[Illustration]

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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.

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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

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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.

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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.

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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.

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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.