperienced +physicians, have been rendered so much worse as to make their cases very +intractable, and tedious to relieve and cure. + +REQUIRE NICELY ADAPTED TREATMENT. As we have heretofore indicated, there +is no class of diseases that require nicer adaptation of medicines to +each individual case, than those of the urinary organs. Medicines which, +in one stage of these diseases are beneficial and curative, in another +stage are often exceedingly injurious. Hence it is that we claim it to +be impossible for any one to put up any set prescription, or proprietary +medicine, that will meet the wants of a large percentage of this class +of cases. The only rational course to be pursued is to examine carefully +each case as it is presented; find out the exact condition and stage of +the disease with which the patient is afflicted, and then prescribe for +it such special medicines as are nicely and exactly adapted to the +patient's condition. These, in many cases, will have to be changed from +time to time, to suit the ever-changing condition of the disease, as it +is modified by the treatment. Not only have the manufacturers of +"buchus," "kidney cures," etc., committed grave errors by prescribing +stimulating diuretics for almost all kidney and bladder diseases, under +the impression that, as the patient passes only a small quantity of +urine at a time, the kidneys should be stimulated to secrete more, but +physicians in general practice have been very prone to commit the same +error in their practices. When the bladder and kidneys are in a weak and +diseased condition, incapable of efficient action, the bladder being +already unable to dispose of the diminished quantity of urine secreted, +it is simply outrageous practice to administer medicines calculated to +stimulate the kidneys to perform more work. By being thus forced, these +organs become seriously diseased. It would appear most unreasonable to +whip and spur a horse already jaded from overwork. Common sense would +dictate rest, which always does good; but, as the bladder is weak, the +doctor whips up the kidneys with drugs, thus endeavoring to force them +to secrete more urine, and thereby the poor, crippled bladder, which is +incapable of disposing of even the diminished quantity secreted, is +actually made to do more work in a diseased and feeble condition, than +it would perform in a sound, strong, and healthy state. The results of +this pernicious practice are _Bright's_ disease of the kidneys, cystitis +or inflammation of the bladder, and numerous other grave maladies. + + * * * * * + + + + +KIDNEY DISEASE. + + +Diseases of the kidneys are generally very slow in their inception, +coming on gradually and manifesting no special symptoms of their +presence until they have assumed a formidable character. For this reason +they are the more dangerous. Simple derangement of the urinary secretion +is no evidence of disease of these organs, as changes in the color, +quantity and specific gravity of the urine are often produced by changes +of temperature, active or sedentary habits, mental emotion, and +sometimes by articles of diet, or drink, as well as by the use of +different drugs. + +The existence of disease of the kidneys in the early stages can only be +positively determined by a microscopical and chemical examination of the +urine, which reveals to us the presence of casts, epithelia, blood, pus, +etc. The microscope informs us not only of the presence of disease, but +very often of the particular portion of the kidney in which it is +located, as well as of the stage which the disease has reached. We are +also aided by chemistry in determining the exact abnormal condition of +the kidneys by the detection of albumen, sugar, etc. These examinations, +by aid of the microscope and chemical re-agents, should never be +neglected by the physician. Without them his diagnosis, or judgment of +the patient's condition, is simply guess-work. With them he is enabled +to base his treatment upon certain and positive knowledge of the +patient's real and true condition. + +The usual symptoms of chronic disease of the kidneys, but which vary +materially with the age, constitutional peculiarities and temperament, +are weakness in the small of the back, pains in the region of the loins +and groins, numbness of the thigh on the side of the affected kidney +(for often only one organ is affected), high-colored and often scalding +urine, many times depositing a sediment, sometimes white or milky urine, +bloody urine, frequent desire to pass the urine, partial impotency, +pains in the testicles and shooting into the loins, suppression or +inability to pass the urine, gravel, stone in the bladder, dropsical +swellings, swelling of the testicles, irritability and pain in the +bladder, mucous and sometimes seminal discharges oozing from the +urethra. + +WHEN THE BLADDER IS AFFECTED the prominent symptoms usually complained +of are irritability of the bladder, accompanied by a frequent desire to +urinate, inability to retain more than a small quantity of urine, and +this for a short time only, pain in the region of the bladder, extending +into the back, thighs, etc., hot scalding sensations in passing the +urine, sediment in the urine, and sometimes bloody urine. The appetite +is usually diminished, there is a depression of spirits, the urine is +often passed only by drops, and is irregular in quantity and quality, +frequent inability to pass the urine at all, in males partial impotency, +with dull disagreeable pain in the testicles and irritation of the +urethra, attended with mucous and sometimes seminal discharges oozing +from the urethra. Some of these symptoms may be present as the result of +functional or organic disease of other organs than the kidneys or +bladder, and to distinguish them with positive certainty is impossible +without the aid of a microscopical and chemical examination of the +urine. + + * * * * * + + + + +BRIGHT'S DISEASE. + + +This affection may appear in either an acute or chronic form. The acute +form is frequently a complication, or sequel of scarlet fever, +diphtheria, cholera, typhoid fever, erysipelas or measles, and is +frequently developed by intemperance. The acute form of the disease is +very rapid in its progress, often destroying life by uraemic +poisoning--the retention of urea in the system. + +The symptoms of the acute form are diminution or suppression of urine, +dry skin, chills, thirst, pains in the loins, and a general dropsical, +puffy condition of the system, especially manifesting itself in the +earlier stages under the eyes, but gradually showing itself in the +oedema, or swelling of the feet, and lower extremities generally. Unless +promptly relieved, the patient dies of coma (stupor), or from +convulsions. No person should be so rash as to attempt the treatment of +this dangerous affection without the aid of the best medical skill that +can be procured. + +IT IS THE CHRONIC FORM OF BRIGHT'S DISEASE that we propose principally +to discuss in this article. True Bright's disease of the kidneys is an +insidious and most fatal form of organic disease. + +We venture to assert that less than one per cent. of those who imagine +they have "Bright's," have this disease at all. We find that most of +those who, as one of our Faculty puts it, _insist upon having_ Bright's +disease, base their "diagnosis" upon the ever-changing condition of the +urinary secretion, and especially upon the copiousness of the deposit; +whereas, in true Bright's, deposits of any kind are rarely met with. +Perhaps the form of deposit most commonly mistaken for Bright's disease, +is that known to medical men as the _urates_. When the urates are in +excess they form a heavy pinkish deposit of a flocculent nature within +from five to thirty minutes after the urine has been passed--that is, +after it has been passed sufficiently long to cool. To prove that the +deposit is urates, heat the specimen to the temperature of the blood, +when the deposit in question will disappear. Excess of urates has now +been definitely traced, in the majority of instances, to functional +torpidity of the liver. + +Another common form of deposit is that in which the reaction of the +urine, instead of being acid, as in health, is either neutral or +alkaline, and in which the earthy phosphates are precipitated for this +reason. The earthy phosphates, when thrown down by a neutral or an +alkaline condition of the urine, appear as a heavy white deposit, which, +though usually devoid of clinical significance, is certainly calculated +to frighten timid patients who read of the "terrible ravages of +Bright's" in the advertisements of various popular "kidney cures." To +prove that the precipitate is phosphatic in its nature, add a few drops +of vinegar and it will disappear; whilst, if, after the vinegar has been +added, the specimen be brought to the boiling point, not only both the +urates and phosphates remain in solution, but there is only one single +substance known to pathological chemistry that can form a deposit under +these conditions--and that substance is albumen, which, if present in +quantity, is always indicative of serious disease. + +The papers are filled with the plausible but unwarranted statements of +the manufacturers of various "kidney cures," who anxiously desire that +every one should be impressed with the idea that all their troubles +arise from kidney disease in order to sell large quantities of their +medicines. In many cases the unfortunate patient is rendered much worse +by the use of remedies that are not suited to his condition, and which +will not cure the real trouble with which he is affected. + +Daily we are consulted by persons in whose cases these errors have been +made. In reality, true Bright's disease is not a common affection, and +nine out often individuals who think that they suffer from it, or the +early stages of the trouble, in fact have something more curable. In +some cases it is an affection of the liver, which forces an excretion of +unnatural salts by the kidneys, and thus renders the urine acrid and +irritating, or they may be suffering from some other disease, such as a +deformity or enlargement of certain glands, as the prostate; unnatural +position of the organs, as with women who suffer from weakness, the +uterus pressing forward on the bladder and urethra, and thus showing +every evidence of disease in the urinary canal. It is as common for +persons to suffer from deformity of the urinary canal as from misshapen +limbs, or from noses and ears not of proper size and proportion. + +The urinary canal, from the bladder outward, is narrow and delicate. Any +disease or injury therein is liable to result in gradual contraction, +which may be manifested long years after the cause has been forgotten, +or has disappeared. These affections, to the inexperienced, or the +physician who is not particularly alert and cautious in his diagnosis, +are liable to cause error, and he will pronounce a given case Bright's +disease, when in reality there is some simple cause for the irritation +of the urinary canal, and the pains in the kidneys, etc., all of which +frequently result from a slight damming up of the flow of water, and the +prevention of free expulsion from the system of the salts of which the +body is relieved by the kidneys. They cannot work under pressure. When, +from any cause, the flow of water is checked, and, as it were, dammed up +so that a slight pressure is put upon the kidneys below, their secretion +is most materially interfered with, and the many trains of symptoms that +usher in disease of the kidneys, appear. + +The true, and only sure way to relieve these conditions, as can be +understood by any one, is to remove the real cause. The use of any +medicine that stimulates the kidneys to an irritable action, under such +pressure, is to be avoided, as it only makes the trouble worse, +increases the amount of water that is dammed up, and results in more +serious manifestations of constitutional disease; whereas, by merely +relieving the choked outlet, the flow of water becomes free, and the +kidneys are speedily restored to their natural condition. This is well +illustrated by the following: + + +Case 113,396. + + As recorded at the Invalids' Hotel. L.C.K., farmer, age 41, + married. For a period of nearly ten years, as a result of + slight injury, he had suffered from cloudy and + unhealthy-looking water, with some burning on passing it; + frequent calls to urinate; swelling of the limbs, loss of + energy and strength; headache, etc.; gradually there appeared + severe pain in the back, at times recurring with a sense of + fullness in the abdomen. For a period of nearly eight years he + had been constantly treated by physicians at his home, all of + whom had investigated his case. He had made several long + journeys to consult the manufacturers of a much-advertised + "kidney cure," who, after pretending to examine his urine, + scientifically (none of the proprietors are physicians), + assured him that, without the shadow of a doubt, his disease + was Bright's, and that he might be cured by their "kidney + cure," which was for sale at all drug stores. For a period of + eighteen months he steadily took this "cure," which, he states, + he is sure aggravated his disease, as, although his sufferings + at times were less, he felt that he was not improving in the + least, and that his disorder was not being properly controlled. + His home physician went with him on several occasions, + consulted with the owner of the proprietary medicine, and was + equally mistaken in his diagnosis. After consulting many + doctors, all of whom assured him they could give him treatment + that would prolong his life somewhat, and make his condition + comfortable, but that no treatment would affect his cure, he + was induced, by reading our article, heretofore referred to, to + consult us. A very thorough examination of the case was made, + which resulted in finding two contractions of the urethra, + which admitted only the smallest sized probe, and which, + necessarily, prevented the free flow of the urine. These were + speedily removed, when, much to the surprise of his family + physician, who accompanied him, over thirty-seven ounces of + fluid were drawn from the bladder. This gave him immediate and + perfect relief. The pains and aches in the region of the + kidneys, the weakness and tenderness, and the many other + uncomfortable symptoms with which he was troubled, all + disappeared. From a feeble and irritable invalid, in a few + weeks he was converted into a happy and cheerful man. The + symptoms of congestion and irritability of the kidneys + gradually disappeared, and in thirty days after visiting us he + writes that he feels himself entirely sound and well. This + gentleman states that he will be pleased to correspond with any + one who wishes to learn the particulars of his case, and his + full name and address will be furnished to any inquirer. + +Bright's disease when fully established is characterized by degeneration +of the kidneys. Submitted to examination, after death by this disease, +these organs present various appearances. Hence, the degeneration that +characterizes the disease has been designated as waxy degeneration. Some +pathologists contend that the disease consists of several different +renal maladies, all of which, however, agree in the one ever-present +symptom of a more or less albuminous condition of the urine. + +As to the causes of kidney disease, it may be said that any thing which +will give rise to a greater or less degree of congestion of the kidney +will induce either a temporary albuminous condition of the urine, or a +true Bright's disease of the kidneys. Suppression of perspiration, by +exposure to cold and wet, want of cleanliness, deficiency of nutritious +diet, liver disease, certain poisons in the system, as of scarlet fever, +measles, erysipelas or diphtheria, taken in conjunction with sedentary +habits, bad air, excessive mental labor or worry, may each occasion an +albuminous urine, and finally result in Bright's disease, but of all +causes that appear to produce this disease, none are so prolific as +intemperance. A scrofulous diathesis, or habit of body, may strongly +predispose to the disease, and chronic kidney disease frequently follows +acute rheumatism and the practice of masturbation. In some instances the +chronic form of Bright's disease follows an acute attack, but is more +often developed slowly and insidiously without any known cause. + +THE SYMPTOMS of this fatal malady generally appear so gradually that +they excite but little or no concern until it has reached its more +advanced and dangerous stages. Frequently, a puffy, watery or flabby +condition of the face, particularly under the eyes, is the first symptom +noticed, and the patient may observe that his urine is diminished in +quantity. The urine is sometimes abundant, but generally more scanty +than in health, is acid in its reaction, and generally of a low specific +gravity. The countenance is generally somewhat pale and bloodless, +which, taken with the dropsical condition of the system, and the +constant albuminous condition of the urine, points the expert specialist +to Bright's disease of the kidneys. Various circumstances and conditions +may give rise to the temporary presence of albumen in the urine, and, +although albumen may be temporarily absent from the urine even when +Bright's disease exists, yet this is not common. There are certain +indirect symptoms which point clearly and almost unmistakably to the +presence of this disease. These are deep-seated pain or weakness in the +back, gradual loss of flesh, red, brown, or dingy urine, more or less +drowsiness, and as the disease advances, a smothering sensation, or +difficulty in breathing, with dropsical puffiness or swelling. +Occasional attacks of nausea and vomiting are common; pains in the limbs +and loins, which are often mistaken for rheumatism. Irregularity of the +bowels is also common. The skin becomes harsh and dry, not perspiring +even under active exercise. Sometimes these symptoms are years in their +development, being very obscure at first, and in some cases the disease +has been known to prove fatal without the patient having experienced any +extraordinary symptoms. With those whose systems are enfeebled by want, +intemperance, exposures or disease, as scrofula or syphilis, the first +symptoms usually observed will be a frequent desire to urinate, +occasional attacks of diarrhea, flatulency, dropsical swelling of the +face, especially under the eyes, and afterwards of the extremities, +paleness and increasing debility. Stupor, apoplexy and convulsions are +the forerunners of a fatal termination. + +Microscopical and chemical examinations of the urine are the only +reliable means of diagnosis, and should be often repeated. (See Urinary +Signs, in Appendix.) As albumen is often present in the urine without +the existence of Bright's disease, it is impossible, except by the aid +of the microscope, to distinguish true Bright's from other affections of +the kidneys. In both purulent urine, and that containing blood, albumen +will be found by the usual tests, but in smaller quantity than in +Bright's disease. Albumen, with disintegrated epithelia, hyaline, and +large granular casts, as well as waxy casts, are peculiar to, and +characteristic of, this disease. + +In the treatment of this malady, our specialist's experience has been +very great, and attended with marvelous success. Of course, after the +substance of the kidney has degenerated and broken down, and become +destroyed to any great extent, a cure is impossible. But that we now +possess remedies of great value, and specific power over this terrible +disease, we have the most positive evidence in the remarkable success +attended in its treatment. Most cases that are curable can be managed +successfully at a distance, the necessary medicines being sent either by +mail or express. Our specialists have cured many in this way who were so +bloated from dropsical effusion as to weigh twenty-five to forty pounds +more than usual. In our Sanitarium, where we have had the advantage of +our Turkish baths and other appliances, we have cured some cases in +which the removal of the dropsical effusion reduced the patient's weight +sixty pounds. + +We cannot, In conclusion, too strongly condemn the general resort to +strong diuretics so often prescribed by physicians for all forms of +renal maladies, but which, by over-stimulating the already weak and +delicate kidneys, only aggravate and render incurable thousands of cases +annually. Not less harmful are the many advertised "kidney cures," +"kidney remedies," "buchus," and kindred preparations. They all contain +powerful, stimulating diuretics, and, while they may appear for a short +time to do good, invariably render the case worse and far more difficult +to cure. The cases of Bright's disease reported cured by these +preparations are cases of far less dangerous maladies, made to appear, +by exaggerated accounts of them, as true Bright's disease. The use of +these general, ready-made or proprietary remedies in any case of true +Bright's disease is hazardous in the extreme. In no disease is there +greater necessity for treatment nicely adapted to the exact condition of +the patient (which should always be carefully ascertained by +microscopical and chemical examinations of the urine) than in this. As +it is a disease that runs a slow course, there is always time to send +samples of the urine for examination by expert specialists, and no other +physician than a specialist of large experience should be entrusted with +the treatment of a malady so dangerous in its character, and in the +diagnosis and treatment of which general practitioners commit such +frequent, and often fatal, errors. (SEE TESTIMONIALS.) + + +DIABETES. (POLYURIA AND GLYCOSURIA.) + + +There are two essentially different varieties of this disease, one of +which is called _Diabetes Insipidus_, or _Polyuria_, and the other +_Diabetes Mellitus_, or _Glycosuria_. The first is characterized by an +increase in the amount of urine excreted, and yields readily to proper +treatment. The second is characterized by the presence of sugar in the +urine, and under ordinary treatment often proves fatal. + +The _causes_ are obscure, and are therefore not very well understood by +the profession. + +SYMPTOMS. A notable increase of the quantity of urine excreted is the +first symptom which attracts the patient's attention. Frequently, +several quarts, or even gallons, of urine are daily excreted, and it is +paler than natural. The patient experiences extraordinary thirst, and +has an almost insatiable appetite, though at the same time he loses +flesh and strength. The tongue may be either clammy and furred or +unnaturally clean and red. The bowels become constipated, and a peculiar +odor is observed in the patient's breath and exhales from his body. The +skin becomes harsh, dry, and scurfy. There are dizziness, headache, +dejection, lassitude, and not unfrequently blindness, caused by +cataract, is developed in one or both eyes. The intellect is blunted, +and, as the disease progresses, the emaciation and debility increase, +and pulmonary diseases develop; or, perhaps, an uncontrollable diarrhea +sets in, and the patient dies from exhaustion. + +In this disease, as in Bright's, we have many medicines that produce +specific curative effects, enabling our specialists to treat it with +greatly increased success. The disease is readily diagnosticated, or +determined, by chemical examination of the urine, so that we have been +enabled to treat this class of cases very successfully at a distance, +and without personal examinations. Great attention should be paid to the +diet in these cases. It should be highly nutritious, but anything of a +sweet or starchy nature must be avoided. + +The following articles are wholesome and afford sufficient variety, +viz.: of animal food--beefsteak, game, poultry, fish, eggs, cheese, +cream, butter; of vegetables--spinach, dandelion greens, turnip tops, +watercresses, lettuce, celery, and radishes; of drinks--tea, coffee, +claret, water, brandy and water, beef-tea, mutton-broth, or water +acidulated with tartaric, nitric, citric, muriatic, or phosphoric acid. +The _forbidden_ articles are oysters, crabs, lobsters, sugar, wheat, +rye, corn or oatmeal cakes, rice, potatoes, carrots, bests, peas, beans, +pastry, puddings, sweetened custards, apples, pears, peaches, +strawberries, currants, etc., also beer, sweet wines, port, rum, gin, +and cider. (SEE TESTIMONIALS.) + + +CHRONIC INFLAMMATION OF THE BLADDER. (CHRONIC CYSTITIS.) + + +This affection, also called _catarrh of the bladder_, is an inflammation +of the mucous lining of this organ. It may occur at any period of life, +but it oftenest appears in the aged, and is usually associated with some +obstruction to the flow of urine. + +CAUSES. It may be due to colds, injuries, irritating diuretics, +injections, extension of disease from the kidneys or adjacent organs, +intemperance, severe horseback riding, recession of cutaneous +affections, gout, rheumatism, etc.; but it more frequently results from +stricture of the urethra, enlarged prostate gland, gravel, and +gonorrhea. It is also caused by an habitual retention of the urine, and +sometimes results from masturbation or self-abuse. + +SYMPTOMS. There is an uneasy sensation in the bladder, and heaviness and +sometimes pain and weakness in the back and loins. The urine is scanty, +and, although there is a desire to void it frequently, it is passed with +difficulty. If allowed to stand, it deposits more or less mucus, which +is sometimes mistaken for semen. As the disease progresses, the quantity +of the mucus increases. It is very viscid, and adheres to the sides of +the vessels, so that if an attempt be made to pour it out, it forms +long, tenacious, ropy threads. Sometimes the quantity of mucus is so +great that on exposure to cold the whole mass becomes semi-solid, and +resembles the white of an egg. The excreted urine is alkaline, acrid, +exhales a strong odor of ammonia, and soon becomes exceedingly fetid. +Sometimes the urine becomes so thick that great difficulty is +experienced in expelling it from the bladder. Nocturnal emissions, +impotency, and loss of sexual desire are apt to ensue. Occasionally +there will be a spasmodic contraction of the bladder, with straining and +a sensation of scalding in the urethra, and sometimes the patient is +unable to urinate. + +When ulceration occurs in the progress of the disease, as it is apt to +in its advanced stages, blood will occasionally be seen in the urine. In +the advanced stages of the disease the system becomes greatly +debilitated, emaciation supervenes, with hectic fever, nervous +irritability and, finally, death. + +TREATMENT. A strict observance of the rules of hygiene is essential to a +cure. We must ascertain the cause if possible, remove it, and thus +prevent it from perpetuating the disease. The various causes and +conditions involved in different cases demand corresponding +modifications of treatment; hence, it is useless for us to attempt to +teach the non-professional how to treat this complex disease. We have +succeeded in curing many severe cases without seeing the patient, being +guided in prescribing by indications furnished by microscopical and +chemical examinations of the urine. (See Urinary Signs in Appendix.) In +fact, nearly all cases can be cured at their homes, and without a +personal examination being made. In the worst cases, we have found it +best to have our patients at our institution, where we can wash out the +bladder with soothing, healing lotions, and thus make direct +applications to the diseased parts. (SEE TESTIMONIALS.) + + +GRAVEL. + + +When the solid constituents of the urine are increased to such an extent +that they cannot be held in solution, or when abnormal substances are +secreted, they are precipitated in small crystals, which, if minute, are +called _gravel_. Another cause of the precipitation of these salts is a +stricture of the urinary canal which, by interfering with the free +expulsion of all the fluid from the bladder, results in the retention of +a portion, which gradually undergoes decomposition. Salts from the urine +are thus precipitated in the same way that they are thrown down in urine +which is allowed to stand in a vessel. Any one can illustrate this, by +allowing a small quantity of the urinary secretion to stand for a few +days either in an open or a closed bottle. Soon a white, flaky deposit +will be observed, which will become more and more dense, and finally +fine grains will be seen precipitated at the bottom of the bottle. +Similar grains, lodging in the folds of the bladder, gradually increase +in size, by the precipitation of more salts around them, and ultimately +become a source of much irritation. When of large size, they are termed +_calculi_ or stones. When these formations occur in the kidneys they are +termed _renal calculi_; when in the bladder, _vesical calculi_. There +are several varieties of gravel, each depending upon different +conditions of the system for its formation. The two prominent varieties +are the red, containing uric acid, and the white, or phosphatic, gravel. + +SYMPTOMS. When the deposits are in the kidneys, there is pain in the +back and loins, occasionally cutting and severe; sometimes it darts down +the course of the ureter to the bladder, and extends even to the thighs. +When the deposits are in the bladder, there is a frequent desire to +urinate, with a bearing-down, straining pain; also a cutting or +scratching sensation in the urethra during micturition. In the male, +intense pain is often experienced at the end of the penis. When the +urine is voided in a vessel and allowed to settle, a gravelly deposit is +seen, generally of a red or a white color, and the particles varying in +size. + +TREATMENT. These urinary deposits indicate a general derangement of the +system, as well as a local disease. Nutrition is imperfect and some of +the excretory organs are not properly performing their functions, or, +perhaps, some portion of the body is being too rapidly wasted. Very +frequently we find these gravelly formations as the result of a +rheumatic or a gouty diathesis. It is also a well-known fact that +torpidity of the liver throws an excessive amount of work on the +kidneys. These organs then, in part, perform the function of the liver, +and hence unnatural activity is required of them, and the secreting of +such substances as uric acid, which precipitates readily and gives rise +to severe irritation of the urinary canal. + +In order to treat these cases rationally and successfully, it is first +necessary to ascertain by microscopical and perhaps chemical +examinations, the character of the deposit. By such an examination, the +exact condition of the system which gives rise to these abnormal +products may be definitely determined, and the remedies to be employed +indicated. As the non-professional are not qualified to make such +examinations, it would be useless for us to suggest specific treatment +for the various forms of this affection. + +Samples of the urine may be sent to us with a brief description of the +symptoms experienced, and the proper medicines to cure can be returned +by mail or express. Our specialists are treating, with uniform success, +large numbers of cases in this way. (SEE TESTIMONIALS.) + + +STONE IN THE BLADDER. + + +Few affections to which the human flesh is heir are more painful than +this terrible affliction. The cutting operation heretofore required to +remove it, is considered one of the most dangerous operations that the +surgeon is ever called upon to perform. + +The death of the Emperor Louis Napoleon, of France, from an operation +for the removal of a stone, at the hands of surgeons renowned for their +skill, gave new impetus to the efforts of surgeons to invent some method +that would be less dangerous than that which has been heretofore +commonly employed. The cutting operations have been the rule. Of these +the operation by median-section is the safest, and is most commonly +employed for the removal of stones that are not too large, while the +lateral operation is used where the stone is more than about one inch in +its smallest diameter. + +As will be seen by the consultation of any hospital record, the deaths +in these various operations have been, in adults, from one in three to +one in every four cases--a very large percentage, and sufficient to +deter any sufferer from undergoing an operation except for the relief of +a condition which is in itself worse than death. Even when this alarming +death-rate is explained to sufferers, they willingly undergo the +operation, feeling that they would rather die than longer continue in +their pain and anguish. + +Our specialists, not satisfied with the results of these operative +measures, in their studies of the disease endeavored to perfect some +other means by which these foreign bodies could be removed from the +bladder without such great danger and pain. The operation by crushing, +and removal without cutting, appeared to them to present the most +practicable advantages, and they therefore devote their entire time to +the improvement of this method for the removal of stone. + +The method of crushing was first invented by a French surgeon many years +ago; but, owing to his crude instruments, and the difficulty that was +experienced in expelling the pieces of stone, the operation was seldom +employed by surgeons. The improvements in these methods at the hands of +Bigelow and Sir Henry Thompson, with those that have been made by our +specialists, have resulted in our being able to present to sufferers +with this disease, a means of cure which is, we are assured, the most +successful known to modern medical science. + +There have been so far in the history of the treatment of this malady by +the new method of cure, one hundred and twenty-odd cases operated upon +at the hands of prominent surgeons, all of which were with less perfect +methods than that of our specialists, and there were but four deaths in +this large number. By the advantages which are the result of further +improvements by our specialists, we can assure you that this mortality +is even less in our hands; in fact, approaches, as near as possible, to +a perfect method of cure. + +We think that in a moderately healthy subject, one in which the kidneys +are not badly diseased as the result of irritation from the calculus, +the operation is almost absolutely safe. The method consists in the +crushing of the stone, and its removal from the bladder by means of +small silver catheters attached to an apparatus which gently and +perfectly removes, by suction, all the pieces which are thrown to the +bottom of the bladder. This operation has now been performed in our +institution in a very large number of cases with uniform success, and +the cures have been effected in from six to eight weeks without a single +unpleasant symptom arising during their progress. By this method it is +not necessary to remove the entire calculus at one operation, if it is a +large one. By the old cutting operation this was required, as the +bleeding was great, and what was to be done had to be done immediately, +or the patient would die from the _hemorrhage_. With the new method a +part of the large calculus, or when several exist, one or two of them, +may be removed at a time, after which the patient can rest and gain +strength for the second; or, if necessary, for the third operation. + +The largest stone removed by us in this way was one weighing between +seven and eight hundred grains, for which three operations were +required. It is necessarily performed under a mild anæsthetic, which +prevents suffering and secures the perfect relaxation of the patient. In +the case in which this large amount of stone was removed we feel certain +that a cure could not possibly have resulted from a cutting operation, +as the heart was seriously affected, and the physical condition of the +patient so low, as the result of years of suffering, that death would +have occurred while undergoing the operation. By carefully pursuing the +new method, and not prolonging the sittings more than a few minutes each +time, the entire stone was evacuated. The health of the patient +constantly improved during the interval of three operations, which +covered a space of seven weeks. This stone was as large as a hen's egg. + +Small calculi or gravel are readily removed in a few moments' time by +the new method. In no case is there any bleeding. Instead of a large, +gaping wound being left after the operation, from which secondary +hemorrhage may take place, or poisoning result from the irritation of +decomposing urine, the parts are left in a healthy state with the +surface unbroken. The stone, a constant source of irritation, is +removed, and the health is speedily restored. + +When it is impossible for the patient to visit us, a careful examination +of the urine is made, and if gravel have been passed, these are +carefully examined also. An idea of the composition of the stone is +arrived at by this means, and treatment is directed to dissolve it. +Success has commonly followed this method of treatment, when the stone +has not been very large. With the gradual reduction of the size of the +stone the irritation subsides, and the general health of the patient +improves. (SEE TESTIMONIALS.) + + +CHRONIC ENLARGEMENT OF THE PROSTATE GLAND. (HYPERTROPHY.) + + +The prostate gland lies just in front of the base of the bladder, and +surrounding the urethra, or urinary canal. Enlargement, therefore, of +this body, if it be of considerable extent, causes it to encroach and +press upon the base of the bladder, and to more or less constrict the +urinary canal near the base or outlet of the bladder. The enlargement +may be only slight, or the dimensions of the gland may be increased from +the size of a large chestnut, its normal dimension, to the volume of a +pullet's egg, or even to the size of an orange. + +Hypertrophy of the prostate generally arises from causes which operate +in a slow and permanent manner. Whatever has a tendency to produce a +determination of blood to, and an engorgement of, this organ, is capable +of producing the affection, an augmented flow of blood to the the part +having the effect to increase the nutrition. Among the most frequent +causes of this affection, are excessive venery, masturbation, disease of +the bladder, stricture of the urethra, horseback exercise, gonorrhea, +and the employment of strong, stimulating diuretics. Some of the worst +cases that we have had to deal with have occurred in old men, and, in +fact, the malady is more common to those advanced in life; but it is +frequently produced in those of middle age by the causes enumerated. + +Among the earliest symptoms of the disease is an uneasy feeling in the +region of the base of the bladder. There is a more frequent desire to +urinate than usual, and, in the course of time, this frequency becomes +more urgent; still no particular notice may be taken of it, it being +considered as "only a slight inconvenience." After several months, or it +may be years, the discomfort increases, and nightly calls to empty the +bladder become habitual. By and by the patient begins to find the +discomfort of getting out of his warm bed very troublesome; still no +notice to taken of it. He does not consider it worth his while to +consult a doctor for "such a trifle." In the course of time the patient +is obliged to get out of bed twice during the night instead of once. +Afterwards, the calls become still more frequent and urgent; the +inconvenience more evident; finally, pain is substituted for +inconvenience, and then the doctor is consulted. Unless a specialist of +experience be consulted, the bladder will most probably be examined, and +medicine will be prescribed only to excite the kidneys to secrete more +urine, which does harm instead of good; the disease slowly, but surely +progressing. Patients often write us that they have had something wrong +with the bladder for a number of years, having to urinate more +frequently than they ought; sometimes having to do so three and four +times during the night; in extreme cases even every half hour or so, and +that they are not able to pass it freely, but only in small quantities, +and attended with much pain. These symptoms are not always constant, but +let up for a few weeks and then appear again. Things go on in this way +for a year or two, perhaps, when the passage of the urine is completely +shut off for several hours, and the patient is in great agony until the +bladder is relieved by the use of the catheter. After such instrumental +relief, for a day or two the urine may be natural again, coming at +first, perhaps, in very small quantities, but by and by more freely. +Then, after a week or two intervening, there may be another complete +stoppage, attended, as before, with intense suffering, which will have +to be again relieved by the use of an instrument. + +The foregoing is a fair account of the usual progress of the disease and +its symptoms. As the prostate gland becomes more irritated and inflamed +from the natural progress of the disease, or from the irritation caused +by the passage of instruments, or the employment of strong, harsh, +stimulating diuretics, the urine becomes cloudy, and still later is +found to have deposited during the night in the chamber utensil a +quantity of thick, tenacious, and usually offensive mucus. There is apt +to be more or less discomfort in the rectum, or lower bowel, produced by +the pressure of the enlarged prostate upon it. Rarely, the first +intimation of a large prostate occurs through a sudden retention of the +urine, and the patient being under the impression that there was nothing +wrong with the organ previously. Closely questioned, however, the +information is elicited that there has been a long train of mild +symptoms, similar to those that we have described, preceding the attack +of retention of the urine. This shows the importance of early attention +and proper treatment when such symptoms are manifested. However slight +the inconvenience experienced, it should not be neglected. The disease +should be brought under control at the outset by skillful and +nicely-adapted treatment. Usually before a person suffers from +toothache, the decay occasioning it has been gradually progressing +without pain for from five to eight years. Just as the decay of the +tooth may be arrested by the early attention of the dentist, so may +prostatic disease by early attention be not only promptly relieved, but +permanently cured. + +Disease of the prostate being slow in its inception and progress, is +also slow to yield even to the most skillful treatment. Being slow to +develop, patients rarely seek assistance until the organ has become so +large as to be seldom restorable to a size where mechanical means can be +wholly dispensed with for relieving the bladder. Most surgeons are too +much in the habit of depending on the catheter for the relief of the +patient, and usually instruct the sufferer how to use it, telling them +that this, the catheter, is to be their only doctor for life. Great as +is the relief afforded by the catheter, which has often saved life, yet +it is a fact that its frequent and prolonged use often renders disease +of the prostate very intractable and often wholly incurable. Frequent +use of the catheter, without any treatment to prevent the further +enlargement of the diseased gland, or to reduce its size, permits the +part to go on enlarging, and, besides, the constant use of the catheter +irritates the prostatic portion of the urethra, causing thickening of +the lining membrane, and sooner or later a more or less complete organic +stricture of this canal, depending upon thickening of the lining mucous +membrane, as well as upon the encroachment of the gland itself upon this +canal. Besides, when the use of the catheter is once commenced, even +when the enlargement is not very great, it is with the utmost difficulty +that we have been able to induce patients to leave off its use. The +bladder, becoming accustomed to its use, refuses to obey the will +without this help. The irritation set up in the parts by the friction of +the catheter causes inflammation and exudation in the lining membrane. +This extends to the structure of the prostate itself and increases the +hypertrophy or enlargement. It will, therefore, be seen how important it +is to early resort to treatment to relieve the first manifestations of +this affection. A disease of so delicate a nature, and one so often +confounded with other maladies by inexperienced physicians, should only +be intrusted for treatment to expert specialists of large experience in +the management of this and kindred maladies. + + * * * * * + + + + +STRICTURE OF THE URETHRA. + + +Stricture of the urethra generally results from some specific disease of +the urethra, but may be caused by sexual excesses, exposure, or strain, +or by the practice of masturbation or self-abuse. It runs a course +varying in time from a few days to many weeks or months, during which +time the patient is often unaware of the real cause of his sufferings. + +Commonly, the attention is first called to a stricture by a slight +discharge, or smarting sensation, or the appearance of an undue amount +of mucous deposit in the urine. Occasionally, some difficulty in +starting the water, or a diminution in the size and force, or a twisting +of the stream as it flows, is the first symptom. This passive stage is +of variable duration. When skillful treatment is instituted at this +stage of the disease, a speedy cure is easily effected without pain or +danger. Any exposure, improper use of instruments, or irritating cause, +may speedily give rise to the alarming symptoms due to closure of the +urethra, from which fatal consequences may suddenly ensue. + +[Illustration: Fig. 2. +A Single Stricture of the Urethra.] + +This condition is illustrated in Fig. 2, which shows the hard and tough +stricture which surrounds the soft mucous membrane that lines the +urinary canal. When irritated or inflamed, as the result of a cold or +other cause, the mucous membrane becomes swollen and thickened, and, as +the stricture will not yield and enlarge, the result is that the urethra +is almost completely closed, and it becomes impossible to pass the +urine. Great pain is experienced, and the surgeon has to be called to +draw off the urine with a catheter, which, at best, is a very difficult +and painful operation, when the urethra is so irritable and constricted. + +TREATMENT. In the earlier stages of the malady, relief is given by the +skillful use of instruments for dilating the canal, or, where this fails +by the operation of urethrotomy, for which we employ an improved and +ingenious instrument, by which the stricture is readily and almost +painlessly divided. + +IMPROVED METHODS. Our surgeons have operated upon many hundreds of bad +cases by a very ingenious and almost painless method, that requires no +use of bougies in the after-treatment. This saves the patient an immense +amount of pain and annoyance, and enables him to go home almost +immediately after the operation. + +The ordinary after-treatment, by dilatation with bougies, is very +tedious, and often more painful than the operation itself, so that our +peculiar method of treatment has been hailed with joy by those familiar +with the old and unnecessarily-painful systems of treatment. Besides, +our more improved method has been followed by far more perfect cures in +every case operated upon. + +In many of the cases coming under our observation and treatment, there +have been several strictures, as illustrated in Fig. 3, which shows the +urethra constricted at three different points, besides a congenital +contraction at its mouth or meatus. + +[Illustration: Fig. 3. +Condition of the Urethra with three Strictures and a congenital +contraction +at the meatus or outlet.] + +SPERMATORRHEA not infrequently results from stricture of the urethra, +even when the affection is quite slight. Our attention was first called +to this subject by the consideration of the numerous cases in which +epileptic convulsions or "fits," and other serious diseases of the +nervous system in children, have resulted from an unnatural contraction +of the prepuce or foreskin, constituting what is termed _phimosis_. + +Every surgeon of experience has met with many of these cases of reflex +irritation. It occurred to us, that, inasmuch as these contractions of +the foreskin give rise to nervous diseases of an alarming nature, may +not an unnatural narrowing of the urethral canal, which must have +exactly the same effect in retarding the flow of the urine, give rise to +irritable nervous affections in adults. May not unnatural irritation and +excitement of the sexual organs, so set up, cause loss of semen to occur +during sleep, and consequent nervous and general debility? + +It is a well recognized fact that the urethral canal should bear a +certain definite and proportionate size to that of the penis, just as +the length of the arm should naturally bear a certain proportion to the +length of the body. In the case of some parts of the body, +disproportionate development of the part may not give rise to anything +further than unsightliness; but when we find the small size of the +urethra retarding the free passage of the urine, then we may expect, if +this condition is long continued, to find more or less irritation of the +urethra and, perhaps, of the bladder, also. When there is a contraction +of the urethra at its external orifice, or at any point along its +course, unnatural pressure is put upon the urinary canal behind the +constricted portion, and these parts must bear an undue strain during +the passage of the urine. + +It is a well established fact that improper diet, cold, exposure, and +over-work exert a very powerful modifying influence upon the urinary +secretion, frequently causing an acrid and irritating condition of this +fluid. This condition, when associated with a contracted urethra, must +result in irritation of the mucous membrane lining this canal back of +the stricture, if long continued or frequently repeated. As an +illustration, we have a hose pipe from which, by means of a small +nozzle, water is expelled a considerable distance, but a great tension +is put upon the hose behind the nozzle. If the pressure is increased +greatly the hose will burst; but, if the small nozzle be replaced with a +larger one, the projection of the stream will be quite as great, but all +undue tension of the pipe is overcome and the danger of bursting is done +away with. We have, in an unnaturally contracted urethra, a favorable +condition for the development of disease in the urinary canal and +adjacent parts of the generative organs. Irritation is set up in the +urethra behind the stricture by undue strain in passing water, and the +frequent reoccurrence of acrid urine, as the result of any of the causes +we have already mentioned, this irritation keeps gradually increasing. +It will be felt more during the periods when the urine is acrid, but may +pass unnoticed even at such times. The seminal sacs and the prostate and +Cowper's glands communicate with the deeper portions of the urethra by +means of canals or ducts, lined with mucous membrane which is continuous +with the urethral mucous membrane. Hence we can readily see that not +only by reflex nervous irritation are those parts debilitated, through +the contraction of the urethra, but the affection is apt to extend by +continuity of the mucous membrane, and thus become more and more +manifest, through symptoms of disease of the testicles, prostate gland +and seminal vesicles, and these disorders become more and more seated +the longer the morbid condition of the urethra is allowed to run on, +until there may be an entire loss of the sexual functions, occurring at +an age when there should be present the most vigorous manhood. From no +other cause can we explain the common prevalence of disease of the +deeper portions of the urethral canal and bladder, many times confounded +with other diseases of the urinary and generative organs. + +The following is the history of a case that fully illustrates the +foregoing statements: + + +CASE 112,289. MR. O.C.E., SINGLE, 32 YEARS OF AGE. + +[Illustration: Fig. 4. +Condition of the urethra in Case 112,289; permanently cured at the +Invalids' Hotel and Surgical Institute.] + + He applied to us suffering from entire loss of the sexual + function, with great nervous debility, and there was a thin + slimy discharge from the urethra, and the usual symptoms of + melancholia and weakness. He had lost all taste for business, + and was extremely nervous, from the fact that he was engaged + to be married, and felt that his condition would not permit + it. On examination a contraction of the urethra was found at + the point shown in Fig. 4, which had probably been present + for years. He stated that he never had been just right in + those parts, but had lived a virtuous life, had never had any + venereal disease, and, hence, the true nature of his trouble + had not been suspected. With the removal of the stricture + there was an immediate improvement in his condition, which + became more and more rapid, as his system gained strength and + reaction became manifest. At the end of two months he wrote + that he felt sound and well, and that he had experienced the + most wonderful improvement in every way. His vital strength + was fully restored, and he was most profoundly grateful. + +Chronic inflammation of the bladder, sometimes called catarrh of the +bladder, an affection that is elsewhere herein fully treated of, and +chronic inflammation of the kidneys, and true Bright's disease, as well +as prostatic disease, are all liable to result from strictures of the +urethra. Hence, it behooves one suffering from this malady to have it +promptly and skillfully treated. + +FALSE PASSAGES. In very rare cases of impassable stricture, or in which +fistulous openings, or false passages, have formed, through which the +urine flows or dribbles away, we have resorted to the operation of +perineal section with the most gratifying results. The cases requiring +this operation are rare ones, in which death must generally result but +for the relief afforded by the operation. + +DANGEROUS USE OF INSTRUMENTS. The worst and most dangerous cases of +stricture with which we have met, in a long and extensive experience, +were rendered thus by the careless or unskillful use of bougies, +catheters, or sounds. Many surgeons and physicians are most recklessly +careless or unskilled in the use of these most dangerous instruments, as +the many cases of false passage or stricture of the most painful and +dangerous kind, caused or aggravated by their ignorant or improper use, +sorrowfully testify. + +DELAY DANGEROUS. By proper treatment of stricture in its early stages, +all danger and pain are avoided, and a cure is effected in a very short +time. In an extensive practice, in which we yearly treat hundreds of +cases, we have never yet failed to give perfect and permanent relief +from stricture, or diseased prostate or urethra, without the necessity +of cutting instruments of any kind, when we have been consulted before +injury of the urethra has been produced by improper use of instruments. +Having specialists who devote their entire time to the study and cure of +these diseases, we are thereby enabled to attain the highest degree of +skill in the management of these cases. + +GREAT SKILL REQUIRED. The urethra is a sensitive and delicate canal, and +is surrounded by tissues the most delicate, and lined with mucous +membrane which is highly vascular and filled with sensitive nerves. The +introduction of any instrument is to be undertaken only when absolutely +required, and, when necessary, it should be so skillfully and carefully +effected that no pain or irritation can result. The slightest +awkwardness is liable to cause an unnoticeable injury, which results in +false passage or an effusion of plastic lymph around the canal, and as +it organizes, the formation of the most troublesome organic stricture. +The attention not only of sufferers, but also of the profession, is +called to the remarkable success of our operation, perineal section, by +which a cure of extremely bad cases of impassable stricture and false +passages, or urinary fistulas, is effected in from thirty to forty days, +and with very little suffering. That we have been successful in such +cases must be considered as conclusive evidence that no case of +stricture, false passage, or urinary fistula, is beyond the reach of our +skill. + + * * * * * + + +TESTIMONIALS. + + +In a practice embracing the treatment of a vast number of cases of +diseases of the Urinary Organs, it has been our good fortune to effect +many remarkable cures. The experience gained in this field of practice +has made our specialists skilled experts, and hence hundreds consult +them as a last resort. In fact we seldom get a case, in this line, that +has not been the rounds of the home physicians before applying to us for +relief and cure. The cures, therefore, which we shall introduce here are +the more remarkable because of the failure, in nearly every case, of +other medical men to benefit or cure. They are not the every-day, +ordinary cases met with in the general practitioner's rounds, but +complicated, obstinate ones, which had generally been given up as +hopeless before coming to us. + + +CASE 4A-3431. "WASTED TO A SHADOW." BLEEDING FROM KIDNEYS. A SEVERE +CASE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: T.S. Bailey, Esq.] + +_Gentlemen_--I think it my duty to write to you concerning my case. In +the year 1886 I was seized with inflammation of the bladder and passed +nothing but thick blood, owing to heavy work, and I consulted a doctor +and he said there was no cure for such a bad case; but he gave me +medicine and it relieved me at the time I used it; and I took 16 bottles +and I got worse and wasted to a shadow. I quit taking the medicine, and +other complaints came, as rupture in the spermatic cord, for which I +applied to you and soon got relief. And in 1891 the bladder disease made +its appearance, and I wrote to the Invalids' Hotel and Surgical +Institute and got no reply as our mails were stopped on account of snow +drifts. I sent for the best doctor in Listowell and I still got worse, +and he said I might live three or four weeks, but there was no stoppage +of the disease. And I got so weak that I had to support myself by the +furniture in my room; and I wasted down to 100 lbs. in two weeks; and I +applied to your Institute and I received my medicine in a few days, and +in two weeks I began to gather strength and now I am hearty and well and +my weight is 145 lbs. I feel so thankful to the Medical Association and +its Staff of skilled men. It is 15 months since I quit taking your +medicines and no signs of the disease returning. + + Yours gratefully, + THOMAS S. BAILEY, + Dorking, Wellington Co., Ont. + + +CASE 23A-877. INFLAMMATION OF THE BLADDER, WITH OTHER COMPLICATIONS. +SUFFERED EXCRUCIATING PAIN IN URINATING. + +[Illustration: G.W. Heffner, Esq.] + +For many years I suffered with inflammation of the Prostrate Gland and +Bladder. It became gradually worse and I endured extreme pain, so much +so that I was laid up for weeks at a time, and almost gave up in +despair. I was persuaded to go to the Invalids' Hotel and Surgical +Institute. I have never regretted following this advice. While there I +submitted to an operation by their specialist. This was entirely +painless and the result perfectly satisfactory. I left in a short time +delighted, and have since been strong and well. I cannot speak in too +high praise of this famous Institution; the rooms are large and +pleasant, the food the very best, the attendants kind and attentive and +the staff of physicians skillful and of large experience. I highly +recommend all invalids to the World's Dispensary Medical Association. I +feel confident that all the benefit to be derived from medical treatment +is to be received at this Institution. + + Yours truly, + GEO. W. HEFFNER, + Chicago, Ills. + + +CASE 2A-103. INFLAMMATION OF BLADDER, COMPLICATED WITH KIDNEY DISEASE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: M. Manheim, Esq.] + +_Gentlemen_--Having been a patient in your Invalids' Hotel for several +weeks, I take great pleasure in telling other sufferers of my treatment +which I received under your efficient staff of physicians, surgeons and +nurses, and I will say with clear conscience that every care and comfort +was given me that could be wished for. I am sure that your Institution +is far in advance of the age, and would wish that every invalid could +avail himself of the treatment that I received in your most excellently +kept Invalids' Hotel. I cheerfully give this as my testimonial to +individuals, friends and sufferers. My health is so fully restored that +I look upon life with pleasure and comfort, whereas before I was a +suffering, nervous invalid, unable to sleep and much of the time in +torment. Wishing you success, + + I am your friend and well wisher, + M. MANHEIM, + Georgetown, S.C. + + +CASE 859,143. BLADDER, RECTAL, KIDNEY AND LIVER DISEASE. "ENTIRE URINARY +ORGANS ONE MASS OF SORES." "DESPAIRED OF CURE." + +[Illustration: S.C. Tracy, Esq.] + +My disease was caused by the roughness and exposure incidental to the +life of a miner, working in the gold mines of California and Montana. I +had much of the time to work in water, with my clothes wet, which +finally brought on a severe pain In my kidney, which ere long completely +prostrated me. I employed and was treated by six different physicians, +the best I could obtain in my section of country, and who while seeming +to understand the nature of my disease, yet gave me no remedy that +afforded me any real relief. I grew worse under the treatment of them +all. The pain in the kidney left me, but immediately located in the +bladder. My bladder became very painful and commenced to ulcerate and +fill up. It seemed from the excruciating agony I suffered, that there +must have been an abscess in either the kidney or bladder, and from the +large amount of pus discharged at one time, it appeared to me that my +kidneys, bladder and the entire urinary organs were one mass of sores +and pus mixed with blood. I had to use injections of laudanum daily in +the lower bowels to ease the pain and live. Was reduced by long +suffering, looking for each day to be my last. I felt that no human +power on earth could help me. No language can describe, and God only +knows, the agony I suffered. From what I have already written, you may +form some faint conception of my physical condition at the end of six +years' treatment by the best medical aid I could get in the section +where I was living. I also used for some time (with no benefit), +"Warner's Safe Cure," and in fact, tried every means that I could hear +of, but to no permanent relief. Such was my condition when I was led +finally to consult and be treated by your Association, though I had but +faint hope of obtaining any relief from any one. With the very best +description I could give in writing of my case, and all the information +you got from me, you would not undertake the case until you were further +informed, and for which caution I sincerely thank you. You wrote me--"we +are at a loss to definitely determine your condition. We have an opinion +based upon the facts before us, but we feel that we must have a personal +examination." In the condition I was then in, I could not have been kept +alive to reach the first railroad station, which was only six miles from +my house, and much less to travel to Buffalo. Indeed I wrote you, that +if you would cure me for nothing, I was unable to go to you. In reply, +you then advised me to take your "Special Remedies" until I could +improve sufficiently to go to Buffalo for examination. Now this frank +answer of yours, removed every doubt from my mind, and convinced me that +you were _honorable physicians_. On March 10th, 1883, I began taking +your "Special Remedies," as you prescribed them, and at the end of three +years' constant treatment, I was improved sufficiently to go to Buffalo +to your Institute, where I was examined as you required of me. When I +reached your Institute, I was there carefully examined and received a +month's treatment. When I reflect on my condition and my suffering when +I first began to use your specifics, and see what I am now, I feel that +no words can too glowingly express my gratitude to your Association for +the physical benefits you have conferred upon me by your treatment of my +despaired-of case. + + SAMUEL C. TRACY + Platteville, Wis. + + +DOUBLE VARICOCELE AND STRICTURE OF THE URETHRA. + +[Illustration: C. Hanson, Esq.] + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.: + +_Gentlemen_--I have taken treatment from you for several months for +nervous debility, and although I am not quite fully cured as yet, I have +been greatly benefited, and believe, if I had come to you before I was +duped and swindled by different quacks and was more dead than alive, I +would to-day be a thoroughly well man. + +I have also been to your Institute twice for surgical operations, and +cannot too highly praise the Hotel, or the skill and care of the +attending surgeons and nurses. They are gentlemen in every way and the +Invalids' Hotel is just as represented. + +I shall advise all suffering from chronic diseases to go to you for +relief, as I have never seen any one there who was not cured or greatly +benefited. + + Very truly yours, + CHRISTIAN HANSON, Esq. + Austin, Mower Co., Minn. + + +CASE 23A-890. DISEASE OF THE URINARY ORGANS. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: F.A. Empsall, Esq.] + +_Gentlemen_--I feel it my duty to give my testimonial in behalf of your +grand Institution. I had an operation performed at your place two years +ago for the relief of a very painful disease of urinary passage, and, +thanks to your skill, I was cured, and have enjoyed the best of health +since. I earnestly recommend your Institution to all who are suffering, +and still further let me thank you for the kindness I received at the +hands of everybody connected with the Institution. I am, + + Respectfully yours, + FRANK A. EMPSALL, + P.O. Box 980, Pittsfield, Berkshire Co., Mass. + + +CASE 2A-208. RETENTION OF URINE. SUFFERED INTENSE PAIN. + +[Illustration: P.J. Hamill, Esq.] + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +_Dear Sirs_--To your favor of the 20th ult., would say that I can only +speak in the highest terms of your Institution. After suffering for ten +or twelve years with retention of the urine, and bladder difficulties, I +can say that I found immediate relief at your hands. When going to your +place, about six years ago, I was suffering with intense pain, loss of +appetite, and unable to eat a good meal. I now weigh 170 lbs., do a good +day's work and feel well in every respect. I am only too glad that I am +able to praise your Institution, and can highly recommend it to any one +who is suffering as I was. With great respect, I remain. + + Yours very truly, + P.J. HAMILL, + Utica, N.Y. + + +CASE 80,115. ENLARGED PROSTATE AND CHRONIC CATARRHAL INFLAMMATION OF +BLADDER. + +[Illustration: Abraham Schell, Esq.] + +Several years ago I had occasion to become an inmate of the Invalids' +Hotel and Surgical Institute, No. 683 Main Street, Buffalo, N.Y. I was +afflicted with an enlarged prostate and chronic Inflammation, or +catarrhal condition of the bladder. I was largely benefited by the +treatment I received there, and had I remained a little longer, as I was +advised to do by the doctor who attended me, I should have fully +recovered. I was so nearly cured that I did not think it necessary to +remain longer, as I supposed nature would do for me what remained to be +done, to effect a perfect cure. My business was urgent. I could not well +remain longer. In this I made a mistake, I should have remained longer. +I was seventy-two years old at the time. I bear willing testimony to the +ability of the medical staff and the interest the doctors take in the +welfare of their patients. The nurses and all the subordinates were very +kind and seemed to vie with each other to contribute to the pleasure and +happiness of the inmates of the Institute. One will find the Institute +equipped with all the improvements known to modern science, for the +promotion and restoration of health. It is impossible to do justice to +its merits in a short article of this kind. Persons must go there and +see and judge for themselves, of the wonders of this extraordinary +medical establishment. If they cannot recover their health there, in my +Judgment, it is of no use to go elsewhere. + + ABRAHAM SCHELL, + Knight's Ferry, Cal. + + +CASE 820,804. OBSTINATE AND COMPLICATED DISEASE. + +[Illustration: John H. Smith, Esq.] + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: + +_Gentlemen_--Yours of July 12th to hand. I am only too glad to comply +with your request. Having suffered for many years with a complication of +diseases and feeling conscious that they were rapidly making serious +inroads upon my constitution, and that I was speedily becoming unable +and incapacitated to attend to my ordinary business. I resolved, after +reading a number of testimonials from your patients, to place myself +under your treatment at the Invalids' Hotel and Surgical Institute. With +heart-felt gratitude I can truthfully say I am relieved of my trouble. I +most cheerfully and earnestly recommend this Institution to all who are +afflicted with chronic and painful diseases, no matter of what nature. +During my stay there I saw some wonderful cures and surgical operations. + + Yours truly, + JOHN H. SMITH, + Deckertown, Sussex Co., N.J. + + +CASE 520,425. COMPLICATION OF DISEASES. + +[Illustration: Andrew Holes, Esq.] + +Without solicitude or hope of pecuniary reward, with heart-felt +gratitude and a desire to aid my fellow-man to health and happiness, +allow me to state, that as an inmate for more than a month of the +Invalids' Hotel and Surgical Institute at No. 663 Main Street, Buffalo, +N.Y., I feel warranted in its highest recommendation. While there I saw +and talked with a great number of people who came there as a last +resort, to be cured of almost every chronic disease to which flesh is +heir, and they were unanimous in their praise of the Institution and the +skilled specialists who constitute its professional staff. + + ANDREW HOLES, + Moorhead, Minn. + + +CASE 654,500. DISEASE OF KIDNEYS AND OTHER COMPLICATIONS CAUSED BY +EXPOSURE AND MALARIA. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: J.W. Dean, Esq.] + +_Gentlemen_--Having spent a short period of time at the Invalids' Hotel +and Surgical Institute, No. 663 Main Street, Buffalo, N.Y., I must say I +found it fully equal in every respect to the claims made for it by the +proprietors. It was filled with invalids who were under the care of a +corps of physicians and surgeons and the fact that all the sick people +appeared to be improving, and that they were both cheerful and hopeful, +and that they all spoke well of the Institution and of its doctors, was +calculated to inspire confidence in one who went there himself to be +treated. The greater number of these cases, as far as I was able to +learn, were chronic and of a complicated character. They represented a +wide range of the States and Territories of the Union, and had in each +exhausted the resources of the home physicians. Having myself been +treated by your Faculty for a complication of troubles induced by +exposure and malaria, I feel that I owe my restoration to health to your +skill and devotion, at a time when I was unable to perform labor and was +much discouraged, and had failed to obtain relief elsewhere. You are at +liberty to make any use you may desire of this communication. + + Very respectfully yours, J.W. DEAN, + Chariton, Putnam Co., Mo. + + +CASE 620,230. DIABETES AND INFLAMMATION OF BLADDER, GIVEN UP BY HIS HOME +DOCTORS AS SURE TO DIE IN A FEW WEEKS. RESTORED TO ACTIVE WORK ON HIS +FARM. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: J.D. Parks, Esq.] + +_Gentlemen_--I received your kind letter the 12th, and was glad to hear +from you and have no objection to your making use of my name in any way +to help the sick and suffering, for I know what it is to be sick. I was +sick for seven years; could not do anything; was visited by seven +doctors and was treated by four, and was given up to die by one of the +best doctors of Russellville. He said I could not live longer than fall. +He treated me for Sugar Diabetes, while the rest said I had inflammation +of the bladder. After giving up all hopes of being cured at home, a +friend got me to write to Dr. Pierce's Institution and after +corresponding: awhile I decided to go and be treated. I was there one +month and I never was cared for or treated more kindly by any one. No +parents could have been better to their sick children. I cannot speak +too highly of the Institution, and I believe I would have been in my +grave to-day if I had not gone and been treated. + +I feel great pleasure in expressing to you my sincere thanks for the +cure that has been effected in my case, by your very skillful treatment, +whereby I am now entirely and I trust permanently cured from a dangerous +disease, which had defied the utmost skill of all former medical +attendants for the past five years, and from which I had despaired of +being: relieved. I am happy to state that my health is so good since +taking the month's course of treatment at your Institute, and, the home +treatment since my return, that I am now able to carry on the work of my +farm. + +I would cheerfully recommend all persons requiring medical or surgical +aid to consult you at the earliest possible opportunity, as I know by +personal experience that the facilities cannot be surpassed for +treatment of all classes of chronic diseases. + + Most gratefully yours, + J.D. PARKS, + Homer, Logan Co., Ky. + +P.S.--I have always recommended my neighbors to your Institution and was +the cause of F.M. Brasher taking treatment, who was cured after two +doctors gave him up. J.D.P. + + +CASE 820,426. COMPLICATION OF DISEASES. A GRATEFUL PATIENT'S WORDS OF +PRAISE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: William Henkel, Esq.] + +Gentlemen--Having been in your Institution as a sufferer from two +distinct chronic diseases of years' standing, and having been placed +under the charge of your specialists, I was speedily relieved of my +afflictions. The Invalids' Hotel is a place as much like home as it is +possible for such an institution to be. The physicians and surgeons are +all expert specialists and thoroughly efficient; the nurses are very +competent, attentive and kind; and, in fact, the whole _personnel_ of +the Invalids' Hotel endeavor to do their best to make the patients feel +like being at home. I always felt while there as if I was one of the +family. I gladly recommend your Institution to all persons who are +afflicted with any kind of chronic disease, for from my own experience I +_know_ the professional staff will do all which they promise to do. +Please accept my thanks for the speedy benefits and perfect cure of my +diseases, and I think your Institution is worthy of the highest +endorsement. + + Yours truly, + WILLIAM HENKEL, + No. 1917 Congress Street, St. Louis, Mo. + + +"_A question of life or death!_" + +CASE 2A-107. STONE IN BLADDER. CASE SIMILAR TO THAT OF COL. ELLIOTT F. +SHEPARD, WHO DIED IN NEW YORK WHILE UNDERGOING AN OPERATION. + +[Illustration: David S. Clark, Esq.] + +_Gentlemen_--I am seventy-seven years of age and have resided in Erie +for sixty-two years, and for thirty-six years have been an elder in the +First Presbyterian Church. During four or five years I suffered from a +painful affection of the bladder; the severity permitted neither freedom +from pain by day nor calm repose by night. Meanwhile, I consulted +leading physicians and visited numerous health resorts. Neither time, +means nor effort were spared that I might be free from pain. Relief came +unexpectedly. A signal act of Providence, that should be acknowledged +daily, brought your Institution to my notice, though I had then no +acquaintance with any one connected with it. With me it was a question +of life or death. Up to last March I was in a condition of unendurable +torture. I knew that at my age, after the months of pain already borne, +that any operation would be serious, perhaps fatal. Accordingly, I +arranged my temporal affairs and carefully "set my house in order." On +the 13th of March last, I started for Buffalo to your Institution. Still +uninformed as to the cause of my trouble, I submitted to a searching +examination, as to my habits, constitution, parentage, the age and cause +of death of my parents, and other facts, from which a tolerable +biography could have been prepared. All was kindly intended. Their aim +was to locate my ailment and then to determine my ability to undergo an +operation. Having found a stone in the bladder, they advised that it be +crushed and extracted. By a strange coincidence as this was announced, I +learned of Col. Elliott F. Shepard's death under an operation for the +same disease. He was many years my junior, and seemingly far better able +to undergo the operation. Still, in my desperation, I determined to go +on. During five days, I was under treatment for the coming operation. On +the 18th of March the stone was crushed and extracted. It was a complete +success. Of the consideration, tenderness and skill of the surgeon and +his assistants, I cannot too strongly speak. Of the gentle and assiduous +nurses, the system and completeness of the whole establishment, as it +moved along as one harmonious whole, in all its departments, I cannot +sufficiently express my admiration. I am now relieved of a state of +torture, and restored to health and happiness equal to any period of my +life. This I say with sincerity and emphasis. Since then I have gained +twenty-two pounds in flesh. I wish my words could reach the ear of every +one similarly affected, throughout our land, to banish all doubts and +take advantage of the science, skill and pleasant surroundings so +happily blended in your Institution, for the removal of pain and the +mitigation of distress. + + DAVID S. CLARK, Erie, Pa. + + +CASE 520,123. STONE IN BLADDER. 1200 GRAINS OF STONE REMOVED WITHOUT +CUTTING. PASSED BLOOD IN GREAT QUANTITIES FROM THE BLADDER. DOCTORS AT +HOME (AS USUAL) DISCOURAGED HIM FROM COMING TO US. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: + +[Illustration: James Vine, Esq.] + +_Gentlemen_--I am glad to make public the wonderful cure that you +accomplished in my case. For ten years I was a sick man, and during +three years I suffered so much that life was a burden. My business had +to be given up and the torments were something that could not be +described. Every little while I had to urinate, and each time suffered a +spasm of pain, like a knife thrust; the use of a catheter was painful +and often it took long and painful trials before the water could be +drawn off. I passed blood, in quantities at times. When I went to your +place we had given up hope of a cure, and relief was all that I looked +for. My doctors at home discouraged me. I spent four weeks in your +Invalids' Hotel, and now at the age of sixty-seven years am sound and +hearty as any one, work from five in the morning until seven at night. I +manage a large and active business and enjoy life. I cannot express my +high praise of your Institution. Your doctors are skillful and the +nurses all kind and good. All understand their business and attend to +it. I came home a new man and cannot say enough for your praise, and to +express my thanks for the wonderful cure and comfort I have enjoyed. + + Yours, + JAMBS VINE, SR. + +P.S.--You removed a stone that weighed over 1200 grains from my bladder, +without cutting. The operation gave me complete relief. While there and +since, I have seen a great many skillful cures done by you. + + J.V., SR., St. Catherines, Out. + + +CASE 620,610. STONE IN BLADDER--WEIGHT 530 GRAINS--SUCCESSFULLY REMOVED +WITHOUT CUTTING. NEIGHBORS TOLD HIM HE WOULD BE "BROUGHT HOME IN A BOX." + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: + +[Illustration: C.A. CHURCH, ESQ.] + +_Gentlemen_--Seeing the picture of the Invalids' Hotel and Surgical +Institute in our local newspapers, called to my mind the treatment I +received there in 1887. I had been suffering for ten or twelve years +with bladder trouble, and our home physicians did not seem to understand +the cause or the trouble, and I finally corresponded with your faculty, +and their advice was to come and have an examination. I had been a great +sufferer and was so weak that I could hardly walk from the hotel to the +depot, and those who saw me start said that I would be brought home in a +box. Soon after my arrival an examination revealed a stone in my +bladder. After a few days' treatment to strengthen up the system, the +stone was taken out, weighing 530 grains. Four or five others were +afterwards taken out of smaller size, and I am still alive. Will soon be +seventy-six years old, and I cannot speak too highly of the care and +attention I received from the physicians and nurses while there. +Everything that was provided was of the best; good food, glean +apartments; and no better place can be found for treatment of the many +diseases they advertise to cure. + +Anyone suffering from bladder or kindred trouble can find relief at the +Invalids' Hotel, Buffalo, N.Y. + + Respectfully, + C.A. CHURCH, + New Berlin, N.Y. + + +CASE 620,258. STONE IN THE BLADDER--GREAT SUFFERING FOR +YEARS--HEART-FELT GRATITUDE. + +[Illustration: Wm. H. Miller, Esq.] + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +I would not be a true man If I did not acknowledge at this time (as I +should have done long ago), with words of gratitude, the wonderful +relief I received at your Institution five years ago. It affords me the +greatest pleasure to say to you and to the world at large, that the +treatment and operation I received at your Institution was an entire +success and a miraculous cure. After twenty-five long years of suffering +such as few people endure, caused from exposure while in the military +service of the United States, I contracted kidney and bladder disease, +which shortly afterwards resulted in the formation of a calculus or +stone. I experimented with medicines. Special Prescriptions, etc., from +some of the most eminent physicians in the world, in fact everything +that promised relief and help for my kidneys was used, but received no +relief, until the bladder discomfort became unendurable. As a last +resort, knowing full well that life with me would be very short unless I +could receive immediate relief, I went to your famous Institute, where I +was treated and operated upon and a large stone was removed from the +bladder. The old method of cutting, which is so dangerous, was not +employed, but the new and painless process of crushing; this process was +an agreeable surprise to me, no pain and no risk, as in the old method +of cutting. From the day of the operation I began to improve, and in a +few weeks thereafter I returned home to my wife, family and friends, a +well and happy man, and I have spent the last five years with ease, +comfort and pleasure--a living, walking testimonial for your renowned +Institute. Believe me, when I say that words fail me to express to you +my sincere gratitude for your marvelous and almost miraculous cure +effected in my case. I feel sure no invalid could receive more skillful +and kindly attention anywhere in the world. I would urge every sufferer +to take treatment at the Invalids' Hotel and Surgical Institute, +believing it to be the most skillful, and feel sure that it is the most +advanced of the age. + + Sincerely and gratefully yours, + WM. H. MILLER, + Stoyestown, Somerset Co., Penna. + + +CASE 720,402. STONE IN BLADDER ONE AND A HALF INCHES IN DIAMETER +SUCCESSFULLY REMOVED WITHOUT CUTTING OR PAIN. + +[Illustration: Thos. Daltry, Esq.] + +From severe exposure when in the army, I brought upon myself an acute +attack of rheumatism, from which I suffered terrible pain. Following +this I began to be troubled with my bladder and kidneys. For three years +I experienced considerable discomfort. There was severe burning and +scalding, and urination caused much pain. I passed two pieces of gravel +and became convinced that I had stone in the bladder. Was examined by my +home physician, who said there was no stone. I was not satisfied, +however, and went to the Invalids' Hotel and Surgical Institute. I was +examined by their specialist. After an injection of cocaine and +carefully cleansing out the bladder, a stone was found about one inch +and a half in diameter, probably similar in its composition to the +pieces already passed. I was advised to have it operated upon and +removed, which I arranged to do. The process used was their new and +painless one of crushing, no knife or other cutting instrument being +employed. The stone was readily grasped by the crusher and reduced to +small fragments. The evacuator was then introduced and the stone +entirely removed. After a few weeks' careful attention my health was +entirely restored and I was able to leave for home. I take great +pleasure in making public my wonderful cure. I could not speak in too +high praise of those who took charge of my case, nor recommend too +highly this famous Institution. It is about three years since I was +operated on, and pave not felt any bad effects since. + + THOS. DALTRY, + Huntington, Huntington, Co., Ind. + + +CASE 820,539. GRAVEL OR STONE WITH CHRONIC KIDNEY AND BLADDER DISEASE. +CURED NINE YEARS AGO AFTER BEING GIVEN UP TO DIE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Mr. O. Thompson.] + +In 1884, at the age of fifty-four years. I was prostrated with Kidney +and Bladder complaint and told by the best physicians that I was but ten +days out of the grave. I applied to your Institute for help and received +treatment, and now after nearly nine years am in comparatively good +health. All this time I have been able to do much work and to oversee my +farm. Two stones or gravel were passed while under home treatment. No +further formations have developed. The many cases I have recommended to +you have all been more than satisfied with the results of their +treatment. I wish to thank you for the great benefit and care I received +at your hands. + + Yours truly, + ORVILLE THOMPSON, + Avoca, Steuben Co., N.Y. + + +CASE 859,612. A STRONG ENDORSEMENT. + +[Illustration: H.E. Bankston, Esq.] + +_To whom it may concern:_ + +This is to certify that I took treatment at the Invalids' Hotel and +Surgical Institute, Buffalo, N.Y., and I was cured of a chronic trouble +that had been maltreated by other physicians. While there I saw a man +who had been cured by the specialists, who had before been given up to +die by the best doctors in Troy, N.Y. Of course, the case must have been +a very stubborn one. I afterwards saw a man here, in Georgia, die, who, +if he had been in Pierce's Surgical Institute under the treatment and +care of his skilled doctors and nurses, I know would have most assuredly +got well. Why? Because it was only a case of _stone in the bladder_, and +they are easily cured at Dr. Pierce's Surgical Institute. I think almost +any chronic disease can be cured there, if taken in time, judging from +my observations while an inmate of that Institution. + + H.E. BANKSTON, + Barnesville. Pike Co., Ga. + + +CASE 820,260. COMPLICATION OF DISEASES. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: + +[Illustration: J.F. Ritter, Esq.] + +_Gentlemen_--It is now about six months since I discontinued your +treatment, and as I have had no return of the old symptoms, I consider +it unnecessary to take more medicine. When I visited your Institution +some two years ago, I had but faint hopes of ever being restored to +health, as I was suffering from a complication of diseases. My case was +an unusually obstinate one, yet I am satisfied that a cure could have +been accomplished in half the time, had I been able to follow your +directions in regard to diet more closely. I hereby tender you my +sincerest thanks for the kind treatment received while at your +Institution. Those days will always be the happiest in my memory. I will +close by giving your faculty my sincere thanks, and hope success will +crown your business. + + Yours very gratefully, + J.F. RITTER, + Medford, Jackson Co., Oreg. + + +Stricture, the result of injury from falls and accidents, is +particularly difficult of permanent cure. The following gratuitous +recommendations are from cases belonging to this class who entirely +approve of the publication, with full name, photo-gravure and address. + + +CASE 820,507. STRICTURE CURED AFTER MANY OPERATIONS BY OTHER SURGEONS +HAD PROVEN TO BE FAILURES. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: + +[Illustration: Archie Ritchie, Esq.] + +I would state that I am an architect, fifty-two years of age, that about +seventeen years ago I fell from a scaffold, a distance of eighteen feet, +across a beam, striking upon the perineum. A physician was immediately +called and I was treated by him for about eight or ten weeks. A catheter +was introduced into the bladder, but caused such intense pain and +anguish that it had to be withdrawn. It was tried again but could not be +introduced on account of the lacerations in the urethra, caused by the +violence used. A consultation was held and an operation recommended. An +anæsthetic was used and a cut made through the perineum from the outside +into the bladder. A catheter was inserted into the bladder, tied in +place and left in position for about eight weeks. After eight or nine +weeks the catheter was removed, but it was four or five weeks before the +wound in the perineum healed. After a few months I began to have a +urinary difficulty, and symptoms of urethral stricture. This condition +continued until the urethra was entirely closed, and it was impossible +to make water. A physician attempted to pass a catheter, but could not +do so. He continued to treat me by the process of dilation for five or +six months. I began to feel more comfortable, but the symptoms of +stricture would manifest themselves again. I then went to a hospital at +Toronto. There I was treated also by the dilating method. The treatment +was continued for about four weeks, but became so very painful, and +there was so much irritation in the urethra, that it was impossible to +endure it longer. They then called an electrical specialist and he began +treatment by electrolysis. In about three weeks I went home, but in a +short time the stricture again manifested itself; the contraction was +very marked, and micturition very difficult. It grew gradually worse and +I could not receive any comfort or benefit. I returned to Toronto to +take further treatment from the electrical specialist. During the +operations of dilation of the urethra, I passed some gravel. After four +weeks treatment I returned home, but in about two months was as bad as +ever, and last October went back to Toronto and was again treated by the +electrical method. The doctor had much difficulty in inserting the +smallest catheter, and it caused intense pain and suffering. The last +time he attempted to insert a catheter, there seemed to be something +give way, and a large amount of pus and fluid passed from the rectum. +The physician told me an abscess had formed. I returned home and tried +to keep as comfortable as possible, but could not micturate with any +degree of satisfaction or comfort. I gradually began to grow worse and +there was a return of the stricture with inflammation of the bladder. In +March, 1892, there began to be formed gravel in the bladder. They would +at times obstruct the flow of urine entirely. I kept going from bad to +worse, until the urethra appeared to be entirely closed. The physician I +called found it impossible to pass a catheter Into the bladder, and +advised me to go to some hospital where I could receive proper +treatment, and where proper appliances for this class of cases were +used, as he felt satisfied nothing could be accomplished for me at home. +I then came to the Invalids' Hotel and Surgical Institute in Buffalo to +receive treatment, and the treatment has been so successful that the +urethral stricture as well as the gravel have been removed. After I +returned home I felt as if a great load had been lifted from my +shoulders. I have no irritation at all as I used to have, and I can keep +my water for six or seven hours without any trouble, and the water seems +to be clear and free from sediment of any sort, and in general I feel as +I never expected to again. The doctors here were dumb-founded at the +short time I was in getting fixed at your Institution, and feel ashamed +to ask any questions as to treatment. Many months have passed and I +continue well and active in my profession. Any one I can send the way of +your Institution you may be sure I shall do so, and thanking you +personally for your kind and successful treatment of my case, + + I remain ever your well-wisher, + ARCHIE RITCHIE, Architect, + Mount Forest, Ont. + + +GRATEFUL LETTER FROM A PROMINENT ARCHITECT. + +TO THE WORLD'S DISPENSARY MEDICAL ASSOCIATION: + +_Gentlemen_--It is again with the greatest of pleasure that I write you +after twelve months since I was treated in your Institution, to add to +my former testimonial. With the blessing of good health I have been able +to attend to my business as well as ever, and have the greatest of +comfort in every respect, and feel about ten years younger than I was +when I came to your Institution for treatment, and I have still again to +thank you, gentlemen, for the kind and courteous attention I received +from every one I came in contact with in your Institution, while under +treatment, and shall ever remember my visit to your Hotel with pleasure, +and shall advise any one suffering under the same trouble, with whom I +may come in contact, to come to your valuable Institute for treatment, +where they can have the best of attention and skill. Again thanking you, +gentlemen, for what you have done for me, I hope that your Institute may +long be kept up to minister to suffering humanity. God bless your staff +of physicians, and may success attend you, is the wish and prayer of +ever your well-wisher and grateful patient, + + ARCHIBALD RITCHIE, + Mt. Forest, P.O., Ont. + +[_See Mr. Ritchie's former communication, on page 857._] + + +CASE 2A-126. PAINFUL IMPEDIMENT TO THE ACTION OF URINARY ORGANS. + +[Illustration: Edward Compton, Esq.] + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: + +This is to certify that I have been to the Invalids' Hotel and Surgical +Institute, at Buffalo, N.Y., for treatment, and cannot speak in too high +terms of the staff of physicians and surgeons, or of the treatment which +I received. I consider the Hotel one of the best in the country, the +table being excellent, and the treatment the very best to be found in +the land. It is a most pleasant place to stay. The attention which is +given by the nurses could not be better. As surgeons I think your +specialists possess the finest skill that can be found. Any person +suffering should not delay, but go at once and be treated and get well. +You are at liberty to use this endorsement in any way that will do the +most good. + + With gratitude, I remain, + EDWARD COMPTON, + Chillicothe, Ill. + + +CASE 620,380. STRICTURE, THE RESULT OF INJURY--CURE PERMANENT. + +[Illustration: Mr. Fay Sawdy.] + +The stricture, which resulted from an injury, had been greatly +aggravated by uric acid crystals which were continually forming in the +urine. Patient had rheumatism, causing this acid state of the system. He +had been a great sufferer for many years, continually experiencing the +nervousness, smarting, pain and burning, with occasional attacks of +urethritis, common to the malady in this form. This made the stricture +almost unbearable, and he was practically incapacitated for his labor at +the time that treatment was undertaken in our Institution. He had been +to the Hot Springs and in the care of other physicians with no +satisfactory results. The relief of the stricture by our new and +painless method was followed by very great improvement in his condition, +after which appropriate remedies for the rheumatism were administered, +and the result was a very gratifying and satisfactory relief from his +difficulty. Patient afterwards embarked in business as a proprietor of a +hotel of his own, and has been ever since very active in carrying on the +business, and extremely successful. The stricture showed no tendency to +recur, as is commonly the case where it is cured by other methods than +employed by us. Many years elapsed from the time that it was treated +before the testimonial appended was written. + + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +_Dear Doctors_--I want to thank you, but words cannot express my +gratitude, for your treatment white at your Institution, but I will say +for the benefit of persons afflicted with stricture, that I was entirely +cured by you, and after several years have not seen any signs of its +returning. + + Yours truly, + FAY SAWDY, Proprietor Hotel Sawdy, + Earlville, Madison Co., N.Y. + + +CASE 551,864, URETHRAL STRICTURE--NASAL CATARRH--CURED IN TWENTY DAYS--A +PREVIOUS OPERATION BY A NASHVILLE (TENN.) SURGEON UTTERLY FAILED. + +[Illustration: S.A.D. Smith, Esq.] + +WORLD'S DISPENSARY MEDICAL, ASSOCIATION. Buffalo, N.Y.: + +In September, 1886, I was examined by one of your able staff of +physicians and was found to be suffering with a bad form of nasal +catarrh and with two strictures in the urethra (water passage). After a +few days' general treatment, I was operated upon and turned over to be +cared for by the nurse, from whom I received all the attention that was +necessary. To my utter astonishment I was dismissed in twenty days from +the Surgical Institute, cured of the stricture. I had been operated on +by one able surgeon of Nashville, Tenn., and was worse after the +operation than before. I have never had a symptom of the stricture since +I was dismissed from the Invalids' Hotel and Surgical Institute, and +have been in better health than ever before in my life. + + Very truly, + S.A.D. SMITH, + Laurel Hill, Tenn. + + +CASE 820,201. STRICTURE OF THE URETHRA OF THREE YEARS' STANDING--COULD +PASS URINE ONLY IN DROPS AND WITH GREAT PAIN. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: + +[Illustration: Frank Brendell, Esq.] + +_Gentlemen_--Wishing to add my testimony as to your great skill in +surgery, I will say that I suffered with stricture of the urethra, due +to an injury, for about three years. It became so bad that at times I +could pass water only in drops and with great pain. I went to a doctor +here, who used sounds which helped me for a time, but in less than six +weeks I was worse than ever. Hearing of your place, I came to you and +had a painless operation performed, and have ever since been thoroughly +cured. I experience no trouble or pain. It is three years since I had +the operation, and the cure has proved permanent. You have my deepest +gratitude. + + Yours truly, + FRANK BRENDELL, + Olean, Catt. Co., N.Y. + + +CASE 820,472. COMPLICATED AFFECTION OF NERVOUS SYSTEM AND URINARY +ORGANS. + +[Illustration: E.J. Archer, Esq.] + +_To the afflicted with chronic Diseases:_ + +It is with great pleasure that I refer to the successful treatment, +together with the kind care and attention received at the hands of the +professional staff, both physicians and nurses, of the world-renowned +Invalids' Hotel and Surgical Institute. In every way It verifies their +statement--"Not a hospital but a pleasant remedial home," and as such I +add my name to the thousands who know and recommend it to the afflicted. +Not only was this true in my own case, but in many which came under my +observation while there, so I say to the afflicted--visit them if you +can and if your case (no matter of what character) is Within human +skill, you will never have to regret it. + + Very sincerely yours, + EDWARD J. ARCHER, + Plainwell, Mich. + + +CASE 520,408. STONE IN THE BLADDER. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: + +[Illustration: Rob't Worthington, Esq.] + +_Gentlemen_--For six years I had been a great sufferer from stone in the +bladder. The discomfort increased, until it almost became unbearable. +Hearing of the universal success of the specialist at the Invalids' +Hotel and Surgical Institute, in similar cases, I went there and +submitted to an operation. The method employed was their new and +painless one of crushing, no knife or cutting instrument being used. I +felt no pain afterward, there was no fever, and I could have gone home +the day after. The operation was witnessed by one of my friends, who +says it was very artistic and done with skill. It was a complete +success, for I have not been troubled in the least, although nearly +seven years have passed. + +I feel that I cannot speak in too high praise of this renowned +Institution and its staff of skilled physicians. No invalid need fear to +place himself under the skillful treatment and kindly care to be +received there, for I am confident that all the benefit known to medical +science, can be obtained at the Invalids' Hotel and Surgical Institute. + + ROBERT WORTHINGTON, + Staunton, Fayette Co., Ohio. + + +CASE 114,747. NERVOUS DEBILITY, DYSPEPSIA, KIDNEY AND LIVER +DISEASE--CURED. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION: + +[Illustration: B.V. Wright, Esq.] + +_Gentlemen_--I take pleasure in informing you that the treatment you +gave me for the relief of an affection of the spine and nervous system, +disease of the digestive organs, kidneys and liver, has been entirely +successful. I had feared that my health was gradually being undermined, +prior to entering your institution, and I can testify to the perfect +appointment that you have, the excellent apparatus for the +administration of electrical and other massage treatment and baths. My +relief was most satisfactory, and the cure has remained permanent. + +I take pleasure in recommending your institution to the afflicted, +believing that you have the very best treatment for chronic diseases +known, and I have had an opportunity to satisfy myself, from +conversation with other invalids in your Institution, of the care and +skillful treatment that you administer, and its excellent effects. I +believe that it is fully abreast of the times, and equal to any +institution in the world. + +With many good wishes and thanks for my cure, + + I remain, Yours truly, + B.V. WRIGHT, + Graniteville, Middlesex Co., Mass. + + +CASE 790,698. DIABETES CURED BY HOME TREATMENT. + +[Illustration: Mrs. Woodruff.] + +_To whom it may concern_: + +This is to certify that for a number of years I was a constant sufferer, +and what was many times termed a hopeless victim of that terrible +disease, diabetes. The symptoms were indeed alarming; my strength being +so completely exhausted that my walking from room to room was attended +with difficulty. My nerves were in a constant tremor, and in fact no +other words than that, "I was completely out of fix all over," will +express my condition. Having purchased a bottle of Dr. Pierce's Favorite +Prescription for my daughter, and in looking over the directions of the +accompanying circular and finding my own case so thoroughly described, I +decided at once to give his special home treatment a trial, which I did +during the three months that followed. This proved to be all that was +required for the restoration of my usual health, and during the four +years which have since elapsed I have had not the slightest reason for +believing otherwise than that a perfect cure has been effected, and can +most heartily recommend Dr. Pierce's medicines and treatment to any or +all who may be suffering with kidney complaint in any form. + + Very sincerely yours, + MRS. MARY A. WOODRUFF, + Columbus Junct., Louisa Co., Ia. + + +CASE 795,590. INCONTINENCE OF URINE--CURED BY SPECIAL HOME TREATMENT. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: Miss Richman.] + +_Dear Sir_--I consider myself duty-bound to you and suffering humanity +to acknowledge the benefit that I have received from your treatments. +From babyhood till I was twenty years old I was continually bothered +with a weakness of the muscles of the bladder, that gave me much +trouble, both by night as well as day. I doctored with several +physicians and tried all patent medicines, but could not get any relief +until I took your medicine about six months, and now I am sound and +well. It has been over two years since I quit taking your medicine, and +have had no symptoms of the disease returning. + + Yours most gratefully. + Miss MOLLIE RICHMAN. + North Cove, + Pacific Co., Wash. + + +CASE 4A-2,226. BRIGHT'S DISEASE AND GRAVEL CURED BY SPECIAL HOME +TREATMENT. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: J.W. Thompson, Esq.] + +_Dear Sir_--You have my thanks and best wishes for your success, as you +cured me of what the doctors here called Bright's Disease and Stone in +the Bladder. They did me no good, so I concluded to write to you, which +I did, and am happy to say your medicine worked like a charm. God and +myself only know how I suffered. I lost fifty-six pounds of flesh in six +weeks and I thought my time had come, but when I commenced taking your +medicine, in three days I saw a change for the better was taking place, +and in one month I considered myself cured. I am still in good health +and can do as hard a day's work as any man. Again I thank you. Your +charges were reasonable and any one suffering as I was should write you +at once. + +Any person writing to me must send stamped addressed envelope if wanting +an answer. + + J.W. THOMPSON, + St. John, Whitman Co., Wash. + + +CASE 2A-223. INFLAMMATION OF THE BLADDER. RETENTION OF URINE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: E.A. Brown, Esq.] + +_Gentlemen_--I had been a terrible sufferer for many years with Bladder +trouble. I had experienced the greatest discomfort, and tried in vain to +find relief. I was persuaded to go to the Invalids' Hotel and Surgical +Institute, I went and while there submitted to a course of treatment +that gave me relief, and was entirely satisfactory. Three years have +elapsed and I continue well. I take the greatest pleasure in making +public my cure. No sufferer going there can fail to receive all the +benefit to be derived from medical treatment. The staff of physicians +are skillful and of large experience; the attendants kind and attentive, +and the Institution, in all its appointments, not to be excelled in the +country. I had been told by other physicians, Jealous at your success, +not to go to your place, but I am now more than pleased that I +disregarded their advice. + + E.A. BROWN, + Corfu, N.Y. + + + * * * * * + + + + +RUPTURE. (BREACH OR HERNIA.) + + +By the term _Hernia_, we mean a tumor, which is formed by the +displacement of the intestines, the omentum (covering of the bowels), or +both, and which protrudes from the abdominal cavity. The most common +varieties are _umbilical, inguinal_ and _femoral_ hernia. Children are +most subject to umbilical, males to inguinal, and females to femoral, +hernia. + +[Illustration: Fig. 1. +Indirect Inguinal Hernia. + +Sketched from a case subsequently +cured by our improved method +of treatment. ] + +CAUSES. These are either _predisposing_ or _exciting_. Any thing which +occasions general or local muscular debility, as dropsy, pregnancy, +abscesses, wounds, obstructions to natural evacuations, etc., is a +predisposing cause of hernia. The exciting cause is pressure applied to +the contents of the abdomen, as straining in evacuating the bowels and +bladder, lifting heavy weights, or violent physical exertion. + +SYMPTOMS. The only characteristic symptom of hernia is the presentation +of an elastic, or doughy tumor of variable size, which either gradually +or suddenly makes its appearance. There is flatulence, uneasiness, and +sometimes pain in the abdomen. + +Sharp and dull pains frequently recurring and confined to the locations +where ruptures appear should receive attention. Examination will not +infrequently reveal a small enlargement. If a hernia, this will usually +disappear after a night's rest and may not be again noticed until the +next day, or for several days. On coughing, with the finger applied to +the enlargement, a sensation of an impulse (succussion), or slight +additional protrusion will be felt + +The trouble appears at any time of life, an analysis of seventy thousand +cases indicating that it is most common in debilitated persons, and that +there is a constant decrease in the frequency of the affection from the +first to the thirteenth year, after which rupture is more and more +frequently met with as age advances. + +[Illustration: Fig. 2. + +This figure illustrates a case of Femoral +Hernia which was radically cured by our +improved method. This tumor is a little +lower on the thigh than in cases of inguinal +hernia. Femoral Hernia is most common +to females, and inguinal in males.] + +INGUINAL HERNIA (see Fig. 1) is more common than all other forms of +rupture. It is more frequently met with in men, and when severe there is +usually a mass of intestine which falls into the scrotum and has an evil +effect, by pressing upon the testicle. The protrusion follows the +spermatic vessels and hence it usually appears low down in the abdomen +and on one or both sides of the pubic bone. + +FEMORAL HERNIA (see Fig. 2), most common in women of mature life, is +felt as a lump below the strong ligament in the groin which forms the +line of separation between the thigh and the abdomen. On its outer side +and close to it can be felt the beating or pulsation of the large artery +of the thigh. + +UMBILICAL HERNIA (see Fig. 3) appears at or near the navel and is most +common in children. It may be present from birth, or it may result from +fretting and crying at any period of childhood. + +[Illustration: Fig. 3. + +UMBILICAL HERNIA. + +Sketched from a case subsequently +cured by our new method.] + +Sufferers from any form of rupture are constantly subject to the danger +of strangulation. This occurs when, from any cause the free return of +the contents of the protruded part of the intestine is prevented. It is +an accident of a serious nature, inasmuch as nearly fifty per cent. die +if not carefully operated upon, and with the most skillful treatment, +one in four cases terminates in death. + +Every individual should guard against rupture by maintaining, by proper +exercise, diet, and rest, a condition of vigor and tonicity of the +muscular system. + +When debilitated, all strains and exertions should be care fully avoided +until the health is built up, and the relaxation overcome. + +TREATMENT. The palliative treatment of hernia is by _reduction_ and +_retention_. Reduction consists in returning the protruding intestine to +its proper place through the opening by which it escaped. This is +accomplished either by manipulation or by a surgical operation. +Retention is effected by wearing a mechanical appliance called a +_truss_. + +As soon as the tumor protrudes, or the "bowel comes down," the patient +should assume the recumbent posture, with his shoulders and feet +elevated. The patient or an attendant should grasp the hernia, and with +gentle, but gradually increasing pressure upon the tumor attempt to +replace it. At the same time let the patient knead the bowels upward by +pressing upon the integument, so that the intestine may, as far as +possible, be pushed away from the point of protrusion. Sometimes the +contraction of the muscular fibres at a point where the hernia makes its +exit is so great that the tumor cannot be replaced. In this case the +system should be relaxed with lobelia (not given in doses to produce +vomiting), and as soon as the patient is thoroughly under its influence, +the manipulations may be resumed. When there is any difficulty +experienced in putting back the "breach," or rupture, professional +assistance should be promptly summoned. After the reduction of the +rupture, a truss should be properly adapted, applied, and constantly +worn, to prevent the protrusion of the intestine. + +[Illustration: Fig. 4. +The above cut fairly illustrates a case of Double +Inguinal Hernia, complicated with Hydrocele, +cured at the Invalids' Hotel +and Surgical Institute.] + +Of the latter instruments there are several hundred varieties for sale +throughout the country. With the exception of about one-half dozen +forms, which embody the true principles of a proper truss, they are, +without exception, harmful. Unless proper support be given to the walls +of the abdomen, and that without constant pressure, a truss does harm; +then, too, the shape of the pad must be such as to avoid pressure where +it is not required; otherwise, as in the case where a small ring is worn +upon a finger, there is a gradual loss of strength and a depression +formed in the healthy tissue, which can be plainly seen and felt. In +this way trusses do harm, and such evil consequences may follow the +_improper_ application of a _good_ truss. + +SURGICAL TREATMENT. When the hernia has become strangulated and cannot +be returned by manipulation, a surgical operation is necessary. Whenever +the necessity for such a procedure is apparent, it should be performed +_immediately_, for the greater the delay the greater the liability to +fatal results. The operation consists in cutting down upon the +strangulated bowel, thus relieving it of its constriction and +facilitating its replacement. It is a delicate operation, and must be +skillfully performed. After the operation, the patient requires +appropriate hygienic treatment. + +[Illustration: Fig. 5. + +This figure illustrates a Double Inguinal +Hernia, of large size, which was permanently +cured by our improved method of +treatment. The left side (_b_) shows the _direct_ +descent of the bowel into (_c_) the scrotum, +while on the right side (_a_) the rupture +is indirect, the bowel descending through +the internal ring and inguinal canal.] + +THE RADICAL CURE. A small percentage of cures will follow the proper use +of a good truss, and the advertisements of the so-called rupture cures +are founded upon such cases. These impostors pretend that the use of +some vaunted salve, ointment, or styptic lotion, applied on the outside, +will heal and cure the deep-seated separation of the muscular fibres. +The truss in these cases is the curative means in the small number that +are relieved, and for it but few dollars should be charged instead of +the exorbitant prices demanded by these impostors. + +Improvements in surgery in this age of wonders, have kept apace with the +advances in electricity and other branches of science. Diseases and +deformities which only a few years ago were considered incurable are now +overcome and cured with certainty and without risk or suffering. +Especially is this true with reference to hernia or rupture. + +Our specialists have devoted much attention to the radical cure of +rupture, or breach, with the most gratifying results. Formerly we +employed and advocated the use of the injection treatment only. This +method was tested and brought to a most efficient and practical stage, +so that we now apply it in the treatment of over eighty percent. of the +cases that are presented at our Institution. This plan of cure, as used +by us, is a great advance over that of any similar one in use, +throughout the country. Our fluid is much more safe in its effects, +never gives rise to the troublesome abscesses and inflammation that is +common to the use of the injection fluids that have been advised on the +Heatonian method. The fluid we use is a bland and healing agent, which +produces an exudation behind the cords that surround the inguinal rings, +and forms a well defined truss pad of moderate size in such position +that the rupture cannot pass by it and appear externally. It causes also +an adhesive inflammation limited to the hernial sac, that completely +closes it. + +This treatment is rendered _entirely painless_ by the use of a solution +which is injected underneath the skin with a fine hollow needle attached +to a small syringe, and which tends to produce complete local +anæsthesia, or loss of feeling so that the procedure is thoroughly and +carefully carried out without any risk or discomfort. + +The needle used by us for the treatment of the hernia is so perfected +that any possible injection of the fluid into the abdominal cavity, or +upon the coating of the intestine, is an impossibility, and in no way +can an injection be made into a blood vessel or nerve so as to produce +any discomfort or trouble. We thus avoid all the risks that pertain to +the usual plan of injection. + +There is a small percentage of cases, as before stated, in which this +form of treatment is not likely to give a permanent cure, from the fact +that the omentum or intestine has become adherent externally, to the +sac, or in the scrotum, to the coverings of the testicle. This makes the +complete replacement of the rupture without cutting an impossibility, +and in such cases even where the hernial opening is closed, treatment by +injection only would not result in a permanent cure. + +Our aim is to treat all cases of rupture that we undertake in such a +manner that _by no possibility can the deformity return_. We therefore +have for the cure of these cases another method, by which with our local +anæsthetic fluid, we are able to perform a surgical operation without +any distress whatever to the patient. The greatest risk of the old +operation for rupture was the danger of general anæsthesia with +chloroform or ether, or some similar agent. The great majority of +individuals cannot bear the inhalation of the large quantities of these +anæsthetics necessary to secure loss of feeling without consequent +nausea, and at times an effect upon the heart that often results +seriously. The risk from the anæsthetic is much greater than from the +surgical procedure. By our method, this risk is entirely done away with. +The pain dispelling fluid enables our operator to pursue his method +WITHOUT GIVING THE PATIENT ANY PAIN OR DISCOMFORT WHATEVER. During the +operation he is in full possession of all his faculties, and can assist +in any way desired by coughing, or straining, in order, at any time, to +complete the protrusion of the rupture and show its entire extent of +surface when the sac is laid bare. We then replace the rupture +completely; suture the sac so that the rupture will have no pocket into +which to descend, and then firmly unite the rings by a plan that we have +invented, and BY WHICH THEY ARE MADE MORE STRONG AND FIRM THAN IN THEIR +ORIGINAL STATE. + +Early in our experience, and while using the plan of treatment that is +usually employed for the radical cure of rupture, we had occasional +relapses of the difficulty, but since using our improved method we have +had no such trouble. We can assure our patients that there is less risk +of the appearance of the rupture at the point where the operation is +performed than there is of a new breach forming. The success of this +treatment has been invariable. None of the plans of treatment that we +pursue for the cure of rupture tend to keep the patient in bed more than +a few hours. There is little or no pain, after either of our plans of +treatment, and out of the many hundreds which we have treated and +perfectly cured, in no instance have we had any inflammation or serious +manifestation--there being no fever or general reaction. It is a matter +of great surprise to our patients, who undergo our treatment for the +radical cure of rupture, that by our varied methods, the object is +accomplished with so little discomfort and with no pain whatever. + +From two to three weeks' personal attention of our specialist, is +usually all that is required even in the worst cases. + +NO TRUSS IS NEEDED AFTER OUR TREATMENT. WE CONSIDER A CASE CURED ONLY +WHEN THE PATIENT IS ABLE TO DO WITHOUT A TRUSS OR SUPPORT IN ALL THE +USUAL WALKS AND VOCATIONS OF LIFE. + + * * * * * + + +TESTIMONIALS. + + +The testimonials that we append are but a small number out of the great +mass that we have received. A very large percentage of individuals who +have been treated by us for rupture desire that their disability be held +a matter of sacred confidence and with all such we take pleasure in +guarding their confidence with the greatest care. Others are quite +willing that their experience may be made public in this manner for the +benefit of similar sufferers. + +If the following letters had been written by your best known and most +esteemed neighbors they could be no more worthy of your confidence than +they now are, coming, as they do, from well known, intelligent and +trustworthy citizens, who, in their several neighborhoods, enjoy the +fullest confidence and respect of all who know them. + + +A LOCOMOTIVE ENGINEER + +TESTIFIES TO HIS CURE OF RUPTURE. THE CONSTANT JAR OF A LOCOMOTIVE IS +ONE OF THE SEVEREST TESTS THAT CAN BE APPLIED TO A RECENTLY CURED CASE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: F.W. Frost, Esq.] + +_Gentlemen_--After suffering a number of years from a painful Rupture, I +went to the Invalids' Hotel and Surgical Institute, at Buffalo. While +there, I submitted to an operation which was not painful. It was done +without chloroform, ether or any dangerous anæsthetic. Under the +skillful treatment of your specialists and the very close and kind +attention of your nurses, in less than a month, I left the Institution +feeling like a new man. I have every reason to believe that the Hernia +will never return, and that I am permanently cured. It it a great relief +to go without a truss. + + Very respectfully, + F.W. FROST, + Rotterdam June, Schenectady Co., N.Y. + + +A LOCOMOTIVE ENGINEER'S + +ADVICE TO SUFFERERS FROM RUPTURE. THE CONSTANT JAR OF A LOCOMOTIVE IS +ONE OF THE SEVEREST TESTS THAT CAN BE APPLIED TO A RECENTLY CURED CASE. +THROW AWAY TRUSSES. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: F.S. Auchenpaugh, Esq.] + +_Gentlemen_--I am an engineer--running an engine on the Western Division +of the Fitchburg Railroad. I had a severe case of double Hernia; still, +have always worked along with them until this winter. One side was of +twenty-five years' standing--the other of about eight years. This winter +I was laid up sick with pneumonia; in coughing so much, which of course +was made necessary by that terrible disease, I strained myself so that +after getting up from my sick-bed, I was not able to go to work, as I +could get no truss that would hold the rupture. I was talking with +Brother Stagg one day. He asked me "why I did not go to the Invalids' +Hotel and Surgical Institute, at Buffalo, N.Y., and get cured?" I went, +and in three weeks was cured, so that I could dispose of my truss +entirely. + +I wish to say this comes from me direct; it was my own proposition that +this letter be made public. + + Yours respectfully, + F.S. AUCHENPAUGH, + Rotterdam, N.Y. + + +RUPTURE FROM BOYHOOD. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: A. Sauvain, Esq.] + +_Gentlemen_--I am glad to say that I was cured at the World's Dispensary +Medical Association after suffering from boyhood until the age of +twenty-five from a hernia, or rupture, by a treatment of twenty days. It +is now five years since I was cured, and can say that I was permanently +cured. You have my most sincere gratitude for your skillful operation +and the good care received in your Institution while there. I can +recommend your nurses and physicians most highly, and I think your +Institution unequaled in this country. + + Yours truly, + ALBERT SAUVAIN, + Silverton, Marion Co., Oreg. + + +HERNIA--LEFT INGUINAL--PRESENT EIGHT YEARS WITH NERVOUS PROSTRATION. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: A.J. Kidder, Esq.] + +_Gentlemen_--I take greatest pleasure in making public the most +wonderful cure I received at the Invalids' Hotel and Surgical Institute +of Buffalo. + +I had suffered severely for eight years with a left inguinal hernia; had +tried many physicians and medicines, but found only temporary relief. I +was greatly run-down, and my nervous system considerably shattered. My +friends persuaded me to go to the Invalids' Hotel and Surgical +Institute. While there I was operated on by their specialist, and in a +few weeks began to gain strength and energy so that I could return home, +and have since felt entirely well. + +Words could not do justice to my feeling in regard to this institution. +There is no place like it for medical aid, and I would urge all invalids +to go there, feeling confident that they could no where receive more +skillful treatment or more kind attention and care. + + Respectfully, + A.J. KIDDER, + North Yam Hill, Yam Hill Co., Oreg. + + +HERNIA. CURED SEVERE PAIN. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: J.H. Riemer, Esq.] + +_Dear Sirs_--Your favor received and found that you would like to have +me give you a testimony of my case I will say in reply that I was +treated at the Invalids' Hotel and Surgical Institute, for Hernia on the +left side. It was not large but it gave me severe pain while working. I +wore a truss but it did not relieve the pain very much. I read in the +paper one night your advertisement and a week after I started for the +Invalids' Hotel, and took the treatment for rupture and went home sound +and happy, like a new man, and I can work harder than ever and can +assure anyone interested that it is no humbug. + + With the best wishes, + JOHN H. RIEMER, + Zion, Wis. + +P.S.--If any one would like to inquire about my case give them my full +address and I will inform them about it, if they enclose return stamped +and addressed envelope for reply. J.H.R. + + +"SOUND AS A DOLLAR." + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: B.F. Hook, Esq.] + +_Gentlemen_--Am greatly pleased to report that the operation for the +radical cure for rupture received at your Institution in May, 1889, has +proved entirely successful. I am sound as a dollar. My case was an +extremely troublesome and dangerous one. Many times I required the +assistance of a surgeon to reduce it. No truss would hold it a whole +day. My two weeks' stay with you was worth thousands of dollars to me. +Will gladly answer any inquiry and would advise any one suffering from +hernia to take the radical cure. + + Very truly yours, + B.F. HOOK, + Holmesville, Holmes Co., Ohio. + + +RUPTURE, DYSPEPSIA OR INDIGESTION, AND KIDNEY DISEASE. + +[Illustration: A.N. Kingsley, Esq.] + +The following is from the widely-known and popular proprietor of the +Kingsley House at Ashuelot, N.H.: "It may seem useless to add testimony +to the overwhelming mass already given of the many remarkable cures +performed at your Institution, but I deem it a pleasure and a duty to +add mine to your long list as _very remarkable_. I had a rupture of +twenty-seven years' standing, with hemorrhage of the kidney for six +months, preceding my visit to your Institute, and was also troubled +badly with indigestion, all of which ailments had reduced me in strength +and flesh to a mere skeleton. Had been treated by many local physicians, +who failed to do me any good. I could walk but a very short distance +when I left my home on the 8th of July, 1892, for treatment at your +Institution, with but little faith or hope of ever being any better. But +through your skillful treatment I was able to return to my home on the +9th of August, 1892, and consider myself permanently cured, having had +to take no medicine since. Considering my case _almost a miracle_, I +cannot speak too highly of your Institute and skillful treatment, to +which I feel that I am indebted for my continued existence. You are at +liberty to refer to me, and to use this as you see fit. + + Very respectfully, + A.N. KINGSLEY, + Ashuelot, Cheshire Co., N.H. + + +RUPTURE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: H. Keifer, Esq.] + +_Gentlemen_--About four years ago, when working on a scaffold it gave +way, and I fell a few feet and the strain and jar caused a rupture in +the right side. I did not pay very much attention to this until I +noticed that it was enlarging. It finally grew so that I could not work. +I used several kinds of trusses that did me no good. + +I went to the Invalids' Hotel and Surgical Institute, and submitted to +an operation which was entirely painless and proved most satisfactory in +every respect. Since then I have been well and able to do hard work for +a man of my age (72). I feel no inconvenience from the rupture. + +I take pleasure in recommending the Institute to all who are in need of +help. I can highly recommend the physicians and nurses and the kind +attention I received while there. I am now well and sound as ever. + + Yours truly, + HENRY KEIFER, + Spring Green, Sauk Co., Wis. + + +HERNIA AND PILES CURED WITHOUT PAIN. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: J.J. App, Esq.] + +_Gentlemen_--I have been successfully treated at your institution for +piles and also rupture of the left side. + +Your institution is all it claims to be, and the treatment of my case +was accomplished without pain and apparently any risk. Your method of +using locally cocaine as an anæsthetic is such a decided improvement. I +did not have to take any dangerous ether or chloroform, but had a small +quantity of medicine injected that made the operation as painless as +though it was being done on some one else. At the same time I knew +everything and could see what was being done. + +You have my kindest thanks for the good care and many attentions given +me. Your nurses and physicians all give kind and skillful care. + + Yours very truly, + J.J. APP, + Bolivar, Tuscarawas Co., Ohio. + + +HERNIA OR RUPTURE. + +LARGE PROTRUSION OF SIXTEEN YEARS' STANDING. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: M.G. Hartzell, Esq.] + +_To the afflicted_: For sixteen years I was troubled with Hernia, caused +by heavy lifting. It was on the right side and the protrusion sufficient +to extend into the scrotum. I purchased trusses, but none of them could +be worn with comfort, and I suffered very much. I concluded to go to the +Invalids' Hotel and Surgical Institute and see if I could not obtain +relief. While there I submitted to an operation. The result was entirely +satisfactory. The pain in my back subsided; my general health began to +tone up, and in a short time, thanks to the skill of their specialist +and the kind attention of their nurses, I felt like a new man. I take +pleasure in highly recommending the Institution to all the afflicted. I +feel confident that all the benefit to be derived from medical or +surgical treatment is to be received at the Invalids' Hotel and Surgical +Institute. + + Yours respectfully, + M.G. HARTZELL, + Deadwood, So. Dakota. + + +DOUBLE RUPTURE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +_Gentlemen_--It is with much pleasure that I write you this testimonial +of the wonderful cures you have performed for me. + +[Illustration: D. Hartley, Esq.] + +In the year 1883, I became ruptured on the _left_ side. I immediately +wrote you (having heard of your fame in curing all kinds of diseases) +for your terms of treatment which I received by return mail, you also +stating you were positive you could cure me. Through unavoidable +circumstances I was unable to come to your Institution until December, +1886. During this time I had tried wearing a truss, which only made it +worse, and very much aggravated my complaint as it was impossible to +hold the rupture in its place. However I arrived at the Invalids' Hotel +on December 8th, 1886. On being examined by one of your staff, I was +pronounced a bad case, but by your mode of treatment you could cure it. +I was therefore, operated upon by one of your specialists, without any +cutting however and comparatively little pain, by your scientific +method, and in thirty days returned home cured. The time I had to remain +there, I believe, was much longer than most persons treated for the same +complaint. + +Since then I have worked very hard sometimes (my occupation being that +of a farmer,) so much so that I became ruptured on the _right_ side +three years ago,--the other side remaining perfectly sound without any +protection. I considered myself very unfortunate in being in this +position again, fortunate in knowing where to go for relief, and very +soon was back in your Institution where I was successfully treated and +perfectly cured and am to-day a sound man and able to do any kind of +work on my farm. + +I write this testimonial for the sake of suffering humanity, and wish +you to use it in any way that the greatest number of persons may read +it. As for myself, I would not be in the condition I once was and not +know of your Institution for all I could see. I not only recommend your +Institution for the complaint of which I was cured but for all chronic +diseases or anything requiring a skillful surgical operation, believing +your Staff of Physicians and Surgeons to be second to none anywhere. +Your nurses and attendants, and every accommodation, also, being all +that is necessary to make your Institution everything that its name +implies--a complete Invalids Hotel and Surgical Institute. + + Respectfully yours, + DAVID HARTLEY, + P.O. Box 84, Wyoming, Out. + +P.S.--I have also received much benefit from taking your "Golden Medical +Discovery" for dyspepsia and liver complaint, and being broken down +generally. A few bottles worked wonders, and I have been well ever +since, and that was quite a number of years ago. + + D.H. + + +RUPTURE. + +A GRATEFUL PATIENT'S WORDS OF PRAISE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main Street, Buffalo, N.Y.: + +[Illustration: W. Henkel, Esq.] + +_Gentlemen_--Having been in your Institution as a sufferer from two +distinct chronic diseases of years' standing, and having been placed +under the charge of your specialists, I was speedily relieved of my +afflictions. The Invalids' Hotel is a place as much like home as it is +possible for such an institution to be. The physicians and surgeons are +all expert specialists and thoroughly efficient; the nurses are very +competent, attentive and kind; and, in fact, the whole _personnel_ of +the Invalids' Hotel endeavor to do their best to make the patients feel +like being at home. I always felt while there as if I was one of the +family. I gladly recommend your Institution to all persons who are +afflicted with any kind of chronic disease, for from my own experience I +_know_ the professional staff will do all which they promise to do. +Please accept my thanks for the speedy benefits and perfect cure of my +diseases, and I think your Institution is worthy of the highest +endorsement. + + Yours truly, + WILLIAM HENKEL, + No. 1917 Congress Street, + St. Louis, Mo. + + +STRANGULATED RUPTURE OR BREACH + +IN A CHILD TWO YEARS OLD, CURED. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.: + +[Illustration: Rev. R. Krause, Esq.] + +_Dear Sirs_--Our boy is, since the operation, quite well and healthier +than ever before, so that I presume, the rupture, or a part of it, may +have existed since his birth. Even that small lump in the groin has, as +much as I can feel by touching, completely disappeared. I take this +opportunity of expressing my heart-felt thanks for the kind and +christian-like treatment my wife and boy experienced from you and the +nurses. God bless you and let you live long for the welfare of suffering +men. Dr. Pierce's Invalids' Hotel of Buffalo, N.Y., deserves to be +recommended to every sufferer of whatever disease. Eight years ago I +underwent a successful operation, saving my body a member. The dangerous +outgrowth, which made the operation a necessity, never returned. In +regard to your specialist, I wish to remark, that his skillful way of +performing operations reminded me very much of Bernard von Langenbeck, +professor of surgery in the University of Berlin, where I was a student. +He is just as tender and sympathetic with his patients as that famous +director of the Prussian Royal Clinical Hospital has been. As to the +medicines of Dr. Pierce, I recommended them to members of my +congregation, who told me that they did them good. Dr. Bastian, of +Dansville, N.Y., a druggist, told me that your medicines are bought by +the same persons again and again. I consider this to be the best +recommendation. A medicine which is of no effect will not be bought a +second time by the same person. + + Yours, REV. RICHARD KRAUSE, Portway, N.Y. + +[Illustration: Mrs. Krause.] + +[Illustration: Master H. Krause.] + +Mrs. Mary Krause, the mother of the little boy whose case is above +reported, writes: "In respect to your medicines I can only say that they +have done me and others much good, especially when I suffered with +chronic catarrh and doctored with your physicians. I shall never forget +the kind treatment I received from your physicians and nurses during the +time I had to stay in your house, while our Herman had to go through +that dangerous operation which was necessary to cure his strangulated +rupture. I can recommend your Institute and medicines to all suffering +people." + + +HERNIA OR RUPTURE + +[Illustration: B. Galland, Esq.] + +OF FOURTEEN YEARS CURED "SOUND AS A DOLLAR." + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +_Dear Sirs_--In reply to yours of the 29th ult., in which you kindly +make inquiry in regard to my physical condition, I would say, that I am +now, I think, as sound as a dollar, and consider that after I had bad +fourteen years of suffering with Hernia, and being cured as I was last +winter at your Institute, makes me under great obligations to the +science and skill of the World's Dispensary Medical Association. + + Very respectfully yours, + ROBERT GALLAND, + Orangeville Mills, Barry Co., Mich. + + +IRREDUCIBLE HERNIA. + +PRESENT FROM BOYHOOD--PROTRUSION OF ENORMOUS SIZE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +[Illustration: D. Nitschke, Esq.] + +_Gentlemen_--I take pleasure in reporting that I have not worn the truss +for a long period, and that I have been at work steadily at my business +of binding and printing, running a large establishment, for over four +years, without any trouble whatever from the rupture. It has remained +permanently and perfectly cured. You will remember my case as a most +severe one. I am a man of sixty years of age, and the disease had been +the source of serious discomfort to me since childhood. The protrusion +was the size of a man's head, and could not be replaced. I was forced to +give up all exercise, and suffered much at my daily work from +inconvenience and pain. Any injury upon the protrusion, which could not +always be protected, was followed with much discomfort, and my general +health was seriously affected. The passage of the food through the +confined intestines was a painful process often times, and kept me in +great misery. I am thankful to state that since your operation the +rupture has remained sound and well, and I have been relieved of all +difficulty of the kind. I now enjoy excellent health, and am at my +business daily from twelve to sixteen hours, and on my feet constantly, +yet without any manifestations whatever of the re-appearance of the +rupture. You have my most sincere gratitude for the skillful operation +and the good care received in your Institution while there. I can +recommend your nurses and physicians most highly, and think your +Institution is unequaled in this country. + + With many good wishes, I am, + Very truly yours, DANIEL NITSCHKE, + 2067 Franklin Ave., Toledo, Ohio. + + +COMPLICATION OF DISEASES. + +[Illustration: A. Holes, Esq.] + +Without solicitude or hope of pecuniary reward, with heart-felt +gratitude and a desire to aid my fellow-man to health and happiness, +allow me to state, that as an inmate for more than a month of the +Invalids' Hotel and Surgical Institute at No. 663 Main Street, Buffalo, +N.Y., I feel warranted in its highest recommendation. While there I saw +and talked with a great number of people who came there as a last +resort, to be cured of almost every chronic disease to which flesh is +heir, and they were unanimous in their praise of the Institution and the +skilled specialists who constitute its professional staff. + + ANDREW HOLES, + Moorhead, Minn. + + +HERNIA OR RUPTURE OF 11 YEARS' STANDING. + +[Illustration: L. Crist, Esq.] + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: + +_Gentlemen_--Allow me to express my thanks to you for the attention and +benefits received at the hands of your skillful staff of surgeons and +nurses. I had been a sufferer from Hernia for eleven years and tried +everything, but was no better. I finally went to the Invalids' Hotel and +Surgical Institute, and am now entirely cured and enjoy splendid health. +I heartily recommend yours to be the most skillful treatment of the age. + + With best wishes, + LEWIS CRIST, + No. 67 Frankston Ave., Pittsburgh, Pa. + + +RUPTURE, + +AGGRAVATED BY OCCUPATION AS A LOCOMOTIVE ENGINEER--COULD NOT BE HELD IN +PLACE--AFTER TREATMENT SUBJECTED TO THE TRYING TEST OF THE CONSTANT JAR +OF THE LOCOMOTIVE YET PROVES RELIABLE. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, NO. 663 Main Street, Buffalo, +N.Y.: + +[Illustration: J.M. Keach, Esq.] + +_Gentlemen_--It has long been my desire to make a statement of my cure +for the benefit of all those persons who have suffered in like manner. I +had a rupture that was very large and difficult to hold in place. +Trusses of all kinds were tried. They were painful and would not hold +it. The rupture would come down constantly when at my engine and give me +fearful pain. I was cured at the Invalids' Hotel and Surgical Institute, +Buffalo, N.Y., by a treatment that is safe and certain. My cure has been +permanent, although I have worked steadily. + + Yours sincerely, JAMES M. KEACH. + No. 68 Bissell Ave., Buffalo, N.Y. + + +FEMORAL HERNIA. + +[Illustration: Miss M.V. Thomas.] + +This patient, aged thirty-four years, was always delicate; suffered from +malarial fever each year for ten years past. The hernia was caused by +lifting her father, who was on his sick-bed, during five different +times, causing terrible suffering. The hernia was treated by our +Specialist, and in eighteen days the lady was able to return home. + +She reports: + +_Gentlemen_--I am grateful to you for a permanent cure of the hernia, +and happy to inform you that I have felt no signs of rupture since I was +at your Institution. + + Respectfully yours, + Miss MATTIE V. THOMAS, + Albion, Noble Co., Ind. + + +"A LIVING DEATH FOR YEARS." + +WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.: + +[Illustration: H. Wood, Esq.] + +_Gentlemen_--In the hope that some sufferer from hernia may be induced +to take your treatment for that disease, I send you this certificate, +containing a synopsis of my case and cure of the same. My life was a +living death for years. I had almost lost all hope of ever being cured, +and was plunged in despair, as I had tried so many trusses, appliances +and remedies, each one in successive repetition, a failure. In January +and February of the year '89, I entered your Institution for treatment, +my malady being an inguinal hernia on the right side, of twenty years' +standing--from childhood. I was then impressed with the feeling that it +was my last chance, and that it would be my last effort, and to be +candid I had very little hope that a cure would be effected. To me my +condition seemed appalling, as I dare not eat, drink, laugh, exercise or +perform any of the functions of life without having to reduce my +rupture, frequently as often as forty or fifty times _per diem_, while +on occasions the reduction would occupy hours of untold agony. No truss +or appliance that I could get would retain the rupture, and I had tried +all sorts as fast as they came to my knowledge. Marvelous as it may +appear to all sufferers from this distressing affliction, I was +discharged from your Institute in thirty days, a well and sound man, and +only from memory and the record do I know that I was ever ruptured. I +have at times since performed some of the hardest kinds of work for long +periods, but no sign of weakness has ever appeared. I do not consider +the necessary operation performed as attended with any danger; it is no +comparison to the chances a person takes who in the daily walks of life +is tortured with a rupture. + +While an inmate of your Institution, I was accorded the kindest and most +considerate treatment from all members of your staff and employees with +whom I came in contact. I consider the appointments and cuisine of the +establishment as perfection. You are at liberty to make the fullest and +freest use of this testimonial you may see fit in your judgment, and I +will cheerfully answer any communication from any sufferer referred to +me for more explicit testimony. + + I am, Sincerely yours, HENRY WOOD. + Mason Valley, Nev. + + + * * * * * + + + + +CROUP, MEMBRANOUS AND SPASMODIC. + + +[Illustration: Fig. 1. +False Membrane in Croup. From a specimen +in Dr. Gross' cabinet.] + +Every family should be made acquainted with the symptoms and treatment +of this disease. Especially is this true in the case of those living +remote from a physician. From the lack of this knowledge on the part of +parents, many a little one has perished before medical assistance could +be obtained. In some of its forms its progress is very rapid, and, +unless relief is obtained in a few moments, or hours at the most, death +ensues. + +There are several quite distinct pathological conditions of the vocal +and respiratory organs which have, in popular parlance, been designated +as croup. But two of these are worthy of consideration here. These are +_true_ or _membranous_ croup, in which a false, semi-organized membrane +is formed, and _spasmodic croup_. Both may result fatally, but the +former is much the more dangerous. + +MEMBRANOUS CROUP is supposed to originate in the trachea, from which, as +it progresses, it often extends upward to the larynx, and downward to +the bronchial tubes. It is the result of severe inflammation of the +mucous membrane, and is characterized by the formation of a false +membrane, which covers or lines the inner surface of the true structure +(see Fig. 1). It is formed of a coagulable, semi-fluid exudation from +the mucous membrane. On being brought to the surface and into contact +with the inspired air, this substance grows thick and tough, or +leathery, as we find it. It is the obstruction in the respiratory canal +which this foreign matter causes that gives rise to the labored +breathing, and the ringing, brassy cough, together with the crowing or +whistling inspiration characteristic of croup. Before recovery can take +place this membrane must be detached and expelled. The cough is nature's +effort to accomplish this work. + +The formation of this adventitious membrane in the larynx is attended +with more danger than when it is confined to the trachea. In most cases +in which the disease has had a very speedily fatal termination, an +examination has shown that the larynx was its chief seat. + +SYMPTOMS. True croup is generally preceded by what is known as "a cold." +The child coughs, sneezes, and is hoarse. It is the hoarseness and the +peculiar _character_ of the cough which indicate the tendency to croup. +This has been already described. In addition, the child is restless, +fretful and feverish. The disease makes rapid strides. Finally the cough +ceases to be loud and barking, and is very much suppressed; the voice is +almost gone; the face is very pale; the head thrown back; the nostrils +dilated and in perpetual motion, the pulse at the wrist very feeble, +great exhaustion, more or less delirium, and, finally, death comes to +the relief of the little sufferer. Convulsions sometimes occur in the +last stages, and soon terminate fatally. + +TREATMENT. No time should be lost in commencing treatment. Hot +fomentations should be applied to the throat and upper portions of the +chest. The free inhalation of steam should be employed early. The +following treatment has been found very effectual in membranous croup, +and is recommended by the highest authorities: Yellow subsulphate of +mercury, or turpeth mineral, three to five grains, depending upon the +age of the child, for one dose. If it does not cause vomiting in fifteen +minutes, give a second dose. This, however, is seldom necessary. If the +turpeth mineral cannot be obtained, sulphate of copper or sulphate of +zinc may be given instead, as directed under the head of Emetics, in +Part III, Chapter II. If there be a quick pulse, hot skin, a hurried +breathing, and an occasional ringing cough, the child should be kept in +bed, comfortably covered, but not overloaded with clothes, and the +tincture or fluid extract of veratrum viride administered as follows: +Take fluid extract of veratrum, five drops; sweet spirits of nitre, one +teaspoonful; pure water, twenty teaspoonfuls; mix, sweeten with white +sugar, and give a teaspoonful of the mixture every half-hour to two +hours, according to the age of the child and the severity of the case. +If there be great prostration, with cold extremities, the carbonate of +ammonia should be administered, in doses of from one to two grains, +every second hour, in gum arabic mucilage. Quinine is a valuable remedy, +and is tolerated in large doses. The patient's body should be frequently +sponged with warm water in which a sufficient quantity of saleratus or +ordinary baking-soda has been dissolved to render it quite strongly +alkaline. If the bowels be constipated they should be moved by an +injection of starch-water. Beef tea and other concentrated, supporting +diet should be administrated. In those cases in which there is a +tendency to croup, the Golden Medical Discovery, together with iron and +the bitter tonics, should be given to build up the system and counteract +such tendency. The treatment which we have advised has been put to the +severest tests in the most severe forms of the disease, and has resulted +most successfully. If, however, in any case it does not give prompt +relief, our advice is to lose no time in summoning a physician who is +known to be skilled in the treatment of diseases of children. + +SPASMODIC CROUP. In this affection no false membrane is formed. It seems +to have a nervous origin. Most frequently the child is awakened in the +night by a sense of suffocation. He may cry out that he is choking. The +countenance is livid, the breathing is hurried and each respiration is +attended by a crowing sound. The child has fits of coughing or crying, +and makes vehement struggles to recover his breath. This complaint, +unlike croup, is unattended by fever, it being of a purely spasmodic +character with no inflammation. + +Apply hot fomentations to the throat, and give frequent small doses of +tincture or fluid extract or syrup of lobelia, to produce slight nausea; +or, better still, an acetic syrup of blood-root, made by adding one +teaspoonful of the crushed or powdered root to one gill of vinegar and +four teaspoonfuls of white sugar. Heat this mixture to the boiling +point, strain, and administer from one-fourth to one teaspoonful every +half-hour or hour. Slight nausea should be kept up, but it is +unnecessary to produce vomiting. This is usually all the treatment that +is required. + + +WHOOPING-COUGH. (PERTUSSIS.) + + +This is primarily a disease of the nervous system, involving the +respiratory organs through the medium of the pneumogastric nerve. It is +considered a disease of childhood, though we have met with it in _old +age_. It is eminently a contagious affection, and occurs generally but +once during life. + +SYMPTOMS. It is at first manifested by a catarrhal cough, gradually +developed. After a while it becomes paroxysmal, generally worse at +night. The cough is severe, and long-continued; when a prolonged +inspiration occurs, it is accompanied by a peculiar shrill sound, the +characteristic _whoop_, which, when once heard, is never forgotten. The +cough is attended by a copious secretion of glairy mucus, which is +brought up at the latter part of the paroxysm. During, or at the end of +the paroxysm, vomiting frequently occurs, and sometimes nosebleed. The +cough is so severe at times, that the patient turns purple, gasps for +breath, and presents all the symptoms of suffocation. Bronchitis +sometimes is a troublesome complication. Immediately preceding a +paroxysm of coughing a sense of impending danger appears to seize the +child, and it runs to its mother, or grasps some support, as if for +protection. Until the paroxysmal character and peculiar _whoop_ is +developed, the disease is diagnosed with difficulty. + +TREATMENT. We have found the Golden Medical Discovery to modify the +disease and cut it short. The philosophy of its action can be readily +understood by its effect on the pneumogastric nerve, as explained under +consumption and bronchitis. Jaborandi, described under the head of +diaphoretics, often speedily arrests this disease. The employment of an +infusion of red clover blossoms, in small doses, is of undoubted value +in modifying the irritation of the air-passages, and may be used to good +advantage with, or in alternation with the Golden Medical Discovery. +Exposure to cold and wet should be avoided. + + +NOSEBLEED. + + +Hemorrhage from the nose is commonly the result either of a catarrhal or +an inflammatory condition of the nasal mucous membrane. Individuals are +susceptible to it who are oppressed by fever or constitutional diseases +that reduce the strength. There is also a condition of the nervous +system in which there is congestion of the nerve centres which favors +manifestations of this somewhat troublesome difficulty. + +CAUSES. In some instances an examination of the nose will reveal the +presence of a small point of congested vessels, usually about the size +of a split pea. Upon this portion of the mucous membrane small scabs +form, and at any time when they may be dislodged, by accident or +otherwise, a hemorrhage will ensue. + +The constitutional conditions that produce the tendency to hemorrhage +are most important. In individuals of a debilitated condition, it +results from the lack of a proper amount of fibrin in the blood. Where +the blood becomes thin, or loses a large share of its red corpuscles, +the individual is pale, and hemorrhages are frequent from the mucous +surfaces of any portion of the body, the nasal mucous surface being +especially liable to such attacks. + +TREATMENT. This is local and constitutional. Where there is +constitutional imperfection, it should be remedied. Usually in young +women there is some difficulty with the ovarian or uterine circulation, +and the attack of hemorrhage from the nose is reflex in its character, +appearing just before or at the time of the menstrual flow, accompanied +with troublesome headache. The correction of this form is by the use of +the "Favorite Prescription" and "Golden Medical Discovery," using of +each a teaspoonful three times a day, taking the "Prescription" before +meals and the "Discovery" after meals. If the bowels are constipated, +the "Pellets" should be employed, in order to overcome any congestion of +the liver which favors the manifestation of nosebleed. In children there +is usually a debilitated state of the system, which is best remedied by +the use of a half teaspoonful dose of the "Discovery," taken three times +a day, after meals, with sweetened water. This treatment should be +continued for a month or six weeks. By this means the blood-making +organs rapidly improve in their activity and functions, the blood +becomes rich in corpuscles and fibrin, thus strengthening the walls of +the blood-vessels and tending to prevent a hemorrhage following undue +excitement or injury. With men the use of laxatives is of great +importance. One or more of the "Pellets," taken on retiring at night, +are most beneficial. Where the blood is not up to the standard of +purity, even though the individual be fleshy, the "Discovery" should be +used, a teaspoonful or two, three times a day, after meals, in +conjunction with plenty of outdoor exercise and the best of food. Where +the hemorrhages occur in those having too much blood, the diet must be +corrected by the use of vegetables and fruit, diminishing the amount of +meat and pastries to a minimum. The amount of fibrin should also be +increased by the use of the "Golden Medical Discovery." + +LOCAL TREATMENT. Of those applied directly to the membrane, Dr. Sage's +Catarrh Remedy, used according to the directions which wrap the bottle, +is excellent in bringing about a normal condition of the mucous +surfaces. Following this, a small amount of Subnitrate of Bismuth may be +snuffed into each nostril. Usually the amount required to cover a +three-cent silver piece is sufficient. The powder dries the surface and +favors the speedy formation of a coagulum, or clotted covering, which +effectually checks any further hemorrhage. The application of a firm +compress to the upper lip will also diminish the flow of blood through +the arteries that run to the anterior portion of the mucous surface. +Good effects often follow the use of a small piece of ice applied to the +nape of the neck. This, with a reclining posture, will cause contraction +of the blood-vessels. If the Subnitrate of Bismuth is not to be readily +obtained, the use of any other powder such as starch, finely divided and +baked so as to be free from a tendency to form starch paste when applied +to a mucous surface, is equally good. Well-browned flour is also +serviceable. The use of the contents of a puff-ball, which contains many +millions of fine spores, has been employed from time immemorial. The use +of such drying powders tends to favor the speedy formation of clots. +Where the small points of engorged vessels are to be readily reached, +use a solution of the Tincture of Chloride of Iron, one part in four of +water, applying with a small pledget of soft cotton wrapped about, or +fastened to, the end of a pencil or stick. In this way the solution may +be applied in very small amount to the spot where the hemorrhage +appears, and will give immunity from future attacks. Any of the styptics +(see pages 320-325) can be called into service. Those who have the +advantage of the city drug store may use a solution of basic ferric +sulphate (Monsell's solution), or the spray of a three or four percent. +solution of cocaine. The latter is one of the most pleasant and +effective remedies in these emergencies. Before its administration the +nasal cavity should be cleansed by snuffing up the nostrils salt and +warm water. When washed, immediately apply the spray. If the +constitutional condition which led to the hemorrhage continues, the +general remedies--of which the "Golden Medical Discovery" is the most +efficacious--should be administered. This agent increases the number of +red blood corpuscles, and enriches the blood in fibrin, so that the +relief obtained is absolutely permanent. + + +INFLAMMATION OF THE STOMACH. (GASTRITIS.) + + +Gastritis is generally defined as an inflammation of the mucous membrane +of the stomach. However, the cellular, muscular, and serous tissues are +all liable to be more or less affected. Gastritis may be either _acute_ +or _chronic_. Either form is a distinct modification of disease, +manifesting peculiar symptoms and requiring special remedies. + +_Acute Gastritis_ generally occurs as a result or complication of other +diseases. It is an occasional feature In scarlatina, serious cases of +bilious fever, and in cutaneous affections of every description. The +mucous membrane of the stomach is placed in intimate communication with +all the vital organs, by means of the nerves of the solar-plexus, hence +the sympathy between the stomach and skin, and the morbid condition of +the stomach occasioned by disease of other organs. + +THE EARLY SYMPTOMS of acute gastritis are a burning sensation in the +stomach, accompanied by nausea and frequent vomiting. The respiratory +movements are rapid and shallow, the pulse is hard and short, and as the +disease progresses, becomes small, frequent, and thready. The tongue +usually retains its natural appearance, but it is sometimes dry and +tinged with a vivid scarlet at the tip and edges. Intense thirst and +hiccough are occasional symptoms. The facial expression is haggard, and +indicative of the most intense suffering. The stomach will not retain +the mildest liquids. In the early stages of the disease, the ejections +consist of chyme and mucus, streaked with blood. As it progresses, the +vomiting becomes a sort of regurgitation, the contents of the stomach +being ejected without any apparent nausea or effort. The ejections then +consist of a dark-colored granular matter, resembling what is known in +yellow fever as _black-vomit_. + +CAUSES. Formerly it was supposed that this was a very common disorder, +and the term _acute gastritis_ was applied to every development of +symptomatic fever. But late clinical and pathological investigations +clearly indicate that acute gastritis is of rare occurrence. It may be +caused by the excessive and habitual use of alcoholic drinks, especially +if taken without food, by copious draughts of cold water, or by intense +emotions. But its _general_ cause is the ingestion of irritating and +corrosive poisons. + +Where the former causes are known not to exist, the presence of poison +should always be suspected. As the cause sometimes becomes a matter of +legal investigation, it is very important that the practitioner should +be able to determine the _real_ origin. If caused by poison, the disease +is very suddenly developed, the patient complaining of a very intense +burning sensation in the throat and the lining membrane of the mouth, +which will generally show the action of the poison. A diarrhea is also +more apt to accompany the disease. If inorganic or vegetable poisons are +known or suspected irritants, the appropriate antidotes should be +promptly administered. For a list of the principal poisons and their +antidotes, with practical suggestions for treatment, the reader is +referred to the article in this volume, on Accidents and Emergencies. + +TREATMENT. The inflammation should be allayed, and a tea made of +peach-tree leaves is very serviceable. Small pieces of ice, swallowed, +will generally allay the thirst and vomiting, and a mucilage of +slippery-elm is very soothing to the inflamed mucous membrane. This is +an important disease, and its management should be entrusted to a +skillful physician. + + +CHRONIC INFLAMMATION OF THE STOMACH. + + +_Chronic Gastritis_ is sometimes mistaken for dyspepsia or gastralgia. +It is very necessary to discriminate between these diseases, as the +appropriate remedies of the latter will often only aggravate and augment +the former. + +A chronic inflammation of the stomach is a very common affection and has +many phases, but the term chronic gastritis is applied only to that +species of inflammation occasioned and accompanied by irritation. It is +seldom a result of the _acute_ form. + +THE SYMPTOMS of chronic gastritis are various and sometimes vague. Among +those which are prominent we may mention an irregular appetite. At times +it is voracious and the patient will consume every available article of +diet, while at others he will experience nausea and disgust at the sight +of food. Even when very hungry, one mouthful of food will sometimes +produce satiety and cause vomiting. The appearance of the tongue is +variable, sometimes natural, at others thickly coated. The desire for +drink is capricious, varying from intense thirst to indifference. +Another prominent symptom is a sense of heaviness and heat in the +epigastric region, after partaking of food. Often a small quantity, as a +teaspoonful of milk, will produce a sensation of weight, as a heavy ball +lying at the pit of the stomach. This symptom is frequently accompanied +by a frontal headache, and a small and wiry pulse. Dull or shooting +pains are experienced in the stomach and between the shoulders, and the +patient becomes weary, melancholy, and emaciated. + +CAUSES. The general cause of chronic gastritis is excess in eating or +drinking, and the use of alcoholic liquors. We have known it to be +produced by drinking _hard_ cider. Great mental excitement predisposes +the system to this affection. Occasionally it is a result of febrile +diseases, as scarlatina, typhoid fever, etc. In some families there is a +constitutional tendency to its development. + +TREATMENT. All medicines which tend to irritate the stomach, should be +studiously avoided. The bowels should be kept regular, and the skin +clean by frequent bathing. Stimulants of all kinds must be avoided. As a +principle article of diet, we would recommend milk and farinaceous +articles. If these precautions be observed, nature will sometimes effect +a cure. Lime water and the subnitrate of bismuth, in twenty-grain doses +three or four times a day, are useful to allay irritation. Other +suggestions applicable to its domestic management, maybe found under the +hygienic and medicinal treatment of dyspepsia, to which we refer the +reader. + + +NEURALGIA OF THE STOMACH. (GASTRALGIA.) + + +Gastralgia is a neuralgic affection of the stomach, unaccompanied by +inflammation. It is sometimes mistaken for chronic gastritis, although +there is a marked difference in the symptoms. + +A PROMINENT SYMPTOM OF GASTRALGIA is a _paroxysmal_ pain radiating from +the epigastric region, to all parts of the thoracic cavity. The pain is +sometimes lessened by walking, lying on left side, or by gentle +pressure, and usually abates after eating, but is renewed in a few +hours. The patient occasionally experiences a sense of heaviness at the +pit of the stomach, nausea, and frequent salty eructations. The tongue +is white, the appetite variable, and there is no desire for liquids. The +sleep is usually refreshing, and when not suffering from acute pain, the +patient is apparently well. + +The _distinguishing_ symptom of this disease is a feeling of intense +despondency, and, sometimes, a morbid fear of death. + +An effectual method of distinguishing between gastralgia and chronic +gastritis is by the administration of an alcoholic stimulant. If +gastritis be the affection the pain will be augmented; whereas, if it be +gastralgia, it will be relieved. + +CAUSE. The cause of gastralgia is a local or sympathetic irritation of +the nerves distributed to the stomach. + +TREATMENT. The pain of gastralgia is sometimes allayed by using half a +teaspoonful of subcarbonate of bismuth, and repeating the dose, if the +attack is not relieved. The following is a very effectual remedy: take +twenty grains of quinine, combined with one drachm of prussiate of iron, +and divide it into ten powders, and administer a powder every three +hours until the pain is completely arrested. Temporary relief may be +given by administering one-quarter of a grain of morphine, or ten to +twenty drops of chloroform in a teaspoonful of glycerine, slightly +diluted, taken in one dose. One of the most effective remedies for +preventing a return of the attacks is that invigorating tonic and +alterative, the "Golden Medical Discovery." The patient should be +careful in diet, and not eat too much food, which should not only be of +a nutritious kind, but easy of digestion. Cleanliness, suitable +clothing, bodily warmth, exercise, and rest must not be neglected. +Sometimes it is lingering and requires long persistence in hygienic and +medicinal treatment. Everything tending to promote the tone of the +digestive organs, and improve the functions of the system generally may +be considered advantageous in this neuralgic affection. + + +PERITONITIS. + + +The _peritoneum_, or serous membrane which lines the abdominal cavity +and invests the intestines, is liable to become inflamed. When this +occurs, the affection is termed peritonitis, and may be divided into the +_acute_ and _chronic_ forms. + +ACUTE PERITONITIS. This form may be circumscribed; that is, confined to +one spot, or it may extend over the entire surface of the peritoneum, +when it is known as _general_. + +SYMPTOMS. There is headache, quick pulse, tongue coated white, +countenance pallid, features pinched, respiration difficult, nausea and +vomiting, severe pain in the abdomen, which is extremely sensitive to +pressure and becomes very much distended. There is also pain in the +limbs, the bowels are constipated, and, in exceptional cases, diarrhea +is a prominent symptom. The urine is deficient in quantity, and there is +sleeplessness, chilliness, and great general prostration. Vomiting and +coughing or sneezing increase the pain. An erect position occasions +intense suffering. The patient is compelled to assume a recumbent +posture and is inclined to lie on the back, for in that position the +sufferer experiences the least pressure of the vital organs against the +peritoneum. There is also an inclination to draw up the lower limbs and +retain them in a flexed position. + +CAUSES. Prominent among these are injuries which have been inflicted +upon the intestines, compression of the colon, or rectum, perforation of +the stomach or bowels, either by violence or some pre-existing disease, +thus allowing the discharge of blood, urine, bile, or fecal matter into +the abdominal cavity; also abortion, over-exertion, and exposure to wet +or cold. As acute peritonitis is always a grave disease, involving more +or less danger to life, it is the wisest course to employ a physician +and trust the case to his management. The same remark is equally +applicable to the chronic form of the disease. + +CHRONIC PERITONITIS. Like the acute, it may be either _circumscribed_ or +_general_. This form is sometimes, though rarely, a sequel of the acute. +When it appears independently of the acute, it is generally associated +with some cutaneous affection pertaining to the abdominal cavity, and +the inflammation is induced by the tumor. If chronic peritonitis be +connected with the _tubercular_ diathesis, tubercles may be discovered +upon the surface of the stomach and alimentary canal, and may also be +found in the lungs and brain. + +When the affection is not tubercular there will appear in the abdominal +cavity an effusion of serous fluid of greater or less quantity, mingled +with blood and pus. When such an effusion takes place, the abdomen +gradually increases in size, or becomes smaller than is natural. There +is pain, attended by soreness upon pressure, and the patient becomes +emaciated. + +Inflammation of the peritoneum is frequently an accompaniment of +_puerperal fever_, which is a disease peculiar to childbirth, and which +may arise from cold, or be communicated from one parturient patient to +another by midwives. + +TREATMENT. In the remedial management of acute peritonitis, it is +obviously necessary to use some agent which will at once influence and +change the congested state and inflammatory condition. One of the best +agents employed to make a decided impression upon the vascular system, +subdue inflammation, and modify its action, is the fluid extract of +veratrum viride, administered in full doses, and repeated until the +system shows its effects in a decided manner. Warm fomentations applied +to the abdomen are sometimes very serviceable, and are objectionable +only because of their liability to dampen the bed-clothes. When the +abdomen will bear a thick, warm poultice, apply it, and then cover the +entire surface with oiled silk. The tincture of opium, in doses +sufficient to relieve pain and quiet the peristaltic action of the +intestines, is generally necessary. + + +EPIDEMIC CHOLERA. + + +This is an epidemic disease, supposed to be due to an impalpable +specific poison, but as to the exact nature of this poisonous matter +nothing definite is known. + +This plague first made its appearance on our continent in 1834. Owing to +its great fatality, it is a disease much to be dreaded. + +SYMPTOMS. These are well defined. It is characterized in its earlier +stages by pain in the stomach and bowels, especially in the umbilical +region, nausea, vomiting, diarrhea; later, the purging is excessive, and +the matter dejected resembles rice-water, and contains white, solid, +curd-like matter. The patient loses strength, and sinks rapidly. The +secretory organs fail to perform their functions normally, the skin is +sometimes moist, but oftener cold and dry; but little if any bile is +found in the excretions, and the urine voided is very scanty. There is +general nervous derangement, as indicated by the spasmodic contraction +or cramping of the muscles. This first attacks the extremities, but soon +affects the entire body, and gives rise to excruciating pains. The head +is affected by singing, roaring, disagreeable noises in the ears, the +pulse is feeble, but quick, the nails are of a bluish color, the tongue +is coated white, the eyes are sunken, and the patient has a corpse-like +appearance; the temperature of the body rapidly falls, the surface +becomes deathly cold, and, unless the disease is promptly arrested in +its course, speedy dissolution follows. The disease is rarely prolonged +beyond twenty-four hours, and sometimes terminates within three or four +hours after its first attack. + +TREATMENT. The kind of medicine required depends upon the severity of +the attack and stage of the disease. In all cholera epidemics, there are +premonitory symptoms, such, as an uneasy sensation at the pit of the +stomach, and a rumbling of the bowels. This is apt to be followed by a +painless diarrhea, which occasions no alarm, and the patient pays but +little attention to it. Herein is the great and dangerous mistake. The +patient is already in the stage of _invasion_, which must be promptly +arrested, or he will suddenly be precipitated into the stage of +_collapse_. The patient should lie down, and have placed about him +bottles filled with hot water, thereby exciting warmth upon the surface +of the body. At the same time, administer two teaspoonfuls of the +Extract of Smart-weed. If the symptoms are urgent, repeat the dose every +fifteen minutes. Brandy, thickened with sugar, may also be given. In +either the stage of _invasion_ or _collapse_, the leading indication is +to establish _reaction_ by promoting perspiration. Bathe the feet in +water as hot as can be borne, give the Extract of Swart-weed freely, and +thus endeavor to excite profuse diaphoresis. No time should be lost, for +delays are dangerous. When the reaction is established, the patient +should remain quiet, and not attempt to exert himself. + +After reaction has taken place, the sweating should be maintained for +twelve hours, and the patient should drink slippery-elm tea and +toast-water, and partake sparingly of soft toasted bread and chicken +broth. The food should be fluid and nutritious, but taken in small +quantities. Do not disturb the bowels with laxatives until the third day +after the patient begins to improve, and then they may be moved by an +injection of warm water. Great care should be taken that the patient +does not indulge too soon or too freely in the use of food. When a +skillful physician can be had, no time should be lost in securing his +services, but since in epidemics of this nature, medical men are +generally overworked, and not always easily and promptly to be had, we +have been quite explicit in giving full directions for treatment. + +CHOLERA MORBUS, also known as _sporadic cholera_ and _simple cholera_, +usually occurs during the summer months. The attack may be sudden, +although it is usually preceded by a sensation of uneasiness and colicky +pains in the stomach. + +SYMPTOMS. Nausea, vomiting and purging are the most prominent symptoms. +The discharge from the bowels is at first of a thin, yellow appearance, +but finally it becomes almost colorless. Sometimes, after the contents +proper of the bowels have been evacuated, the dejections have a bilious +appearance. Severe cramps and pain accompany the vomiting. The vomiting +and purging usually occur in paroxysms, but finally become less +frequent, a reaction takes place, the extremities grow warm, and the +patient gradually recovers. It may be accompanied by intense thirst and +a quick pulse, yet the surface may be cool. + +CAUSES. Cholera morbus is most prevalent in warm climates, and +especially in malarial districts. It is generally the result of eating +indigestible articles of food, such as unripe fruit or uncooked +vegetables. Stimulating drinks, or those articles which furnish the +elements for fermentation, also favor the production of this disease. + +TREATMENT. If the attack be superinduced by eating unripe or stale +fruit, it may be proper to give an emetic or a cathartic, but ordinarily +first give a full dose of the Extract of Smart-weed, and, if the vomited +matter is very sour, give the patient a weak, alkaline drink, which may +be made by dropping a few live, hard-wood coals into a tumbler of water. +This will not only assist in neutralizing the acidity of the stomach, +but will help to allay the thirst and accompanying fever. If the patient +throw up the first dose of the Extract of Smart-weed, a second should be +given. Do not allow the patient to drink cold water, and give only +tablespoonful doses of the alkaline solution every thirty minutes. If +the thirst is great, occasionally give a tablespoonful of a tea made +from scorched Indian meal, which not only allays the desire to drink, +but also the irritation of the stomach. If to be obtained, give a tea of +the leaves or bark of the peach tree. The patient should be well covered +in bed and kept warm. Laudanum by the stomach, or by enema, may he +necessary in severe cases to relieve the pain and check the purging. Hot +fomentations applied to the bowels are very valuable. A mustard plaster +applied over the abdomen will assist materially in relieving the nausea +and vomiting. It should not be left on sufficiently long to blister. +When the affection is promptly treated as we have suggested, the patient +generally quickly recovers. If, however, it does not yield to these +measures, the family physician should be called in. + + +ACCIDENTS AND EMERGENCIES. + + +Accidents and emergencies which require immediate attention frequently +occur. Professional aid cannot always be quickly obtained and hence +fatal results often follow. It is, therefore, important that all persons +should not only know how to proceed under such circumstances, but that +they should be able to exercise that deliberation and self-control so +necessary in emergencies of all kinds. Most persons are more or less +affected by the sight of blood or severe wounds, and it requires an +effort to maintain self-possession. One should act resolutely; otherwise +he will find himself overcome and unable to render any assistance. + + +WOUNDS. + + +Wounds may be classified as _incised, punctured, contused, lacerated_, +or _poisoned_. + +_Incised_ wounds are those which are made with a sharp, cutting +instrument, and are characterized by their extent of surface. + +_Punctured_ wounds are made with a pointed instrument, and distinguished +for their depth rather than breadth. + +_Contused_ wounds are those produced by bruises. + +_Lacerated_ wounds are those in which the flesh is torn and mangled. + +_Poisoned_ wounds are made with a poisoned instrument, or by some +poisonous reptile or insect or rabid animal. + +[Illustration: Fig. 1. +The field Tourniquet as applied. ] + +In all cases of wounds, the immediate danger is in the _shock_ produced +upon the nervous system, and in the liability to _hemorrhage_. + +SHOCK. If severe, the shock is attended with symptoms of extreme +prostration, such as a feeble pulse, shivering, partial unconsciousness, +fainting, hiccough, vomiting, and involuntary discharges of the urine +and feces. + +[Illustration: Fig. 2. +Mode of employing flexion for the +arrest of hemorrhage from a wound +located below the elbow. ] + +TREATMENT OF SHOCK. The clothing should be loosened immediately after +the accident, so that the blood may have free circulation, and the +patient should be kept in a recumbent position. He should have plenty of +fresh air. Camphor or ammonia may be inhaled. If he can swallow, +stimulants may be given, as whiskey or brandy, but with care that they +do not run into the trachea, or windpipe. If he be unable to swallow, +they may be administered as injections, but should gradually be +discontinued as reaction takes place. A warm pillow placed at the back +and the use of electricity may be beneficial. + +HEMORRHAGE, or bleeding, may generally be controlled by a _compress, +tourniquet, flexion of the joint_, or _styptics._ A _compress_ consists +of several folds of cloth laid upon a wound, the edges of which have +been brought together, and made secure by a moderately tight bandage. + +[Illustration: Fig. 3. +Mode of employing flexion for the arrest of hemorrhage from a wound +below the knee.] + +_A tourniquet_ may be extemporized by rolling a handkerchief into a cord +and tying it around the limb, over a compress, between the wound and the +heart. A stick should then be thrust between the handkerchief and skin +and twisted around several times, until the pressure is sufficiently +great to arrest the circulation of the blood in the wounded part. A +representation of this operation may be seen in Fig. 1. + +[Illustration: +Mode of employing flexion for the arrest of hemorrhage from a wound +located between the thigh and knee.] + +_Flexion of the joint_, as represented in Figs. 2, 3, and 4, is adapted +to many cases of hemorrhage. As water cannot flow through a rubber tube +bent at a sharp angle, so the acute flexion of a limb prevents the free +flow of blood through the arterial tubes. + +In some cases, _styptics_ may be directly applied to the wounded +tissues. Cold acts as a powerful styptic, and may generally be made +available for arresting hemorrhage. + +POISONED WOUNDS. The treatment of these should chiefly consist in the +prevention of the spread of the poison. This may be done by tightly +applying bandages above the wound and scarifying or sucking the parts. +Nitrate of silver may then be used and the ligatures removed. Alcohol, +in any form, is an antidote to snake poison. For the stings of insects, +apply aqua ammonia, fresh earth, raw onion, plantain, or spirits of +turpentine. + + +FRACTURES AND DISLOCATIONS. + + +The treatment of injuries received from the fracture of bones and the +dislocation of joints should never be attempted by the inexperienced, +nor should the management be left to incompetent physicians but +_skillful_ surgical aid should at once be summoned. + + +SPRAINS. + + +A sprain consists of a sudden and forcible stretching of the ligaments +and tendons connected with a joint, without there being any dislocation. +It is attended with severe pain and is followed by rapid swelling. + +The treatment should consist of measures to prevent inflammation, +promote absorption, and restore a healthy action. The affected part +should be kept at rest in an elevated position, and hot or cold water +applied frequently. If there is much inflammation, fomentations of hops +may be used. The Compound Extract of Smart-weed is an excellent +application. + +When the acute symptoms have disappeared, absorption should be favored +by systematic rubbing and the application of stimulating liniments, or +by the use of a well-adjusted bandage. Passive motion may be resorted to +gradually and the subject may use the joint moderately. Should any +stiffness remain, warm salt water douches should be employed and the +Extract of Smart-weed applied once a day. + + +BRUISES. + + +Bruises or contusions are caused by falls, wrenches, or blows from blunt +instruments, without breaking the skin. The soft tissues are lacerated +and blood is poured out into them, constituting _ecchymosis_. The +discoloration passes through various shades from a bluish-black to a +violet, a green, and finally, a yellow. + +If the bruise is severe, the affected part should be kept at rest and +frequently bathed with the Compound Extract of Smart-weed or the +tincture of arnica. If inflammatory symptoms supervene, fomentations and +poultices should be applied. + + +FOREIGN BODIES IN THE NOSE. + + +Foreign bodies, such as beads, peas, coffee-grains, and small +gravel-stones are occasionally introduced into the nostrils of children, +becoming fastened there, and causing great anxiety and alarm. If allowed +to remain, they generally cause inflammation and suffering. + +Such bodies may generally be washed out by gently injecting a stream of +tepid salt water with a syringe or Dr. Pierce's Nasal Douche. In no case +should force be used. If these means fail, a competent surgeon should be +consulted. + + +FOREIGN BODIES IN THE THROAT AND AIR-PASSAGES. + + +Foreign bodies are generally arrested so high up that they may be seen +by simply depressing the tongue, and removed with the finger or a pair +of forceps. The head should be thrown back in such a position as to +cause the chin to project as little as possible beyond the prominence +known as Adam's apple, in order that the finger or forceps may be +readily introduced and the body released and ejected. When the foreign +bodies are so small as to pass out of sight in the larynx, windpipe, or +esophagus, it is generally difficult to extract them, and the services +of a surgeon are required. Fortunately, however, there is not much +immediate danger from suffocation in such cases. + + +DROWNING. + + +Recovery from drowning sometimes occurs when life is apparently extinct. +The treatment, however, should be immediate and energetic, and should be +given in the open air, unless the weather be too cold. + +TREATMENT. The patient should be gently placed upon the face with his +wrists under his forehead. The tongue will then fall forward and the +water run out of his mouth and throat, while the windpipe, or +air-passage, will be free. To restore respiration, he should be +instantly turned upon his right side, his nostrils excited with snuff or +ammonia, and cold water dashed upon his face and chest. If this +operation prove unsuccessful, replace the patient upon his face, care +being taken to raise and support his chest, turn the body gently on the +side and quickly again upon the face. Alternate these movements about +every four seconds, and occasionally change sides. When the body is +turned on the face, gentle but efficient pressure should be made along +the back, between the shoulder blades, to assist in forcing the air out +of the lungs, but this pressure ought to be removed before the patient +is turned back on his side. Persistently repeat this operation, and +success will often be the reward. As soon as respiration is established, +warmth may be promoted by the application of warm flannels to the body +and bottles of hot water to the stomach, armpits, thighs, and feet. +During the entire process of restoration, the body should be thoroughly +rubbed _upwards_. Turning the body upon the back or handling it roughly +should be avoided. The person should not be held up by his feet, or be +rubbed with salt or spirits. Rolling the body on a cask is improper, and +injections of the smoke infusion of tobacco are injurious. Avoid the +constant application of the warm bath, and do not allow a crowd to +surround the body. + + +FAINTING. + + +When a person faints, _he should be allowed to remain or be placed in a +recumbent posture_, and his clothing immediately loosened. The +extremities should be rubbed, the patient permitted to have plenty of +fresh air, and, if at hand, ammonia or camphor should be applied to the +nostrils. + + +BURNS AND SCALDS. + + +The danger arising from burns and scalds depends not only upon the +extent of surface involved, but also upon the depth of the injury. Burns +are most dangerous when occurring upon the head, chest, or abdomen. + +TREATMENT. Soothing applications, and those which will exclude the air, +should be made. Grated potato, poultices of slippery-elm, sweet oil, +cotton saturated in a mixture composed of two or three grains of +carbolic acid and two ounces of glycerine, and linseed oil and white +lead, are all beneficial for the treatment of burns. If internal +treatment be necessary, it should be given under the direction of a +competent physician. + + +SUN-STROKE. + + +In cases of sun-stroke, the patient should be at once removed into the +shade. If the face is _flushed_, apply cold water to the head and neck, +and mustard to the feet. The body should be bathed in tepid water and +the head slightly elevated. If the countenance is pale, the symptoms +denote exhaustion, and the patient should be kept in a recumbent +position, the extremities rubbed, camphor and ammonia inhaled, mustard +applied to the spine, and stimulants, such as brandy or whiskey, should +be administered. + + + POISONS AND THEIR ANTIDOTES. + ----------------------+-------------------------------------------------- + POISONS. | ANTIDOTES. + ----------------------+-------------------------------------------------- + ACIDS. | + | + Acetic Acid. | Alkalies--carbonate of soda and potash--also + Citric Acid. | lime and magnesia are antidotes to these + Muriatic Acid. | poisons. As soon as the acid is neutralized, + Tartaric Acid. | mucilaginous teas, such as flax-seed, gum + | arabic, or slippery-elm, may be given. + | + Sulphuric Acid | Soap, in solution, or magnesia will counteract + (Oil of Vitriol). | its influence. Water should _not_ be given + | as it causes great heat when mixed with this + | acid. + | + Nitric Acid | Lime-water, carbonates of lime and magnesia + (Aqua Fortis). | in solution, are the only antidotes. Give + Oxalic Acid. | mucilaginous drinks. + | + Carbolic Acid. | There is no special antidote. Oil, glycerine, + | milk, flour and water, white of eggs, + | magnesia, and flax-seed tea may be used. + | + Prussic Acid. | Ammonia, by inhalation or in solution, may + Laurel Water. | be used. Apply a cold _douche_ to the head. + Oil of Bitter Almonds.| + | + These agents are | + speedily fatal. | + | + ----------------------+-------------------------------------------------- + | + ALKALIES. | + | + Liquor of Ammonia. | Vegetable acids, such as vinegar, lemon-juice, + Water of Ammonia. | citric and tartaric acids, neutralize this + Muriate of Ammonia. | poison. + | + Liquor of Potassa. | All the fixed oils, such as linseed, castor + Nitrate of Potassa | and sweet oil, also almonds and melted lard + (Saltpetre). | destroy the caustic effects of these poisons + Carbonate of Potassa | Mucilaginous drinks may be given. + (Pearlash). | + Salts of Tartar. | + + + + --------------------+----------------------------------------------------- + POISONS. | ANTIDOTES, + --------------------+----------------------------------------------------- + | + IODINE. | Starch, wheat flour mixed with water, + In its | whites of eggs, milk, and mucilaginous + different forms. | drinks are excellent antidotes. + | + --------------------+----------------------------------------------------- + | + VOLATILE OILS AND | + AGENTS. | + | The same antidotes as in case of poisoning + Creosote | with iodine may be used in this, or the + (Oil of Smoke). | stomach may be evacuated with an emetic or a + Oil of Tar. | stomach-pump. + Oil of Turpentine. | + | + --------------------+----------------------------------------------------- + | A powerful emetic of white vitriol or mustard + | should be given at once, cold should be + ALCOHOL. | applied to the head, and the extremities + | vigorously rubbed. + | + --------------------+----------------------------------------------------- + ANTIMONY AND ITS | + COMPOUNDS. | If vomiting has not occurred, induce it by + | tickling the throat and giving large draughts + Tartar Emetic | of warm water, after which administer + Butter of Antimony | astringents, such as infusions of galls, oak bark, + Oxide of Antimony. | Peruvian bark, or strong green tea. + | + --------------------+----------------------------------------------------- + | + ARSENIC AND ITS | + COMPOUNDS. | + | + White Arsenic. | Oils, or fats lard, melted butter, or milk + Yellow Sulphuret of | should be given, then induce vomiting with + Arsenic | sulphate of zinc, sulphate of copper or + Red Sulphuret of | mustard; fine powdered iron rust or magnesia + Arsenic | may be given every five or ten minutes. + King's Yellow. | Mucilaginous drinks should be given as soon + Fly Powder. | as the stomach is evacuated. + Arsenical Paste. | + Arsenical Soap. | + Scheele's Green. | + Paris Green. | + | + --------------------+----------------------------------------------------- + COPPER AND ITS | + COMPOUNDS. | Avoid the USE of vinegar. Give albuminous + | substances, such as milk, whites of eggs, wheat + Blue Vitriol | flour in water, or magnesia; yellow prussiate + Verdigris. | of potash in solution may also be given freely. + | + + + + --------------------------+------------------------------------- + POISONS | ANTIDOTES. + --------------------------+------------------------------------- + LEAD AND ITS COMPOUNDS. | In lead, or painters' colic purgatives + | and anodynes may be given, together + Acetate of Lead | with large doses of iodide of + (Sugar of Lead) | potassium. + White Lead. | + Red Lead. | + Litharge. | + --------------------------+-------------------------------- + MERCURY AND ITS | + COMPOUNDS. | Albumen in some form should be + | given; if the poison is not + Corrosive Sublimate. | absorbed, follow with a mustard + White Precipitate. | or lobelia emetic. + Red Precipitate. | + Calomel. | + --------------------------+----------------------------------- + ACRONARCOTICS. | + | The general treatment indicated for + Ergot | this class of poisons, is to + Black Hellebore. | evacuate the stomach with a + Veratrum Viride | stomach-pump or an emetic composed + (American Hellebore). | of fifteen or twenty grains of + Aconite. | sulphate of zinc or copper, or large + Foxglove. | doses of mustard, repeated every + Gelseminum. | quarter of an hour until the full + | effect is produced. + | + Belladonna. | Morphine, sassafras, iodine, and + Stramonium. | stimulants. + | + Nux Vomica. | Large doses of camphor, chloroform, + Strychnia. | and tobacco, may all be beneficial. + | + Poison Oak. | Muriate of ammonia, in solution, may + Poison Vine. | be applied externally, and from ten + | to fifteen grains given internally; + | soda is also useful. + --------------------------+----------------------------------- + NARCOTICS | + | + White Henbane. | Sassafras may be used as an antidote + Opium. | for henbane. Belladonna is an + | antidote of opium; cold water should + | also be applied to the head + | of the patient, and the extremities + | should be well rubbed. + --------------------------+----------------------------------- + ANIMAL POISONS. | Excite vomiting by drinking sweet + | oil. Sugar and water, milk, or + Spanish Fly. | linseed tea in large quantities, and + Potato Fly. | emollient injections are valuable. + | + + + +POSTERIOR SPINAL CURVATURE. + +(HUMPBACK.) + + +Posterior curvature of the spine, sometimes known as Pott's Disease, +occurs most frequently in children, and is generally developed before +the seventh year. Children of a scrofulous diathesis are especially +liable to this affection. It is generally due to disease of the +inter-vertebral cartilages and bodies of the vertebræ. It comes on in a +slow, insidious manner, hence, it often makes serious inroads upon the +spine and system before its character is even suspected. + +[Illustration: Fig. 1. + +The above portion of the spinal column shows the manner of the breaking +down of the vertebræ from caries, +and the absorption of their bony +structure.] + +Generally the first point of invasion is the cartilaginous substances +between the bodies of the vertebræ, beginning with inflammation, and +finally resulting in ulceration and a breaking-down of the cartilages. +It next invades the vertebræ themselves, and producing caries, or death +and decay of the bony substance, which softens and wastes away, as shown +in Fig. 1. The vertebræ become softened and broken down, and weight of +the body pressing them together produces the deformity known as +"humpback." (See Fig. 2 and Fig. 3.) + +SYMPTOMS. Among the various symptoms present in the earlier stages of +the disease, and during its progress, we deem it necessary to mention +only a few of the more prominent ones. While the patient is yet able to +go around, the disease manifests itself by occasional pain in the +bowels, stomach, and chest. Often there is a hacking cough, nervousness, +lassitude, and a generally enfeebled condition of the whole system. The +patient is easily fatigued; there is apparent loss of vitality, impaired +appetite, a feeling of tightness across the stomach and chest, gradually +declining health, and loss of flesh and strength, torpidity of the +liver, deficient secretions, constipation, and morbid excretions from +the kidneys. The victim, in passing chairs, tables, and other objects, +instinctively places his hands upon them, and, as the disease +progresses, when standing, leans upon some support whenever possible. In +walking, he moves very carefully and cautiously, with elbows thrown back +and chest forward, to assist the body in keeping its equilibrium. The +body being kept in an upright position, the patient bends the knees +rather than the back in stooping, as illustrated in Fig. 5, and the body +is frequently supported by the hands being placed upon the thighs or +knees. Sudden movements or shocks cause more or less pain. + +The development of the disease then becomes rapid; suffering increases, +and pain about the joints and lower extremities and muscles of the +posterior part of the pelvis is experienced; numbness and coldness of +the extremities are felt; locomotion becomes more difficult, and a +slight projection is observed upon the back. Even in this somewhat +advanced stage of the disease, when the symptoms are so apparent, many +cases are shamefully neglected because an ignorant adviser says it is +nothing serious and that the patient will outgrow it. The pain and +tenderness not always being in the back, the inexperienced are very +often misled as to the true character of the trouble. This distortion or +deformity of the back now becomes painfully prominent; the diseased +vertebræ quickly soften and waste away; the pressure upon the spinal +cord increases, and paralysis of the limbs supervenes; the power of +locomotion is lost, and, at last, the danger is realized and the +struggle for life begins. + +[Illustration: Fig. 2.] + +[Illustration: Fig. 3.] + +Thus, through ignorance, neglect, and improper treatment, the poor, +helpless victim is doomed to a life of hideous deformity and suffering. +We would, therefore, urge upon parents whose children are afflicted with +this terrible disease, the great importance of placing them under the +care of surgeons who have for many years made the treatment of such +cases a specialty, and who have every facility and all necessary +surgical appliances for insuring success in every case undertaken. + +[Illustration: Fig. 4. +Appearance of a child suffering from +Pott's disease of the spine.] + +[Illustration: Fig. 5. +Mode of stooping adopted by a child +suffering from spinal disease.] + +TREATMENT. The great essentials for the successful treatment of disease +and deformities of the spine are first, a thorough knowledge of the +structure and parts involved by the disease; secondly, the adjustment of +mechanical appliances perfectly adapted to the requirements and +necessities of each individual case, and the proper use of our system of +"vitalization," applied to the spinal muscles to strengthen the weaker +and relieve the undue contraction of the stronger. For many years our +specialists have experimented, and have given the various appliances in +common use in these cases most thorough and practical tests, and have +found them very defective, being generally constructed upon wrong +principles. The physician who sends to a mechanic for an appliance, such +as are now made in the shops of most instrument makers, and uses the +same, is doing himself an injustice, and barbarously torturing his +patient by forcing him to wear an apparatus which is heavy, clumsy, and +inevitably injurious, instead of being beneficial in its results. In the +treatment of diseases and deformities of the spine, there should be no +compromising; the appliance that fails to give complete support should +not be worn. In our treatment of these maladies we employ only +appliances which are constructed under the personal supervision of our +specialists, upon principles dictated by common sense and the actual +necessities of the case. We do not confine the body in an iron jacket. +Our apparatus is light, yet durable, and is worn by the most delicate +children without pain or inconvenience. It gives proper support to all +parts, and is so nicely adjusted as to produce pressure only upon those +points which should receive support, leaving the muscles of the spine +freedom of action, thereby assisting in their development. In many +hundreds of cases treated by our specialists, the disease has been +entirely cured and the deformity removed. After seeing the patients and +adjusting the appliances, they can generally be treated at their homes. + + +LATERAL CURVATURE OF THE SPINE. + +(CROOKED BACK.) + + +[Illustration: Fig. 6. +Lateral curvature of the spine. E to F, the primary curve.] + +[Illustration: Fig. 7. +A mild case of lateral curvature of the spine.] + +This deformity appears more frequently in anæmic persons, in whom the +flexibility and elasticity of the muscles are weakened, than in those of +a plethoric habit. It is generally contracted during youth, between the +ages of twelve and eighteen. Persons of sedentary and indolent habits +are especially liable to this deformity, hence, girls are most +frequently its victims. It is never seen among the natives of tropical +countries who habitually live in the open air, and seldom among the +barbarous races of northern latitudes. A distinguishing feature of the +American Indian is his erect carriage. The _primary_ curvature is +generally toward the right side, as represented in Figs. 6 and 7. Figs. +8 and 9 show the disease in a more advanced stage. The ribs are thus +forced into an unnatural position, and the vital organs contained in the +cavity of the chest are compressed or displaced, thus distorting the +form of the whole upper portion of the body. + +[Illustration: Fig. 8. +Lateral curvature in an +advanced stage. ] + +[Illustration: Fig. 9. +Lateral curvature in an +advanced stage. ] + +SYMPTOMS. The first indication of lateral curvature of the spine is a +marked projection of the right scapula, or shoulder-blade. It is +sometimes first observed by the dressmaker, or, accidentally, while +bathing. The right shoulder is slightly elevated, while the left hip is +depressed and projects upward. If not corrected while in its earlier +stages, it progresses very rapidly, and a second curvature is developed. +The symptoms vary in different cases, and in the early stages are +somewhat obscure and undefined, but generally the patient feels a sense +of uneasiness, languor, stupor, and nervousness, loss of energy and +ambition, general debility, poor appetite, gradually declining health, +loss of strength and flesh, and, as the disease progresses, a slight +elevation of one of the shoulder-blades is noticed, as well as the +deviation of the spine to one side. The curve, or distortion, of the +spine increases more rapidly as the body becomes heavier, the spine +often assuming the shape of the letter S, and, from compression by +torsion of the vertebræ and distortion of the ribs, the vital organs are +encroached upon, causing serious functional derangement of the heart, +lungs, liver, and stomach, producing, as its inevitable consequence a +list of maladies fearful to contemplate. + +CAUSES. In rare instances, the lateral curvature of the spine is due to +defects of certain bones of the pelvis or limbs. Cases are recorded in +which this deformity was caused by diseases of the abdominal organs, +but, as we have intimated, it is generally due to a lack of tonicity of +the muscles, or, as a late writer has expressed it, "Want of +correspondence in the antagonism of those muscles which control the +motions of the spinal column." Habitual sitting or standing in a leaning +posture, or standing upon one foot, thus constantly using one set of the +muscles of the back, while the other becomes enfeebled by the lack of +exercise, is a common cause of this deformity. The habit which so many +school-girls contract of drawing up one foot under the body while +sitting, often produces a lateral curvature of the spine. + +TREATMENT. No disease or deformity of the spine is so easily cured and +perfectly corrected, if the proper plan of treatment is pursued. To +correct this deformity, many ingenious forms of apparatus have been +devised and invented by our specialists, which should be carefully +adjusted to each individual case. In addition to this, our method of +treatment by "vitalization," and by mechanical movements and +manipulations, is almost indispensable in these cases. It never fails to +give relief, and, if properly pursued, invariably results in a permanent +cure. + + +DEFORMED FEET, HANDS AND LIMBS. + + +There are thousands whose feet, hands, and limbs are almost entirely +useless, besides having an unsightly appearance. Their condition has +been helpless so long, their treatment so varied, and their hopes of +relief or cure have been so often disappointed, that few can believe the +truth of our statement, when we positively assert that we can correct +and cure nearly all cases of talipes, club, or crooked feet and deformed +hands, and make them as perfect in appearance, and as useful in action, +as feet and hands which have never been deformed. While this may seem +miraculous, or even impossible, to those who are unacquainted with the +wonderful improvements and rapid progress made in this department of +surgical science, it is attested and verified by living witnesses whose +feet and hands were once deformed and useless, but which have been made +perfect by our new and improved method of treatment. We do not make +these statements in a spirit of vain boastfulness, but having devoted +many years to improving and perfecting surgical appliances and +apparatus, and having had practical experience in the successful +treatment of thousands of cases, we do say that our manner of treatment +is original and employed only by us. We entirely ignore the ineffectual +methods usually employed in such cases. Our treatment causes no pain, +and little inconvenience, yet the curative results are speedy and +certain, and a hundredfold more satisfactory than those obtained by any +other course. + +[Illustration: Fig. 10. +Talipes Equinus.] + +[Illustration: Fig. 11. +Talipes Calcaneus.] + +We have most thoroughly tested all the best forms of treatment +heretofore devised and employed in this class of diseases, and have +adopted the best features of all the various methods heretofore pursued. +We have combined these with our own improvements and, as the result, we +have perfected a thorough and efficient system of treatment, based upon +scientific principles. + +[Illustration: Fig. 12. +Talipes Valgus.] + +[Illustration: Fig. 13. +Double Club-foot.] + + + +[Illustration: Fig. 14. +Bow-legs.] + +[Illustration: Fig. 15. +Knock-knees.] + +[Illustration: Fig. 16.] + +[Illustration: Fig. 17.] + +[Illustration: Fig. 18.] + +[Illustration: Fig. 19.] + +[Illustration: Fig. 20.] + +[Illustration: Fig. 21.] + +[Illustration: Fig. 22. +The above illustrations represent various Deformities cured by our +Specialists +at the Invalids' Hotel and Surgical Institute.] + + * * * * * + + + + +MECHANICAL AIDS + +IN THE TREATMENTS OF + +CHRONIC DISEASES. + + +We have, in different parts of this work, referred to a large variety of +ingeniously devised machinery and apparatus employed at the Invalids' +Hotel and Surgical Institute, in the treatment of chronic diseases. +Although we can, on paper, give but a meagre idea of the variety and +adaptability of these valuable mechanical appliances, yet we will +endeavor to illustrate and explain a few of our machines for the +application of transmitted motion. + +[Illustration: Fig. 1. +The Manipulator. ] + +Fig. 1 represents a machine, called the Manipulator, which transmits +motion through suitable attachments, which are adjustable by means of +the ratchet _G_, so as to reach all parts of the body. It is equally +available for applying motion to the head, feet, or any intermediate +part of the body. + + _B, B_ are rubbing attachments, with two opposing elastic, adherent +surfaces, between which an arm or a leg may be included. These have +alternate reciprocating action from the rock-shaft _H_, and are made to +approach each other, and press the included part at the will of the +patient. This is sometimes called the double-rubber, and is made +detachable if desired. + +_A_ is the lever, by which the two parts of the double-rubber are made +to compress the arm or leg. + +[Illustration: Fig. 2. +Manipulator Extended.] + +[Illustration: Fig. 3. +Manipulator Folded.] + +_D_ is a single attachment for rubbing. It may be connected at either +side of the machine, so as to present the rubbing surface in four +different directions, as may be most convenient. It will act +perpendicularly, horizontally, or diagonally, and from below or from +above the part receiving the action, according to requirements. The +shank of the rubber may have any special form to suit special cases. + +_C_ is the _foot holder._ It communicates to the leg the semi-rotary or +oscillating motion of the rock-shaft. It may be attached to either end +of the rock-shaft. + +_E_ is the _hand holder,_ which, grasped by the hand, communicates +motion to the arm, shoulder, and chest; or the hand may be inserted +passively, when the effect of motion is more confined to the hand and +fore-arm. + +In the position shown in Fig. 2, by means of the single rubber +attachment, the manipulator acts upon the upper portion of the trunk, +neck, head, and arms; by means of the hand-holder, upon the arms; by +means of the double-rubber, upon the arms, shoulders, and scalp. + +[Illustration: Fig. 4. +Rubbing the Arms.] + +When the acting part or head is lowered to its extreme limit, the +machine occupies the least space. In this position, by means of the +foot-holder it communicates oscillation to the legs; by means of the +single-rubber, it acts upon the feet, ankles, and lower leg; by means of +the double-rubber, it acts upon the legs, including the feet, the +patient either sitting or lying. + +In all of these applications of motion, energy travels from inanimate to +animate matter; non-vital contributes to vital energy: and the various +processes through which vital power is developed are promoted and +carried forward in a degree till the point which constitutes health is +attained. + +[Illustration: Fig. 5. +Rubbing the Legs.] + +The name, _Manipulator_, is very naturally applied to the instrument, +the action of which resembles so much that of the living operator. It +is, however, impossible for the unaided hand to impart the degree of +rapidity necessary to secure the effects easily attained by this +machine; and, practically, restoration is often secured in cases in +which it is quite unattainable by any other remedial agent. + +[Illustration: Fig. 6. +Rubbing the Chest and Abdomen.] + +Motion, transmitted by the manipulator, exerts a curative effect in +_all_ chronic affections, and is not limited, as is sometimes supposed, +to paralytic affections and deformities. In these latter affections it +is a great assistance in effecting a cure; while, in chronic affections, +whatever the local symptoms, it supplies the additional energy which is +indispensable for recovery in all diseases of long standing. + +[Illustration: Fig. 7. +Rubbing the Back.] + +_Mode of Operation_.--Fig. 4 represents the manipulator in operation. +The machine is propelled by steam power at the Invalids' Hotel and +Surgical Institute, but may be worked by hand, as here represented. One +arm is inserted between the double-rubbing pads, which are raised to +about the height of the shoulders, the patient being seated at the side +of the machine; the other hand is placed on the lever, and as much +pressure is applied as is perfectly agreeable, care being taken to +diminish the pressure at any part which is unusually sensitive. All +portions of the arm from the shoulder down are successively included in +the rubbers, while a suitable degree of reciprocating or rubbing action +is obtained by giving motion to the wheel. + +To apply the same operation to the other arm, the patient may either +turn in his seat or change his position to the opposite side of the +machine. + +If any portion of the extremity is affected with inflammation or +swelling, it is necessary to apply the action described to the whole of +the unaffected portion first; after this the affected part may be +beneficially operated on, provided that the sensations are strictly +heeded, and that it is so managed that only a comfortable feeling is +produced. + +[Illustration: Fig. 8. +Oscillating the Arms and Chest.] + +In Fig. 5, the patient is so seated beside the machine that he can +insert one thigh between the pads of the rubber, and also control the +lever with the hand. It is sometimes more convenient to suspend a +movable weight from the lever. While the machine is running, he can +withdraw the leg gradually, as each portion receives its proper amount +of action, till the whole, including the foot, becomes glowing with the +effect. The boot or shoe affords no impediment to the effect, and should +remain on. + +[Illustration: Fig. 9. +Oscillating the Legs.] + +Sometimes, especially in the beginning, or when the feet are habitually +cold, it is better to apply the action only from the knees down. + +The rubbing-pad (d) may be attached to either side of the machine, +according to convenience or effect sought. The action derived from the +right end of the rock-shaft is much less severe than that from the left, +on account of the shape of the rubber appendage, and at the beginning +should be used in preference. In Fig. 6, the patient sits on an ordinary +stool, or, if feeble, in a chair, and presents any portion of the chest +or abdomen to the action of the rubber. The instrument is raised or +lowered to suit convenience, while the patient gently presses portions +of the trunk successively upon the rubbing-pad. The degree of the effect +is thus always under the absolute control of the one receiving the +action. This operation, like the preceding, produces great heat, reddens +the skin, relieves pain, and greatly stimulates the functions, not only +of the skin, but of the organs contained in the cavities of the chest +and the abdomen. + +[Illustration: Fig. 10. +Vibrator operated by Manipulator.] + +The same operation may be applied also to the legs while the patient is +standing. + +In Fig. 7, the back is presented to the action of the rubbing-pad. The +action will, if desired, be made to reach from the neck to the hips, and +even to the thighs. All sensitive portions of the back should at first +be omitted, in order that they may be benefited by the +counter-irritation or drawing away of the blood. This is easily produced +by those familiar with the use of the machine. The rubbing of the back +should be deferred till the close of each application, in order that the +spinal centers may be relieved of hyperaemia, or excess of blood. + +The machine, as represented by Fig. 8, is brought to the desired +elevation, about as high as the shoulders, and the hand-holder is +attached. One arm is extended horizontally, and the hand grasps the +hand-holder, while rapid motion is given by turning the wheel. An +alternate twisting motion is communicated to the arm, which causes +corresponding pressure and relaxation of all the soft tissues of the +limb, combined with slight rubbing or attrition. The action is increased +by contracting the muscles, and also by grasping at greater distance +from the center. Both hands may grasp at the same time, or the two sides +may receive the motion in turn. The effect is similar to that of the +rubbing before described, but it is less limited; by grasping firmly, it +may extend to the whole chest. + +[Illustration: Fig. 11. +Vibrating Kneader.] + +The foot-holder is attached, as shown in Fig. 9, and brought by the +means before described to a position to receive one foot at a +comfortable elevation, the leg being extended, while the patient is +seated in an ordinary chair in an easy position. The action is precisely +like that above described as applied to the arm, and extends to the +thigh and pelvis. If the knee is slightly flexed, the action is almost +entirely confined to the lower leg. Each leg may be operated on in turn. + +_Mode of Applying Mechanical Movements to Very Feeble +Invalids_.--Experience demonstrates that no degree of feebleness +excludes the beneficial use of these operations. Invalids too weak to +stand, or able to help themselves in the least degree are often treated +with perfect success. A judicious use of the Manipulator _always_ +increases nutrition and strength without any fatigue or exhaustion, +however feeble the patient may be. It is only necessary to provide for +these cases additional conveniences, so that the applications can be +made in the recumbent position, and also that proper intervals of rest +be allowed between successive operations. For this purpose couches are +provided, each containing a certain portion of the Manipulator. These +are operated by means of a short connecting-rod, joining the rock-shafts +of the two pieces of mechanism, as shown in Fig. 10. The Vibrator has +two small discs, or heads acting through an opening in the couch on +which the invalid rests. These impinge with a rapid, direct stroke upon +the portion of the body exposed to the action. The top of the couch is +adjustable, and is quickly placed at the elevation which secures the +proper force of the instrument, as shown in Fig 11. By simply turning +and moving the body, the patient brings any part in contact with the +vibrating discs. The cut represents the Vibrator, in which the force +impinges at right angles with the surface of the body, sending waves of +motion through its substance. + +[Illustration: Fig. 12. +Apparatus for the Rubbing in a Recumbent Position.] + +The rubbing which is shown in Figs. 4 and 5 may be applied to all parts +of the body in a recumbent position. A couch is required of similar +construction to the vibrating couch, but with a rubbing-pad instead of +vibrating heads acting through the opening and operated by appropriate +connections, as shown in Fig. 12. The top is adjustable, and the degree +of effect desired is capable of easy regulation. The patient turns +different portions of the body to the action of the rubber as required. + +KNEADING. Kneading is a process applied chiefly to the abdomen. The +purpose of this operation is to increase nutrition, the muscular power +and action of the abdominal walls, and the function of the organs which +they contain. Three modes of applying this operation by the mechanical +apparatus are in use, effected by the Direct, the Rotary, and the +Revolving Kneader. + +[Illustration: Fig. 13. +Apparatus for Rotary Kneading.] + +THE DIRECT KNEADER. This resembles in form and action the vibrating +instrument shown in Fig. 11. The impinging heads, however, are made +broader, the motion greater in extent, and the rate of motion less than +one-tenth of that employed for the purpose of vibrating. This slowness +of motion seems to increase the action of the muscles. + +THE ROTARY KNEADER. The action of the kneading heads in this form of +apparatus, as shown in Fig. 13, is _inward_ and _upward_ alternately, +and it is eminently well calculated to stimulate the action of the +abdominal organs. + +THE REVOLVING KNEADER. In the form of kneading apparatus, shown in Fig. +14, two thick rollers, which move freely on axes at the extremities of +arms, projecting on either side of a shaft turned by a crank or belt, +are made to act alternately upon each side of the abdomen. + +In the methods of kneading above described, the degree of force acting +on the body is governed by an arrangement for elevating or depressing +the upholstered top of the couch upon which the patient rests, and +through which the action is transmitted to the body. + +If this form of apparatus is driven at a rate ten times more rapidly +than is desired for kneading, the effect is vibratory, and it is, in +fact, used for that purpose. + +[Illustration: Fig. 14. +Apparatus for Kneading with Rollers.] + + +THE CURE OF SWELLINGS AND TUMORS. + + +The application of motion through the Manipulator promotes absorption, +and thus all kinds of _swellings_ and non-malignant _tumors_ are made to +diminish under its use. In these cases the vessels of the affected part +are distended with stagnant blood, and a portion of the fluid passes +through their walls, distending the surrounding tissues, which become +more or less hardened. By the transmission of active motion to the +affected parts, the contents of the vessels are urged forward; the +outside fluids are thus permitted to return to the general circulation +and become subject to the energetic vital action of the general system, +local deficiencies of oxidation being increased to the normal degree, +causing destruction of morbid matter and giving place for new and +wholesome nutritive materials for vital use. In short, normal functional +activity is established, both locally and generally. Scrofulous, +dropsical, rheumatic, and other local accumulations disappear, and even +tumors are dispersed, by the use of the Manipulator, in cases in which +the knife would otherwise be required. + + +COUNTER-IRRITATION AND REVULSION. + + +Artificial means have always been employed to produce an energetic flow +of blood in different parts of the body, thereby relieving morbid +distention of the vessels, and consequent irritation and pain in +neighboring parts. Cupping, hot applications, mustard, capsicum, +blisters, and other irritants, are resorted to, but their effects, while +generally very good in acute cases, are too transient to be of material +aid in chronic affections. By the use of the Manipulator, we can produce +the most thorough revulsive effects, operating upon large surfaces, and +causing large masses of muscle to receive an increased amount of blood, +thus drawing it away from parts oppressed by too great a supply, +constituting engorgement. No injury is done to the parts acted upon; on +the contrary, they are strengthened by the application, which can be +repeated as often as necessary till relief is permanent. Thus, the head, +heart, digestive organs, liver, chest, or whatever part is oppressed by +excess of blood, may be speedily and permanently relieved. By means of +this ability to relieve any part of the system from engorgement, and +consequent inflammation and its results, are we enabled to permanently +cure a large variety of chronic inflammatory, ulcerative, and nervous +affections. + +Local inflammations by this method of treatment may be speedily cured. + + +CURE OF NEURALGIA. + + +By the transmission of motion through the Manipulator and other +ingeniously devised apparatus and machinery, we increase the functional +power and activity of the muscles, and thereby diminish morbid +sensibility of the nerves, which is present in neuralgia. Prolonged and +excessive nervous action is attended with too great a rush of blood to +the nerve-centers, which can only be relieved by increasing the flow in +the muscles. Congestion, or hyperaemia, in the spinal cord or brain, or +both, is a condition ever present in neuralgia. The application of +motion through the manipulator causes the blood to flow to the muscles, +thus relieving nervous congestion and consequent neuralgia. + + +CURE OF PARALYSIS. + + +In no single disease has the transmission of motion through the +Manipulator proved more thoroughly efficacious than in _paralysis_. The +most prominent requirements in these cases seem to be the following: + +Excess of blood in the brain and spinal cord needs to be removed and +diverted to parts in which it will be useful instead of obstructive. + +The contractile power of the capillaries should be improved. + +The quality of nutritive fluids should be improved by the promotion of +oxidation through increased circulation. + +These and many more wants of disordered nerves, are readily supplied by +transmitted motion. + +The Manipulator combines, in a single ingenious mechanical contrivance, +the several movements best adapted for the promotion of healthy +functional activity. + + +CURE OF DEFORMITIES. + + +"Deformities arising from _paralysis and contractions of muscles and +tendons_, producing stiffened joints and distorted limbs, are of common +occurrence. A rational explanation of the wonderful curative results +which follow the employment of transmitted motion in these cases may not +be without interest to the reader. The muscles are composed of _bundles_ +of little fibers which glide upon one another in every movement. Another +set of fibers called _connective tissue_, holds the fibers together in +bundles or separate muscles, and interlaces and crosses them in every +direction. Now, if these fibers remain long in a fixed position, or are +involved in inflammation, there is danger of adhesions forming between +them, producing permanent immobility; gliding movements are interfered +with, and the muscle ceases to perform its function. Inflammation gives +rise to effusion, or the formation of a kind of cement which binds +together the muscular fibers and prevents motion. + +Rubbing, kneading, and actively manipulating the affected parts with +that intensity of administration secured by the manipulator, rends +asunder and breaks up these minute adhesions, re-establishing gliding +motions, causes absorption of effused materials, and restores the +affected part to a normal condition. + +[Illustration: Fig. 15. +Muscular fibre highly +magnified.] + +The deformed limb is straightened by the filling out of the +muscle-cells, and increasing the length and also the nutrition of the +affected muscles. No pulling or _forced extension_ is required. +Deformity ceases when the conditions upon which it depends are removed +by rational appliances, which are always agreeable. No brace, splints, +or other confining appliances are necessary, except in rare cases in +which the bones are very badly distorted. + +In withered and deformed limbs, resulting from infantile paralysis, the +manipulator furnishes the most agreeable, direct, and certain remedy. It +restores nutrition, sensation, and power, and dispenses almost wholly +with mechanical supports. Club-feet, wry neck, spinal curvature, +hip-joint disease, white swellings, and stiffened joints, are all +readily amendable to the curative effects of motion administered by the +manipulator and other machinery. + +Contracted and shortened muscles are gradually lengthened by vigorous, +long-continued, and frequently repeated rubbing with the manipulator +across their longitudinal fibers; bound-down and confined tendons are +liberated and normal movements established. + + +DISEASES OF WOMEN. + + +Uterine and ovarian congestion, chronic inflammation, discharges, morbid +enlargement, prolapsus, anteversion and retroversion, anteflexion and +retroflexion, and other derangements of the womb and its appendages, are +radically cured by the vibratory, rubbing, kneading, and other +movements, administered through the manipulator and other mechanical +appliances employed at the Invalids' Hotel and Surgical Institute. + +To those who are tired of taking medicine, this mode of treatment +commends itself as being both agreeable and efficient. There is no case +too weak, nervous, or helpless for the use of this curative agent. It is +entirely devoid of objectionable features, being _always applied outside +the clothing_. + +CAUSE OF FEMALE WEAKNESS. The true relations of cause and effect are +very liable to be misunderstood, when considering the various diseases +incident to the organs contained in the female pelvis. Treatment +intended to be remedial is therefore very often misdirected and fails to +afford relief, positive injury frequently resulting instead. When the +nature of these diseases is properly understood, their cure can be +effected with comparative ease. + +These diseases are always attended with weakness, which is often very +great, of the muscles that hold the diseased organs in position. The +muscles forming the walls of the abdomen, and the diaphragm, or midriff, +all of which are concerned in the act of respiration, become feeble and +only partially perform their functions. In health, they act constantly, +even during sleep, producing a rhythmical movement, which is +communicated to the contents of the abdominal and pelvic cavities. This +motion promotes a healthy circulation in the parts. In almost all +affections of the pelvic organs, this normal condition is greatly +diminished. + +Diminution of the motions of respiration is attended with an increase of +the amount of the blood in the pelvic organs, constituting an +engorgement of the parts, called congestion, or inflammation. This gives +rise to enlargement of the womb, ulcerations, tumors, and a multitude of +kindred secondary effects, usually considered as the primary disease and +treated as such. The contents of the cavity of the trunk, weighing +several pounds, are allowed to gravitate down and rest upon the contents +of the pelvis, forcing the congested uterus and ovaries down out of +their natural positions, and often bending or tipping the womb in +various directions. A long list of symptoms follows as the natural +consequence of these abnormal conditions. + +RATIONAL TREATMENT. Ovarian congestion and inflammation, inflammation of +the uterus, ulceration of this organ, deranged menstruation, leucorrhea +with the attendant pain, nervousness, and other derangements depending +upon loss of supporting power in the abdominal muscles, all result from +loss of the _natural_ motions of respiration, and consequent deranged +circulation. These several conditions can be cured by removing their +cause. When the power of the parts involved in the weakness is restored, +all these morbid conditions disappear. Judicious cultivation of power in +the weakened supports is attended with certain curative results. This is +best accomplished by mechanical motion, by which the normal circulation +is restored, inflammations and congestions are subdued, displacements +corrected, ulcers healed, and functional activity is re-established. + + +RECAPITULATION. + + +Motion properly transmitted to the human system by mechanical apparatus +is transformed into other forms of force identical with vital energy, by +which the ordinary processes of the system are greatly promoted. + +It increases animal heat and nervous and muscular power to the normal +standard. + +It removes engorgement or local impediments to the circulation. + +The electrical induction produced renders it a most efficacious remedy +for paralysis of all kinds. + +It removes interstitial fluids and causes rapid absorption and +disappearance of solid and fluid accumulations. + +It is a powerful alterative, or blood-purifier, increasing oxidation and +stimulating excretion. + +It diminishes chronic nervous irritability and promotes sleep. + +Deformities are easily cured without the cutting of tendons, or use of +mechanical supports. + +It hardens the flesh by increasing muscular development and improves +digestion and nutrition. + + * * * * * + + + + +WORLD'S DISPENSARY MEDICAL ASSOCIATION + +INCORPORATED UNDER STATUTE ENACTED BY THE LEGISLATURE OF NEW YORK. + + +[Illustration] + +Dr. R.V. PIERCE, having acquired a world-wide reputation in the treatment +of Chronic Diseases, resulting in a professional business far exceeding +his individual ability to conduct, some years ago induced several +medical gentlemen of high professional standing to associate themselves +with him, as the Faculty of the World's Dispensary and Surgical +Institute, the Consulting Department of which has since been merged into +the Invalids' Hotel. The organization is duly incorporated under a +statute enacted by the Legislature of the State of New York, and under +the name and style of the "WORLD'S DISPENSARY MEDICAL ASSOCIATION," of +which Dr. PIERCE is President, and in the affairs of which he will, as +heretofore, take an active and constant part. + + * * * * * + +EUROPEAN BRANCH, NO. 3 NEW OXFORD STREET, LONDON, ENG. + + * * * * * + +IMPORTANT ANNOUNCEMENT. + +Dr. R.V.PIERCE, having in the Fall of 1880 resigned his seat in +Congress, has since been able to devote his whole time and attention to +the interests of the Association, and those consulting our Medical and +Surgical Faculty have the full benefits of his council and professional +services. That he should prefer to give up a high and honorable position +in the councils of the nation, to serve the sick, is conclusive evidence +of his devotion to their interests and of love for his profession. + + * * * * * + +[Illustration: +Invalids' Hotel and Surgical Institute, 663 Main Street, Buffalo, N.Y.] + + + +INVALIDS' HOTEL + +A MODEL SANITARIUM AND SURGICAL INSTITUTE. + +NOT A HOSPITAL, BUT A PLEASANT REMEDIAL HOME, + +ORGANIZED WITH + +A FULL STAFF OF EIGHTEEN PHYSICIANS AND SURGEONS + +AND EXCLUSIVELY DEVOTED TO THE + +TREATMENT OF ALL CHRONIC DISEASES. + + +This imposing Establishment was designed and erected to accommodate the +large number of invalids who visit Buffalo from every State and +Territory, as well as from many foreign lands, that they may avail +themselves of the professional services of the Staff of Skilled +Specialists in Medicine and Surgery that compose the Faculty of this +widely-celebrated institution. + + +DESTROYED BY FIRE. + + +On the sixteenth of February 1881, the original Invalids' Hotel was +totally destroyed by fire. Although occupied at the time by a large +number of invalids, yet, through the extraordinary exertions of the +Faculty and employees, all were safely removed from the building without +injury to any one. The Board of Trustees took prompt steps to rebuild, +for the accommodation of the many sufferers who apply, to avail +themselves of the skill, facilities and advantages of treatment which +such a perfectly equipped establishment affords. Profiting by the +experience afforded by several years' occupancy of the original +Invalids' Hotel building, which at the date of its erection was the +largest and most complete establishment of its kind in the world, we +believe we have, in the building of the elegant structure illustrated +herein, made great improvements over the original Invalids' Hotel, for +the accommodation of our patients. Although our new building has only +been occupied about two years, yet almost immediately our business +required the erection of a very large addition thereto, to accommodate +our growing practice. This large _Annex_, which is about the size of the +original building, has ever since been kept well filled with patients, +hailing from every State and Territory of the United States, Canada and +occasionally from a foreign country, + +THE INVALIDS' HOTEL AND SURGICAL INSTITUTE IS PLEASANTLY SITUATED AT NO. +663 MAIN STREET, + +in the city of Buffalo, just above and outside the business and bustle +of this Queen City of the Lakes. It is easily reached from the railroad +depots by the Exchange and Main Street car lines (see map on last page +of this book). It is a substantially built brick building, trimmed with +sandstone, well lighted and provided with a patent hydraulic elevator, +so that its upper stories are quite as desirable as any, being more +quiet than those lower down. It is well provided with fire escapes, and, +in fact, nothing has been neglected that can add to the comfort and +home-like make-up of this popular national resort for the invalid and +afflicted. Great pains and expense have been assumed in providing +perfect ventilation for every room and part of the building. + +[Illustration: Grand Entrance.] + +[Illustration: Ante-room.--Invalids' Hotel and Surgical Institute.] + +The surroundings of the Hotel are very pleasant, it being located in the +finest built part of the city, among the most elegant residences. + + +STAFF OF PHYSICIANS AND SURGEONS. + + +Only men who are, by thorough education and experience, especially +fitted to fill their respective positions, have been chosen to serve as +physicians and surgeons in this institution. After having spent a very +large sum of money in erecting and furnishing this national resort for +invalids with every requirement and facility for the successful +treatment of all classes of chronic diseases, it is the determination of +the Board of Directors that the Faculty of Physicians and Surgeons shall +be superior in culture, experience and skill. + +We have not the space to speak, individually, of the eighteen +professional gentlemen composing the Faculty, but will say that among +them are those whose long connection with the World's Dispensary and +Surgical Institute has given them great experience and rendered them +_experts_ in their specialties. Several of them had previously +distinguished themselves in both private and hospital practice, had held +important chairs as lecturers and teachers in Medical Colleges, and had +filled responsible positions in military and civil hospitals; also in +some of the most noted Asylums, Dispensaries, and Sanitary Institutions +in the land. + +With such a staff of Physicians and Surgeons, efficient and trained +nurses, and with all the most approved sanitary, medical and surgical +appliances which study, experience, invention and the most liberal +expenditure of money, can produce and bring together in one institution, +the Invalids' Hotel and Surgical Institute affords the afflicted unusual +opportunities for relief. + + +THE GRAND ENTRANCE. + + +The entrance to the Invalids' Hotel and Surgical Institute is covered by +a lofty porch of beautiful design, the roof of which is supported upon +heavy iron columns. Above the massive double doors, through which the +visitor enters, are large, heavy panels of beautifully wrought stained +glass, on which the words "Invalids' Hotel and Surgical Institute" stand +out conspicuously. + +[Illustration: +Gentlemen's Reception-room, +Invalids' Hotel and Surgical Institute.] + + +FIRST FLOOR. + + +The first floor of the building is reached through a beautifully +finished vestibule, by a short flight of broad, easy stairs, and once +inside the visitor is struck by the beauty of design as well as by the +home-like appearance of the surroundings. The wood-work is mainly of +hard woods, oak and cherry predominating. In a large part of the house +the floors are of oak, with a cherry border, neatly finished in oil and +shellac, and covered with rich rugs and elegant carpets of the very best +quality. + +[Illustration: Ladies' Parlor.--Invalids' Hotel and Surgical Institute.] + +On the first floor is the gentlemen's reception-room, which is thronged +with patients from early in the morning until late in the afternoon. It +is entirely distinct from the large reception-room and parlors for lady +patients, and the utmost privacy is secured throughout the whole +arrangement of the Institution. On this floor are the suites of offices, +parlors, and private consultation-rooms, some fifteen in all; also a +well furnished reading-room and circulating library, for the use of the +inmates of the Institution. On all sides are beautifully frescoed walls +adorned with numerous choice engravings and other pictures. All the +rooms throughout the house are furnished in the best of style, and in a +manner to afford the utmost comfort and cheerfulness of surroundings for +the sick and afflicted who seek this remedial resort. The Turkish and +other baths are elegantly fitted up on the first floor, opposite the +reading-room. + + +THE UPPER FLOORS. + + +Above the first, or main floor, the building is divided into separate +rooms and suites of rooms for the accommodation of patients. All are +well lighted, have high ceilings, and are cheerful and well ventilated +apartments. On the second floor is the large medical library and medical +council-room, for the exclusive use of the Faculty, also the +museum-room, which contains a large and valuable collection of +anatomical and morbid specimens, many of them being obtained from cases +treated in this Institution. On this floor are also suites of rooms, +occupied by the Bureau of Medical Correspondence, wherein from ten to +twelve physicians, each supplied with the improved graphophone, are +constantly employed in attending to the vast correspondence received +from invalids residing in all parts of the United States and Canada. +Every important case receives the careful consideration of a council +composed of from three to five of these expert specialists, before being +finally passed upon and prescribed for. + +[Illustration: Library and Reading-room--Invalids' +Hotel and Surgical Institute.] + + +ON THE THIRD FLOOR + + +are the large treatment-rooms, supplied with all the apparatus and +appliances for the successful management of every chronic malady +incident to humanity. Electrical apparatus of the latest and most +approved kinds, some of it driven and operated by steam-power, dry +cupping and equalizing-treatment apparatus, "vitalization" apparatus, +numerous and most ingenious rubbing and manipulating apparatus and +machinery, driven by steam-power, are among the almost innumerable +curative agencies that are here brought into use as aids in the cure of +human ailments. Our + +ELECTRICAL OUTFIT + +[Illustration: President Pierce's Business Office--Invalids' Hotel and +Surgical Institute.] + +is the finest to be found in any sanitarium in the United States and, we +believe, in the world. There are two forty-cell galvanic batteries with +switch boards for controlling the voltage, or force, from the whole +power to one-fortieth of this amount, at the will of the physician. +Safe-guards in the shape of milli-ampere meters continually indicate to +the operator the force of the current. There is a dynamo for charging +the storage batteries, which may be used in a patient's room when this +method is found more convenient or more comfortable for the invalid. +There are two static or Franklin machines. These are used when the +milder current is desired, and for spraying, sparking, etc. One of the +instruments is of high voltage and furnishes us with the X rays for +examining the interior parts of the body. The largest treatment room +also contains a powerful ozone generator, operated by a dynamo. This +supplies the room with allotropic oxygen and is invaluable in treating +diseases of the lungs and air passages. This supplies the patient with +vitalized air, equal to the most salubrious atmosphere in any part of +the globe. + +Beyond this and separated by a court, across which is an iron bridge, +are the large dispensing-rooms, stocked with drugs and medical compounds +of almost endless variety, and representing every branch of the _materia +medica_. Here all medicines prescribed are most carefully and specially +prepared for each individual case. Those to be sent away by mail or +express, to patients being treated at a distance, are placed in trays, +with full directions for use, and sent to another large room, where they +are carefully packed, and shipped thence to their destination. + + +FOURTH FLOOR. + + +On the fourth floor are located the surgical operating-rooms and +surgical ward. There are also a large number of nice, large, well +furnished separate rooms on this floor, used principally for the +accommodation of surgical cases. Strong, broad, iron staircases connect +all the upper floors with the ground, so that in case of fire, patients +need have no fear of being unable to get out safely. In fact, the +building has been constructed so as to render the rapid spread of fire +through it impossible, all the floors being laid on cement. + + +A STEAM PASSENGER ELEVATOR + + +is provided, so that the upper floors are quite as desirable as those +lower down. The dining-rooms for gentlemen, as well as those for +ladies, are located in the basement, which is reached either by +stairways or by the elevator. The kitchen, store-rooms, chill-rooms, +pantries, and all culinary arrangements are also in the basement. + + +FIRE-PROOF VAULTS. + + +Six large fire-proof vaults are provided in this building in which to +preserve, secure from observation, as well as from fire, all records of +cases examined and treated by the Faculty. + +Throughout all this vast building the visitor is struck with the +wonderful order and system with which every detail is carried out. + + +THE BATH DEPARTMENT. + + +[Illustration: A glimpse at the Turkish Bath Department.] + +The Invalids' Hotel and Surgical Institute, as hereinbefore indicated, +is provided with Turkish, and other approved baths, with a +treatment-room, fitted up with vacuum and movement-treatment apparatus +of the most modern and approved style. These and much more ingeniously +devised apparatus and appliances are brought into use in a great variety +of chronic affections with marvelously successful results. A perfect +system of physical training, especially adapted to the wants of the +invalid and weak, and most skillfully conducted and applied, is not the +least important among the many advantages that the chronic sufferers +here find. + + +THE SURGICAL DEPARTMENT. + + +In the Surgical Department, every instrument and appliance approved by +the modern operator is provided, and many and ingenious are the +instruments and devices that the Faculty of this institution have +invented and perfected to meet the wants of their numerous cases. + + +OUR REMEDIES. + + +In the prescribing of remedies for disease, the Staff resort to the +whole broad field of _materia medica_, allowing themselves to be +hampered by no school, _ism_,_pathy_, or sect. The medicines employed are +all prepared by skilled chemists and pharmacists, and the greatest care +is exercised to have them manufactured from the freshest and purest +ingredients. Our Faculty probably employ a greater number and variety of +extracts from native roots, barks and herbs in their practice than are +used in any other invalids' resort in the land. All of the vegetable +extracts employed in our practice are prepared in our own Laboratory. + + +REGULATION OF DIET. + + +The table is supplied with an abundance of wholesome and nutritious +food, especially adapted and prepared to suit the invalid, it being +varied to suit each particular case. The Faculty recognize the +importance of proper food as one of the greatest factors in the +treatment of chronic diseases. While properly regulating and restricting +the food of the invalid when necessary, they also recognize the fact +that many are benefited by a liberal diet of the most substantial food, +as steaks, eggs, oysters, milk, and other very nutritious articles of +diet, which are always provided in abundance for those for whom they are +suited. + +[Illustration: View of Lake and Boat-house.--Buffalo Park.] + +From previous experience somewhere, some people get the impression that +they are to be half starved at such an institution as this. If this is +the case anywhere it is not so here, as any one who has ever resided at +our sanitarium will attest. + + +TRAINED ATTENDANTS. + + +A sufficient number of trained and experienced nurses are employed, that +those requiring attendance may have the very best of care. + + +GOOD ORDER. + + +The institution is conducted in an orderly manner, that the utmost quiet +may be secured. The Faculty insist, upon the part of the invalid, while +under treatment, on the observance of habits of regularity in eating, +sleeping, bathing and exercise. Only by such observance of hygienic laws +can they succeed in their course of remedial training, and make the +treatment curative. + + +AMUSEMENTS. + + +While insisting upon strict observance of rules established for the good +of the patient, they do not make their requirements so rigid as to +interfere with the comfort and enjoyment of their patients, but, on the +contrary, endeavor, in every manner possible, to provide innocent and +entertaining amusements for all, recognizing the great importance of +pleasant occupation of the mind, as an essential part of the treatment. +Hence the introduction of music, amusing games, light reading, and +kindred agencies for pleasant entertainment, is not neglected. + + +UNPARALLELED SUCCESS. + + +[Illustration: One of the Private Consultation-rooms, Ladies' +Department.] + +The founder of this institution commenced, many years ago, with little +capital, to build up a business in the treatment of chronic diseases and +devoted himself diligently to that end. His reputation for skill in his +chosen field of practice gradually extended until, to-day, his fame and +that of the World's Dispensary and Invalids' Hotel and Surgical +Institute, are simply world-wide. As the business increased those +eminent for skill have been induced to join the Faculty, until eighteen +professional gentlemen, each devoting his attention to a special branch +of practice, constitute the Medical and Surgical Staff. + +[Illustration: Soldiers' Monument.--Lafayette Park, Buffalo.] + +One reason why we excel in the treatment of _chronic diseases_ is the +fact that we are supplied with all the modern improvements in the way of +instruments, appliances and remedial agents used in the healing art, the +expense of which deters the local physician in general practice from +procuring, for the treatment of the limited number of cases that come +within the circuit of his practice. The treatment of such cases requires +special attention and special study to be successful. + + +A COMMON SENSE VIEW. + + +It is a well-known fact, that appeals to the judgment of every thinking +person, that a physician who devotes his whole time to the study and +investigation of a certain class of diseases, must become better +qualified to treat them than he who attempts to treat every ill to which +flesh is heir, without giving special attention to any particular class +of diseases. Men, in all ages of the world, who have _made their marks_, +or who have become famous, have devoted their lives to some special +branch of science, art or literature. + + +LIBERALITY. + + +We wage no war against any physician, no matter what school of medicine +he may represent; but, on the other hand, we invite the co-operation of +all regular physicians. We are always ready and willing to impart to +them any information or render any assistance that will be of mutual +benefit to them and their patients. + + +OUR PHYSICIANS AND SURGEONS + + +do not travel to solicit practice, having all the business that they can +attend to at our institution, nor do we employ any agents to travel and +peddle or otherwise sell our medicines. If any one engaged in such +business, represents himself as in any way connected with our +institutions, he is a swindler and should be apprehended and prosecuted +as such. And any one who will give us such information as will lead to +the arrest and conviction of any person so misrepresenting will be +liberally rewarded. + +[Illustration: Undergoing Examination of the Lungs +at the Invalids' Hotel and Surgical Institute.] + +While not permitting any member of our professional staff to travel and +solicit practice, yet we are always willing to accommodate and send a +specialist to visit important or critical cases in consultation, or +otherwise, or to perform important surgical operations as explained on +page 971 of this book. + +Let none deceive you by representing that they have heretofore been +connected with our institution and have thereby learned our original and +improved methods of treatment. We have a large and competent Staff of +Specialists and while we have sometimes found it necessary to make +changes, yet we always manage to retain the most expert and skillful, as +we cannot afford to part with the services of those who excel. + +[Illustration: Chemists' Department.--Invalids' Hotel and Surgical +Institute.] + +By adopting similar names to those which have long designated our +world-famed institutions, some have endeavored to deceive and mislead +invalids who were seeking relief. Others have named so-called "Electric" +Trusses, "Liver Pads," and other contrivances after our President, +thereby expecting to reap benefits from Dr. Pierce's well-known +professional standing. Neither the Doctor nor this Association have any +interest in any such articles. + +NO BRANCHES.--Remember we have no branches except the one at No. 3 New +Oxford Street, London, England. + +Those desiring to consult us by letter, should address all +communications plainly to + + <b>World's Dispensary Medical Association, + _No. 663 MAIN STREET,_ + BUFFALO, N.Y.</b> + + * * * * * + + + + +WORLD'S DISPENSARY. + + +The immense building erected and occupied by the World's Dispensary +Medical Association as a Laboratory, wherein are manufactured our Dr. +Pierce's Standard Family Medicines, as well as all the various +Tinctures, Fluid Extracts and other pharmaceutical preparations used by +the Staff of Physicians and Surgeons of the Invalids' Hotel and Surgical +Institute in their practice, is not inappropriately called the _World's +Dispensary_, for within its walls is prepared a series of remedies of +such exceeding merit that they have acquired world-wide fame, and are +sold in vast quantities in nearly every civilized country. + +[Illustration: World's Dispensary.--New Laboratory Building.] + +The structure, located at 660 to 670 Washington Street, immediately in +the rear of the Invalids' Hotel and Surgical Institute, is of brick, +with sandstone trimmings, six stories high, and 100 feet square. Its +most striking architectural features exteriorly are massiveness, +combined with grace and beauty of outline, and great strength. + + +THE BASEMENT. + + +The basement or first story opens on a level with the Washington Street +sidewalk, and is occupied by a plant of two large boilers, which supply +the steam to run a huge American engine, of 100 horse-power, built by +the American Engine Co., Bound Brook, N.J. It drives all the machinery +of the establishment, including drug mills, pill machines, packing +machinery, a large number of printing presses, folding machines, +stitching, trimming, and many other machines, located on the different +floors, and used in the manufacture of medicines, books, pamphlets, +circulars, posters, and other printed matter. On this floor is located +steam bottle-washing machinery, and also the shipping department. Here +may be seen huge piles of medicine, boxed, marked, and ready for +shipment to all parts of the civilized world. A large steam freight +elevator leads from this to the floors above. + + +MACHINERY. + + +[Illustration: Postal, Advertising, Wrapping and Mailing Departments.] + +In addition to the power engine just mentioned is a 25 horse-power +upright engine for running the dynamo for electric lighting, with a +capacity of three hundred (300) lights. This engine and dynamo were also +manufactured for us by the American Engine Company of Bound Brook, N.J. +There is a small dynamo with a capacity of one hundred (100) lights used +during the day to light safes, vaults, dark closets and hallways. All +the offices and rooms of patients are supplied with electric light, as +well as illuminating gas. An automatic Worthington pump is also located +in the basement. This supplies the elevator and sprinkling system. The +sprinklers come into play only in case of fire, when they are +self-acting. This pump at its best is capable of forcing nearly two +hundred gallons of water a minute. There is no place in which pure water +is more desirable than in the manufacture of medicines. Our New York +filter could, if such a large quantity were ever required, furnish the +Dispensary with one hundred (100) barrels of pure water a day. Just +beyond the south wall and buried several feet under ground is a +boiler-shaped tank capable of storing ten thousand (10,000) gallons of +medicine. + + +MAIN FLOOR. + + +The main or second floor of the Dispensary is entered from Main Street, +through a hall leading from the Invalids' Hotel and Surgical Institute. +On this floor are located business offices, counting-room, the +advertising department and mailing rooms. Large, fire-proof vaults are +provided for the safe keeping of books, papers, and valuables, whilst +the counting-room and offices are elegantly finished in hard woods, and +present a beautiful and grand appearance. + + +THIRD FLOOR. + + +On this floor are the Association's extensive printing and binding +works. Fourteen large presses, driven by power, with numerous folding +machines, trimming, cutting, and stitching machinery, are constantly +running in this department. Here is printed and bound Dr. Pierce's +popular work of over a thousand pages, denominated "The People's Common +Sense Medical Adviser," over 1,200,000 copies of which have been sold. +Millions of pocket memorandum books, pamphlets, circulars and cards are +also issued from this department and scattered broadcast to every +quarter of the globe. + + +FOURTH FLOOR. + + +Large mills for crushing, grinding and pulverizing roots, barks, herbs, +and other drugs occupy a considerable part of this floor. Extensive +drying-rooms, in which articles to be ground in the drug mills are +properly dried, are also located upon this floor, as are also thousands +of reams of paper ready for printing the different books, pamphlets, +labels, etc. In large rooms set aside for that purpose, are stored vast +quantities of labels and wrappers, for use in putting up medicines. + + +FIFTH FLOOR. + + +On this floor is located ingeniously devised filling and bottling +machinery, also rooms for labeling, wrapping, and packing medicines; +others are occupied for the storage of crude drugs, glass, corks, and +supplies for use in the general business. + + +SIXTH FLOOR. + + +This entire floor is occupied with mixing, percolating, distilling, +filtering, and other processes employed in the manufacturing of +medicines. Every process is conducted under the watchful care of an +experienced chemist and pharmacist, and in the most perfect and orderly +manner; the apparatus employed being of the most approved character. +Here are manufactured all the various medicinal preparations and +compounds prescribed by the Faculty, in the treatment of special cases. + + +GENERAL CONSIDERATIONS. + + +[Illustration: Section of Chemical Laboratory.--World's Dispensary.] + +In all departments of this vast business establishment, the visitor is +struck with the perfect system which everywhere prevails, and the +wonderful accuracy with which every process and transaction is carried +on and consummated; hence the uniformity of purity and strength for +which the medicines here manufactured have so long been celebrated. To +this, also, is due much of the marvelous success attained in the +department established for the special treatment of chronic and +obstinate cases of disease. In this department the Faculty are not at +all limited or hampered in prescribing, and do not confine themselves in +the least to the proprietary or standard medicines manufactured for +general sale through druggists, but employ a series of curative agents +unsurpassed in variety and range of application. They aim to carefully +adapt their prescriptions to each individual case. + + * * * * * + + + + +THE + +INVALIDS' HOTEL AND SURGICAL INSTITUTE + +_SOME OF THE CAUSES THAT LED TO ITS ERECTION, AND THE ADVANTAGES WHICH +IT AFFORDS._ + + +[Illustration: One of the Private Consultation-rooms, Gentlemen's +Department.] + +The destinies of institutions, like those of men, are often determined +by pre-existing causes. The destinies of some men are like those of +way-side plants, springing up without other apparent cause than the +caprice of nature, developing without any apparent aim, yielding no +perfected fruit, and finally, dying, leaving scarcely a trace of their +existence. Thus it is with institutions which have their origin only in +man's caprice. To be enduring, they must be founded upon the needs and +necessities of humanity. Many of the great men of the world owe their +greatness more to surrounding circumstances than to the genius within +them. The highest genius can be dwarfed or deformed by the force of +adverse circumstances; hence the poetic truth of Gray in those exquisite +lines: + + "Some mute inglorious Milton here may lie, + Some Cromwell guiltless of his country's blood." + +Opportunity is the guiding star of genius. Without it, genius would +drift hither and thither upon the restless, ever-changing waves of +circumstance, never casting anchor in a secure haven. Upon opportunity, +too, depends the success of institutions. By opportunity we mean a real +and acknowledged public want. Whoever undertakes to supply this want +finds himself upon the crest-wave of prosperity. It was to supply such a +want that this institution was erected. + + +A REMEDIAL HOME. + + +Of the seventy millions of people living in the United States to-day, it +is estimated that nearly twelve millions are sufferers from chronic +disease. Think for a moment! Twelve millions of people slowly but surely +dying by the insidious and fatal development of chronic diseases! This +is an appalling fact. And yet this is the very class of diseases with +which the general practitioner is least familiar. + +As a general practitioner of the healing art, fresh from _curriculum_, +the founder of this institution early realized that the grand +unpardonable sin of the medical profession was the neglect to more +thoroughly study and investigate this class of diseases. + +The profession is diligently cauterizing and poulticing the sores which +now and then appear on the surface, but the internal chronic disease, of +which these are merely the external signs, is too often overlooked or +neglected. + +Some years ago we devised and put into practical operation a method of + + +TREATING PATIENTS AT THEIR HOMES, + + +without requiring them to undergo personal examinations. We reasoned +that the physician has abundant opportunity to accurately determine the +nature of most chronic diseases without ever seeing the patient. In +substantiating that proposition, we cited the perfect _accuracy_ with +which scientists are enabled to deduce the most minute particulars in +their several departments, which appears almost miraculous, if we view +the subject in the light of the early ages. Take, for example, the +electro-magnetic telegraph, the greatest invention of the age. Is it not +a marvelous degree of accuracy which enables an operator to _exactly_ +locate a fracture in a sub-marine cable nearly three thousand miles +long? Our venerable "clerk of the weather" has become so thoroughly +familiar with the most wayward elements of nature that he can accurately +predict their movements. He can sit in Washington and foretell what the +weather will be in Florida or New York, as well as if hundreds of miles +did not intervene between him and the places named. And so in all +departments of modern science, what is required is the knowledge of +certain _signs_. From these, scientists deduce accurate conclusions +regardless of distance. A few fossils sent to the expert geologist +enables him to accurately determine the rock-formation from which they +were taken. He can describe it to you as perfectly as if a cleft of it +were lying on his table. So also the chemist can determine the +constitution of the sun as accurately as if that luminary were not +ninety-five million miles from his laboratory. The sun sends certain +_signs_ over the "infinitude of space," which the chemist classifies by +passing them through the spectroscope. Only the presence of certain +substances could produce these solar signs. + +[Illustration: Medical Library and Council-room.--Invalids' Hotel and +Surgical Institute.] + +So, also, in medical science, + + +DISEASE HAS CERTAIN UNMISTAKABLE SIGNS, + + +or symptoms, and, by reason of this fact, we have been enabled to +originate and perfect a system of determining with the greatest accuracy +the nature of chronic diseases without seeing and personally examining +our patients. In recognizing diseases without a personal examination of +the patient, we claim to possess no miraculous powers. We obtain our +knowledge of the patient's disease by the practical application of +well-established principles of modern science to the practice of +medicine. And it is to the accuracy with which this system has endowed +us that we owe our almost world-wide reputation for the skillful +treatment of all lingering, or chronic, affections. This system of +practice, with the marvelous success which has been attained through it, +demonstrates the fact that diseases display certain phenomena, which, +being subjected to scientific analysis, furnish abundant and +unmistakable data to guide the judgment of the skillful practitioner +aright in determining the nature of diseased conditions. + +So successful has been this method of treating patients at a distance +that there is scarcely a city or a village in the United States that is +not represented by one or more cases upon the "Records of Practice" at +the Invalids' Hotel and Surgical Institute. In all chronic diseases that +are curable by medical treatment, it is only in very rare cases that we +cannot do as well for the patient while he or she remains at home, as if +here in person to be examined. But we annually treat hundreds of cases +requiring surgical operations and careful after-treatment, and in these +cases our Invalids' Hotel, or home, is indispensable. Here the patient +has the services not only of the most skillful surgeons, but also, what +is quite as necessary in the after treatment, of thoroughly trained and +skilled nurses. + +What should be the essential characteristics of an Invalids' Home? + + +CLIMATE. + + +Obviously, the most important of these characteristics is _climate_. +Climatology, from being a mere speculative theory, has arisen to the +deserved rank of a science. The influence of the climate of a country on +the national character has long been observed and acknowledged. The +languid but passionate temperaments of the South are like its volcanoes, +now quiet and silent, anon bursting forth with terrible activity, +flooding entire cities with molten fire; or, like its skies, now sunny, +cloudless, an hour hence convulsed with lightnings and deluging the +earth with passionate rain; or like its winds, to-day soft, balmy, with +healing on their wings, to-night the wind fiend, the destroying simoom, +rushing through the land, withering and scorching every flower and blade +of herbage on its way. On the other hand, the calm, phlegmatic +temperament of the North accords well with her silent mountains, her +serener skies, and her less vehement, but chilling winds. The South, +too, is the native home of the most violent acute diseases, such as +yellow fever and cholera. But, aside from this general climatic +influence, there is the yet more restricted one of locality. It has +often been observed that certain classes of diseases are most prevalent +in certain localities, the prevalence in every instance being due to +peculiarities of climate. + + +EXTREME HEALTHFULNESS OF BUFFALO. + + +In the published records of the examination for military service in the +army, during our late civil war, this fact was clearly and definitely +stated, and maps were prepared and presented showing the comparative +prevalence of certain diseases in the several States and districts +represented. The maps are prepared by a graduation of color, the lighter +shades indicating the localities where the special disease under +consideration is least prevalent; and it is a very significant and +important fact that in all chronic diseases not due to occupation or +accident, Buffalo and its immediate vicinity is marked by the lighter +shades. Thus, in epilepsy, paralysis, scrofula, rheumatism, and +consumption, our city is little more than tinted with the several colors +used to denote these diseases. + +[Illustration: A Patient's Room.--Invalids' Hotel +and Surgical Institute.] + +There is a popular, but unfounded, belief that Buffalo is a hot-bed for +pulmonary diseases. This idea could have originated only in an ignorant +disregard of facts; for medical statistics prove that in her freedom +from this class of diseases she is unrivaled by any city in America, not +excepting those on the seaboard. + + +EVIDENCE OF HEALTH STATISTICS. + + +Compare, if you please, the statistics of Buffalo with those of the +great Eastern cities in this respect. In Boston and New York the +death-rate from consumption shows a ratio of about 1 to 5 of the whole +number of deaths. In Baltimore and Philadelphia the ratio is 1 to 6, +while in Buffalo the death rate from consumption is only 1 to 10--very +remarkable difference in favor of our city. Only last summer a gentleman +residing in the eastern part of our State collected and compared the +health statistics for 1876 of all the prominent cities in the United +States. The result showed that + + +BUFFALO OUTRANKS ALL IN HEALTHFULNESS. + + +A great deal of precious breath has been expended in blustering about +"Buffalo zephyrs," as our delightful lake breezes are sometimes +ironically termed. It seems to be a popular belief among our sister +cities that old Boreas has chosen Buffalo for his headquarters. When we +hear a person dilating upon "Buffalo's terrific winds," we are reminded +of one of our lady acquaintances who recently returned from a European +tour. She was asked how she enjoyed her sea voyage, and she replied, +"Oh, it was delightful, really charming! There is something so grand +about the sea!" We were not a little surprised at this enthusiastic +outburst, as we had been told by a member of her party that the lady had +industriously vomited her way to Hamburg and back again. But the lady's +enthusiasm was easily explained. It is fashionable to characterize sea +voyages as delightful, charming, etc. Now, we suspect this popular +notion about our "trying winds" is traceable to the same source. It has +become customary to call Buffalo a "windy place," and so, when the +traveler feels a slight lake breeze, he imagines it to be a terrific +gale. Whatever may have originated this notion, certain it is that it is +utterly, undeniably false; and, in making this denial, we are not alone +dependent upon observation, but upon the + + +FACTS OF SCIENCE. + + +The issue of July 18, 1874, of the Buffalo _Commercial Advertiser_, +contained a series of tables, furnished by the Signal Service Bureau, +showing the velocity of the wind at eleven prominent cities for the year +1873. An examination of the table shows that the total velocity for the +year was the _lowest in Buffalo_ of any of the lake ports; while +Philadelphia and New York showed far higher aggregates of velocity than +our city. On this subject, in the issue of August 21st of the same year, +the editor pleasantly remarks: "Only the interior and southern seaboard +cities, and not many of them, show a lower total velocity of wind than +is marked against this city; and as for those places, heaven help their +unfortunate inhabitants in the sultry nights of the summer season, when +they are gasping in vain for a breath of that pure, cool lake air, which +brings refreshing slumbers to the people of blessed, breezy Buffalo." + + +EQUABILITY OF CLIMATE. + + +[Illustration: +One of our Physician's Rooms--Bureau of Correspondence--Invalids' +Hotel and Surgical Institute.] + +Then, in regard to _equability of climate_, the great desideratum for +invalids in any locality, here again sentiment and science are greatly +at variance. An examination of the official records of the Signal +Service Bureau, and the statistics of the Smithsonian Institute, showed +that out of a list of forty cities on the continent Buffalo ranked +highest for equability of climate. Thus we quote from an editorial in +the _Advertiser_ of the same issue: "While the aggregate of change for +Buffalo stood at 67 for the year, that of Philadelphia reached 204, +Washington was 224, Cincinnati 205, St. Louis 171. Winchester, in one of +the healthiest parts of Virginia, reached as high as 201. Aiken, in +South Carolina, a famous resort for invalids, touched 220. St. +Augustine, one of the lowest in the list, showed a much less equable +climate than that of Buffalo, being 94 to our 67." The transition from +summer to winter, and _vice versa_, is exceedingly gradual, and, +consequently, Buffalonians are seldom afflicted with those epidemic +diseases which generally appear in other localities during the spring +and summer months. Thus the thermometric readings of the Signal Service +Bureau for 1873, show that the average temperature for July and August +was 74°. For September it was about 64°, which was again reduced by +about 10° for October. The monthly average for November was 73°, and for +December 25°, which was also the average for January. Then the readings +for February showed an average of 26°, for March 32°, and 43° for April. +A more equable and gradual transition from midsummer heat to midwinter +cold cannot be shown by any locality on this continent. Seldom does the +mercury rise above ninety during our warmest summers, or fall below zero +in our most severe winters. In J. Disturnal's work, entitled "The +Influence of Climate in North and South America," published by Van +Nostrand, in 1867, the climate of Buffalo is thus characterized: "From +certain natural causes, no doubt produced by the waters of Lake Erie, +the winters are less severe, the summers less hot, the temperature night +and day more equable, and the transition from heat to cold less rapid, +in Buffalo than in any other locality within the temperate zone of the +United States, as will be seen by the following table." The table +referred to shows that, "during the summer months, the temperature of +Buffalo is from 10° to 20° cooler than that of any other point east, +south, or west of the ports on Lake Erie; while the refreshing and +invigorating lake breeze is felt night and day." The author further adds +that "during the winter months the thermometer rarely indicates zero, +and the mean temperature for January, 1858, was 20° above." + +A careful investigation into the comparative climatology of the several +great social and commercial centers, proved _Buffalo to be superior to +all others in the climatic requirements for the invalid_. Besides, it +has the important advantage of being a central point of traffic and +travel between the West and the East. + + +ADVANTAGES OF LOCATION. + + +The second important consideration in projecting this home for invalids +was _location_. It has generally been customary to locate institutions +of this character in rural districts, removed from the advantages of +city life, on the plea of escaping the confusion and excitement so +detrimental to recovery. The result is well known. Invalids have +regarded them more as pleasure resorts than health resorts, spending the +summer months there, but fleeing to their homes at the fall of the first +snow-flake. The good that was done in the summer is undone by +carelessness and exposure in the winter. A location that would combine +both city advantages and rural pleasures, seemed to us, upon reflection, +to be the desirable one. Fortunately, Buffalo afforded the happy mean. +Our extensive parks, our unsurpassed facilities for yachting, fishing, +and all aquatic sports, our many sylvan lake and river retreats, our +world-famed Niagara,--certainly a more desirable selection of rural +scenes and pleasures cannot be found in another locality in America. + + +A GENUINE HOME. + + +In erecting the Invalids' Hotel and Surgical Institute, our paramount +design was to make it a genuine home--_not a hospital_--a home where the +child of fortune would miss none of the comforts of her palatial home, +while the poor man would find not only health but his pleasures +multiplied a thousand fold. + + +OUR TERMS MODERATE. + + +The wholesale merchant's prices are far less than those of the retail +dealer. He can afford it, his sales are so much larger. It is on +precisely the same principle that we are able to make the rates at the +Invalids' Hotel and Surgical Institute comparatively low. If we had only +a limited number of patients, we should be obliged to make the charges +commensurate with our expenses; but our practice having become very +extensive, and the income being correspondingly large, we are enabled to +make the rates at the Invalids' Hotel and Surgical Institute so moderate +that all who desire can avail themselves of its medical, surgical, and +hygienic advantages. + +[Illustration: Prescription Department--Invalids' Hotel and Surgical +Institute.] + + +FACILITIES FOR TREATMENT. + + +Of the many advantages afforded by the Invalids' Hotel and Surgical +Institute, in treating disease, we can make only brief mention of a few +of the more prominent. + + +DIVISION OF LABOR. + + +In the examination and treatment of patients, our practice is divided +into specialties. Each member of the Faculty, although educated to +practice in _all_ departments of medicine and surgery, is here assigned +to a special department only, to which he devotes his entire time, study +and attention. + + +ADVANTAGES OF SPECIALTIES. + + +The division-of-labor system proves as effectual in the exercise of the +professions as in manufactures. In the legal profession this has long +been a recognized fact. One lawyer devotes his attention specially to +criminal law, and distinguishes himself in that department. Another +develops a special faculty for unraveling knotty questions in matters of +real estate, and, if a title is to be proved, or a deed annulled, he is +the preferred counselor. In a certain manner, too, this has long been +practiced by the medical profession. Thus some physicians (and we may +add physicians who call themselves "regular," and are specially caustic +in their denunciation of "advertising doctors") are accustomed to +distribute cards among their patrons, certifying that they give special +attention to diseases of women and children. In this institution each +physician and surgeon is assigned a special department of medicine or +surgery. By constant study and attention to his department, each has +become a skillful specialist, readily detecting every phase and +complication of the diseases referred to him. Not only is superior skill +thus attained, but also _rapidity_ and _accuracy_ in diagnosis. + +Thoroughness and efficiency in any branch of learning can be secured +only by devoting to it special study and attention. When the faculty of +a university is to be chosen, how are its members selected? For +instance, how is the chair of astronomy filled? Do they choose the man +who is celebrated for his general scholastic attainments, or do they not +rather confer it upon one who is known to have devoted special attention +and study to the science of astronomy, and is, therefore, especially +qualified to explain its theories and principles? Thus all the several +chairs are filled by gentlemen whose general scholarship not only is +known to be of the highest standard, but who devote special attention to +the departments assigned them, thus becoming proficient specialists +therein. The same system of specialties is observed in the departments +of a medical college. The professor who would assume to lecture in all +the departments with equal ease and proficiency would be severely +ridiculed by his colleagues; and yet it is just as absurd to suppose +that the general practitioner can keep himself informed of the many new +methods of treatment that are being constantly devised and adopted in +the several departments of medicine and surgery. + + +PROGRESS IN MEDICINE. + + +In no other science is more rapid and real progress being made at the +present time than in that of medicine. Even the specialist must be +studious and earnest in his work to keep himself well and accurately +informed of the progress made in his department. Thus it so often +happens that the general practitioner pursues old methods of treatment +which science has long since replaced with others, acknowledged to be +superior. The specialist, on the contrary, by confining his studies and +researches to one class of diseases only, is enabled to inform himself +thoroughly and accurately on all the improvements made in the methods +and means of practice in his special department. + +The difference between the practice of specialists and that of general +practitioners is aptly illustrated by the difference between the +old-fashioned district school, in which the school-master taught all the +branches, from a-b-abs to the solution of unknown quantities and the +charmed mysteries of philosophy, and the modern seminary, with its +efficient corps of teachers, each devoting his or her whole attention to +the study and teaching of one special department of learning. + +We attribute the success which has attended the practice at the +Invalids' Hotel and Surgical Institute, in a great measure, to a wise +adoption of this system of specialties. + + +ADVANTAGES OFFERED TO INVALIDS. + + +Obviously, the most important of these advantages is _facility of +treatment_. Of the thousands whom we have cured of chronic diseases, we +have probably not seen one in five hundred, having accomplished the +desired result through remedies sent either by mail or express, and +advice given by letter. Yet in some obstinate forms of disease, we can +here bring to bear remedial means not to be found or applied elsewhere. + +That thousands of cases of chronic disease, pronounced incurable, have, +by our rational and scientific treatment, been restored to perfect +health, is conclusively proved by the records of practice at the +Invalids' Hotel and Surgical Institute. Here, in obstinate cases, are +brought to bear all the most scientific remedial appliances and methods +of treatment. + +A system of mechanical movements, passive exercises, manipulations, +kneadings and rubbings, administered by a large variety of +ingeniously-contrived machinery, driven by stream-power, has been found +especially efficacious and valuable, as an aid to medical and surgical +treatment, in the cure of obstinate cases of nervous and sick headache, +constipation, paralysis, or palsy, stiffened joints, crooked and +withered limbs, spinal curvature, tumors, diseases of women, especially +displacements of the uterus, or womb, such as prolapsus, retroversion +and anteversion, chronic inflammation, enlargement and ulceration of the +uterus, and kindred affections; also in nervous debility, sleeplessness, +and other chronic diseases. Mechanical power, or force, is by these +machines transmitted to the system, in which it is transformed into +vital energy and physical power or strength. This mechanical, passive +exercise, or movement-cure treatment, differs widely from, and should +not be confounded with, "Swedish movements," to which it is far superior +in efficacy. Coupled with our improved and wonderful system of +"Vitalization" treatment, it affords the most perfect system of physical +training and development ever devised. For the restoration of power to +wasted, undeveloped, or weakened organs or parts, for their enlargement, +this combined movement and "Vitalization" treatment is unequaled. It can +be applied to strengthen or enlarge any organ or part. We also employ +both Dynamic and Static electricity, "Franklinism" and Electrolysis, and +chemical, Turkish and other baths, in all cases in which they are +indicated. Inhalations, administered by means of the most approved +apparatus, are employed with advantage in many obstinate lung, +bronchial, and throat affections. We have no hobby or one-idea system of +treatment, no good remedial means being overlooked or neglected. + +[Illustration: A glimpse of some +of the rooms for the +application of Electricity, +Mechanical +Massage, "Vitalization" +treatment, and +other agencies prescribed by our Staff; +furnishing a perfect system of physical +and remedial training, carefully adapted +to the wants of the most delicate and feeble, +as well as to the more robust.] + + +A FAIR AND BUSINESS-LIKE OFFER TO THE AFFLICTED. + + +Reader, are you accustomed to think and act for yourself? Do you consult +your own reason and best interests? If so, then do not heed the counsel +of skeptical and prejudiced friends, or jealous physicians, but listen +to what we have to say. + +You perhaps know nothing of us, or our systems of treatment, or of the +business methods we employ. You may _imagine_, but you _know nothing_, +perhaps, of our facilities and advantages for performing cures in cases +beyond the reach or aid of the general practitioner. Knowing nothing, +then, of all these advantages, you still know as much as the would-be +friend or physician who never loses an opportunity to traduce and +misrepresent us, and prejudice the afflicted against us. + +Now to the point--are you listening? Then permit us to state that we +have the largest, the best, and the finest buildings of any like +Association, company, or firm in this country. We employ _more_ and +_better_ Medical and Surgical Specialists in our Invalids' Hotel and +Surgical Institute than any similar Association, company, or individual, +and actually have more capital invested. We have a thoroughly qualified +and eminent Specialist for every disease that we treat. We treat more +cases, _and absolutely cure more patients_ than any similar institution +in America. In addition to those we treat medically, we perform all the +most difficult surgical operations known to the most eminent Surgeons, +and so frequently do many of these operations occur with us that some of +our Specialists have become the most expert and skillful Surgeons on +this continent. + +We wish to add further that we are responsible to _you_ for what we +represent; we therefore ask you to come and visit our institutions; and, +if you find on investigation that we have misstated or misrepresented +_in any particular_ our institutions, our advantages, or our success in +curing Chronic Diseases, _we will gladly and promptly refund to you all +the expenses of your trip_. We court honest, sincere investigation, and +are glad and anxious to show interested people what we can do and are +daily doing for suffering humanity. Can a proposition be plainer? Can an +offer be more fair and business-like? If, therefore, you are afflicted, +and are seeking relief, come where genuine ability is a ruling feature, +where _success_ is our watchword and the alleviation of human suffering +our mission. + +Whether arriving in our city by day or night, _come directly to the +Invalids' Hotel and Surgical Institute, 663 Main Street_, where you will +be hospitably received and well cared for. + +Address all correspondence to + + WORLD'S DISPENSARY MEDICAL ASSOCIATION, + _663 Main Street, BUFFALO, N.Y._ + + * * * * * + + + + +SUCCESSFUL TREATMENT OF CHRONIC OR LINGERING DISEASES. + + +[Illustration] + +For many years the founder of the Invalids' Hotel and Surgical Institute +and World's Dispensary has devoted himself very closely to the +investigation and treatment of chronic diseases. Some few specifics +have, during this time, been developed for certain forms of chronic +ailments, and given to the public, but they have not been lauded as +"cure-alls," or panaceas, but only recommended as remedies for certain +well-defined and easily recognized forms of disease. These medicines are +sold through druggists very largely, and have earned great celebrity for +their many cures. So far from claiming that these proprietary medicines +will cure all diseases, their manufacturers advise the afflicted that, +in many complicated and delicate chronic affections, they are not +sufficient to meet the wants of the case. These must have special +consideration and treatment by a competent physician and surgeon, the +medicines and other remedial means required being selected and prepared +with reference to each particular case. + +In order to be able to offer those afflicted with chronic ailments the +most skillful medical and surgical services, Dr. Pierce, many years ago, +associated with himself several eminent physicians and surgeons, as the +Faculty of the old and renowned World's Dispensary, the consulting +Department of which is now merged with the Invalids' Hotel and Surgical +Institute. + + +DIVISION OF LABOR. + + +In the organization of the medical and surgical staff of the Invalids' +Hotel and Surgical Institute, several years ago, we assigned to one +physician the examination and treatment of diseases of the nervous +system; to another, surgical operations and the treatment of surgical +diseases; a third had charge of catarrhal and pulmonary diseases and +affections of the heart; a fourth attended to diseases peculiar to +women; a fifth, to diseases of the eye and ear; a sixth, to diseases of +the digestive organs; a seventh, to special surgical cases; to another +we entrusted diseases of the urogenital organs; and to others, various +other specialties. Now that our practice has become so very extensive as +to require for its conduct a greatly increased number of physicians and +surgeons. Thus four physicians and surgeons devote their undivided +attention to the examination and treatment of diseases of the urinary +and generative organs of men. Three physicians give their sole attention +to diseases peculiar to women and three to those of the nasal organs, +throat and chest, embracing all chronic diseases of the respiratory +organs. Thus we have a full council of three and four physicians in +these several specialties. In several other divisions we have two +specialists. No case is slighted either in the examination or in the +treatment. All doubtful, obscure or difficult cases are submitted to a +council composed of several physicians and surgeons. Skilled +pharmaceutists are employed to compound the medicines prescribed. For +the purpose of enabling us to conduct our extensive correspondence (for +we have an extensive practice en every part of the United States and +Canada, as well as in Great Britain from our London branch), +graphophones are employed, to which replies are dictated, recording the +words of the speaker. Afterwards the letters are written out in full, +generally on a type-writing machine, which prints them in a plain, +legible style. These machines are operated as rapidly as a person can +think of the letters which compose a word, each operator thus +accomplishing the work of several copyists. This system, by which we are +enabled to correspond with our patients as rapidly as we can talk, has +been rendered necessary by the growth of our business, which has +attained immense proportions, giving rise to so large a correspondence +that a dozen physicians cannot possibly conduct it all and give each +patient's case careful attention, without the employment of graphophones +and all other facilities which modern invention has given us. By the +adoption of these various means, we are enabled to fully meet the +demands of the afflicted, and give every case the most careful +attention. + +[Illustration: Faculty of Invalids' Hotel and Surgical Institute in +Session.--Council-room.] + +As many persons, particularly young ladies and gentlemen, having catarrh +or almost any other chronic disease, especially if of the urogenital +organs, are very sensitive and fearful that somebody will know that they +are afflicted and employing medical treatment, precautions are taken +that none who consult us may incur the least risk of exposure. Although +none but the most honorable and trustworthy gentlemen are employed as +assistants, yet as a _guarantee_ of perfect security to our patients, +that every communication, whether made in person or by letter, will be +treated as _sacredly confidential_, each professional associate, clerk, +or assistant, is required to take a solemn oath of secrecy. Great care +is also taken to send all letters and medicines carefully sealed in +plain envelopes and packages, so that no one can even _suspect_ the +contents or by whom they are sent. + + +ADVANTAGES OF SPECIALTIES. + + +By thorough organization and a perfect system of subdividing the +practice of medicine and surgery in this institution, every invalid +consulting us is treated by a specialist--one who devotes his undivided +attention to the particular class of diseases to which his or her case +belongs. The advantage of this arrangement must be obvious. Medical +science offers a vast field for investigation, and no physician can, +within the limit of a single life-time, achieve the highest degree of +success in the treatment of _every_ malady incident to humanity. A +distinguished professor in the medical department of one of our +universities, in an address to the graduating class, recently said: +"Some professional men seem to be ashamed unless they have the character +of universal knowledge. He who falls into the error of studying +everything will be certain to know nothing well. Every man must have a +good foundation. He must, in the first place, be a good general +practitioner. But the field has become too large to be cultivated in its +entirety by any individual; hence the advantage of cultivating special +studies in large towns, which admit of the subdivision of professional +pursuits. It is no longer possible to know everything; something must +be wisely left unknown. Indeed, a physician, if he would know anything +well must be content to be profoundly ignorant of many things. He must +select something for special study, and pursue it with devotion and +diligence. This course will lead to success, while the attempt to do +everything eventuates unavoidably in failure. Let there be single hands +for special duties." Our institution is the only one in this country in +which these common-sense-ideas are _thoroughly_ carried out. The +diversified tastes and talents of physicians cause each to excel in +treating some one class of diseases, to which he devotes more attention +and study than to others. One medical student manifests great interest +in the anatomy, physiology, pathology, and treatment of diseases of the +eye. He becomes thoroughly familiar with all the minutest details +relative to that organ and its diseases, and so thoroughly qualifies +himself in this branch of knowledge that he is able to cure an +inflammation or other affection of the eye in a very short time. Another +student is more interested in some other class of diseases, for the +study of which he has a liking, and neglects to inform himself in the +ophthalmic branch of medical and surgical science. If after engaging in +the practice of his chosen profession, he is consulted by persons +suffering from diseases of the eye, he tortures them with unnecessary +and oftimes injurious applications, clumsily and carelessly made, and, +as the result of such unskillful treatment, the inestimable blessing of +sight may be sacrificed. + +[Illustration: A Corner in Printing Department.--World's Dispensary.] + +The great majority of physicians allow acute maladies, diseases of +children, and the practice of midwifery, to engross most of their time +and attention. They manifest an absorbing interest in everything that +relates to these subjects, and devote little or no time to acquiring an +intimate knowledge of the great variety of chronic maladies which +afflict mankind. They acquire skill and reputation in their favorite +line of practice, but are annoyed if consulted by one suffering from +some obscure chronic affection, usually turn the invalid off with a very +superficial examination, and, perhaps, only prescribe some placebo,[6] +apparently indifferent as to the result, but really desiring thus to +conceal their lack of familiarity with such diseases. The specialist, +the treatment of chronic diseases being his vocation, is equally annoyed +if consulted by those suffering from acute diseases, but does not pursue +the inconsistent course of assuming to treat them. He refers them to +those of his medical brethren whose daily dealings with such cases make +them, in his way of thinking, more competent than himself to render +valuable service to such sufferers. He recognizes the fact that no man +is likely to succeed in any line of study or business for which he +possesses no talent or relish, nor does he believe in being a +"jack-at-all-trades and master of none." + + +ADVERTISING. + + +Having thoroughly qualified himself for the practice of some particular +branch of the healing art, the specialist sees no impropriety in +acquainting the public with his ability to relieve certain forms of +suffering. He believes that medical men should possess equal rights with +other business men, and that any code of medical ethics which would +deprive him of any of the sacred rights guaranteed to all by the liberal +laws of the country, is professional _tyranny_, and merits only his +contemptuous disregard. Nor does he display any false modesty in the +_manner_ of making known his skill. He maintains that he has an +undoubted right to place his claim to patronage before the public by +every fair and honorable means. He recognizes the display of goods in +the merchant's show-windows as no less an advertisement and in no better +taste than the publication of a card in the newspaper. So, likewise, he +regards the various devices by which the extremely _ethical_ physician +seeks to place himself conspicuously before the public, as but so many +ways of advertising, and as not more modest than the publication of +cures actually performed, or than his announcement through the public +press of his professional resources for treating certain maladies. + + +The physician who expresses a "holy horror" of the "_advertising +doctor_," liberally bestowing upon him the epithet of "quack," announces +_himself_ a graduate, talks learnedly and gives notice to the public in +_some_ way that he is ready to serve them. He endeavors to impress upon +the mind of the patient and family his skill, frequently exaggerates as +to the extent of his practice, rides furiously about when he has no +professional calls, keeps up business appearances by driving several +horses, or joins influential societies. He may make a great display in +style, manner, dress, pretensions, writing for the newspapers, +exhibiting literary pedantry, referring to the superior facilities +afforded by some particular school or society to which he belongs; or by +editing and publishing a medical journal, ostensibly for the advancement +of medical science, but practically to display titles or professorships, +to publish reports which flatteringly allude to cases he has treated, +the number of capital surgical operations he has performed, or the +distinguished families he is treating. All these are but _modes of +advertising_ professional wares; in short, are artful, though not +refined, tricks, resorted to for private announcement. We say to all +such adventurers in modern advertising diplomacy, that these indirect, +clandestine methods are not half so candid and honorable as a direct +public statement of the intentions and proposals of a medical +practitioner, who thereby incurs an individual responsibility before the +law and his fellow-men. + +No good reason has ever been assigned why any well educated physician, +trained in the school of experience until he becomes proficient in +medical skill, may not publish facts and evidence to disclose it, +especially when these are abundant and conclusive. The following +extracts from an able article by the Rev. THOMAS K. BEECHER embodies a +sound view of the subject of medical advertising. He says: + +* * "I am glad that the doctor cured him; I am glad that the doctor put +it in the paper that he could cure him. And if any doctor is certain +that he can cure such diseases and don't put it in the paper, I am +sorry. What a pity it would have been had this doctor come to town with +his wealth of science and experience and gone away leaving him uncured! +What a pity it would have been if he had been so prejudiced against +advertising as to read the responsible certificate of the doctor and +give him the go-by as a quack! What are newspapers for, if not to +circulate information? What more valuable information can a newspaper +give than to tell a sick man where he can be cured? If a man has devoted +his life and labor to the study of a special class of diseases, the +necessity of his saying so becomes all the more pressing. His _duty_ to +advertise becomes imperative. + +"When I was in England, I found on all the dead walls of London, +placards, declaring that Dean Stanley, Chaplain to the Prince of Wales, +would preach at such a place; that his grace the Archbishop (I think) of +Canterbury would preach at another time and place; again, that an Oxford +professor would preach. In short, religious notices were sprinkled in +among the theater bills, and the highest church dignitaries were +advertised side by side with actors, singers, and clowns. Of course, I +was shocked by it, but in a moment I bethought me--if it be all right +and dignified to hire a sexton to ring a bell when the minister is going +to preach, it is all the same to silence the bell and hire a +bill-sticker to tell the same news, the essential thing being to tell +the truth every time. The remedy for the lying advertisements is for +honest men to tell the truth. 'When iniquity cometh in like a flood, +then the spirit of the Lord lifts up the standard.' A really able man, +whatever be his gifts, makes a great mistake if he fail to use those +gifts through want of advertising." + +If a physician possesses knowledge that enables him to remedy diseases +heretofore regarded as incurable, what virtue or modesty is there to +"hide his light under a bushel"? In this free country the people think +and act for themselves, and hence all have a deep concern in the subject +of health. The strong popular prejudice against the doctors who +advertise is due to the fact, that by this method so many ignorant +charlatans are enabled to palm off their worthless services upon the +uneducated and credulous; but the practice of such imposition should not +cause a presumption against the public announcement of real skill, for +the baser metal bears conclusive evidence that the pure also exists. + +Every step in scientific investigation, every proposition which relates +to the interest and happiness of man, every statement and appeal +involving a valuable consideration, must be submitted to the scrutiny +and judgment of individual reason; for every person has the right to +form his own conclusions, and justify them by experience. Those claims +which are only supported by empty assertion are very doubtful. Misty +theories vanish before the sun of truth. He who renders professional +services cannot be successful, unless he be sustained by real merit. + + +TREATING PATIENTS WHO RESIDE AT A DISTANCE. + + +We can treat many chronic diseases as successfully without as with a +personal consultation, as our vast experience enables us to correctly +determine the malady from which the patient is suffering, from a history +of the symptoms, and answers to questions furnished. We have not seen +one person in five hundred of those whom we have cured. + +Some may suppose that a physician cannot obtain, through correspondence, +a sufficiently accurate idea of the condition of a patient to enable him +to treat the case successfully; but a large experience in this practice +has proved the contrary to be true, for some of the most remarkable +cures have been effected through the medium of correspondence. In most +long-continued cases, the patient has thought over his symptoms hundreds +of times. The location of every pain, whether acute or mild, constant or +occasional, and the circumstances under which it occurs, have been +carefully noted. He has observed whether he had a rush of blood to the +head, was feverish or chilly, whether troubled with cold hands and feet, +whether full of blood, or pale and bloodless; and he states these +matters with accuracy and common sense when writing to us, for he has a +very good, if not a professional, knowledge of the relative importance +of these symptoms. So in regard to digestion, he states what kinds of +food agree with him, or whether he is troubled with excessive acidity or +a flatulent condition of the stomach. He also informs us whether his +tongue is coated and bilious, or clean and healthy, and gives many other +particulars too various to enumerate, by which we are enabled to gain a +perfect understanding of the case. If his description be not +sufficiently complete to enable us to obtain a definite understanding of +the case, he is requested to answer a list of important questions which +are sent him. The people are far more intelligent in these matters than +physicians are generally willing to admit. A patient is often confused +while being personally examined by a physician, and gives imperfect or +incorrect answers. After he has left the presence of the physician, he +finds that he has failed to enumerate many of the most important +symptoms. In consulting by letter, the patient is not embarrassed, he +states the exact symptoms, and carefully reads over the letter to see if +it is a complete and accurate description of his sufferings. In this way +he conveys a much better idea of the case than if present in person, and +subjected to the most thorough questioning and cross-examination. The +timid lady and nervous young man write just as they feel; and one +important reason why we have had such superior success in treating +intricate and delicate diseases, is because we have obtained such true +and natural statements of the cases from these letters, many of which +are perfect pen-pictures of disease. As bank-tellers and cashiers, who +daily handle large quantities of currency, can infallibly detect +spurious money by a glance at the engraving or a touch of the paper, so +the experienced physician, by his great familiarity with disease, +becomes equally skilled in detecting the nature and extent of a chronic +malady from a written description of its symptoms. + + +URINARY SIGNS. + + +A careful microscopical examination and chemical analysis of the urine +is a valuable aid in determining the nature of many chronic diseases, +particularly those of the nervous system, blood, liver, kidneys, +bladder, prostate gland and generative organs. This important fact is +not overlooked at the Invalids' Hotel and Surgical Institute, where an +experienced chemist is employed to make such examinations and report the +result to the attending physicians. Medical authors, professors, and +practitioners of all schools, admit and even insist upon the importance +of such examinations in diagnosticating diseases. Many practitioners +neglect to take advantage of this invaluable aid, while others fear that +if they attach much importance to such examinations they will be ranked +with "uroscopian" or "water" doctors, a class of enthusiasts who claim +to be able to correctly diagnosticate every disease by an examination of +the urine. Persons consulting us and wishing to avail themselves of the +advantages afforded by these examinations can send small vials of their +urine by express. The vials should be carefully packed in saw-dust or +paper and enclosed in a light wooden box. All charges for transportation +must be prepaid, and a complete history of the case including the age +and sex of the patient, must accompany each package, or it will receive +no attention. This saves valuable time by directing the examination into +the channels indicated, thus avoiding a lengthy series of experiments. +As we are daily receiving numerous vials of urine, every sample should, +to prevent confusion, be labeled with the patient's name. + +[Illustration: Binocular Microscope used at the Invalids' Hotel and +Surgical Institute.] + +[Illustration: Fig. 1.] + +There is a natural, definite proportion of the component elements of +every solid and fluid of the human body. These proportions have been +reduced to definite standards, a deviation from which affords evidence +of disease. Thus, there being a fixed standard in a normal proportion of +the elements of the blood, any deviation from it, as in anæmia, +leucocythæmia, etc., indicates disease. So also the standard proportion +of the urinary elements being known, any considerable change, either in +quantity or quality of its parts, bears unmistakable evidence of +disease. The invention of the microscope has provided increased +facilities for detecting diseases by examination of the urine. By the +aid of this wonderful instrument, we are enabled to discover with +absolute certainty the various urinary deposits characteristic of +different maladies; thus in Fig. 1, A represents in a general way the +sediment of abnormal urine as seen under the microscope. In division B +is represented oxalate of urea upon precipitation by oxalic acid. +Nitrate of urea is represented in division C. A deficiency of urea in +the urine, with albumen and casts present, is a most important guide in +the diagnosis of Bright's disease. The average quantity of urea present +during health is 21.57 parts in 1,000. The microscopic examination of +the urine, notwithstanding the distaste, and even contempt, which many +physicians manifest for such investigations, is pursued at the Invalids' +Hotel and Surgical Institute, with inestimable benefit to our patients. +It has revealed the existence of many serious affections, which, with +all our other modes of investigation, we might have been unable to +detect. It has also thrown light upon many obscure chronic diseases. + +[Illustration: Fig. 2.] + +We have already spoken of the marked changes effected in the urine by a +derangement of the digestive functions. It is a matter of surprise that +physicians generally pay so little attention to the urine when dyspepsia +is suspected, since all admit that an examination of that excretion +furnishes unmistakable evidence of the nature and complications of the +disease. In this way we are many times enabled to determine whether the +indigestion is caused by congestion or functional disease of the liver +or kidneys or by nervous debility. And when such cases are treated in +accordance with the indications furnished, increased success attends our +practice. In Fig. 2 highly magnified urinary deposits, which indicate +impairment of the digestive functions, are represented. The crystals are +composed of oxalate of lime and appear in the different forms shown in +the five sections, of octahedral, decahedral, round and dumb bell +shapes. The latter are formed in the kidneys, and are sometimes +discovered adhering to casts. + +[Illustration: Fig. 3.] + + +INVALUABLE AIDS IN DETERMINING DISEASES OF THE KIDNEYS AND BLADDER. + + +[Illustration: Fig. 4.] + +The various forms of gravel, Bright's disease of the kidneys, +hæmaturia, inflammation of the kidneys and bladder, diabetes, and other +functional and organic diseases of the urinary organs effect +characteristic changes in the urine, thus enabling us to distinguish +them with certainty and exactness. Some of the various microscopical +appearances of the urinary deposits in diseases of the kidneys and +bladder, are represented in Fig. 3. In division A is represented pus and +mucus, with decomposition, indicating suppuration somewhere along the +urinary tract. In B pus globules are alone represented. In the division +marked C are shown blood corpuscles as they are arranged in blood drawn +from a vein or artery. D represents the same separated, as they always +are when present in the urine. In E highly magnified oil globules are +represented. If present in the urine, they indicate disease of the +kidneys. In F are represented epithelial cells, the presence of which in +large numbers is indicative of diseases of the mucous lining of the +urinary organs. + +Fig. 4 represents the microscopic appearance of phosphates in the +urine. These are present in great quantity in cases of nervous debility +and kindred affections. By attaching the _camera lucida_ to the +microscope we can throw an image of these urinary deposits upon paper. +By the art of the engraver this may be faithfully traced, and thus we +are enabled to produce an accurate representation of them. Some of the +beautiful crystalline deposits shown in Fig. 4 represent less than a +millionth part of a grain, yet their forms are delineated with +geometrical precision. Earthy phosphates are often mistaken for pus and +also seminal fluid. Phosphates are always found in decomposed urine, +otherwise they indicate brain affections, acute cystitis, etc. +Experience has taught us that the voiding of urine loaded with +phosphates is a forerunner of cystitis, or enlargement of the prostate +gland, or both. In fact, persons so affected are "prone to serious +consequences from mild attacks of almost any and every acute disease." + +[Illustration: Fig. 5.] + +Fig. 5 represents the microscopic appearance of mixed urinary deposits. +In division A is represented fermentation spores as they appear in +diabetic urine. Pasteur asserts that the germs of this fungus get into +the urine after it has been passed. Urates appear in division B. These +indicate waste of flesh, as in fevers, consumption, prolonged physical +efforts, etc. Division C pictures urates of ammonia. These appear in +alkaline decomposition of the urine; it is isomeric with uric acid in +acid urine. In division D is represented urate of soda, which is present +in the tissues of persons suffering from gout. The crystals shown in +division E consist of the same salt. + +[Illustration: Fig. 6.] + +In Fig. 6, division A, is represented purulent matter as it appears in +the urine. The formation of pus in different parts of the genitourinary +system is accompanied by the appearance of pus corpuscles in the urine. +When fat globules, represented in division B, are found in the urine, +they indicate fatty degeneration. In division C are representations of +the cells found in the urine of persons suffering from cystitis or other +inflammatory diseases. + +[Illustration: Fig. 7.] + +Fig. 7, divisions A and B, represent different forms of cystine. +Fortunately this substance is rarely found in the urine. When present +however it indicates liability to, or the actual presence of, a calculus +or stone in the bladder. In division C is a representation of the +deposits seen in the urine of those who are greatly debilitated. In +division D are seen epithelial cells mixed with mucus. + +[Illustration: Fig. 8.] + +In Fig. 8, division A, are represented the caudated cells from the deep +structure of the bladder. The cells represented in division B are +amyloid concretions, found where there is an enlarged prostate gland. + +Fig. 9 represents the appearance of spermatozoa as seen in the urine. +When present, they afford indisputable evidence of the escape of semen +in the renal excretions. + +We might add many other illustrations of urinary deposits and state +their several indications, but a sufficient number has been introduced +to show the importance and practical value of microscopic examinations +of the urine in revealing obscure diseases. + +Although the microscope is of inestimable value in examining the renal +excretion, it does not entirely supersede other valuable instruments and +chemical re-agents in determining constitutional changes. By the +urinometer we determine the specific gravity of the urine; by the use of +litmus its acid or alkaline reaction, is ascertained; while various +chemicals, when added to it, produce certain specific changes, according +to the morbid alterations which it has undergone by reason of disease. +By the application of heat, or the addition of a few drops of nitric +acid, the albumen, which is invariably present in Bright's disease of +the kidneys, is coagulated. By the employment of other re-agents we may +determine the presence of sugar--a characteristic of diabetic urine. And +thus we might mention almost innumerable chemical tests by which the +several changed conditions of the urine, _characteristic_ of different +diseases, may be ascertained with _absolute certainty_. + + +THE MOST EMINENT MEDICAL AUTHORITIES ENDORSE IT. + +Dr. Eberle, a distinguished allopathic author, thus writes: "Whatever +may be the disease, the urine seldom fails in furnishing us with a clue +to the principles upon which it is to be treated." + +Dr. Braithwaite also says: "We can arrive at a more accurate knowledge +respecting the nature of diseases from examining the urine than from any +other symptom." + +Golding Bird, whose writings are regarded as sound and practical by the +most learned of the medical profession, says: "The examination of the +urine in disease is now regarded as one of the most important aids in +diagnosis, and which it would be injurious alike to the welfare of the +patient and the credit of the practitioner to avoid." + +[Illustration: Fig. 9.] + +The eminent Dr. F. Simon writes as follows: "From the physical and +chemical state of the urine, the attentive and observing physician may +obtain a great quantity of information for ascertaining and establishing +a diagnosis. More than all other signs, the correct examination of the +sediment is of importance to the physician. * * * For the medical man it +is the compass which guides him in the unlimited chaos of disease and +its treatment; for the patient it is the thermometer of his condition, +the premonitory indication of the decrease or aggravation of his malady; +and for the healthy man it is the regulator of his diet and his life. +Every one is aware of the variations of the barometer, and we know that +the fluctuations of the column of mercury are closely associated with +the variable conditions of the atmosphere; so, to the practical +observer, variations of the urine, as well as the elements composing it, +point out with certainty the changes in health, and the condition of the +organs." + +While we recognize the importance of examining the urine as an aid in +distinguishing diseases, and have made this old German method of +diagnosis a special study, yet we do not claim that _all_ diseases can +be unmistakably distinguished by such examinations _alone_. We take a +conservative position and have no confidence in that class of ignorant +fanatics whose pet hobby is "uroscopy." + +From every person who solicits our professional services, we require +explicit answers to numerous important questions, that we may know the +age, sex, vocation, etc., as well as the prominent symptoms manifested. + + +CONSULTATIONS BY LETTER. + + +Formerly, we published in this book a very extensive list of questions +to be answered by those consulting us, but a large experience has +convinced us that beyond requiring answers to a few leading questions, +which we still retain, it is better to let the patient describe the +malady in his or her own way and language. After receiving and +considering such a history, if we do not fully understand the patient's +malady, we will ask such further questions as may be necessary. The +patient should, however, in addition to writing name, post-office, +county, and state, _plainly_, state the name of the town containing the +nearest express office. Next give age, sex, whether married or single, +complexion, height, present and former weight, if known, and occupation. +State also if you have been a hard worker, and whether it is necessary +for you to labor hard now, how long you have been out of health, and +from what particular symptoms you suffer most. Follow this with a +history of your case in your own language. If you find in this volume an +accurate description of your disease, state the page and paragraph where +it occurs. + + +FREE CONSULTATION. + + +We now make no charge for consultation by letter, but, instead of the +one dollar formerly charged by us as a consultation fee, as we are +desirous of making our facilities for treatment known to invalids far +and near, we request that all persons writing to us for advice send us +the names of all those within the circle of their acquaintance who are +in any way in need of medical or surgical treatment for chronic +diseases. If convenient, send the list on a separate piece of paper. + + +CHARGES MUST BE PREPAID. + + +Should you send a vial of urine for analysis, about a cupful will do, +and _all express charges on it must be prepaid_. All liquids are +excluded from the mails, when discovered, and yet we have received +hundreds of samples through the mails safely when put in homoeopathic or +other _very small_ vials, well corked and carefully packed in a light +tin can or _wooden_ box, or in a light pine stick bored out hollow, the +vial being carefully packed in sufficient saw-dust or blotting paper to +absorb all liquid should the vial get broken. Letter postage, that is, +two cents for each one ounce or fraction thereof, must be paid upon +these sealed packages. Send the first urine that is passed after rising +in the morning. + + +RELIABLE MEDICINES. + + +Next in importance to a correct understanding of the patient's disease, +is the possession of reliable remedies for its treatment. Many of the +medicines employed by physicians engaged in general practice are +prepared from old drugs that have lost all their medicinal virtues, and +hence are utterly useless and ineffectual. Many vegetable extracts are +inert, because the plants from which they are produced were not gathered +at the proper time. To give the reader an idea of the great care which +we exercise in the selection and preparation of our medicines, he is +requested to read under the head of "The Preparation of Medicines," in +"The People's Common Sense Medical Adviser." + + +OUR TERMS FOR TREATMENT + + +require the payment of monthly fees, in advance, which entitles the +patient to medicines specially prepared for and adapted to his or her +particular case, and to all necessary attention and advice. Our fees for +treatment are moderate, varying according to the nature and requirements +of each particular case, and will be made known at the time of +consultation. + + +WHY OUR FEES ARE REQUIRED IN ADVANCE. + + +We receive applications from strangers residing in all parts of America, +and even in foreign countries, and it is not reasonable to suppose that +credit could be dispensed so indiscriminately. It would not be a correct +business transaction for a merchant to send a barrel of sugar or a roll +of cloth to a stranger living hundreds of miles away, to be paid for +when used. Our knowledge and medicines constitute our capital in +business, and an order upon that capital should be accompanied with an +equivalent. Some applicants refer us to their neighbors for a +testimonial of their integrity. We cannot spare the time or employ +assistants to make such inquiries for the sake of trusting any one. +Should credit be thus indiscriminately given, there would necessarily be +losses, and, to compensate for these, and the extra expense incurred by +the employment of assistants, our fees would have to be much larger, +thereby imposing the burden upon those who _do_ pay. Instead of +following this method of procedure, we place professional services +within the reach of all, so that a greater number may be benefited. Many +invalids say that they have paid large sums of money to medical men for +treatment without obtaining relief. Unfortunately our land is cursed +with quacks and unprincipled practitioners, who seek no one's good but +their own, and it is a defect in our law that it permits such swindlers +to go unpunished. Not so reprehensible is the family physician who +fails, because his limited and varied practice does not permit him to +become proficient in treating chronic diseases. + +The following beautiful sentiment of Hood truthfully expresses the +sacredness of the physician's trust: + + "Above all price of wealth + The body's jewel. Not for minds or hands profane + To tamper with in practice vain. + Like to a woman's virtue is man's health; + A heavenly gift within a holy shrine! + To be approached and touched with serious fear, + By hands made pure and hearts of faith severe, + E'en as the priesthood of the One Divine." + +We are in regular practice, responsible for what we say and do, and +cordially invite those who desire further evidence of our success in +curing chronic diseases to come to the Invalids' Hotel and Surgical +Institute and satisfy themselves of the truthfulness of our statements. + +We are warranted in saying that our responsibility and disposition for +fair dealing are known to many of the principal mercantile houses, as +well as to all prominent American editors. We also refer to our present +and former patients, one or more of whom may be found in almost every +hamlet of America. To all who are under our treatment we devote our +highest energies and skill, fully realizing that an untold blessing is +conferred upon every person whom we cure, and that such cures insure the +permanency of our business. On the contrary, we realize how unfortunate +it is for us to fail in restoring to health any person whom we have +encouraged to hope for relief. We are careful, therefore, not to assume +the treatment of incurable cases, except when desired to do so for the +purpose of mitigating suffering or prolonging life; for we never wish to +encourage false hopes of recovery. + + +TERMS FOR BOARD AND TREATMENT AT THE INVALIDS' HOTEL AND SURGICAL +INSTITUTE + +are moderate, varying with the nature of the case and the apartments +occupied. At times so great is the number applying to avail themselves +of the skill of our Faculty, and the advantages which our institution +affords, that we are unable to receive all applicants. To be sure of +securing good apartments, it is well to engage them sometime ahead, and +make an advance payment of fifty dollars or more upon them, which will +be refunded in case acute sickness or any similar cause should prevent +the patient from occupying them at the time specified. Complete terms +for treatment and board can be arranged only when personal application +for entrance to the institution is made, and the nature and extent of +the disease and the necessary treatment fully determined by personal +examination of the case. If satisfactory terms and arrangements cannot +at that time be agreed upon, or if the case be deemed incurable, any +advance payments that have been made to secure good apartments will be +promptly refunded. + + +SPECIAL ADVICE. + + +Those coming here to consult us personally, should bring the money to +pay for our services and for board and care while remaining here, in the +form of drafts on New York City, Boston or Chicago, and _not_ in the +form of checks on a local or home bank. Such drafts can be purchased in +the home bank by paying a small amount for the exchange. If more +convenient, post office orders payable at Buffalo post office will do. + + +VISITING PATIENTS WHO RESIDE AT A DISTANCE. + + +We are frequently asked to visit patients residing hundreds of miles +away, that we may personally examine their cases, or perform difficult +surgical operations. We can seldom comply with such requests as the time +of our professional Staff is generally very fully occupied. + + +TO PHYSICIANS + +wishing to consult us in intricate cases of chronic diseases under their +treatment, we desire to say that we shall, as in the past, take pleasure +in responding to their solicitations. We have all the necessary +instruments and appliances required in executing the most difficult +surgical operations, and, as we have had much experience in this +department, we are always ready and able to assist physicians who do not +practice operative surgery. In this age of railways and telegraphs +medical and surgical aid can be summoned from a distance and promptly +obtained. + + +OUR MEDICINES + + +as put up for sale through druggists, are not recommended as +"cure-alls," or panaceas, but only as superior remedies for certain +common and easily-recognized diseases. They are our favorite +prescriptions, improved and perfected by long study and a vast +experience in the treatment of chronic diseases, and have gained +world-wide celebrity and sale. We are well aware that there are many +chronic diseases that can only be successfully treated and cured by +careful adaptation of remedies to each individual case. This is +especially true of the ever-varying and delicate diseases of the kidneys +and bladder. It is not less so with reference to nervous debility, +involuntary vital losses, with which so many young and middle-aged men +are afflicted; and we may also include in this list epilepsy or fits, +paralysis or palsy, obstinate gleety discharges, and many other chronic +and delicate ailments of which our staff of physicians and surgeons cure +annually many thousands of cases, but _for which we do not recommend_ +any of our put-up, ready-made, or proprietary medicines. + + +NO RELATIONSHIP WITH HUMBUGS. + + +Had our put-up or proprietary medicines, as sold by druggists the world +over, been adapted to all classes and forms of chronic diseases, there +would have been no necessity for our organizing a competent staff of +physicians and surgeons to act as experts in the treatment of difficult, +obscure, and complicated cases of chronic diseases. That we keep +constantly employed, in our Buffalo and London institutions, eighteen +medical gentlemen, with such helpers as chemists, clerks, etc., is +indisputable proof that the medicines we offer for sale through +druggists should not be classed with the humbug nostrums recommended to +cure everything. They are the outgrowth of our vast and extended +practice in the treatment of chronic diseases; are well-tried, +world-famed, and _honest medicines_. They are not unduly puffed and +lauded, but simply recommended for such diseases as are easily +recognized and which they are _known to cure._ + + +NOT CONFINED IN PRESCRIBING + + +Our physicians, in the treatment of cases consulting us, prescribe just +such medicines as are adapted to each particular case. _They are not +confined in the least_ to our list of a few put-up or proprietary +medicines (valuable as they are when applicable to the case) but resort +to the whole broad range of the _materia medica_, employed by the most +advanced physicians of the age. They are not hampered by any school, +_ism_ or "_pathy_." + + +OUR MEDICINES PREPARED WITH THE GREATEST CARE. + + +The medicines employed are all prepared in our own Laboratory by skilled +chemists and pharmacists, and the greatest care is exercised to have +them manufactured from the freshest and purest ingredients. Our Faculty +probably employ a greater number and variety of native roots, barks, and +herbs, in their practice then are used in any other invalids' resort in +the land. Using vast quantities of these indigenous medicines, we can +afford and do not neglect to have them gathered with great care, at the +proper seasons of the year, so that their medicinal properties may be +most reliable. Too little attention is generally paid to this matter, +and many failures result from the prescribing of worthless medicines by +physicians who have to depend for their supplies upon manufacturers who +are careless or indifferent in obtaining the crude plants and roots from +which to manufacture their medicines for the market. While depending +largely upon solid and fluid extracts of native plants, roots, barks, +and herbs, in prescribing for disease, yet we do not use them to the +exclusion of other valuable curative drugs and chemicals. We aim to be +unprejudiced and independent in our selection of remedies, adopting at +all times a rational system of therapeutics. This liberal course of +action has, in a vast experience, proved most successful. + + + WORLD'S DISPENSARY MEDICAL ASSOCIATION, + 663 MAIN STREET, BUFFALO, N.Y. + + * * * * * + + + + +PRESIDENT GARFIELD'S + +ENDORSEMENT OF THE + +INVALIDS' HOTEL AND SURGICAL INSTITUTE + +_AND ITS FOUNDER._ + + +The following letter from an eminent lawyer of Tennessee, is noteworthy, +inasmuch as it shows the estimation in which Dr. Pierce and the +institutions which he has founded were held by the lamented Garfield, +who was one of the Doctor's intimate friends and colleagues while he was +serving as a member of Congress: + + OFFICE OF H.F. COLEMAN, + ATTORNEY AT LAW, + SNEEDVILLE, TENN., Aug. 11, 1884 + +_World's Dispensary Medical Association, 663 Main St., Buffalo, N.Y._ + +GENTLEMEN:--Your letter of the 31st ult. just received and contents +noted. I am perfectly satisfied with the explanation, and ask pardon for +the sharp letter written you some days since. The mails are very +irregular, as you know, and we are too apt to be impatient and attribute +our mishaps to the wrong cause. Your honesty, integrity and ability are +not doubted in the least by me. + +I have, perhaps, a higher endorsement of you than any other patient +under your care, and for your gratification I will give it to you. + +Some time since I was in conversation with Congressman Pettibone, of +this State, when the following conversation took place: "You say," said +the Major, "that you have visited Dr. Pierce's medical establishment in +Buffalo, New York?" "Yes, sir, I did." "You found everything as +represented?" "Yes, sir, as was represented, and which I assure you was +quite encouraging to a man who had traveled as far as I had to visit an +institution of that kind." "That man, Dr. Pierce," said the Major, "is +one of the best men of the times. While at Washington, during my first +term," he continued, "one day I was in President Garfield's room and a +fine-looking, broad-foreheaded gentleman came in, and President Garfield +arose and took him by the hand and said, 'Good morning, Doctor, I am so +glad to see you,' and then turned and introduced him to me as Dr. +Pierce, of Buffalo, New York. Knowing the Doctor by reputation, and +having seen his pictures, I at once recognized him. He, in a short time, +left the room, and Garfield said to me, 'Major, that is one of the best +men in the world, and he is at the head of one of the best medical +institutions in the world.'" + +With this high endorsement, I have unbounded confidence in your +integrity and ability. + + Very truly yours, + H.F. COLEMAN. + + * * * * * + + +NOTICES OF THE PRESS. + + + * * * * * + + +OUR PROFESSIONAL STAFF. + + +The Buffalo _Evening News_ says: "Each and every member of the medical +and surgical staff of the Invalids' Hotel and Surgical Institute is a +graduate in medicine and surgery from one or more legally chartered +medical colleges, and several of the members have had many years of +experience as army surgeons, and in hospital and general as well as in +special practice. One is a licentiate of the Royal College of +Physicians, Edinburgh; licentiate of the Faculty of Physicians and +Surgeons, Glasgow; licentiate of midwifery, Glasgow; member of the Royal +College of Surgeons, London, England; extraordinary member of the Royal +Medical Society, Edinburgh, etc. Another is a graduate of the University +of Pennsylvania, at Philadelphia; another of the New York Medical +College; another of the Buffalo Medical College, and of the College of +Physicians and Surgeons, New York; another of Cincinnati Medical +College, and of the University of New York; another from Buffalo Medical +College, and diplomas from all these institutions, as well as from many +others equally noted, can be seen at the offices of this institution, if +any one feels any interest in them." + + * * * * * + + +_FROM THE "ROMAN CITIZEN," (ROME, N.Y.)._ + +THE INVALIDS' HOTEL AND SURGICAL INSTITUTE. + + +One of the most extensive institutions in this country for the treatment +of chronic ailments is the Invalids' Hotel and Surgical Institute at +Buffalo, under the control of the World's Dispensary Medical +Association, of which Dr. R.V. PIERCE is President. The hotel itself is +a wonderful affair, combining all the comforts and conveniences of a +luxurious home with the most complete facilities for the successful +treatment of all chronic diseases incident to humanity. Dr. PIERCE has a +world-wide fame as a skillful practitioner, and his corps of assistants +comprises many physicians and surgeons of great ability and large +experience in the treatment of chronic and surgical diseases. Those who +have been treated by the Association are loud in their praises, and we +understand that the number of its patients increases with each +succeeding year. The country is full of people who have been "doctoring" +year after year without successful results, and the probabilities are +that in a majority of such cases a few months spent at the Invalids' +Hotel and Surgical Institute in the care of its medical experts, would +result in material and permanent benefit. + + * * * * * + + +_FROM THE WASHINGTON (D.C.) CHRONICLE._ + +ONE OF THE ATTRACTIONS AT BUFFALO. + + +In the enterprising city of Buffalo some eminent and capable +professional people have established an "Invalids' Hotel and Surgical +Institute," under the comprehensive direction and control of the +"World's Dispensary Medical Association" at 663 Main Street, in that +beautiful city. This Institute is organized with a full staff of +eighteen physicians and surgeons, and the hotel is exclusively devoted +to treatment of chronic diseases. This corps of doctors make a specialty +of chronic maladies, and the Institute is reputed to have abundant +skill, facilities and apparatus for the successful treatment of every +form of chronic ailment, whether requiring for its cure medical or +surgical means. + +The building occupied is a massive one of five stories. + + * * * * * + + +_FROM THE MISSOURI REPUBLICAN_ (_ST. LOUIS_). + +A REMARKABLE PROFESSIONAL SUCCESS. + + +Among the notable professional men of this country who have achieved +extraordinary success is Dr. R.V. PIERCE, of Buffalo, N.Y. The +prominence which he has attained has been reached through strictly +legitimate means, and so far, therefore, he deserves the enviable +reputation which he enjoys. This large measure of success is the result +of a thorough and careful preparation for his calling, and extensive +reading during a long and unusually large practice, which has enabled +him to gain high commendation, even from his professional brethren. +Devoting his attention to certain specialties of the science he has so +carefully investigated, he has been rewarded in a remarkable degree. In +these specialties he has become a recognized leader. Not a few of the +remedies prescribed by him have, it is said, been adopted and prescribed +by physicians in their private practice. His pamphlets and larger works +have been received as useful contributions to medical knowledge. He has +recently added another, and perhaps more important work, because of more +general application, to the list of his published writings. This book, +entitled "The People's Common Sense Medical Adviser," is designed to +enter into general circulation. For his labors in this direction, Dr. +PIERCE has received acknowledgments and honors from many sources, and +especially scientific degrees from two of the first medical institutions +in the land. His works have been translated into the German, Spanish, +French, and other foreign languages. + + * * * * * + + +_FROM THE TOLEDO BLADE_. + + +Dr. PIERCE has now been before the general public long enough to enable +the formation of a careful estimate of the efficiency of his treatment +and his medicines, and the verdict, we are glad to know, has been +universally favorable to both. + + * * * * * + + +_FROM THE ST. LOUIS GLOBE_. + +THE SUCCESSFUL PHYSICIAN. + + +Dr. PIERCE is a type of a class of men who obtain success by careful and +well-directed effort, not attempting too much, nor creating false ideas +as to ability. The only reliable physician, in these days of complicated +disorders and high-pressure living, is the "Specialist," the man who +understands his own branch of the business. Such, in his line, is Dr. +Pierce. He has written a "Common Sense Medical Adviser," which is well +worth reading. With strict business honor, high professional skill, +reasonable fees, and a large corps of competent assistants Dr. Pierce +has made his name as familiar as "household words." + + * * * * * + + +From _the Rocky Mountain Herald_. + + +Dr. R.V. PIERCE, the greatest American specialist, and proprietor of the +World's Dispensary, Buffalo, N.Y., has sent us his new book entitled +"The People's Common Sense Medical Adviser," which is a handsome, large +volume, elegantly got up, with hundreds of wood-cuts and colored +plates, and a complete cyclopedia of medical teachings for old and young +of both sexes. _It has every thing in it,_ according to the latest +scientific discoveries, and withal is wonderfully _commomensical_ in its +style and teachings. + + * * * * * + + +_From the Lafayette Daily Courier._ + + +Dr. R.V. PIERCE, of Buffalo, distinguished in surgery, and the general +practice of the profession he honors, has made a valuable contribution +to the medical literature of the day, in a comprehensive work entitled +"The People's Common Sense Medical Adviser." While scientific +throughout, it is singularly free from technical and stilted terms. It +comes right down to the common-sense of every-day life, and, to quote +from the author himself, seeks to "inculcate the facts of science rather +than the theories of philosophy." This entertaining and really +instructive work seems to be in harmony with the enlarged sphere of +thought, as touching the open polar sea of evolution. He considers man +in every phase of his existence, from the rayless atom to the grand +upbuilding of the noblest work of God. Dr. PIERCE is a noble specimen of +American manhood. He has sprung from the people, and with many +sympathies in common with the masses, has sought to render them a +substantial service in this the great work of his life. + + * * * * * + + +_From the New York Independent._ + +LAURELS FOR TRUE WORTH. + + + "A wise physician, skill'd our wounds to heal, + Is more than armies to the public weal." + +To be honored in his own land is the crowning blessing of the man who +has been "the architect of his own fortune"--the man who has made for +himself, with his own hands and brain, a princely fortune and an +enduring fame. From COMLEY'S History of New York State, containing +biographical sketches of the men who "have given wealth, stamina, and +character" to the Empire State, we clip the following brief sketch of +the distinguished physician, Dr. R.V. PIERCE, of Buffalo: "Every nation +owes its peculiar character, its prosperity--in brief, every thing that +distinguishes it as an individual nation,--to the few men belonging to +it who have the courage to step beyond the boundaries prescribed by +partisanship, professional tradition, or social customs. In professional +no less than in political life there occasionally arise men who burst +the fetters of conventionalism, indignantly rejecting the arbitrary +limits imposed upon their activity, and step boldly forward into new +fields of enterprise. We call these men _self-made._ The nation claims +them as her proudest ornaments--the men upon whom she can rely, in peace +for her glory, in war for her succor. Of this class of men the medical +profession has furnished a distinguished example in the successful and +justly-celebrated physician, Dr. R.V. PIERCE, of Buffalo, N.Y., and any +history treating of the industries of the Empire State would be +incomplete without a sketch of his useful and earnest work. * * * +Specially educated for the profession which he so eminently adorns, he +early supplemented his studies by extensive and original research in its +several departments. He brought to his chosen work acute perceptive and +reflective powers, and that indomitable energy that neither shrinks at +obstacles nor yields to circumstances. In physique, Dr. PIERCE is an +ideal type of American manhood. Of medium stature, robust, his +appearance is characterized by a healthful, vigorous vitality, while the +full, lofty brow and handsomely cut features are indicative of that +comprehensive mental power and remarkable business sagacity which have +combined to place him among the distinguished men of the age. * * * As +an earnest worker for the welfare of his fellow-men, Dr. PIERCE has won +their warmest sympathy and esteem. While seeking to be their servant +only, he has become a prince among them. Yet the immense fortune +lavished upon him by a generous people he hoards not, but invests in the +erection and establishment of institutions directly contributive to the +public good, the people thus realizing, in their liberal patronage, a +new meaning of the beautiful Oriental custom of casting bread upon the +waters. Noted in both public and private life for his unswerving +integrity and all those sterling virtues that ennoble manhood, Dr. +PIERCE ranks high among those few men whose names the Empire State is +justly proud to inscribe upon her roll of honor." Dr. PIERCE has lately +erected a palatial Invalids' Hotel for the reception of his patients, at +a cost of over half a million dollars. + + * * * * * + + +A MAN OF THE TIME. + + +Speaking of Dr. R.V. PIERCE, the _Buffalo_ (N.Y.) _Commercial_ says: "He +came here an unknown man, almost friendless, with no capital except his +own manhood, which, however, included plenty of brains and pluck, +indomitable perseverance, and inborn uprightness, capital enough for any +man in this progressive country, if only he has good health and habits +as well. He had all these great natural advantages, and one thing more, +an excellent education. He had studied medicine and been regularly +licensed to practice as a physician. But he was still a student, fond of +investigation and experiment. He discovered, or invented, important +remedial agencies or compounds. Not choosing to wait wearily for the +sick and suffering to find out (without any body to tell them) that he +could do them good, he advertised his medicines and invited the whole +profession of every school, to examine and pronounce judgment on his +formulas. He advertised liberally, profusely, but with extraordinary +shrewdness, and with a method which is in itself a lesson to all who +seek business by that perfectly legitimate means. His success has been +something marvelous--so great, indeed, that it must be due to intrinsic +merit in the articles he sells, more even than to his unparalleled skill +in the use of printer's ink. The present writer once asked a +distinguished dispensing druggist to explain the secret of the almost +universal demand for Dr. PIERCE'S medicines. He said they were in fact +genuine medicines--such compounds as every good physician would +prescribe for the diseases which they were advertised to cure. Of +course, they cost less than any druggist would charge for the same +article, supplied on a physician's prescription, and, besides, there was +the doctor's fee saved. Moreover, buying the drugs in such enormous +quantities, having perfect apparatus for purifying and compounding the +mixture, he could not only get better articles in the first place, but +present the medicine in better form and cheaper than the same mixture +could possibly be obtained from any other source. + + * * * * * + + +_Extracts from Biographical Sketches of New York Senators._ + + +At the age of eighteen, he (Dr. PIERCE) entered a medical school, and +proved a devoted student, graduating at twenty-three with the highest +honors. A simple knowledge of the routine of practice as then in vogue, +was not enough. He sought new means of healing, and explored "schools" +of practice that were prohibited by his sect. He denounced errors in +the prevailing "schools" and accepted truths belonging to those +prohibited. Every one knows how such daring and destructive innovations +are regarded by the medical profession generally. Dr. PIERCE was no +exception to the rule. But he paid no attention to detraction, pursuing +his own way with that energy which proves now to be a most excellent +ally of his medical instincts. + +The World's Dispensary is to-day the greatest institution of its kind in +the world. More than two hundred persons are employed, eighteen being +skillful physicians and surgeons, each devoting himself to a special +branch of the profession, all acting together when required, as a +council. The printing department of the Dispensary is larger than the +similar department of any paper outside of the _New York Herald._ + + * * * * * + + +_From The New York Times._ + +WELL-MERITED SUCCESS. + + +The author of "The People's Medical Adviser" is well-known to the +American public as a physician of fine attainments, and his Family +Medicines are favorite remedies in thousands of our households. As a +counselor and friend, Dr. PIERCE is a cultured, courteous gentleman. He +has devoted all his energies to the alleviation of human suffering. With +this end in view and his whole heart in his labors, he has achieved +marked and merited success. There can be no real success without true +merit. That his success is _real_, is evidenced by the fact that his +reputation, as a man and physician, does not deteriorate; and the fact +that there is a steadily increasing demand for his medicines, proves +that they are not nostrums, but reliable remedies for disease. The +various departments of the World's Dispensary in which his Family +Medicines are compounded and his special prescriptions prepared, are +provided with all modern facilities. + + * * * * * + + +_The New York Tribune says:_ + + +"The American mind is active. It has given us books of fiction for the +sentimentalist, learned books for the scholar and professional student, +but _few books for the people_. A book _for the people_ must relate to a +subject of universal interest. Such a subject is the physical man, and +such a book 'The People's Common Sense Medical Adviser,' a copy of which +has been recently laid on our table. The high professional attainments +of its author,--Dr. R.V. PIERCE, of Buffalo, N.Y.,--and the advantages +derived by him from an extensive practice, should alone insure for his +work a cordial reception." Price $1.50, post-paid. Address, WORLD'S +DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y. + + * * * * * + + +_From The Boston Daily Globe._ + +A CURE FOR MANY EVILS. + +What can be accomplished by judicious enterprise, when backed up by +ability and professional skill, is shown by the magnificent buildings of +the World's Dispensary and the Invalids' Hotel and Surgical Institute, +at Buffalo. While models of architectural beauty and completeness, their +real worth and usefulness consist rather in the humanitarian objects +they are made to serve. They stand superior to all institutions of their +kind, not only in material proportions but as well in the medical +knowledge and practical experience of those connected with them. In each +department are those and those only who by natural bent and training are +specially adapted to combating their particular class of "the ills which +flesh is heir to." + + + + +VOCABULARY + +OF THE + +COMMON SENSE MEDICAL ADVISER, + + +_GIVING EACH TECHNICAL WORD EMPLOYED, REFERRING TO ITS IMAGES/ADVISE +WHEN POSSIBLE, AND IN CASE THE WORD WILL NOT PERMIT OF A SHORT +DEFINITION, REFERRING TO THE PAGE WHERE A FULL DESCRIPTION OF ITS +MEANING MAY BE FOUND._ + + +A + + +ABDOMEN. The part of the body between the diaphragm and pelvis, +containing the stomach, intestines, etc. The belly. + +ABDOMINAL. Belonging to the Abdomen. + +ABORTION. Expulsion of the foetus before the seventh month of pregnancy. + +ABSORPTION. The function of taking up substances from within or without +the body. + +ACETABULUM. The bone socket which receives the head of the thigh bone. + +ACNE. Pimples upon the face, more common at the age of puberty. + +ADIPOSE TISSUE. A thin membrane composed of cells which contain fat. + +ADVENTITIOUS. Acquired. + +ALBUMEN IN URINE in chemical composition resembles the white of an egg, +and is detected by the application of heat, nitric acid, etc. + +ALBUMINOID. Of the nature of albumen. + +ALBUMINURIA. A condition or disease in which the urine contains albumen. +(See above.) + +ALIMENTARY CANAL. The canal extending from the mouth to the anus, +through which the food passes. + +ALLOPATHY. Allopathic school. Defined on page 293. + +ALTERATIVE. A medicine which gradually changes the constitution, +restoring healthy functions. + +ALVEOLAR PROCESS. The bony structure which contains the sockets of the +teeth. + +AMAUROSIS. Loss or decay of sight from disease of the optic nerve. + +AMENORRHEA. Suppression of the menses. + +AMNION. A membrane enveloping the foetus and the liquid. + +AMPUTATION. The operation of cutting off a limb. + +AMYLOID DEGENERATION. Alteration in the texture of organs, which +resembles wax or lard. + +AMYLOIDS. Foods composed of carbon and hydrogen; as sugar, starch, etc. + +ANÆMIA. Privation of blood. Lack of red corpuscles in the blood. + +ANASARCA. Dropsy attended with bloating all over the body. + +ANATOMY. The science of the structure of the body. + +ANESTHETIC. An agent that prevents feeling in surgical operations, and +in some diseases of a painful nature. + +ANGINA (PECTORIS). Violent pain about the heart, attended with anxiety +and difficult breathing. + +ANIMALCULA, ANIMALCULE. An animal so small as to be invisible, or nearly +so, to the naked eye. + +ANODYNES. Medicines which relieve pain. + +ANTEVERSION. The womb falling forward upon the bladder. Illus. p. 716. + +ANTHELMINTICS. Medicines which destroy or expel worms from the stomach +and intestines. + +ANTIDOTE. A remedy to counteract the effect of poison. + +ANTIFEBRILE. A remedy which abates fever. + +ANTIPERIODIC. A remedy which prevents the regular appearance of similar +symptoms in the course of a disease. + +ANTISEPTIC. Medicines which prevent putrefaction. + +ANTISPASMODICS. Medicines which relieve spasm. + +ANUS. The circular opening at the end of the bowel, through which the +excrement leaves the body. + +AORTA. The great artery of the body arising from the heart. Illus. page +58. + +APERIENT. A medicine which moves the bowels gently. + +APHTHÆ. Sore mouth, beginning in pimples and ending in white ulcers. + +APHTHOUS. Complicated with aphthæ. + +APNOEA. Short, hurried breathing. + +APOPLEXY. The effects of a sudden rush of blood to an organ; as the +brain, lungs, etc. Brain pressure, from rupture of a blood-vessel. + +AQUEOUS HUMOR. The clear fluid contained in the front chambers of the +eye. + +ARACHNOID. A thin, spider-web like membrane covering the brain. + +AREOLAR TISSUE. The network of delicate fibres spread over the body, +binding the various organs and parts together. + +ARTERY. A vessel carrying blood from the heart to the various parts of +the body; usually red in color. + +ARTICULAR. Relating to the joints. + +ARTICULATED. Jointed. + +ARTICULATIONS. The union of one bone with another. A Joint. + +ASCITES. Accumulation of fluid in the abdominal cavity. + +ASPHYXIA. A condition of apparent death owing to the supply of air being +cut off; as in drowning, inhalation of gases, sun-stroke, etc. + +ASPIRATOR. An instrument for the evacuation of fluids from the cavities +of the body, as water in abdominal dropsy, the contents of tumors, etc. + +ASSIMILATION. Appropriating and transforming into its own substance, +matters foreign to the body. + +ASTRINGENTS. Medicines which contract the flesh. + +ATONIC, ATONY. Wanting tone. + +ATROPHIED. Wasted; lessened in bulk. + +ATROPHY. Wasting away; diminution in size. + +AUDITORY NERVES. The nerves connecting the brain with the ears and +employed in exercising the sense of hearing. + +AUSCULTATION. Diagnosing diseases by listening, either with or without +instruments. + + +B + + +BALANITIS. Gonorrhea of the mucous surface of the head of the penis. + +BENIGN. Harmless; a term applied to tumors. + +BEVERAGE. A liquor for drinking. + +BILE. A yellow bitter fluid secreted by the liver. Defined on page 80. + +BILIOUS. Disordered in respect to bile. Relating to bile. + +BILIOUS TEMPERAMENT, VOLITIVE TEMPERAMENT. See page 173. + +BIOLOGY. The science of life. + +BISTOURY. A small cutting knife. + +BLADDER (URINARY). The organ, situated behind the pubic bone, which +holds the urine until its expulsion. Illus. pages 206 and 207. + +BLEBS. Eminences of the skin containing a watery fluid. + +BLOODY-FLUX. A disease characterized by frequent, scanty, and _bloody_ +stools. + +BOIL. An inflamed tumor which comes to a head and discharges matter and +a core. See page 443. + +BOLUS. A large pill. + +BOUGIE. A long, flexible instrument used for dilating contracted canals +and passages. + +BREACH. Some form of hernia of the abdomen. See page 862. + +BROAD LIGAMENTS OF THE UTERUS. Folds of the peritoneum which support the +womb and contain the Fallopian tubes and ovaries. Illus. p. 206. + +BRONCHEA. Tubes formed by the division of the windpipe. Illus. page 64. + +BRONCHOCELE. Thick neck, goitre. + +BUBO. An inflammatory tumor in the groin. + +BULLA. A bleb or large pimple containing transparent fluid. + + +C + + +CACHEXIA. A depraved condition of the system; as from poor food, +syphilis, etc. + +CALCAREOUS. Containing lime. + +CALCIFICATION. The process of forming of, or converting into, chalk. + +CALCULUS, CALCULI. Stones or similar concretions formed by the deposit +of solid matter; of lime, soda, uric acid, urates, oxalates, etc. + +CALISTHENICS. Healthful exercise of the body and limbs, for purposes of +strength and agility. + +CANCELLATED STRUCTURE. Cells communicating with each other forming a +structure resembling "lattice-work." + +CANKER. Ulcers in the mouth. + +CAPILLARIES. Very small blood-vessels. Defined on page 60. + +CARBONIC ACID. A heavy, poisonous gas. Choke damp. + +CARDIAC. Pertaining to the heart. Near or towards the heart. + +CARMINATIVES. Medicines which allay pain in the stomach and intestines +by expelling the gas. + +CAROTIDS. The great arteries at the sides of the neck. + +CARTILAGE. A solid part of the body found in the joints, ends of the +ribs, etc. It is softer than bone but harder than ligament. + +CARTILAGINOUS TISSUE. Parts of the body of the nature of cartilage. + +CARUNCULÆ. Fleshy growths. + +CASEIN. The part of milk which contains nitrogen. Cheese curd. + +CATALYTICS. Medicines which destroy morbid agencies in the blood. +Alteratives. + +CATAMENIA. Monthly flow of the female. + +CATARACT. Opacity of the lens of the eye, or its covering, or both. + +CATHARTICS. Medicines which cause evacuation of the bowels. + +CATHETER. A hollow tube introduced into the bladder through the urethra +for the purpose of drawing off the urine. + +CAUSTICS. Substances which destroy animal tissue. + +CAUTERIZATION. Burning or searing by a hot iron, or caustic medicines. + +CAUTERIZE. To burn or sear by a hot iron, or by medicines which destroy. + +CELL. A little vessel having a membranous wall and containing fluid. The +whole body may be considered as formed of different kinds of cells. + +CELLULAR STRUCTURE. See CANCELLATED STRUCTURE. + +CEREBELLUM. Little brain. Base brain. Illus. page 100. + +CEREBRUM. The upper or large brain. Illus. page 100. + +CERVIX. Neck; neck of the womb. Illus. page 206. + +CHALYBEATE. Mineral waters which contain iron. + +CHANCRE. A virulent, syphilitic ulcer. Figs. 27 and 28, Plate V., +Pamphlet X. + +CHANCROID. Resembling infectious chancre. Soft chancre. + +CHLOROSIS. Green sickness. A disease of young women attended with a +greenish hue of the skin, debility, etc. + +CHOLAGOGUES. Cathartics which stimulate the liver. + +CHORDÆ TENDINEÆ. Cord-like substances about the valves of the heart. +See page 57. + +CORDEE. + +CHOROID. The dark colored lining membrane of the eye. + +CHYLE. Food digested and ready for absorption. See pages 45 and 49. + +CHYLOUS PRODUCTS. See CHYLE. + +CHYME. Food after being subjected to the action of the gastric fluids. + +CICATRIX. The scar or place where parts which have been cut or divided, +are united. + +CILIA. Small hairs. + +CIRCUMCISION. An operation for removing superfluous foreskin. + +CIRCUMVALLATE. Arranged in oblique lines, as the prominences on the back +of the tongue. + +CLAP. Gonorrhea. A venereal disease of the urethra. + +CLAVICLE. See COLLAR-BONE. + +CLINICAL MEDICINE. Investigation of disease at the bedside. + +COAGULATE. To thicken or harden, as heat hardens the white of an egg. + +COITION. Sexual intercourse. The act of generation. + +COLLAR-BONE (CLAVICLE). A bone at the front and top of chest, attached +by one end to the breast-bone and by the other to the shoulder-blade. + +COLON. Part of the large intestines. Illus. page 40. + +COMA. A condition of profound sleep from which it is difficult to arouse +the patient. + +COMEDONES. Pimples on the face. See page 412, and Fig. 8. Plate II. + +COMPRESS. A soft cloth folded to several thicknesses, so that with a +bandage pressure can be applied, or by wetting in hot water, a part can +be subjected to the influences of heat and moisture. + +CONCEPTION. Impregnation of the ovum; the beginning of a new being. + +CONGENITAL. Applied to a disease born with one; from birth. + +CONGESTION. An abnormal amount of blood in a part or organ. + +CONJUNCTIVA. The membrane which covers the external surface of the +eyeball. + +CONJUNCTIVITIS. Inflammation of the eye. + +CONTAGION. The transmission of disease from one to another by contact, +as hydrophobia, syphilis; or otherwise, as measles, scarlet fever, etc. + +CONTAGIOUS. Capable of being transmitted from one person to another. + +CONTINENCE. Abstinence from sexual intercourse or excitement. + +CONVALESCENCE. The recovery of health after sickness. + +CONVOLUTED. Curved or rolled together. + +COPULATION. Sexual intercourse. + +CORIUM. A layer of the akin. + +CORNEA. A transparent covering of the front of the eye. + +CORPUSCLES OF THE BLOOD. Defined and illustrated on page 53. + +COUNTER-IRRITANTS. Defined on page 331. + +COWPER'S GLANDS OF THE MALE. Glands situated in front of the prostate +gland. Illus. page 207. + +COXALGIA. Hip-joint disease. See page 451. + +CRANIUM. The skull. The bones of the head. + +CRAYONS. Sticks or cylinders made of Cocoa butter and medicated. + +CROSS-EYE. One or both eyes drawn towards the nose. Squint. + +CRUSTACEOUS. Belonging to the class of animals covered by a crust-like +shell. + +CUTANEOUS. Belonging to, or affecting, the skin. + +CUTICLE. The outer layer of the skin, consisting of small bony scales. + +CYSTITIS. Inflammation of the bladder. In chronic form, Catarrh of the +bladder. + + +D + + +DEBRIS. Broken-down tissue. Waste material. + +DECOCTION. Defined on page 303. + +DEFECATION. Voiding excrement from the body. + +DEGENERATION, FATTY. The deposit of particles of fat instead of the +proper muscular tissue. + +DEGLUTITION. Swallowing. Conveying food to the stomach. + +DEJECTION OF MIND. Despondency. Low spirits. + +DEJECTIONS. The matter voided from the bowels. + +DELETERIOUS. Destructive. Poisonous. + +DENTITION. Cutting of the teeth in infancy. + +DEODORIZER. A substance that destroys a bad smell. + +DEPLETION. To empty the blood-vessels by lancing a vein or by medicines. + +DEPRAVATION. Corruption. + +DEPURATING. Cleansing. + +DERMATOLOGIST. One who makes diseases of the skin a specialty. + +DESICCATE. To dry up. + +DESQUAMATION. Scaling off of the skin, after fevers. + +DESQUAMATIVE NEPHRITIS, Bright's Disease, in which epithelial cells +escape with the urine. + +DIABETES. Defined on page 835. + +DIAGNOSIS. The determination of a disease by its symptoms or +characteristics. + +DIAGNOSTIC. The symptoms by which a disease is distinguished from +others. + +DIAPHORETIC. Medicines which increase perspiration. + +DIAPHRAGM. Defined on page 32. + +DIATHESIS. Peculiarity of constitution. Predisposition to certain +diseases. + +DIGESTION. The function by which food passing along the alimentary canal +is prepared for nutrition. + +DILATATION. Increasing in size by Instruments or other agencies. + +DILUENTS. Fluids which thin the blood or hold medicines in solution. + +DIRECTOR. An instrument having a groove which directs the knife and +protects underlying parts from injury. + +DISINFECTANTS. Substances which arrest putrefaction. + +DISLOCATION. The act of or state of, being forced from its proper +situation. + +DISTILLED. Separated by heat from other substances and collected by +condensation. + +DIURETICS. Medicines which increase the flow of urine. + +DOUCHE. Dashes of water. An instrument for washing the nasal membrane. + +DRASTICS. Medicines which move the bowels harshly or frequently. + +DROPSY. The accumulation of fluid In the cavities or cellular tissue of +the body. + +DUODENUM. The first portion of the intestines. Illus. page 44. + +DURA MATER. A thick, fibrous membrane lining the skull. + +DYSCRASIA. A bad condition of body. + +DYSENTERY. A disease characterized by frequent, scanty and _bloody_ +stools. + +DYSMENORRHEA. Difficult or painful menstruation. + +DYSPNOEA. Difficult breathing. + + +E + + +EAR, INTERNAL. Defined on page 110. Illus. page 109. + +EARTHY PHOSPHATES. The white deposit in urine, composed of phosphoric +acid and a base. + +ECCHYMOSIS. Black or yellow spots produced by effused blood. Black eye +Is an example. + +ECLECTIC SCHOOL. See page 294. + +ECRASEUR. An instrument which amputates by a loop of wire. + +ECZEMATOUS. Of the nature of Eczema. See page 430. + +EDEMA (OEDEMA). Puffiness of the skin from the accumulation of fluid. +General dropsy. + +EFFLUVIA. Unpleasant odors or exhalations. + +EFFUSION. The pouring out of blood or other fluid. + +ELECTROLYSIS. Decomposing or modifying by the application of +electricity. + +ELIMINATED. Discharged, expelled. + +EMACIATION. Leanness in flesh. + +EMBRYO. The young of an animal at the beginning of its development in +the womb. + +EMETICS. Medicines which empty the stomach upwards. + +EMMENAGOGUES. Medicines which favor or cause menstruation. + +EMPIRICISM. Practicing medicine upon results of experience, generally by +a person without a medical education. + +ENCEPHALIC TEMPERAMENT. Defined on page 177. + +ENDOCARDITIS. Inflammation of the lining membrane of the heart. + +ENDOCARDIUM. The lining membrane of the heart + +ENDOMETRLTLS. Disease of the lining membrane of the womb. + +ENTERIC. Intestinal. + +ENTERITIS. Inflammation of the mucous lining of the small intestines. + +EPIDEMICS. Diseases which attack a number of persons at the name time: +as yellow fever, small-pox, etc. + +EPIGLOTTIS. A cap over the windpipe, allowing the admission of air, but +preventing the introduction of foreign bodies. + +EPITHELIAL CELLS. Cells belonging to the epithelium. + +EPITHELIUM. The thin covering upon the lips, nipple, mucous and serous +membranes and lining the ducts, blood-vessels and other canals. + +ESOPHAGUS (OESOPHAGUS). The food-pipe. Illus. page 44. + +EUSTACHLAN TUBE. The tube leading from the throat to the inner ear. +Illus, page 109. + +EVACUAUT. Cathartic. + +EVOLUTION. Defined on page 14. + +EXCORIATES. Removes the skin in part. + +EXCORIATION. A wound which removes some of the skin. + +EXCREMENTITIOUS. Pertaining to the matter evacuated from the body. + +EXCRESCENCES. Surface tumors; as warts, piles, polypi, etc. + +EXCRETION. The process by which waste materials are removed from the +blood, performed particularly by the lungs, skin and kidneys. + +EXCRETORY DUCTS. Minute vessels which transmit fluid from glands. + +EXHALATIONS. That which is thrown off by the body, as vapor, gases, etc. + +EXPECTORANTS. Medicines which promote discharges from the lungs. + +EXPIRATION. Expelling the breath. + +EXTRANEOUS MATTER. Any substance which finds a place in the body and +does not belong there. Foreign substances. + +EXTRA-UTERINE. Outside of the womb, but in its vicinity. + +EXTRAVASATED. Escaped into surrounding tissues. + +EXTREMITIES. Legs or arms. + +EXUDATION. Substances discharged through the pores. + +EXUDE. To sweat; to pass through a membrane. + + +F + + +FALLOPIAN TUBE. The canal through which the ovum passes from the ovary +to the womb. + +FARADIZATION. The application of electricity by inductive currents. + +FASCIA. The white fibrous expansion of a muscle which binds parts +together. + +FATTY DEGENERATION. The deposit of particles of fat instead of proper +muscular tissue. + +FEBRIFUGE. A medicine which abates or cures fevers. + +FEBRILE. Relating to fever. + +FECUNDATION. The ovum uniting with the male germ. Impregnation. + +FEMORAL HERNIA. Thigh hernia. Illus. page 863. + +FERMENTED. Changed by a process of decomposition. + +FERRUGINOUS. Containing iron. + +FETID. Having an offensive smell. Stinking. + +FETOR. Offensive smell. Stench. + +FIBROUS. Composed of fibres. + +FIBROUS TISSUE. The texture which unites every part of the body. + +FILAMENTS. Fibre; the basis of texture. + +FIMBRIATED. Finger-like. + +FIRST INTENTION, HEALING BY. Healing without suppuration or the +formation of pus. + +FISSURE. A crack. + +FISTULA: FISTULÆ. Small canals or tubes which carry pus or other +liquids through the flesh. + +FISTULA, URINARY. The abnormal communication between the urinary +passages and the external surface. + +FISTULOUS OPENINGS. The outer end of canals or tubes which carry pus to +the surface. + +FLATULENCY. Wind gathered in the stomach or bowels. + +FLEXION OF THE WOMB. A partial misplacement in which the womb is bent +upon itself. + +FLEXURES. Bending. Motion of a joint. + +FLOCCULENT. Combining or adhering in flocks or flakes. + +FLUID EXTRACTS. The active principles of medicines in fluid form. + +FOETUS. The unborn child. + +FOLLICLES (OF HAIR). Small depressions in the skin. + +FOLLICULAR. Relating to or affecting follicles. + +FOMENTATIONS. Local application of cloths wrung out of hot water. + +FORCEPS. An instrument having a motion and use like the thumb and +fore-finger. Pincers. Obstetrical forceps embrace the head of the +foetus. + +FORESKIN. That part of the skin of the penis which is prolonged over the +head of the organ. + +FORMICATION. A sensation like a number of ants creeping on a part. + +FRACTURE. Broken bone. _In compound fracture_ the end of the bone +projects through the skin. + +FUNCTION. The peculiar action of an organ, or part of the body. + +FUNCTIONAL. Pertaining to the specific action of an organ or part. + +FUNDUS. The bottom or base of an organ. The fundus of the womb is its +upper part, when in its natural position. + +FUNGIFORM. Mushroom-shaped. + + +G + + +GALVANISM. Electricity. + +GALVANO-CAUTERY. Burning or scarring by galvanic electricity. + +GANGLION. A nerve center which forms and distributes nerve-power. + +GANGRENE. Death of a part. + +GASTRIC. Pertaining to the stomach. + +GASTRIC JUICE. The digestive fluid supplied by the mucous membrane of +the stomach. + +GELATINOUS. Jelly-like. + +GENERATION. The functions which are active in reproduction. + +GENITALS. The sexual organs. + +GESTATION. Carrying the embryo in the uterus. + +GLANS. Head of the penis. + +GONORRHEA. A discharge of mucous from inflammation of the urethra or +vagina, caused by impure connection. Clap. + +GRANULAR CASTS. Moulds of epithelium found by the microscope in chronic +Bright's Disease. + +GRANULAR LIDS. Roughness on the inner surface of the eyelids. + +GRANULATIONS HEAL BY. See GRANULATIONS. + +GRANULATIONS. Flesh-like shoots, which appear in a wound and form its +scar. + +GRANULES. Small grains. + +GRAVEL. Substances precipitated in the urine resembling sand. + +GROIN. The oblique depression between the belly and thigh. + +GRUBS. Pimples on the face. See page 442. + +GYNECOLOGIST. One who makes the Diseases of Women a specialty. + + +H + + +HAIR BULBS. The expansion or root of the hair. + +HALLUCINATIONS. Perception or sensation of objects which do not exist; +as in Tremens. + +HECTIC. Constitutional; as hectic fever, in which all parts of the body +become emaciated. + +HEMIPLEGIA. Paralysis affecting only one side of the body. + +HEMORRHOIDAL VEINS. The veins about the rectum which enlarge and form +piles. + +HEPATIC. Relating or belonging to the liver. + +HEREDITARY. A disease transmitted from parent to child. + +HERNIA. Defined on page 862. + +HOLLOW OF THE SACRUM. The concave portion of the lower part of the +spinal column within the pelvis. + +HOMEOPATHY. Defined on page 294. + +HYALINE CASTS. Glassy appearing substances found by the microscope in +urine in chronic Bright's Disease. + +HYDRAGOGUES. Cathartics which produce copious watery discharges. + +HYDROCELE. Accumulation of fluid in the scrotum. + +HYDROCEPHALUS. Accumulation of fluid in the membranes about the brain. + +HYDROTHORAX. Accumulation of fluid in the chest cavities. + +HYGIENE. The principles or rules for the promotion or preservation of +health. + +HYMEN. Described on page 687. HYPERSEMIA. Full of blood. Congestion. + +HYPERTROPHY. Enlargement, thickening. + +HYPOCHONDRIAC. A person, usually dyspeptic, who is unreasonably gloomy, +particularly about his health. + +HYPODERMIC SYRINGE. An instrument having a very fine tube and +needle-like point, by which medicines are lodged immediately under the +skin. + +HYSTEROTOME. An instrument described and illustrated on page 696. + + +I + + +IDIOPATHIC. Primary: not depending on another disease. + +ILLICIT. Not permitted; unlawful. + +ILLUSIONS. See HALLUCINATIONS. + +IMPACTED. Wedged. Applied to feces which have remained in the rectum a +long time. + +IMPERFORATE. Without a natural opening. + +IMPOTENCY. Loss of sexual power. + +IMPREGNATION. Imparting the vital principle of the sperm-cell to the +germ-cell, by which a new being is created. + +INCIPIENT. Commencement; first stage. + +INDEPENDENT PHYSICIAN. Defined on page 295. + +INDIGENOUS. Native. Grows in a country. + +INDOLENT. Painless; a term applied to tumors. + +INDURATION. Hardening of a part or organ. + +INFECTION. A prevailing disease. A disease spread only by contact, as +itch, syphilis, etc. + +INFILTRATION. The passage of fluid into the cellular tissue; as in +General Dropsy. + +INFLAMMATION. Defined on page 398. + +INFUSION. Defined on page 303. + +INGUINAL CANAL. A canal situated in the groin, through which the +spermatic cord passes. The common seat of Hernia. Illus. page 862. + +INOCULATE. To communicate a disease by inserting matter in the flesh; as +by vaccination. + +INORGANIC. Mineral. Bodies without organs. + +INSALIVATION. Mixed with the saliva of the mouth, as food. + +INSEMINATION. The emission of sperm in coition. + +INSPIRATION. Drawing in the breath. + +INTEGUMENT. The skin. + +INTENTION, HEALING BY FIRST. Healing without the formation of pus. + +INTERCOSTAL. Between the ribs. + +INTERMITTENT. Having paroxysms or intervals. + +INTERNAL EAR. Described on page 110; Illus. page 109. + +INTUSSUSCEPTION. One part of the intestines forced into another part. + +INVAGINATION. See INTUSSUSCEPTION + +IRIDECTOMY. A surgical operation for the removal of the Iris. + +IRIS. A curtain which gives the eye its color. + +ISOLATION. Separation from others. + + +K. + + +KADESH-BARNEA. The holy place in the desert of wandering; the +headquarters of the Israelites for 37 years. + + +L + + +LABORATORY. The work-room of a chemist or pharmacist. + +LACERATION. A wound made by tearing. + +LACHRYMAL. Belonging to the tears. + +LACHRYMAL GLANDS. Minute organs about the eyes which secrete tears. + +LACTATION. The act of giving suck. + +LACTEALS. The vessels of the breast which convey milk. + +LAMELLA. Layer. + +LAMINAE. Thin bones, or the thin parts of a bone. + +LANCINATING. Acute, shooting pains fancifully compared to the pierce of +a lance. + +LARYNX. That portion of the air-passage indicated in the male by "Adam's +Apple." + +LASCIVIOUS. Lustful; producing unchaste emotions. + +LATERAL OPERATION. Cutting through the perinæum into the bladder. + +LAXATIVES. Medicines which move the bowels gently. + +LESION. Derangement. Tearing or other division of parts, previously +continuous. + +LEUCORRHEA. Described on page 702. + +LIBERAL PHYSICIAN. Defined on page 295. + +LIGAMENT. A white inelastic tendon binding bones together. + +LIGATION. See LIGATURE. + +LIGATURE. A cord or catgut tied around a blood-vessel to arrest +hemorrhage. + +LINE. One-twelfth part of an inch. + +LITHIC DEPOSITS. Sediment or stone formed in the urine by uric acid. + +LOBES. Bound projecting parts of an organ; as lobes of the lungs, of the +liver, etc. + +LOIN. The side of the body between the hip-bone and ribs. + +LOTION. A wash. + +LUMBAGO. Rheumatism in the small of the back and loins. + +LUMBAR VERTEBRÆ. That part of the backbone in the vicinity of the loins. + +LYMPH. A transparent fluid, resembling blood, found in lymphatic +vessels. It contains corpuscles and coagulates. + +LYMPHATICS. Defined on page 49. + +LYMPHATIC TEMPERAMENT. Described on page 157. + + +M + + +MALARIA. See MIASM. + +MALFORMATION. Irregularity in structure. + +MALIGNANT. Applied to diseases which threaten life. + +MAMMÆ. See MAMMARY GLANDS. + +MAMMALIA. Animals that suckle their young. + +MAMMARY GLANDS. The breasts or organs which secrete milk. + +MANIPULATIONS. Examination and treatment by the hand. + +MASSAGE. Kneading, rubbing and stroking the surface to improve +circulation and nutrition and to remove effete material. + +MASTICATION. Chewing. + +MASTURBATION. Excitement of the sexual organs by the hand. + +MEATUS. Canal or passage. External opening of a canal. + +MEDIAN SECTION. An operation for stone in the bladder in which the +perineum and part of the urethra are cut; the prostatic portion of the +urethra is dilated to introduce forceps and withdraw the stone. + +MEDULLA OBLONGATA. Described on page 90; illus. page 96. + +MELANCHOLIA. A mild form of insanity attended with great gloom and +mental depression. + +MEMBRANOUS. Of the nature or construction of membrane. + +MENINGES. Membranes covering the brain. + +MENORRHAGIA. Immoderate monthly flow. + +MENSES. Monthly flow of the female. See page 686. + +MENSTRUATION. The bloody evacuation from the womb. + +MENSTRUUM. A solvent; as water, alcohol, etc. + +MESENTERIC GLANDS. Glands about the peritoneum which secrete lymph. + +MESENTERY. Described on page 49. + +MIASM, MIASMA. A poisonous, gaseous exhalation from decaying vegetation, +or from the earth. + +MIDWIVES. Females who attend women at childbirth. + +MISCARRIAGE. Defined on page 682. + +MOLECULE. A minute portion of any body. + +MONADS. The smallest of all visible animalcules. + +MONOMANIA. Insanity on one subject. + +MUCO-PURULENT. Composed of mucus and pus. + +MUCOUS MEMBRANE. The thin, web-like lining to the canals and cavities +which secretes a fluid by which it is constantly lubricated. + +MUCUS. A mucilaginous fluid found on the surface of certain membranes +which keeps them soft and pliable. See MUCOUS MEMBRANE. + +MUSCLE. The structures of the body which execute movements. + +MUSCULAR TISSUE. The flesh forming the muscles of the body. + +MYALGIA. Muscular rheumatism. + + +N + + +NARCOTICS. Medicines which stupefy. + +NECROSIS. Mortification or death of bone. + +NERVINES. Defined on page 345. + +NERVOUS TISSUE. That part of the body composed of nerve-fibres. + +NEURALGIA. Described on page 635. + +NICOTIN. A poisonous principle of tobacco. + +NITROGEN. One of the gases in the atmosphere. + +NODES. Hard lumps, principally found upon the bones in syphilis. + +NOXIOUS. Injurious. + +NYMPHOMANIA. Extreme desire for sexual intercourse in the female. + + +O + + +OBSTETRICAL. Relating or appertaining to childbirth. + +OCCLUSION. Approximation or closure. + +OEDEMA. See EDEMA. + +OLFACTORY NERVE. The nerve employed in the sense of smell. Illus. page +111. + +ONANISM. See MASTURBATION + +OPACITY. Opaque condition of parts of the eye, causing blindness. + +OPALESCENT. Reflecting a milky light. + +OPAQUE. See OPACITY. + +OPHTHALMIA. Inflammation of the eye. + +OPHTHALMIC. Belonging to the eye. + +OPHTHALMOSCOPE. An instrument for examining the inside of the eye, for +diagnostic purposes. + +OPTIC NERVE. The nerve connecting the brain and eye, and employed in the +sense of sight. + +ORGANIC. Pertaining to the structure of an organ. + +ORIFICE. Opening or mouth. + +OSSEOUS TISSUE. Bony structure. + +OSSIFICATION, OSSIFYING. Made into bone by the deposit of phosphate of +lime. + +OS UTERI. Mouth of womb. Illus. page 206. + +OVA. Plural of ovum. + +OVARIES. Two ovoid bodies situated either side of the womb. Illus. page +206. + +OVARY. The female organ in which the ovum, or germ-cell, is formed. +Illus, page 206. + +OVULATION. The formation of the germ-cell in the ovary and its release +from that organ. + +OVUM. Defined and illustrated on pages 12 and 13. + +OXYGEN. The vital gas of the atmospheric air. + +OZÆNA. Described on page 474. + + +P + + +PALLIATIVE. A remedy or treatment which relieves, but does not cure. + +PAPILLA, PAPILLAE. Small, nipple-shaped prominences found on the tongue, +the skin, etc. + +PARAPLEGIA. Paralysis affecting the upper or lower extremities of the +body + +PARASITES. Animals which live in the bodies of other animals; as the +tape-worm itch insect, etc. + +PARENCHYMA. The texture of an organ; as the liver, kidneys, etc. + +PAROTID GLANDS. These are situated under the ear, just at the angle of +the lower jaw, and secrete saliva. + +PAROXYSMS. The periodical attack, fit or aggravation in the course of a +disease. + +PARTURIENT. Bringing forth or having recently brought forth. + +PARTURITION. Labor; the delivery of the foetus. + +PASTILES. Small medicated lozenges. + +PATHOGNOMONIC. A _characteristic_ symptom of a disease. + +PATHOLOGY. That part of the Science of Medicine the object of which is +the knowledge of disease. + +PEDICLE. The stalk or narrow part of a tumor by which it is attached and +supported. + +PELVIC. Belonging to and relating to the pelvis. + +PELVIS. The lower part of the abdomen or trunk, composed of bone, +containing the genital and urinary organs; supports the backbone and is +supported by the legs. + +PENIS. The male organ of generation. Illus. page 207. + +PEPSIN. The digestive solvent secreted by the stomach. + +PEPTIC. Pertaining to the stomach. + +PERCUSSION. Striking the surface and by the sound produced judging of +the condition of the internal organs. + +PERICARDITIS. Described on page 548. + +PERICARDIUM. The membranous sac enclosing the heart. + +PERINEAL SECTION. An operation by division of the perineum. + +PERINEUM. The space bounded by the end of the spine, sexual organs and +the bony prominences on which one sits. + +PERIOSTIUM. The membranous covering to all bones. + +PERISTALTIC MOTION. A worm-like movement of the bowels by which the food +is moved forward. + +PERITONEUM. The membrane (serous) which lines the abdominal cavities and +surrounds the intestines. + +PERITONITIS. Inflammation of serous membrane lining abdominal and pelvic +cavities. + +PESSARIES, PESSARY. An instrument for holding the womb in its place. + +PESTILENCE. A malignant, spreading disease. A plague. + +PHAGADENIC. That which corrodes or eats away rapidly. + +PHARMACEUTICAL. Anything belonging to pharmacy. + +PHARYNX. The cavity back of the mouth and palate through which the air +passes when breathing and the food when swallowing. + +PHIMOSIS. Elongated prepuce + +PHLEGMONOUS. Affecting the cellular membrane. The common boil is an +example. + +PHOSPHATE. A substance containing phosphorus. + +PHOSPHATES, EARTHY. The white deposit in urine composed of phosphoric +acid and a base. + +PHTHISIC. Consumption. By some the word is used for Asthma, or +difficulty in breathing. + +PHTHISIS. Consumption. See p. 497. + +PHYSIOLOGICAL ANATOMY. The branch of medicine that defines the organs of +the body and their particular actions. + +PHYSIOLOGY. The science which treats of the phenomena and functions of +animal life. + +PIA MATER. The internal vascular membrane covering the brain. + +PIMPLES ON THE FACE. Defined on page 443. + +PLACENTA. Afterbirth. + +PLAGUE. A malignant epidemic; begins in Asia Minor. + +PLETHORA, PLETHORIC. Full of blood; maybe general or confined to a part. + +PLEURA. Defined on page 64. + +PLEURODYNIA. Spasmodic or rheumatic pain in the chest muscles. + +PLEURO-PNEUMONIA. Inflammation of both the pleura and lungs. + +POLLUTION (SELF). Excitement of the sexual organs by the hand or other +unnatural method. + +POLYP. An aquatic animal, as the coral builders. + +POLYPI. More than one polypus. + +POLYPOID. Like a polypus in shape or construction. + +POLYPUS. Tumors which grow from mucous membranes, commonly found in the +nasal and vaginal cavities. + +PORTAL VESSELS. The cluster of veins which join and enter the liver. + +POTT'S DISEASE. Described on page 898; illus. pages 898 and 899. + +POULTICE. A mixture of bread or meal, etc., and hot water, spread on a +cloth and applied to the surface. + +POX. Syphilis. + +PRECOCITY. Prematurely developed. + +PREHENSION. Carrying food to the mouth. + +PREPUCE. Foreskin. + +PROBANG. Soft swab. + +PROBE. An instrument for examining wounds and cavities. A piece of wire +with a blunt point is a probe. + +PROCREATION. Production or generation of offspring. + +PROGNOSIS. Opinion of the future course of a disease. + +PROLAPSUS. A falling down of an organ through an orifice, as the womb, +bowel, etc. + +PROPHYLACTIC. Preventive. + +PROPRIETARY MEDICINES. Described on page 298. + +PROSTATE GLAND. Described on page 778 and illus. on page 207. + +PROTEIDS. goods composed Of carbon, hydrogen, oxygen and nitrogen: as +the white of an egg. + +PROTOZOÖN. First life; life in the lowest scale; as sponges. + +PROUD-FLESH. Abnormal growths which arise in wounds or ulcers. + +PRURITIC. Itching. + +PRURITUS VULVAE. A nervous disease attended with excessive itching of +the external genital parts of the female. + +PSOAS OR LUMBAR ABSCESS. An abscess discharging at the groin. + +PSYCHICAL. The relation of the soul to animal experiences and being. + +PSYCHOLOGICAL. The spiritual potencies of the soul. + +PTYALIN. The ferment of the saliva which converts starch into sugar. + +PUBERTY. The age at which the subject is capable of procreation. + +PUBIC. Relating to the pubes, a part above the genital organs, covered +with hair at puberty. + +PUERPERAL FEVER. Child-bed fever. + +PULMONARY. Relating to the lungs. + +PUPIL. The circular opening in the colored curtain within the eye. + +PURGATIVES. Medicines which cause evacuation of the bowels. + +PURULENT. Discharging pus; as an ulcer. + +PUS. A yellowish, inodorous, creamy secretion from inflamed parts; +contained in abscesses or discharging from ulcers. + +PUSTULAR. Belonging to or affected by pustules. + +PUSTULE. An elevation on the skin, containing pus or "matter," and +having an inflamed base. + +PUTRESCENCE. Decomposition, rottenness. + +PUTRESCENT. Decomposing offensively. + +PUTRIDITY. Corruption. + +PYRÆMIA. Blood-poisoning from the absorption of decomposing pus or +"matter." + +PYLORIC ORIFICE. The lower opening of the stomach; illus. page 39. + +PYRIFORM. Shaped like a pear. + + +Q + + +QUICKENING. The time when the motion of the foetus within the womb is +first perceptible; between the fourth and fifth months of pregnancy. + + +R + + +RADICAL CURE. A cure in which the disease is entirely removed, root and +branch. + +RALES. Noises produced by air passing through mucus in the lungs. + +RECTAL. Pertaining to the rectum. + +RECTUM. The lower portion of the intestines terminating in the anus. + +RECUMBENT. Reclining. + +REFLEX ACTION. See pages 93 and 99. + +REGURGITATION. The act by which blood is forced backwards in an +unnatural manner. + +REMISSION. A temporary diminution of the symptoms of fever. + +REPRODUCTION. Producing living bodies similar to the parents. + +RESOLUTION. The disappearance of inflammation without suppuration. + +RESPIRATION. The function by which the blue blood is converted into red +blood in the lungs. + +RESPIRATOR. Described on page 230. + +RETINA. Defined on page 107. + +RETROCEDENT. Moving from one part of the body to another; as gout. + +RETROCESSION. Change of an eruption from the surface to the inner parts. + +RETROVERSION. A change in the position of the womb in which the top +falls back against the rectum. + +REVULSION, REVULSIVE. Calling the blood away from the diseased part. + +RICKETS. A disease in children characterized by crookedness of the spine +and long bones resulting from scrofula or poor and insufficient food. + +RICKETY. Affected with rickets. + +RINGS (HERNIAL). Circular openings with muscular edges through which a +vessel or part passes. + +RUBEFACIENTS. Medicines which produce redness of the skin. + +RUPTURE. Bursting. Hernia. + + +S + + +SACCHARINE. Like or containing sugar. + +SALIVA. The secretion of the glands of the mouth. + +SALPAE. Little sack-like shaped, soft, fleshy bodies, found in the open +ocean, and sometimes phosphorescent. + +SANATIVE. Curative. Tending to restore lost health. + +SANGUINE TEMPERAMENT. Described on page 163. + +SANITARIUM. An institution for the treatment of the sick. A healthy +retreat. + +SCALES. The epidermis or outer part of the skin consists of minute +scales. See Fig. 50, page 71. + +SCALP. The skin covering the head. + +SCAPULA. Shoulder blade. + +SCIATIC NERVE. The great nerve of the thigh. + +SCIRRHUS. Stony hardness, characteristic of cancer. + +SCLEROTIC COAT. The hard, pearly white covering of the eye. + +SCORBUTIC. Producing scurvy, a disease caused by improper or +insufficient food. + +SCORBUTUS. Scurvy. + +SCROFULOUS. Suffering from a condition of the system characterized by +enlargement of the glands, eruptions, etc., with great susceptibility to +contagion. + +SCROTUM. The bag of skin which covers the testicles. + +SCURVY. A disease due to impaired nutrition. + +SEA TANGLE. A water-plant, which in its dried state is introduced into a +canal and dilates the canal as it expands by the absorption of moisture. + +SEBACEOUS GLANDS. The oil-tubes of the skin. Illus. page 71. + +SECRETION. The process by which substances are separated from the blood. + +SEDATIVES. Medicines which allay irritation or irritability of the +nervous system. + +SEDENTARY. Requiring much sitting. + +SELF-POLLUTION. See SELF-ABUSE. + +SEMEN. The secretion of the testicles which is thrown out during sexual +intercourse and contains the principle of generation. + +SEMI-FLUID. Half fluid. + +SEMILUNAR VALVES. Valves in the heart. See 9 and 17, Fig. 41, page 58. + +SEMINAL VESICLES. Reservoirs for the sperm. See Seminal Sac, on page +207. + +SEPTIC. That which corrodes or produces putrefaction. + +SEPTICÆMIA. Blood-poisoning; usually by absorption. + +SEQUEL. That which follows; the condition or malady which follows a +disease. + +SEROUS. Watery. Pertaining to the serous membrane. + +SEROUS TISSUE. The membranes lining the closed cavities of the body, +which secrete a watery, lubricating fluid. + +SHOCK. Sudden depression of vitality occasioned by injury. + +SITZ BATH. See page 367. + +SLOUGHING. The process of separating a mortified part from a healthy +part, through the agency of pus. + +SMELL, NERVES OF. Illus. page 111. + +SOLAR PLEXUS. Described on page 104. + +SOLVENTS. Those chemicals which break up or dissolve substances. + +SORDES. Foul accumulation on the teeth, noticed in fevers. + +SOUND. An instrument for exploring cavities or canals for diagnosis or +treatment. + +SPECIALTY. That to which special attention is given. + +SPECIFIC GRAVITY. Comparative weight; as between urine and water. + +SPECULUM. An instrument for examining cavities. Illus. pages 717 and +718. + +SPERM. See SEMEN. + +SPERMATIC CORD. The mass of arteries, veins, nerves, absorbents and +their coverings, which passes along the groin and over the pubic bone, +to the testicle. + +SPERMATORRHEA. Described on page 772. + +SPERMATOZOA. More than one Spermatozoön. + +SPERMATOZOON. Defined on page 12; Illus. page 13. + +SPHINCTERS. Bound muscles which close natural openings. + +SPHYGMOGRAPH. An instrument for examining the heart. Illus. page 548. + +SPICULA. A small pointed piece of bone. + +SPINAL COLUMN. The twenty-four bones, which, situated one above the +other, form the backbone. + +SPINAL CORD. Described on page 90. + +SPIROMETER. A gauge of chest capacity. Illus. page 392. + +SPONGE TENT. Compressed, dried sponge previously treated with Gum +Arabic, used for dilating the uterine canal. + +SPORADIC, SPORADICALLY. A term for diseases which appear frequently, +independent of epidemic or contagious influences. + +SPRAIN. A straining or rupture of the fibrous parts of a joint. + +STAPHYLOMA. Protrusion of the eye, sometimes with loss of sight. + +STERILITY. Barrenness. Inability to bear children. + +STERNUM. The breast-bone. + +STETHOSCOPE. An instrument for examining the heart and lungs. + +STIMULANTS. Medicines which increase the vital activity of the body. + +STOOL. Evacuations of the bowels. Dung. + +STRABISMUS. Cross-eyes. + +STRANGULATED. Caught or fastened in the hernial canal. + +STRIATED. Grooved or striped. + +STRICTURE. A contracted condition of a canal or passage; of the +food-pipe, rectum, urethra, etc. + +STRUCTURAL. Belonging to the arrangements of tissues or organs. + +STRUMOUS. Scrofulous. + +STUPOR. Great diminution of sensibility. + +STYE. A little boil on the eyelid. + +STYPTIC. An external astringent wash. + +SUB-ACUTE. A moderate form of acute. + +SUDORIFEROUS GLANDS. Minute organs in the skin, which secrete the +perspiration. Illus. page 70. + +SUPPORTERS (UTERINE). Instruments intended to hold the womb in its +natural position. + +SUPPRESSION. Stoppage or obstruction of discharges; as urine, menses, +etc. + +SUPPURATION. A gathering. Formation of pus, as in an abscess or ulcer. + +SUTURE PINS. Pins or needles, which are passed through the edges of +wounds to bring them together. Thread is then wound around the pin to +hold the edges in place. + +SUTURES. The ragged edges of bones by which they are joined to each +other. Stitches of thread to bring the edges of a wound together for +their union. + +SYMPATHETIC NERVE. Defined on page 101. + +SYMPTOM. A change in the body or in its functions which indicates +disease. + +SYMPTOMATIC. Pertaining to symptoms. + +SYNOVIAL MEMBRANE. The lining of a joint, which from its oily secretion +allows the bones to move freely upon each other. + +SYNOVITIS. Described on page 452. + + +T + + +TAPPING. Removing collected fluid by introducing a hollow tube through +the flesh. + +TEMPERAMENT. Peculiarities of the constitution manifested by traits +which we denominate character. + +TENESMUS. Straining at stool. + +TENT. A compressed, dried cylinder of sponge, previously treated with +Gum Arabic, which enlarges the canal in which it is placed by expansion +from the absorption of moisture. + +TESTICLES. Described on page 773; Illus. page 207. + +THERMOMETER. An instrument for determining temperature. + +THORACIC DUCT. A canal which carries the chyle from its repository in +the abdomen to the large vein in the chest, near the heart. + +THORAX. Chest. + +TINCTURES. Medicines held in solution by alcohol. + +TONIC. Defined on page 350. + +TOPICAL. Local. + +TOPOGRAPHY. Description in detail of a place; in hygiene, to determine +its adaptability to residence. + +TORMINA. Griping of the bowels. + +TORTICOLLIS. Stiffness or contraction of the muscles of the neck. +Wryneck. + +TOURNIQUET. An instrument to stop bleeding. Illus. Fig. 252, page 890. + +TRACHEA. Windpipe. See page 63. + +TRANSLUCENT. Transmitting light, but not permitting objects to be seen +distinctly. + +TRANSUDATION. Passage of liquid through the tissues of the body. + +TRAUMATIC. Relating to a wound or injury. + +TREPHINING. Removing a piece of bone by a cylindrical saw. + +TRITURATE. To pulverize. + +TROCAR. An instrument for removing fluids from cavities. It consists of +a perforator within a cylinder. + +TRUNCATED. Shaped like a pyramid with its top cut off. + +TRUSS. A mechanical appliance for preventing protrusion or +strangulation. Hernial support. + +TUBERCLE. See pages 431 and 498. + +TURN OF LIFE. The change of life when menstruation ceases. + +TYMPANUM. Ear-drum. Illus. p. 109. + + +U + + +UMBILICAL. Of the navel; as umbilical hernia. Illus. page 883. + +UMBILICAL CORD. A cord-like substance which conveys the blood to the +foetus from the placenta or afterbirth. + +UMBILICUS. The Navel. + +UNSTRIATED. Not grooved or striped. + +URÆMIC. Pertaining to blood-poisoning from the presence of urea in the +circulation. + +URATES. The pinkish deposit found in urine. + +UREA. A constituent of the urine. + +URETERS. The canals leading from the kidneys to the bladder. Illus. +pages 85 and 207. + +URETHRA. The canal leading from the bladder outwards, by which the urine +is voided. Illus. page 207. + +URETHROTOMY. The operation for opening the urethra for the removal of +stricture. + +URIC ACID. A constituent of the urine. + +URINARY FISTULA. Abnormal communication between the urinary passages and +the surface. + +URINO-GENITAL ORGANS. Pertaining to the urinary and sexual organs. + +UTERINE. Belonging or relating to the womb. + +UTERINE CAVITY OR CANAL. From the month of the womb to a constriction +called the internal orifice, is a cylindrical space called the canal. +Above this to the fundus or base is a triangular and flat space called +the cavity. + + +V + + +VAGINA. A canal, five or six inches long, situated between the vulva and +womb. + +VAGINAL. Pertaining to the vagina. + +VAGINISMUS. Irritable vagina. + +VALVES OF THE HEART. See page 58. + +VARICOCELE. Described on page 803. + +VARICOSE. Veins that are twisted or dilated. + +VASCULAR. Belonging or relating to vessels. + +VASCULAR SYSTEM. The heart and blood-vessels. + +VEINS. The vessels which return the blue blood to the heart. + +VENEREAL. Syphilitic. + +VENTRICLES. Chambers in the heart. See 5 and 14, Fig. 41, page 58. + +VERMIFUGE. A medicine which destroys or expels worms. + +VERSION. Displacement of the womb forwards or backwards. + +VERTEBRÆ. The twenty-four bones which joined together form the backbone. + +VERTEBRATES. Animals having the jointed skeleton within; distinguishes +between these and insects, worms, oysters, jelly fish, etc. + +VERTIGO. Dizziness Or swimming of the head. + +VESICLES. Small bladders or sacs. Pimples. + +VESICULAR. Belonging to or containing cells. + +VILLI. Minute thread-like projections. + +VIRILE POWER. Masculine vigor. Sexual vigor. + +VIRUS. Poison. The agent which transmits infectious disease. + +VISCERA. (Plural of Viscus.) More than one internal organ. + +VISCOUS. Sticky. Tenacious. + +VISCUS. Any internal organ. + +VITREOUS HUMOR. The fluid in the eye behind the lens. Illus. page 107. + +VOLITIVE TEMPERAMENT. See page 171. + +VULVA. The external organs of generation in the female, or the opening +between these projecting parts. + + +W + + +WALLS. The sides of an enclosure, as the walls of the vagina, which to +soma extent support the womb. + +WHITES. Described on page 702. + + * * * * * + + + + +HOW TO AVOID SWINDLERS + +WHO SOMETIMES INFEST THE CARS AND DEPOTS IN AND NEAR THIS CITY. + + + * * * * * + + +WE WARN ALL THOSE WHO CONTEMPLATE VISITING US, that we have the most +_positive proofs_ that a gang of confidence men have at different times +made it their business to watch for sick and infirm people on the way to +our institutions, and divert them into the hands of "sharpers," +confidence men and swindlers. These men have watched for the coming of +invalids on the cars, in and around the depots, in the offices of the +hotels located near the depots, and if inquiry was made for our +institutions, or if the object of the visit to the city was made known +or suspected from the invalid appearance of the traveler, they at once +commenced weaving their skillfully-wrought web to catch a victim. + + +WE, THEREFORE, + +ADVISE ALL THOSE DESIRING TO VISIT US, + +FIRST.--TO ASK FOR NO INFORMATION FROM POLICEMEN, OR THOSE APPEARING TO +BE POLICEMEN, IN OR ABOUT OUR DEPOTS. CONFIDENCE MEN OFTEN ASSUME A +STYLE OF DRESS SIMILAR TO THAT WORN BY POLICEMEN. + +SECOND.--LET THE OBJECT OF YOUR VISIT TO THE CITY BE KNOWN TO NO ONE +WHOM YOU MEET ON THE CARS, OR IN THE DEPOTS OR NEAR THEM. + +THIRD.--IF YOU HAVE A CHECK FOR BAGGAGE, WHEN THE BAGGAGE-MAN COMES +THROUGH THE CARS, AS ONE DOES ON EVERY TRAIN BEFORE IT REACHES THE CITY, +ASKING IF YOU WILL HAVE YOUR BAGGAGE DELIVERED ANYWHERE IN THE CITY, OR, +IF YOU WILL HAVE A CARRIAGE; IF YOU HAVE A TRUNK, GIVE HIM THE CHECK FOR +IT, PAY HIM 25 CENTS ONLY AND HE WILL HAVE IT DELIVERED AT THE INVALIDS' +HOTEL AND SURGICAL INSTITUTE. 663 MAIN STREET. (Do not forget the +number). You had better, also, procure a ticket from this baggage-man, +or agent, for a _coupe_ or carriage to our place, for which you will +have to pay only fifty cents. (Outside prices are higher.) This saves +all trouble and anxiety, as the agent will look carefully after both +yourself and baggage, and you are sure of reaching our place promptly +and safely. If you have only hand-baggage, such as bundles, +traveling-bags, or similar luggage, you can take it with you in the +carriage without extra cost. + +Mr. C.W. Miller, whose agents solicit on all the in-coming trains for +the delivery of passengers and baggage, has an office in every passenger +depot in this city, to which you can apply if, by any chance, you miss +his agent on the train. + +THE INVALIDS' HOTEL AND SURGICAL INSTITUTE IS OPEN DAY AND NIGHT, AND +YOU WILL BE CORDIALLY RECEIVED AND WELL TAKEN CARE OF. + +THE TABLE IS PROVIDED WITH THE BEST OF FOOD. + +NO HOTEL IN THE CITY HAS BETTER ROOMS OR BEDS THAN THE INVALIDS' HOTEL. + +THIS INSTITUTION IS NOT A HOSPITAL, BUT A COMMODIOUS AND COMFORTABLE +INVALIDS' HOME. + +If all we say of our institutions, and our advantages and facilities for +the successful treatment of disease is not found, on your arrival and +investigation, to be just as we have represented them, WE WILL PAY ALL +THE EXPENSES OF YOUR TRIP AND YOU CAN RETURN HOME AT ONCE. + + +"A WORD TO THE WISE," + + +in the nature of advice, to those about to visit us, in conclusion, may +not be out of place. + +KEEP YOUR BUSINESS TO YOURSELF WHILE ON THE ROAD HERE, ALSO WHEN ABOUT +THE DEPOTS, AND ASK NO QUESTIONS OF ANYBODY. + +MAKE NO TRAVELING ACQUAINTANCES. THEY ARE DANGEROUS. + +Observe the foregoing directions, and any child of twelve years, +possessed of ordinary intelligence, can reach our conspicuous place, 663 +MAIN STREET, Buffalo, N.Y., without fail. + +WORLD'S DISPENSARY MEDICAL ASSOCIATION. + + * * * * * + + + + +[Illustration] + + + + + * * * * * + + + + +INDEX. + + + A + + + Abortion, 682 + Abscess, Lumbar, 446 + Abscess, Psoas, 448 + Absence of the Ovaries, 688 + Absence of the Womb, 689 + Absolutely Painless Operation, 491 + Absorption, 48 + Acacia Catechu, 325 + Accidents, 889 + Acetabulum, 25 + Acetate of Potato, 338 + Acid, Aromatic Sulphuric, 310 + Acid Bath, 367 + Acid, Carbolic, 318 + Acid, Gallic, 325 + Acid, Hydrochloric, 310 + Acid, Muriatic, 310 + Acid, Tannic, 325 + Acid, Uric, 86 + Acids, 309, 895 + Acidum Gallicum, 325 + Acidum Tannicum, 325 + Acne, 442 + Aconite, 346 + Acute Articular Rheumatism, 425 + Acute Bright's Disease, 830 + Acute Bronchitis, 509 + Acute Catarrh, 473 + Acute Gastritis, 883 + Acute Inflammation of the Bladder, 824 + Acute Inflammation of the Bowels, 655 + Acute Inflammation of the Kidneys, 823 + Acute Inflammation of the Liver, 569 + Acute Inflammation of the Stomach, 565 + Acute Laryngitis, 496 + Acute Nephritis, 829 + Acute Peritonitis, 886 + Adhesion, 400 + Adipose Tissue, 20 + Affections, Alphous, 441 + Affections, Boil-like, 443 + Affections, Bullous, 438 + Affections, Eczematous, 430 + Affections, Erythematous, 436 + Affections, Furuncular, 443 + Affections, Nervous, of the Skin, 440 + Affections of the Hair-follicles, 441 + Affections of the Male Generative Organs, 773 + Affections of the Urinary Organs, 825 + Affections of the Urinary Organs, Sympathetic, 826 + Afferent Nerves, 87,93 + Afterbirth, 216 + Age of Nervousness, the, 619 + Ague, 405 + Air-cells, 63 + Air-passages, Foreign Bodies in the, 893 + Air, Pure, 822, 223, 378 + Albumen, 53, 238 + Albuminuria, 422 + Alcohol, 849, 627, 896 + Alcohol Habit, 627 + Alcoholic Liquors, 255 + Alder, 304 + Alkalies, 809, 895 + Alkaline Bath, 367 + Allopathic School of Medicine, 293 + Alnuin, 305 + Alnus Eubra, 304 + Aloes, 328 + Alphos, 441 + Alphous Affections, 441 + Alteratives, 303 + Alteratives, Compounding of, 303 + Alternate Generation, 16 + Althea Officinalis, 336 + Amenorrhea, 687 + American Colombo, 353 + American Hellebore, 347 + American Poplar, 350 + Ammonia, 349 + Amnion, 216 + Amperemeter, 630 + Amygdalus Persica, 346 + Amyloid Degeneration of the Kidneys, 830 + Amyloids, 238 + Anæmia, 419 + Anaesthesia, Local, 806 + Anaesthetics, 806 + Anal Fistula, 583 + Anasarca, 422 + Anatomy, 11 + Anatomy, Physiological, 11, 19, 30, 37, 48, 56, 63, 68, 75, 84, 87 + Anatomy, Physiological, of the Testes, 774 + Anatomy, Physiological, of the Urinary Organs, 823 + Angina Pectoris, 552 + Ammalcular Lite, Universality of, 16 + Animal Extracts as Remedies, 631 + Animal Faculties, 130 + Animal Food, Value of, 241 + Animals, Cold-blooded, 55 + Anise-seed, 325 + Anodynes, 310 + Anteflexions of the Uterus, 714 + Anterior view of Deformed Nasal Cavity, 492 + Anterior view of Nasal Cavity, 490 + Anthelmintics, 319 + Anthrax, 475 + Antidotes for Poisons, 895 + Antiperiodics, 316 + Antiseptics, 317 + Antispasmodics, 318 + Anus, Fistula of the, 583 + Aorta, 58 + Aperients, 326 + Aphasia, 639 + Apnoea, 421 + Appendix Vermiformis, 41 + Apthæ, 553 + Aqueous Humor, 107 + Arachnoid Fluid, 90 + Arachnoid Membrane, 90 + Arbutus, Trailing, 336 + Arctium Lappa, 307 + Areolar Tissue, 19 + Aristolochia Serpentaria, 333 + Aromatic Sulphuric Acid, 310 + Arteries, 58 + Artery, Pulmonary, 58 + Art of Swimming, 274 + Ascaris Lumbricoides, 561 + Ascaris Vermioularis, 561 + Ascites, 423 + Asclepias Tuberosa, 332 + Asclepin, 333 + Aseptic Precautions in Operations, 492 + Ashes, 335 + Ash, Prickly, 349 + Aspen Poplar, 315 + Asphyxia, 421 + Aspidium Filix Mas., 315 + Assafetida Ferula, 318 + Assimilation, 233 + Asthma, 511 + Asthma, Hay, 514 + Astringents, 320 + Ataxia, Locomotor, 640 + Atomizer, 481 + Atomizer, Steam, 482 + Atropa Belladonna, 312 + Atrophy of the Heart, 551 + Atrophy of the Testicles, 773 + Atropia, 312 + Atropin, 312 + Auricle, 57 + Auscultation, 391 + Axis, Cerebro-spinal, 89 + Axis-cylinder, 87 + + + B + + + Back, Crooked, 901 + Baked Mutton, 248 + Balmony, 315 + Baptisia Tinctoria, 318 + Baptisin, 318 + Barber's Itch, 442 + Bark, Cramp, 320 + Bark, Slippery-elm, 335 + Barosma Crenata, 338 + Barosmin, 338 + Barrenness, 707 + Base Ball, 273 + Basilar Faculties, 132 + Battery for home use, 631, 632 + Bath, Acid, 367 + Bath, Alkaline, 367 + Bath, Cold, 356 + Bath, Cool, 357 + Bath, Douche, 365 + Bath, Foot, 366 + Bath, Head, 367 + Bath, Hot, 358 + Bath, Iodine, 368 + Bath, Russian, 358 + Bath, Scott's Acid, 367 + Bath, Shower, 365 + Bath Sitz, 367 + Bath, Spirit Vapor, 382 + Bath, Sponge, 365 + Bath, Sulphur, 368 + Bath, Temperate, 357 + Bath, Tepid, 357 + Bath, Turkish, 358 + Bath, Warm, 357 + Bathing, 353 + Bathing, Sea, 364 + Baths, Medicated, 367 + Bed, 279, 377 + Bedding, 380 + Beef Soup, 247 + Beef Tea, 381 + Belladonna, 312 + Beverages, 248 + Bicarbonate of Potash, 309 + Bile, 80 + Biliary Calculi, 560 + Biliary Salts, 81 + Bilious Colic, 557 + Bilious Disorder, 569 + Bilious Fever, 408 + Biliverdin, 81 + Biology, 11 + Blackberry-root, 321 + Black Cohosh, 305, 341 + Black Pepper, 348 + Black-root, 327 + Black Snake-root, 305, 341 + Black Vomit, 883 + Bladder, 823 + Bladder, Chronic Inflammation of the, 836 + Bladder, Stone in the, 838 + Blood, 53 + Blood Corpuscles, 53 + Blood, Physical Properties of the, 53 + Blood-root, 306 + Blood, Vital Properties of the, 53 + Bloody-flux, 888 + Blue Flag, 307 + Blushing, 62 + Boiled Fish, 247 + Boiled Meat, 247 + Boil-like Affections, 443 + Boils, 443 + Bones, 19 + Bones of the Head, 22 + Bones of the Lower Extremities, 27 + Bones of the Upper Extremities, 25 + Boneset, 316, 341 + Boxing, 273 + Boxwood, 351 + Brain, 95 + Brain Fatigue, 621 + Branny Tetter, 431 + Breach, 864 + Bread, 248 + Bright's Disease, Acute, 830 + Broiled Steak, 247 + Bronchia, 63 + Bronchial Cells, 63 + Bronchitis, 476 + Bronchitis, Chronic, 509 + Bruises, 892 + Buchu, 338 + Bugle-weed, 383 + Bullous Affections, 438 + Burdock, 307 + Burns, 894 + Bursæ Mucosæ, 29 + Butterfly-weed, 333 + Butternut, 328 + Butter-weed, 324 + + + C + + + Chachexia, 431 + Caecum, 41 + Caliculi, 837 + Camp Fever, 408 + Camphor, 312 + Canada Fleabane, 324 + Canals, Haversian, 21 + Canals, Semi-circular, 110 + Canker, 553 + Cannabis Indica, 334 + Capacity, Cranial, 139 + Capillaries, 60 + Capsicum Annuum, 348 + Capsule, Synovial, 29 + Carbolic Acid, 318 + Carbonate of Iron, 354 + Carbuncle, 444 + Carminatives, 325 + Carpus, 26 + Cartilage, 29 + Cartilaginous Tissue, 20 + Cascara Sagrada, 328 + Casein, 82, 338 + Castor Oil, 328 + Catarrh, Acute, 473 + Catarrh, Chronic Nasal, 474 + Catarrh, Hay, 514 + Catechu, 325 + Cathartics, 326 + Catnip, 334 + Caustics, 331 + Cayenne Pepper, 348 + Cellars, Damp, 228 + Cells, Bronchial, 66 + Centres of Ossification, 20, 27 + Centre, Specific, 14 + Cephælis Ipecacuanha, 339 + Cerebellum, 95, 97 + Cerebral Nerves, 89 + Cerebral Physiology, 114 + Cerebro-spinal Axis, 89 + Cerebro-spinal System, 89 + Cerebrum, 95, 98 + Cerevisiæ Fermentum, 317 + Ceruminous Glands, 77 + Cervical Rheumatism, 427 + Cessation of the Menses, 700 + Chalybeate Waters, 250 + Chamomile, 350 + Chamomile, Wild, 834 + Chelone Glabra, 315 + Chelonin, 315 + Chicken-pox, 412 + Chimaphila Umbellate, 338 + Chimaphilin, 338 + Chloride of Iron, Tincture of, 355 + Chloride of Sodium, 815 + Cholagogues, 326 + Cholera, Epidemic, 887 + Cholera Infantum, 555 + Cholera Morbus, 888 + Cholesterin, 81 + Chordæ Tendineæ, 57 + Chorea, 650 + Chorion, 216 + Choroid, 107 + Chronic Articular Rheumatism, 426 + Chronic Bright's Disease, 830 + Chronic Bronchitis, 509 + Chronic Cystitis, 836 + Chronic Diarrhea, 568 + Chronic Gastritis, 884 + Chronic Gout, 430 + Chronic Hepatitis, 569 + Chronic Inflammation of the Bladder, 836 + Chronic Inflammation of the Bowels, 549 + Chronic Inflammation of the Liver, 569 + Chronic Inflammation of the Stomach, 884 + Chronic Laryngitis, 496 + Chronic Nasal Catarrh, 474 + Chronic Peritonitis, 886 + Chronic Ulcers, 454 + Chyle, 45, 49 + Chyme, 45 + Cimicifuga Racemosa, 305, 341 + Circulatory Organs, 56 + Citrate of Iron, 354 + Classes of Food, 238 + Clavicle, 26 + Cleanliness of Body, 281, 380 + Clergymen's Sore Throat, 496 + Climate, 243 + Closure of the Tear-duct, 477 + Clot, 54 + Clothing, 264, 380 + Coagulation, 55 + Coccyx, 23, 25 + Cochlea, 110 + Cochlearia Armoracia, 331 + Coffee, 258 + Cohosh, Black, 305, 341 + Cold-blooded Animals, 55 + Colic, 557 + Colic, Bilious, 557 + Colic, Flatulent, 558 + Colic, Lead, 558 + Colic, Painters', 558 + Coliea Pietonum, 558 + Collinsonia Canadensis, 337 + Colombo, American, 358 + Colon, 41 + Colts-tail, 324 + Columnæ Carneæ, 57 + Column, Spinal, 24 + Comedones, 442 + Compound Extract of Smart-weed, 312, 326, 335, 342, 349 + Compounding of Alteratives, 308 + Conception, Double, 215 + Conception, Prevention of, 212 + Congestive Fever, 406 + Conium Maculatum, 311 + Conjugal Love, 186 + Connective Tissue, 19 + Constipation, 573 + Consumption, 476, 497 + Consumption, Curability of, 503 + Consumption, Tubercular, 497 + Continued Fevers, 407 + Contractility, 34 + Contused Wounds, 889 + Convolutions, 98 + Cookery, 246 + Copper, Sulphate of, 339 + Coptis Trifolia, 354 + Cord, Spinal, 90 + Cord, Umbilical, 217 + Core, 399 + Cornea, 106 + Cornus Florida, 351 + Corpora Olivaria, 95, 96 + Corpora Pyramidalia, 95 + Corpora Quadrigemina, 95, 97 + Corpora Restiformia, 95, 96 + Corpus Callosum, 98 + Corpuscles, Blood, 53 + Corpuscles, Ganglionic, 87, 88 + Costiveness, 573 + Cotton-wool Respirator, 230 + + Cough, 502, 506 + Countenance, 394 + Counter-irritants, 331 + Cow-pox, 411 + Coxalgia, 450 + Cramp Bark, 450 + Cranberry, High, 320 + Cranesbill, 322 + Cranial Capacity, 139 + Cranial Nerves, 100 + Cranium, 22 + Creasote, 317 + Creation, Special, 14 + Creeping Palsy, 640 + Cricket, 273 + Criminal Abortion, 682 + Crocus Sativus, 333 + Crooked Back, 901 + Croup, Membranous, 878 + Croup, Spasmodic, 878 + Crow-foot, 332 + Crura Cerebelli, 97 + Crusted Tetter, 433 + Crystalline Lens, 107 + Cueurbita Chrullus, 338 + Cucurbita Pepo, 338 + Culture, Mental, 276 + Culver's-root, 327 + Cupri Sulphas, 339 + Curability of Consumption, 503 + Cure, Radical, for Hernia, 892 + Curvature of the Spine, Lateral, 901 + Curvature, Posterior Spinal, 898 + Cuticle, 68, 70 + Cutis Vera, 68 + Cypripedin, 320, 345 + Cypripedium Pubescens, 320, 345 + Cystitis, Chronic, 836 + + + D + + + Damp Cellars, 228 + Dancing, 276 + Dandruff, 431 + Danger in the use of Instruments, 846 + Datura Stramonium, 344 + Deadly Nightshade, 312 + Deafness, 476 + Debility, Sexual, Symptoms of, 777 + Decidua, 216 + Decoctions, 303 + Deformed Feet, 903 + Deformed Hands, 903 + Deformed Limbs, 903 + Deformity of the Nasal Septum, 490 + Degeneration of the Heart, Fatty, 551 + Degeneration of the Kidneys, 832 + Deglutition, 233 + Desquamative Nephritis, 833 + Development of the Individual, 192 + Diabetes, 835 + Diagnosis, 390 + Diagnostic Symptoms, 390 + Diaphoretics, 332 + Diaphragm, 32 + Diarrhea, 502, 555 + Diarrhea, Chronic, 568 + Diathesis, 391 + Diathesis, Scrofulous, 445 + Diathesis, Strumous, 445 + Diet, 380 + Digestibility of Food, 248 + Digestion, 37 + Digestive Organs, 37 + Digitalis Purpurea, 387 + Dilatation of the Heart, 551 + Diluents, 335 + Dioecious Reproduction, 202 + Dioscorea Villosa, 320 + Dioscorein, 320 + Diptheria, 414 + Discovery, Golden Medical, 308, 316, 355 + Disease, Bright's, 830 + Disease, Dust and, 229 + Disease, Hip-joint, 450 + Disease, Remedies for, 298 + Disease of the Throat, 476 + Diseases and their Remedial Treatment, 386 + Diseases of the Heart, 547 + Diseases of the Kidneys, 829 + Disease of the Larynx, 476 + Diseases of the Liver, 559, 569 + Diseases of the Skin, 430 + Diseases of the Stomach, 430 + Diseases of the Urinary Organs, 823 + Diseases of Women, 684 + Disinfectants, 317 + Dislocations, 892 + Displacements of the Womb, 713 + Distilled Liquors, 264 + Diuretics, 336 + Dock, Yellow, 304 + Dog-button, 350 + Dogwood, 351 + Domestic Management of Fevers, 403 + Door of Life, the, 681 + Dose, 300 + Double Conception, 215 + Douche Bath, 365 + Douche, Dr. Pierce's Nasal, 486 + Dover's Powder, 311 + Drastics, 326 + Dropsies, 422 + Dropsy of the Scrotum, 821 + Drowning, 893 + Ducts, Lactiferous, 82 + Duodenum, 40 + Dura Mater, 90 + Duration of Pregnancy, 219 + Dust and Disease, 229 + Dwellings, Ventilation of, 226 + Dynamometer, 391 + Dysentery, 588 + Dysmenorrhea, 692 + Dyspepsia, 565 + Dyspnoea, 502 + + + E + + + Ear, Catarrh of the, 477 + Eating, 233 + Eclectic School of Medicine, 294 + Eczema, 430 + Eczema, Infantile, 430 + Eczematous Affections, 430 + Efferent Nerves, 87, 98 + Effusion, 400 + Electricity in Nervous Affections, 629 + Elixir of Vitriol, 310 + Elongation of the Uvula, 419, 495 + Emergencies, 889 + Emetics, 339 + Emetic-weed, 340 + Emissions, Involuntary Seminal, 773 + Emissions, Nocturnal 773 + Emmenagogues 341 + Emotive Faculties 126 + Encephalic Temperament 177 + Endocarditis 549 + Endocardium 57 + Endolymph 110 + Enlarged Spermatic Veins 803 + Enlarged Tonsils 417, 494 + Enlargement of the Prostate Gland 840 + Enteric Fever 407 + Envelope 9 + Epidemic Cholera 887 + Epidermis 68, 70 + Epigea Repens 336 + Epiglottis 67 + Epilepsy 647 + Epsom Salts 328 + Erect Carriage 272 + Ergot 341 + Erigeron Canadense 324 + Eruption, Heat 430 + Eruptive Fevers 408 + Erysipelas 413 + Erythema 436 + Erythemaious Affections 436 + Esophagus 39 + Ethmoid Bone 22 + Eupatorin 316, 341 + Eupatorin (Purpu) 338 + Eupatorium Perfoliatum 316, 341 + Eupatorium Purpureum 338 + Eustachian Tube 110 + Evolution 14 + Examination, Microscopical 398, 825 + Examination of the Urine 397, 625, 825 + Excretion 84 + Exercise 382 + Exercise, Horseback 276 + Exercise, Physical 270 + Exercises of the Gymnasium 275 + Expanding Uterine Speculum 718 + Expectorants 342 + Expectoration 502 + External Auditory Meatus 77, 109 + Extract of Smart-weed 312, 326, 335, 342, 349 + Exudation 422 + Eye 397 + + + F + + + Face, Bones of the 23 + Factories, Ventilation of 226 + Faculties, Animal 130 + Faculties, Basilar 132 + Faculties, Emotive 126 + Faculties, Volitive 129 + Fainting 894 + Falling of the Uterus 713 + Fallopian Tubes 209 + False Measles 413 + False Membrane 878 + False Passages 846 + Fascia 30 + Fasciculus 30 + Fats 238 + Fatty Degeneration of the Heart 551 + Fatty Degeneration of the Kidneys 832 + Favorite Prescription, Pierce's 342, 346, 355 + Favus 441 + Fecundation 211 + Feebleness, Region of 134 + Feeding Infants 235 + Feet, Deformed 903 + Female Generative Organs 206 + Female Regulator 341 + Female Urinary Organs 206 + Femoral Hernia 863 + Femur 27 + Fencing 273 + Fennel-seed 325 + Fergusson Speculum 717 + Fermented Liquors 263 + Fern, Male 315 + Ferri Carbonas 354 + Ferri Citras 354 + Ferri Ferrocyanidum 316 + Ferri Pyrophosphas 354 + Ferri Redactum 354 + Ferrocyanide of Iron 316 + Ferrum 354 + Fever 401 + Fever and Ague 405 + Fever, Bilious 406 + Fever, Camp 408 + Fever, Congestive 406 + Fever, Enteric 407 + Fever, Gastric 405 + Fever, Hay 514 + Fever, Hectic 502 + Fever, Hospital 408 + Fever, Intermittent 405 + Fever, Jail 408 + Fever, Pernicious 406 + Fever, Remittent 406 + Fever, Scarlet 408 + Fever, Ship 408 + Fever, Typhoid 407 + Fever, Typhus 408 + Fever-sore 446, 454, 456 + Fevers, Continued 407 + Fevers, Domestic Management of 403 + Fevers, Eruptive 408 + Fevers, Malignant 407 + Fevers, Putrid 407 + Fibrillæ 30, 32 + Fibrin 53, 238 + Fibroid Polypus 487 + Fibroid Tumors 722 + Fibula 27 + Fish 247 + Fissure of Sylvius 98 + Fistula in Ano 583 + Fits 647 + Flag, Blue 307 + Flatulent Colic 558 + Flax-seed 335 + Fleabane, Canada 324 + Flesh 30 + Flexions of the Uterus or Womb 709, 714 + Fluid Arachnoid 90 + Focus 108 + Foetus 216 + Follicles of Lieberkuhn 79 + Follicular Laryngitis 496 + Follicular Ulcer 718 + Fomentations 386 + Food 233 + Food, Classes of 238 + Food, Digestibility of 243 + Food, Preparation of 236 + Food, Value of Animal 241 + Food, Variety of, Necessary 236, 239 + Foot-bath 366 + Foreign Bodies in the Nose 893 + Foreign Bodies In the Throat and Air-passages 893 + Fountain Syringe 705 + Foxglove 867 + Fractures 892 + Franklin Electric Machine 629 + Frasera Carolinensis 353 + Fraserin 353 + Fretfulness 623 + Frontal Bone 22 + Function 11 + Furuncular Affections 443 + Furunculus 443 + + + G + + + Gall-bladder 80 + Gallic Acid 325 + Gall-stones 560 + Galvano-Faradic Battery 628 + Galvanometer 630 + Gamboge 327 + Ganglia 89, 103, 115 + Ganglionic Corpuscles 87, 89 + Gangrene 400 + Garget 304 + Gastralgia 885 + Gastric Fever 405 + Gastric Juice 45, 79 + Gastritis, Acute 883 + Gastritis, Chronic 884 + Gaultheria Procumbens 325 + Gelatinoid Polypus 487 + Gelsemin 320, 348 + Gelseminum Sempervirens 319, 348 + General Paralysis 639 + General Treatment of Paralysis 641 + Generation 11, 12 + Generation, Alternate 16 + Generation, The Process of 15 + Generative Organs, Hygiene of the 282 + Generative Organs, Male, Affections of the 772 + Gentian 350 + Geranin 323 + Geranium Maculatum 322 + Geranium, Spotted 322 + Germ-cell 12, 15 + Ginger 325, 335 + Gland, Prostate 827 + Gland, Prostate, Enlargement of the 840 + Gland, Sublingual 38 + Gland, Submaxillary 39 + Glands, Ceruminous 77 + Glands, Meibomian 78 + Glands of Brunner 79 + Glands, Parotid 38 + Glands, Salivary 38 + Glands, Sebaceous 70, 77 + Glands, Sudoriferous 69 + Glycocholate of Soda 81 + Goitre 470 + Golden Medical Discovery 308, 316, 355 + Golden Saffron 333 + Golden-seal 352 + Gold-thread 354 + Gouty Headache 635 + Granular Ulcer 717 + Gravel 837 + Gravel-plant 336 + Gravel-root 336, 338 + Gravel-weed 338 + Gray Matter 91 + Great Sympathetic System 101 + Grip, The 471 + Gum Arabia 335 + Gutta Rosacea 433 + Gymnasium, Exercises of the 275 + + + H + + + Habit, Alcohol 627 + Habit, Opium 627 + Habit, Tobacco 627 + Hæmatoxylon Campeachianum 321 + Hæmoptysis 502, 507 + Hair-follicles, Affections of the 441 + Hairs 72 + Hamamelin 322 + Hamamelis Virginica 321 + Hands, Deformed 903 + Hardhack 323 + Haversian Canals 21 + Hay Asthma 514 + Hay Catarrh 514 + Hay Fever 514 + Headache 634 + Headache, Malarial 635 + Headache, Nervous 635 + Headache, Neuralgic 635 + Headache, Periodical 635 + Headache, Rheumatic 635 + Head Bath 358 + Head, Scald 441 + Head, The Bones of the 22 + Health, Light and 231 + Hearing 109 + Heart 56 + Heart, Atrophy of the 551 + Heart, Dilatation of the 551 + Heart, Diseases of the 547 + Heart, Fatty Degeneration of the 651 + Heart, Hypertrophy of the 550 + Heart, Neuralgia of the 552 + Heart, Organic Disease of the 547 + Heat Eruption 430 + Heat, Prickly 432 + Hectic Fever 502 + Hedeoma Pulegioides 341 + Hellebore, American 347 + Hellebore, Swamp 347 + Hellebore, White 347 + Hemiplegia 639 + Hemlock, Poison 311 + Hemorrhage 578, 890 + Hemorrhoids 578 + Hemp, Indian 344 + Henbane 311, 343 + Hepatitis, Chronic 569 + Hermaphrodite 199 + Hermaphroditic Reproduction 199 + Hernia 862 + Hernia, Radical Cure for 866 + Herpes 438 + High Cranberry 320 + Hitus 84 + Hip joint Disease 450 + History of Marriage 188 + Hives 437 + Homes, Site for 227 + Homoeopathy 294 + Hops 312, 345 + Horseback Exercise 276 + Horse-balm 337 + Horse-radish 331 + Hospital Fever 408 + Hot Bath 358 + How to use Vaginal Injections 705 + How to use Water 252 + Human Temperaments 148 + Humerus, 26 + Humid Tetter, 430 + Humor, Aqueous, 107 + Humor, Vitreous, 107 + Humpback, 898 + Humulin, 312, 345 + Humulus Lupulus, 312, 345 + Hydragogues, 326 + Hydrargyri Sulphas Flava, 339 + Hydrarthrus, 452 + Hydrastia, Muriate of, 352 + Hydrastin, 352 + Hydrastis Canadensis, 352 + Hydrocele, 423, 821 + Hydrocephalus, 433 + Hydrochloric Acid, 310 + Hydrothorax, 423 + Hygiene ,222 + Hygiene of the Reproductive Organs, 282 + Hygiene, Practical Summary of, 288 + Hygienic Treatment of the Sick, 375 + Hymen, Imperforate, 687 + Hyoscyamin, 311, 344 + Hyoscyamus Niger, 311, 343 + Hypertrophy of the Heart, 550 + Hysterical Headache, 635 + + + I + + + Icterus, 559 + Ileum, 40, 41 + Imperforate Hymen, 687 + Impetigo, 433 + Impotency, 776 + Impoverished Blood, 626 + Impurities, Mineral, 249 + Incised Wounds, 889 + Incus, 110 + Independent Physician, 295 + Indian Hemp, 344 + Indian Physic, 327 + Indian Poke, 347 + Indian Tobacco, 340 + Indigestion, 565 + Indigo, Wild, 318 + Individual, Development of the, 192 + Indolent Ulcer, 455 + Indulgence, Solitary, 772 + Induration, 400 + Infantile Eczema, 430 + Infants, Feeding of, 235 + Inferior Maxillary Bone, 22 + Inferior Turbinated Bones, 22 + Inflammation, 398 + Inflammation of the Bladder, Chronic, 836 + Inflammation of the Bones, 458 + Inflammation of the Liver, 569, 570 + Inflammation of the Stomach, Acute, 882 + Inflammation of the Stomach, Chronic, 884 + Inflammation of the Vagina, 702 + Inflammation, Phlegmonous, 399 + Inflammation, Termination of, 400 + Inflammation, Treatment of, 401 + Influenza, 471 + Infusions, 303 + Inguinal Hernia, 863 + Insalivation, 233 + Insertion, 31 + Insomnia, 623 + Instruments, Danger in the use of, 846 + Intermediate Muscles, 32 + Intermittent Fever, 405 + Interpretation of Symptoms, 893 + Intestinal Juice, 79 + Intestinal Worms, 561 + Intestines, 49 + Introductory Words, 9 + Involuntary Muscles, 32 + Involuntary Seminal Emissions, 773 + Iodine, 307, 896 + Iodine Bath, 368 + Ipecac, 339 + Ipomoea Jalapa, 326 + Iris, 107 + Iris Versicolor, 307 + Iron, 354 + Iron by Hydrogen, 354 + Iron, Carbonate of, 354 + Iron, Citrate of, 354 + Iron, Ferrocyanide of, 316 + Iron, Pyrophosphate of, 354 + Iron, Tincture of Muriate of, 355 + Irritable Ulcer, 455 + Itch, 434 + Itch, Barber's, 442 + Itching of the Vulva, 702 + + + J + + + Jaborandi, 334 + Jail Fever, 408 + Jalap, 326 + Jalapin, 327 + Jaundice, 559 + Jejunum, 40, 41 + Jessamine, Yellow, 319, 348 + Juglandin, 328 + Juglans Cinerea, 328 + Juice, Gastric, 45, 79 + Juice, Intestinal, 79 + Juice, Lemon, 335 + Juice, Orange, 335 + Juice, Pancreatic, 89 + Juice, Tamarind, 335 + + + K + + + Kidneys, 823 + Kidneys, Diseases of the, 829 + Knee-joint, Tuberculosis of the, 453 + Knot-root, 337 + + + L + + + Labyrinth, 110 + Lacerated Wounds, 890 + Lachrymal Bones, 22 + Lacteals, 48 + Lactiferous Ducts, 82 + Lady's-slipper, Yellow, 320, 345 + Laryngitis, Chronic, 496 + Laryngitis, Follicular, 496 + Larynx, 63 + Larynx, Disease of the, 476 + Latent Life, 11 + Lateral Curvature of the Spine, 901 + Late Suppers, 235 + Laudanum, 310 + Laxatives, 326 + Lead Colic, 558 + Lemons, 335 + Lens Crystalline, 107 + Leptandra Virginica, 327 + Leptandrin, 327 + Lesions, Valvular, 549 + Leucocythæmia, 491 + + Leucorrhea 702 + Liberal Physician 295 + Lichen 431 + Lids, Granular 649 + Life, Latent 11 + Life Line 169 + Life, Origin of 17 + Life-root 341 + Life, Transmission of 181 + Life, Turn of 700 + Ligaments 29 + Light and Health 231, 378 + Limbs, Deformed 903 + Liniments 342 + Liquor Amnii 216 + Liquor Sanguinis 53 + Liquors, Alcoholic 255 + Liquors, Distilled 264 + Liquors, Fermented 263 + Liquors, Malted 262 + Liriodendron Tulipfera 350 + Literature, Obscene 285 + Liver 42 + Liver, Chronic Inflammation of the 569 + Liver Complaint 569 + Liver, Diseases of the 569 + Lobelia Inflata 340 + Lobes 64, 80 + Lobules 64, 80 + Locomotor Ataxia 640 + Logwood 321 + Loss of Sexual Power 776 + Love 184 + Love, Conjugal 186 + Lower Extremities, the Bones of the 27 + Lumbago 427 + Lungs 63 + Lycopin 324 + Lycopus Virginicus 323 + Lymph 51 + Lymphatics 49 + Lymphatic System 49 + Lymphatic Temperament 157 + + + M + + + Machines, Electrical 629 + Macrotin 306 + Macrotys 305 + Mad-dog Weed 345 + Magnesia Sulphas 328 + Malar Bones 22 + Malaria 227 + Malarial Headache 635 + Male Fern 315 + Male Generative Organs 207 + Male Generative Organs, Affections of the 772 + Male Generative Organs, Physiology of the 772 + Malformation of the Vagina 687 + Malformation of the Womb 687 + Malignant Fevers 407 + Malleus 110 + Malted Liquors 262 + Management, Domestic, of Fevers 403 + Mandrake 304 + Manipulator 373 + Marriage 184 + Marriage, History of 188 + Marsh-mallow 336 + Maruta Cotula 334 + Massage 362 + Mastication 233 + Masturbation 286, 772 + Matter, Gray 91 + Matter, Sebaceous 77 + Maxillary Bones 22 + May-apple 304 + May-weed 334 + Meadow Sweet 323 + Meals, Regularity of 234 + Measles 412 + Measles, False 413 + Meatus External Auditory 77, 109 + Mechanical Movements in the Treatment of Paralysis 641 + Mechanical Movements, Value of 371 + Mediastinum 65 + Medical Diagnosis 390 + Medicated Bath 367 + Medicine, Allopathic School of 293 + Medicine, Eclectic School of 294 + Medicine, Homoeopathic School of 294 + Medicine, Preparation of 301 + Medicine, Progress of 292 + Medicine, Properties of 300 + Medicine, Rational 292 + Medicines, Proprietary 298 + Medulla Oblongata 95 + Medulla Spinalis 25 + Meibomian Glands 78 + Melancholy 621 + Membrane, Arachnoid 90 + Membrane, False 878 + Membrane, Mucous 37 + Membrane, Pituitary 111 + Membrane, Synovial 29 + Membranous Croup 878 + Menorrhagia 697 + Menses 210 + Menses, Cessation of the 700 + Menses, Retention of the 687, 688, 689, 690 + Menses, Suppression of the 687, 688, 689, 690 + Menstruation 210, 686 + Menstruation, Painful 692 + Menstruation, Profuse 697 + Mental Culture 276 + Mentha Piperita 326 + Mentha Viridis 326 + Mercury 307 + Mercury, Yellow Subsulphate of 339 + Metacarpus 26 + Metatarsus 27 + Miasm 405 + Microscopical Examination 398 + Miliaria 439 + Milk 381 + Mind, Nature of 146 + Mineral Foods 238 + Mineral Impurities 249 + Mitral Valve 57 + Miscarriage 682 + Modified Small-pox 411 + Monogamy 188 + Morphine 311 + Motherwort 342 + Motion as a Remedial Agent 369 + Motion, Peristalic 49 + Motor Nerves 87, 93 + Mouth 37 + Mouth, Nursing Sore 554 + Mouth, Sore 553 + Movements, Mechanical, in the Treatment of Paralysis 661 + Mucosin 78 + Mucous Membrane 37 + Mucus 78 + Mumps, 471 + Muriate of Hydrastia, 352 + Muriate of Iron, Tincture of, 355 + Muriatic Acid, 310 + Muscles, 30 + Muscles, Intermediate, 32 + Muscles, Involuntary, 32 + Muscles, Voluntary, 31 + Muscular Tissue, 20 + Mustard, 331, 339 + Mutton Soup, 247 + Myalgia, 427 + + + N + + + Nails, 73 + Narcotics, 343, 897 + Nasal Bones, 22 + Nasal Catarrh, Chronic , 474 + Nasal Cavity, anterior view of, 490 + Nasal Cavity, view of deformed, 492 + Nasal Douche, Dr. Pierce's, 485 + Nasal Polypus, 487 + Nasal Tumors, 489 + Nasal Septum, deformed, 490 + Nature of Asthma, 512 + Nature of Disease, 390, 512 + Nature of Mind, 146 + Nature's Mode of Sustaining Health 371 + Neck, Thick, 470 + Necrosis, 456 + Nepeta Cataria, 334 + Nerve-fibers, 87 + Nerve, Pneumogastric, 101 + Nerves, Afferent, 87, 93 + Nerves, Cerebral, 89 + Nerves, Cranial, 100 + Nerves, Efferent, 87, 93 + Nerves, Motor, 87, 93 + Nerves, Olfactory, 100, 111 + Nerves, Sensory, 87, 93 + Nerves, Spinal, 89 + Nerves, Sympathetic, 101 + Nervines, 345 + Nervous Affections of the Skin, 440 + Nervous Debility , 619 + Nervous Exhaustion, 619 + Nervous Headache, 635 + Nervous System, 87, 617 + Nervous System, overworked, 622 + Nervous Tissue, 20 + Nettle-rash, 437 + Neuralgia, 635 + Neuralgia of the Heart, 552 + Neuralgia of the Stomach, 885 + Neuralgic Headache, 635 + Neurasthenia, 620, 622 + Neurilemma, 89 + Nightshade, Deadly, 312 + Nitre, Sweet Spirits of, 338 + Nocturnal Emissions, 773 + Nosebleed, 881 + Nose, Foreign Bodies in the , 893 + Nucleolus, 19 + Nucleus, 19,64 + Nurse, 375, 376 + Nursing Sore Mouth, 554 + Nux Vomica, 350 + + + O + + + Obscene Literature, 285 + Occipital Bone, 22 + OEdema, 422 + Old School of Medicine, 293 + Old Sores, 454 + Oleum Ricini, 328 + Olfactory Nerves, 100, 111 + Onanism, 286, 772 + Opium, 310 + Opium Habit, 627 + Opium, Use of, 384 + Oranges, 335 + Organic Disease of the Heart, 547 + Organic Extracts as remedies, 631 + Organic Impurities in Water, 251 + Organs, Circulatory, 56 + Organs, Digestive, 37 + Organs, Generative, 206, 207 + Organs of Respiration, 63 + Organs, Urinary, 206, 207 + Orifice, Pyloric, 82 + Origin, 31 + Origin of Life, 17 + Os Hyoides, 23 + Osmosis, 46 + Os Orbiculare, 110 + Ossa Innominata, 23, 25 + Osscous Tissue, 20 + Ossification, 20 + Ossification, Centers of, 20, 27 + Ovarian Tumors, 722 + Ovaries, 209 + Ovaries, Absence of the, 688 + Ovaries, Disease of the, 710 + Ovulation, 209 + Ovum, 12, 209 + Ozæna, 474, 475 + + + P + + + Pack, Wet Sheet, 368 + Pain, 395 + Painful Menstruation, 692 + Painters' Colic, 558 + Palate Bones, 22 + Pallor, 62 + Palsy, 638 + Palsy, Creeping, 640 + Palsy, Shaking, 641 + Pancreas, 44 + Pancreatic Juice, 80 + Pancreatin, 80 + Papaver Somniferum, 310 + Papillae, 69, 112 + Paralysis, 638 + Paralysis Agitans, 641 + Paralysis, General, 639 + Paralysis, General Treatment of, 641 + Paralysis, Progressive, 640 + Paraplegia, 639 + Paregoric, 310 + Parietal Bones, 22 + Parotid Glands, 38 + Parotitis, 471 + Parsley, Poison, 311 + Passages, False, 846 + Passions, Influence of Physical Labor on, 283 + Patella, 27 + Patient, Clothing and Bedding of, 380 + Peach Tree, 346 + Peduncles of the Cerebellum, 97 + Pelvis, 25 + Pelvis, Bones of the, 85 + Pemphigus, 139 + Pennyroyal, 341 + Pepper, Black 348 + Peppermint 326 + Pepsin 79 + Percussion 391 + Pericarditis 548 + Pericardium 56 + Perichondrium 29 + Perilymph 110 + Periodical Headache 635 + Periosteum 27 + Peristaltic Motion 45 + Peritoneum 84 + Peritonitis 886 + Permanganate of Potash 318 + Pernicious Fever 406 + Perpetual Reproduction 11 + Perpetuation of the Species 194 + Perspiration 75 + Pertussis 880 + Pettenkoffer's Test 81 + Phalanges 27 + Pharyngitis and Post-nasal Catarrh 493 + Pharynx 39 + Phthisic 511 + Phthisis Pulmonalis 497 + Physical Exercise 270 + Physical Properties of the Blood 53 + Physician, Independent 295 + Physiological Anatomy 11, 19, 30, 37, 48, 56, 63, 68, 75, 84, 87 + Physiological Anatomy of the Urinary Organs 823 + Physiology 11 + Physiology, Cerebral 114 + Physiology of the Male Generative Organs 772 + Phytolacca Decandra 304 + Phytolaccin 304 + Pia Mater 90 + Pierce's Comp Extract of Smart-weed 312, 326, 335, 342, 349 + Pierce's Favorite Prescription 342, 346, 355 + Pierce's Golden Medical Discovery 308, 316, 355 + Pierce's Nasal Douche 485 + Pierce's Purgative Pellets 308, 328 + Pigeon-berry 304 + Piles 578 + Pile Tumors, Radical Cure of 581 + Pine-apples 335 + Pink-root 314 + Pin-worm 561 + Pipsissewa 338 + Pituitary Membrane 111 + Pityriasis 431 + Placenta 216 + Pleura 64 + Pleurisy-root 332 + Pleurodynia 427 + Pleximeter 391 + Pneumogastric Nerve 101 + Podophyllin 304 + Podophyllum Peltatum 304 + Poison Hemlock 311 + Poison Parsley 311 + Poisoned Wounds 890 + Poisons and their Antidotes 895 + Poke 304 + Poke, Indian 347 + Pollution, Voluntary 772 + Polygamy 188 + Polypi 723 + Polypoid Tumors 723 + Polypus, Nasal 487 + Polyuria 835 + Pond's Sphygmograph 548 + Pons Varolii 97 + Poplar 315, 350 + Populin 315 + Pork Steaks 247 + Portal System, Veins of the 60 + Position in Sleep 280 + Position of Patient 393 + Posterior Pyramids 95, 96 + Posterior Spinal Curvature 898 + Post-nasal Catarrh 493 + Post-nasal Syringe 493 + Potash, Acetate of 338 + Potash, Bicarbonate of 309 + Potash, Nitrate of 338 + Potash, Permanganate of 318 + Pott's Disease 898 + Powder, Dover's 311 + Practical Summary of Hygiene 288 + Preface 5, 7 + Pregnancy 212 + Pregnancy, Derangements Incident to 721 + Pregnancy, Duration of 219 + Pregnancy, Signs of 219 + Prehension 233 + Premature Labor 682 + Preparation of Food 236 + Preparation of Medicines 301 + Prescription, Pierce's Favorite 342,346,355 + Prevention of Conception 212 + Prickly-ash 349 + Prickly Heat 437 + Pride-weed 324 + Prince's Pine 338 + Principle, Vital 15 + Processes, Articular 24 + Processes, Spinous 24 + Processes, Transverse 24 + Process of Generation 15 + Profuse Menstruation 697 + Prognosis 390 + Progress of Medicine 292 + Progressive Paralysis 640 + Prolapsus of the Uterus 713 + Properties of Medicine 300 + Proprietary Medicines 298 + Prostate Gland 827 + Prostate Gland, Enlargement of the 840 + Proteids 238 + Prurigo 440 + Pruritus Vulvae 702 + Prussian Blue 316 + Psoriasis 431 + Ptyalin 78 + Puberty 210 + Puccoon, Red 306 + Pulmonary Artery 58 + Pulmonary Tuberculosis 497 + Pulmonary Veins 60 + Pulsatilla Nigricans 346 + Pulse 61, 395 + Pumpkin Seeds 338 + Puncta Lachrymalia 77 + Punctured Wounds 889 + Pupil 107 + Pure Air 222, 223, 378 + Purgatives 326 + Purification of Water 252 + Putrid Fevers 407 + Pyloric Orifice 83 + Pyrophosphate of Iron 354 + + + + Q + + + Quackery Exposed, 780 + Queen of the Meadow, 338 + Quickening, 217 + Quinine, 315 + Quinsy, 416 + + + R + + + Rachitis, 453 + Radical Cure for Hernia, 866 + Radical Cure for Pile Tumors, 581 + Radius, 26 + Rash, 436 + Rash, Papular, 431 + Rash, Rose, 413 + Rational Medicine, 292 + Receptaculum Chyli, 46 + Rectum, 42 + Red Puccoon, 306 + Reflex Action of the Spinal Cord, 93 + Region of Feebleness, 134 + Regularity of Meals, 234 + Regular School of Medicine, 293 + Remedial Agent, Motion as a, 369 + Remedial Treatment of Diseases, 386 + Remedies for Disease, 298 + Remittent Fever, 406 + Renal Calculi, 837 + Reproduction, 11, 196 + Reproduction, Dioecious, 202 + Reproduction, Hermaphroditic, 199 + Reproductive Organs, Hygiene of the, 282 + Resolution, 400 + Respiration, Organs of, 63 + Respiration, Pure Air for, 223 + Respirator, Cotton-wool, 230 + Rete Mucosum, 70 + Retention of the Menses, 687, 688, 689, 691 + Retina, 106, 107 + Retroflexion of the Uterus, 709, 714 + Rheumatic Headache, 635 + Rheumatism, Acute Articular, 425 + Rheumatism, Cervical, 427 + Rheumatism, Chronic Articular, 426 + Rheumatism, Muscular, 127 + Rhubarb, 327 + Ribs, 24 + Rickets, 453 + Right to Terminate Pregnancy, 218 + Rooms, Sleeping, 278 + Rose Rash, 413 + Rosy Drop, 433 + Rubbing, 372 + Rubeola, 412 + Running Scall, 430 + Running-sores, 454 + Rupia, 439 + Rupture, 862 + Russian Bath, 358 + + + S + + + Sacrum, 23, 25 + Sage, 313, 333 + Saleratus, 309 + Salicin, 315, 351 + Saliva, 38, 78 + Salivary Glands, 38 + Salt, 315 + Saltpetre, 333 + Salt-rheum, 430 + Salts, 53 + Salts, Biliary, 81 + Salvia Officinalis, 313, 333 + Sanguinaria Canadensis, 308 + Sanguine Temperament, 163 + Santonin, 313 + Sarcolemma, 32 + Saturnine Colic, 558 + Scabies, 434 + Scalds, 894 + Scall, 433 + Scall, Running, 430 + Scaly Skin Diseases, 441 + Scapula, 26 + Scarlatina, 408 + Scarlet Fever, 408 + School-rooms, Ventilation of, 225 + Sclerotic, 106 + Scott's Acid Bath, 367 + Scrofula, 445 + Scrotum, Dropsy of the, 821 + Scull-cap, 345 + Sea Bathing, 364 + Seat, 390 + Seat-worm, 561 + Sebaceous Glands, 70, 77 + Sebaceous Matter, 77 + Secretion, 75 + Sedatives, 346 + Self-abuse, 286, 622 + Self-pollution, 772 + Semen, 772 + Semi-circular Canals, 110 + Semilunar Valves, 58 + Seminal Emissions, Involuntary, 773 + Sense of Hearing, 109 + Sense of Sight, 106 + Sense of Smell, 111 + Sense of Taste, 112 + Sense of Touch, 113 + Senses, Special, 106 + Sensory Nerves, 87, 93 + Septum, Deformed Nasal, 490 + Serum, 54, 55, 238 + Sexual Abuse, Story of, 394 + Sexual Debility, Symptoms of, 776 + Sexual Influences, 383 + Sexual Power, Loss of, 776 + Shaking Palsy, 641 + Shingles, 438 + Shock, 890 + Shower Bath, 365 + Sick, Hygienic Treatment of the, 375 + Sick-room, 377 + Sick, Visiting the, 383 + Sight, 106 + Signs of Pregnancy, 219 + Site for Homes, 227 + Sitz Bath, 367 + Skeleton, 22 + Skin, 68 + Skin, Diseases of the, 430 + Skin Diseases, Scaly, 441 + Skin, Nervous Affections of the, 440 + Skoke, 304 + Sleep, 278, 382 + Small-pox, 410 + Smart-weed, Compound Extract of, 312, 326, 335, 342, 349 + Smell, 111 + Snake-head, 315 + Snake-root, Black, 306 + Society, Welfare of, 193 + Soda, Glycocholate of, 81 + Soda, Sulphite of 309 + Soda, Taurocholate of 81 + Sodium, Chloride of 315 + Soft Rubber Bulb Syringe 705 + Solitary Indulgence 772 + Sore Mouth 553 + Sore Mouth, Nursing 554 + Sore Throat, Clergymen's 496 + Soups 246 + Spasmodic Croup 878, 879 + Spearmint 326 + Special Creation 14 + Special Senses 106 + Species 14 + Species, Perpetuation of the 194 + Specific Center 14 + Speculum 717 + Spermatic Veins, Enlarged 803 + Spermatocele 803 + Spermatorrhea 620, 772, 844 + Spermatozoön 12 + Sperm-cell 15 + Sphenoid Bone 22 + Sphygmograph, Pond's 548 + Spigelia Marilandica 314 + Spinal Column 24 + Spinal Cord 25, 90 + Spinal Cord, Reflex Action of the 93 + Spinal Curvature, Posterior 898 + Spinal Nerves 89 + Spirit Vapor-bath 362 + Spirometer 391, 392 + Spleen 44 + Sponge Bath 365 + Sprains 892 + Squaw-root 305 + Stapes 110 + Static Electrical Machine 629 + Sterility 707 + Sternum 23 + Stethoscope 391 + Stimulants 348 + Stomach 39, 52 + Stomach, Inflammation of the 882, 884 + Stomach, Neuralgia of the 885 + Stomatitis 553 + Stomatitis Materna 554 + Stone in the Bladder 838 + Stone-pock 442 + Stone-root 337 + Story of Sexual Abuse 394 + Stramonium 344 + Striae 31 + Stricture of the Urethra 775, 843 + Strumous Diathesis 445 + Strumous Synovius 453 + St. Vitus's Dance 650 + Styptics 320, 890 + Sublingual Gland 39 + Submaxillary Gland 38 + Sudatorium 359 + Sudoriferous Glands 69 + Sudorifics 332 + Sulphate of Copper 339 + Sulphate of Quinia 315, 339 + Sulphate of Zinc 318 + Sulphite of Soda 309 + Sulphur Bath 368 + Sulphuric Acid, Aromatic 310 + Sulphur Vapor-bath 368 + Summer Complaint 555 + Sun-stroke 894 + Superior Maxillary Bones 22 + Suppers, Late 235 + Suppression of the Menses 687, 688, 689, 691 + Suppuration 400 + Surgical Treatment of Epilepsy 649 + Sutures 23 + Swamp Alder 304 + Swamp Dogwood 351 + Sweet Elder 307 + Sweet Spirits of Nitre 338 + Swelling 400 + Swelling, White 452 + Swimming 274 + Sycosis 442 + Sylvius, Fissure of 98 + Sympathetic Nerve 101 + Symptoms 390, 392, 393 + Symptoms, Interpretation of 393 + Symptoms 01 Sexual Debility 776 + Synovia 29 + Synovial Capsule 29 + Synovial Membrane 29 + Synovitis 453 + Synovitis, Rheumatic 453 + Synovitis, Strumous 453 + Synovitis, Syphilitic 453 + Syphilitic Synovitis 453 + Syringe, Post-nasal 493 + Syringe, Soft Rubber Bulb 705 + System, Cerebro-Spinal 89 + Systemic Veins 60 + System, Lymphatic 49 + System, Nervous 87, 617 + System, the Great Sympathetic 101 + System, Vascular 56 + + + T + + + Tænia 562 + Tag Alder 304 + Tall Speedwell 327 + Tamarind 335 + Tanacetum Vulgare 341 + Tannin 325 + Tansy 341 + Tape-worms 562 + Tarsus 27 + Taste, Sense of 112 + Taurocholate of Soda 81 + Tea 253 + Tear-duct, Closure of the 477 + Tear-duct, Obstruction of the 477 + Tears 77 + Teeth 37 + Temperaments, Classified 156 + Temperaments, Human 149 + Temperate Bath 357 + Temporal Bones 22 + Tentorium 97 + Tepid Bath 357 + Termination of Inflammation 400 + Test, Pettenkoffer's 81 + Tetter, Branny 431 + Tetter, Crusted 433 + Tetter, Humid 430 + Thick Neck 470 + Thoracic Duct 42 + Thorn-apple 344 + Thoroughwort 316 + Thread-worm 561 + Throat, Disease of the 476 + Throat, Foreign Bodies in the 893 + Throat, Ulceration of the 496 + Thrush 553 + Tibia, 27 + Time for Sleep, 279 + Tinctura Ferri Chloridi, 355 + Tincture of the Chloride of Iron, 355 + Tincture of the Muriate of Iron, 355 + Tinctures, 302 + Tissue, Adipose, 20 + Tissue, Areolar, 19 + Tissue, Cartilaginous, 20 + Tissue, Connective, 19 + Tissue, Muscular, 20 + Tissue, Nervous, 20 + Tissue, Osseous, 20 + Tobacco Habit, 627 + Tobacco, Indian, 340 + Tobacco, Use of, 384 + Tongue, 3, 394 + Tonics, 350 + Tonsilitis, 416 + Tonsils, Enlarged, 417, 494 + Torpid Liver, 569 + Torticollis, 427 + Touch, Sense of, 113 + Tourniquet, 890 + Trachea, 63 + Trailing Arbutus, 336 + Transmission of Life, 181 + Transudation, 422 + Treatment, 390 + Treatment of Diseases, Remedial, 386 + Treatment of Epilepsy, Surgical, 649 + Treatment of Inflammation, 401 + Treatment of Paralysis, 641 + Treatment of the Sick, Hygienic, 375 + Trichina Spiralis, 564 + Tricocephalus Dispar, 562 + Tricuspid Valve, 57 + True Skin, 68 + Trumpet-weed, 338 + Trunk, 23 + Tube, Eustachian, 110 + Tube, Eustachian, Obstruction of the, 477 + Tubercle, 445 + Tubercular Consumption, 497 + Tuberculosis of the Knee-joint, 453 + Tuberculosis, Pulmonary, 497 + Tumors, Fibroid, 722 + Tumors, Ovarian, 722 + Tumors, Polypoid, 723 + Tumors, Uterine, 122 + Turkish Bath, 358 + Turn of Life, 700 + Turpeth Mineral, 339 + Tympanum, 110 + Typhoid Fever, 407 + Typhus Fever, 407 + + + U + + + Ulceration of the Throat, 496 + Ulceration of the Uterus, 717 + Ulcer; Follicular, 718 + Ulcer, Granular, 717 + Ulcer, Indolent, 455 + Ulcer, Irritable, 455 + Ulcer, Varicose, 455 + Ulcers, Chronic, 454 + Ulna, 26 + Umbilical Cord, 217 + Umbilical Hernia, 863 + Umbilicus, 217 + Universality of Animalcular Life, 16 + Upper Extremities, the Bones of the, 25 + Uræmic Headache, 635 + Urea, 86 + Ureters, 84 + Urethra, 86, 827 + Urethra, Stricture of the, 843 + Uric Acid, 86 + Urinary Fistula, 721 + Urinary Organs, Diseases of the, 823 + Urinary Organs, Physiological Anatomy of the, 823 + Urine, 86 + Urine, Examination of the, 397, 825 + Urinometer, 392 + Urticaria, 437 + Use of Tobacco and Opium, 384 + Uterine Pregnancy, 215 + Uterine Speculum 717, 718 + Uterine Tumors, 722 + Uterus, Falling of the, 713 + Uterus, Prolapsus of the, 713 + Uvula, Elongation of the, 495 + + + V + + + Vaccinia, 411 + Vagina, Inflammation of the, 702 + Vagina, Irritable, 702 + Vagina, Malformation of the, 687 + Vaginal Injections, How to Use, 705 + Vaginitis, 702 + Valerian, 320 + Valeriana Officinalis, 320 + Value of Animal Food, 241 + Value of Mechanical Movements, 371 + Valve, Mitral, 57 + Valve, Tricuspid, 57 + Valves, Semilunar, 58 + Valvulæ Conniventes, 40 + Valvular Lesions, 549 + Vapor-Bath, 358 + Vapor-Bath, Spirit 362 + Vapor-Bath, Sulphur 368 + Varicella, 412 + Varicocele, 803 + Varicose Ulcer, 455 + Variety of Food necessary, 239 + Variola, 410 + Varioloid, 411 + Vascular System, 56 + Veins, 59 + Veins, Enlarged Spermatic, 803 + Veins of the Portal System, 60 + Veins, Pulmonary, 60 + Veins, Systemic, 60 + Vena Cava, 56,60 + Ventilation of Dwellings, 226 + Ventilation of Factories, 226 + Ventilation of School Rooms, 225 + Ventilation of Workshops, 226 + Ventricle, 57 + Veratrum Viride, 347 + Vermifuge, 313 + Versions of the Uterus or Womb, 709, 714 + Vertebræ, 23 + Vesical Calculi, 838 + Vestibule, 110 + Viburnin, 320 + Viburnum Opulus, 320 + Villus, 41,48 + Virginia Snake-root, 333 + Visiting the Sick, 383 + Vital Principle, 15 + Vital Properties of the Blood, 53 + Vitreous Humor, 107 + Vitriol, Elixir of, 310 + Vitriol, White 818 + Volitive Faculties 129 + Volitive Temperament 171 + Voluntary Muscles 31 + Voluntary Pollution 772 + Vomer 22 + Vomit, Black 883 + Vulvitis 702 + + + W + + + Wafer-ash 351 + Wakefulness 623 + Warm Bath 357 + Warmth 379 + Water 248 + Water-bugle 323 + Water-hoarhound 323 + Water, How to use 252 + Water-melon Seeds 338 + Water, Organic Impurities in 251 + Water-pink 336 + Water, Purification of 252 + Waters, Chalybeate 250 + Waters, Saline 250 + Waters, Sulphurous 250 + Welfare of Society 193 + Wet Sheet Pack 368 + White Hellebore 347 + White Poplar 350 + White Swelling 452 + White Vitriol 318 + White-root 332 + Whitewood 350 + Whites 702 + Whooping-cough 880 + Wild Chamomile 334 + Wild Indigo 318 + Wild Yam 320 + Willow 351 + Windpipe 63 + Wintergreen 325 + Witch-hazel 321 + Woman and her Diseases 684 + Womb, Absence of the 687 + Womb, Displacements of the 713 + Womb, Elongation of the Neck of the 709 + Womb, Flexions of the 709, 714 + Womb, Malformation of the 687 + Womb, Versions of the 709, 714 + Workshops, Ventilation of 226 + Worms, Intestinal 561 + Wounds 889 + + + X + + + Xanthoxylin 349 + Xanthoxylum Fraxineum 349 + + + Y + + + Yam, Wild 320 + Yeast 317, 335 + Yellow Dock 304 + Yellow Jessamine 319, 348 + Yellow Lady's-slipper 320, 345 + Yellow Subsulphate of Mercury 339 + + + Z + + + Zinci Sulphas 318, 339 + Zinc, Sulphate of 318, 339 + Zingiber Officinalis 325, 335 + + * * * * * + + + + +INDEX TO APPENDIX + + + A + + + Advantages Offered to Invalids 951 + Advantages of Location 948 + Advantages of Specialties 950, 956 + Advertising 958 + Affidavit 905 + Aids, In valuable, in Urinary Diseases 964 + Amusements 932 + Analysis of Urine 962, 967 + Appendix 905 + + + B + + + Bath Department 931 + Beecher on Advertising 959 + Board and Treatment, Terms for 970 + Buffalo Outranks all in Healthfulness 946 + + + C + + + Cause of Female Weakness 919 + Caution 936 + Charges Must be Prepaid 968 + Chemical Laboratory 940 + Chronic Diseases, Mechanical Aids in the Cure of 906 + Chronic Diseases, Treatment of 954 + Climate 944 + Common Sense View, A 934 + Consultation, Free 968 + Consultations by Letter 968 + Consultations with Physicians 971 + Counter-Irritation 916 + Cure of Deformities 917 + Cure of Neuralgia 916 + Cure of Paralysis 917 + Cure of Swellings 915 + Cure of Tumors 917 + + + D + + + Deformities, Cure of 917 + Disease Has Certain Unmistakable Signs 943 + Diseases of Women 918 + Division of Labor 949, 954 + + + E + + + Eminent Medical Authorities 967 + Endorsement, President Garfield's 973 + Equability of Climate 945, 947 + Evidence of Health Statistics 945 + Extreme Healthfulness of Buffalo 944 + + + F + + + Facilities of Treatment 949 + Facts of Science 946 + Fair and Business-like Offer 953 + Fees, Why Required in Advance 969 + Female Weakness, Cause of 919 + Fire-Proof Vaults 930 + Free Consultation 968 + + + G + + + General Considerations 940 + Genuine Home, A 948 + Good Order 932 + + + H + + + Home, A Genuine 948 + Home, Remedial 942 + How to Avoid Swindlers 990 + + + I + + + Important Announcement 921 + Invalids, Advantages Offered to 951 + Invalids' Hotel and Surgical Institute 922, 924, 941 + Invaluable Aids in Urinary Diseases 964 + + + J + + + Joints, Stiffened 951 + + + K + + + Kneader 914 + + + L + + + Liberality 934 + Location, Advantages of 948 + + + M + + + Manipulator 908 + Map of Buffalo 992 + Mechanical Aids in the Cure of Chronic Diseases 906 + Medical Authorities, Eminent 967 + Medicine, Progress of 950 + Medicines, Our 971 + Moderate, Terms 949 + + + + N + + + Neuralgia, Cure of 916 + Not Confined in Prescribing 972 + Notices of the Press 974 + + + O + + + Offer, Fair and Business-like 953 + Our Medicines Prepared with the Greatest Care 972 + Our Physicians and Surgeons 935 + Our Remedies 931 + + + P + + + Paralysis, Cure of 917 + Patient's Room 945 + Patients, Treating at a Distance 960, 971 + Physicians and Surgeons, Staff of 925 + Physicians, Consultation with 971 + President Garfield's Endorsement 973 + Press Notices 974 + Printing Department 939 + Progress in Medicine 950 + + + R + + + Rational Treatment 919 + Recapitulation 920 + Regulation of Diet 931 + Reliable Medicines 969 + Remedial Home, 942 + Revulsion 916 + + + S + + + Signs, Urinary 962 + Specialties, Advantages of 950, 956 + Staff of Physicians and Surgeons 925 + Statistics, Evidence of Health 945 + Steam Passenger Elevator 930 + Surgical Department 931 + Swellings, Cure of 915 + Swindlers, How to Avoid 935, 990 + + + T + + + Terms for Board and Treatment 970 + Terms for Treatment 969 + Trained Attendants 932 + Treating Patients at their Homes 942 + Treatment, Facilities of 949 + Treatment of Chronic Diseases 954 + Tumors, Cure of 915 + Turkish Bath 931 + + + U + + + Unparalleled Success 933 + Urinary Signs 962 + + + V + + + Vibrator 911 + Visiting Patients who Reside at a Distance 971 + Vocabulary 979 + + + W + + + World's Dispensary 937 + World's Dispensary Medical Association 921 + + * * * * * + + + + +FOOTNOTES + + +Footnote 1: Darwin. + +Footnote 2: The males of Cryptophialus and Alcippe, species of marine +animals, are apparent exceptions to this rule. They are parasitic, +possess neither mouth, stomach, thorax, nor abdomen, and are, +necessarily, short-lived. + +Footnote 3: Dalton--Human Physiology. + +Footnote 4: In the use of the terms psychical and psychological, we have +observed the distinction which metaphysicians have recently made. They +employ the term psychical to indicate the relation of the human soul to +sense, appetite, propensity, etc., and psychological, as indicating the +ultimates of spiritual being. In this manner we use the word psychical +as describing the relationship of the soul to animal experiences and +being, and psychological as referring to the spiritual potencies of the +soul. The distinction being introduced, we continue its use rather then +coin new words. + +Footnote 5: Certain disturbances of the bodily organs excite fear. The +apprehension of danger, or simply mental excitement, does not explain +what is called "water fright," "stage fright," terror excited by the +raging of a storm, or the rocking of a boat. In such instances the heart +may beat heavily, the respiration be irregular and attended by +precordial oppression, giddiness, weakness, and physical inability to +articulate a word or recall a thought. These bodily conditions are not +subject to the control of the will, but arise when individuals are +perfectly assured that no danger threatens. At other times, as in a +fearful tempest upon the sea, although the danger be imminent, if the +bodily functions are not disturbed, there is not the least manifestation +of fear. + +Footnote 6: A _placebo_ is a harmless and valueless prescription, which +physicians sometimes make merely to gratify the patient, as a dose of +"bread pills," etc. + + + + + +End of the Project Gutenberg EBook of The People's Common Sense Medical +Adviser in Plain English, by R. V. 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